Schema Therapy for Borderline Personality Disorder. Hannie van Genderen

which schema is present in each mode (see Figure 3.2).

      2  How much time do you spend creating a case conceptualization? Creating a case conceptualization usually takes around five sessions. In exceptional cases, especially if the patient is very distrustful, it can take more time. If there is a strong angry protector who rejects working with a mode model, it can also take more time to make a case conceptualization.It may be necessary to gain the patient's trust first. Or it may be helpful to explain to the patient that her behavior is a survival strategy that hinders working on the problems. A role play with role reversal can sometimes be very enlightening.You must realize that the case conceptualization is always a working model. If new relevant information emerges during therapy, the case conceptualization can be adjusted.

      3  What can I do when the patient is still in panic or desperate at the end of the session? You can offer the patient some support outside the session like calling her later that day or letting her sit in the waiting room. An interesting observation is that most patients automatically go into their detached protector when they leave the room of the therapist at the end of a session in order to stop the bad feelings.