Jane needs help
- Goal: Jane must not fear being alone.
Otherwise: He will continue to show frantic efforts to avoid real or imagined abandonment. Jane’s abandonment fears may be related to his intolerance of being alone. His frantic efforts to avoid abandonment will include impulsive actions such as self-mutilating or suicidal behaviors.
- Goal: Jane must have more permanent, structured, and supportive relationships. He must learn to be more tolerant.
Otherwise: He will continue to show a pattern of unstable and intense relationships. Jane will switch quickly from idealizing other people to devaluing them. He will see things in terms of extremes, either all good or all bad.
- Goal: Jane’s self-image must stabilize, and must not be that of a “victim”.
Otherwise: His self-image (“who-am-I?”) will continue to be very unstable. There will be sudden and dramatic shifts in Jane’s self-image, characterized by shifting goals, values, and vocational aspirations. He may see himself as a “victim” (taking little responsibility for any problem).
- Goal: Jane must avoid impulsive, potentially self-damaging behaviors.
Otherwise: He will continue to show impulsivity in at least two areas that are potentially self-damaging (i.e., gambling, spending money irresponsibly, binge eating, abusing substances, engaging in unsafe sex, driving recklessly, or being impulsively suicidal).
- Goal: Jane must avoid self-mutilating or suicidal behavior.
Otherwise: He will continue to have recurrent suicidal gestures such as wrist cutting, overdosing, or self-mutilation. Jane’s self-destructive acts will usually be precipitated by threats of separations or rejection.
- Goal: Jane’s moods must stabilize.
Otherwise: He will continue to have rapidly shifting moods due to extreme reactivity to interpersonal stress (e.g., intense unhappiness, anger, or anxiety usually lasting a few hours and only rarely more than a few days).
- Goal: Jane must find a purpose and meaning for his life.
Otherwise: He will continue to have chronic feelings of emptiness. Jane will be easily bored and constantly seeking something to do.
- Goal: Jane’s anger must be better controlled.
Otherwise: He will continue to be inappropriately angry. Jane’s anger will be triggered when a caregiver or lover is seen as neglectful, withholding, uncaring, or abandoning.
- Goal: Jane’s paranoid ideation or dissociative symptoms must decrease.
Otherwise: During periods of extreme stress, he will continue to have transient paranoid ideation or dissociative symptoms (e.g., depersonalization), but these will be generally of insufficient severity or duration to warrant an additional diagnosis. These episodes will occur most frequently in response to a real or imagined abandonment. Jane’s paranoid ideation or dissociative symptoms will be transient, lasting minutes or hours.