Episode Guide
Here's an episode-by-episode guide, so you can read more about each episode in depth and search by keyword.
Please note: transcripts and summaries are AI generated.
Episode 014 - Concluding the Prototype Series
Clinicians Eliza and Ken wrap up their personality disorder prototype series, exploring SASB, case formulation, and life beyond DSM labels.
🎙️ Episode Link
Overview:
In the final episode of their personality disorder prototype series, hosts Eliza and Ken step back from case-by-case analysis to reflect on the bigger picture: what they've learned, where they remain ambivalent, and how prototypes function differently from diagnostic labels in actual clinical practice. Using a real case example (given the pseudonym "Sylvia") pulled from the IRT archives, they walk through what happens when a person's interpersonal pattern statistically overlaps two personality disorder categories — and why the more useful question often isn't "which label fits?" but "what story explains this?"
The conversation ranges from the neuroscience of how each host mentally represents the SASB model, to the risks of diagnostic stigma, to the increasingly common experience of patients arriving in session having already self-diagnosed from social media. Throughout, Eliza and Ken return to a central thread: interpersonal prototypes don't just describe a person's suffering — they point directly toward what to do about it.
Who This Episode Is For
Primarily clinicians, especially those doing case formulation with patients who present with overlapping or ambiguous personality disorder features, or those looking for a framework that bridges categorical DSM diagnosis with a more dimensional, narrative-based understanding. It will also resonate with clinicians who feel unsettled by the way personality disorder labels get used (or misused) in and outside the field.
It's also relevant for general audiences — particularly listeners who have encountered personality disorder or mental health terminology through social media and are trying to make sense of how much weight to put on a label versus their own lived story.
🧩 Major Themes and Discussion Points:
1. Ambivalence About Diagnostic Labels Eliza and Ken openly discuss their shared ambivalence about the concept of "personality disorder" as a category — not as a critique of Lorna Smith Benjamin's work, but of the broader exercise of translating rich interpersonal experience into a fixed diagnostic label. They point to their prior work (building on the Panizo et al. paper) showing that while a solid bridge exists between interpersonal theory and DSM-defined personality disorders, that bridge doesn't always need to be crossed.
2. SASB as a Middle Ground Both hosts describe SASB (Structural Analysis of Social Behavior) as occupying a useful middle level of abstraction — more organized than the raw flood of a client's phenomenology, but far less reductive than a single diagnostic label. Because SASB is a navigable, coordinate-based system, it helps clinicians locate a patient's patterns relative to other possible patterns without collapsing all that nuance into one word.
3. The Sylvia Case — When Diagnoses Overlap Ken introduces "Sylvia," a case from the IRT archives whose interpersonal prototype statistically overlaps both obsessive-compulsive and passive-aggressive personality patterns. Rather than forcing a differential diagnosis, Ken shows how returning to Sylvia's actual story — a "good kid" pushed past her limits, resentful of failed caregiving — resolves the apparent diagnostic ambiguity into a single, coherent, human narrative.
4. Self-Diagnosis, TikTok, and Over-Identification Eliza raises a pattern she sees increasingly in practice: patients arriving with self-diagnoses sourced from TikTok or non-clinical books, and sometimes over-identifying with a label ("that's because I'm borderline") in a way that forecloses on agency. She and Ken discuss how prototypes — because they map onto a story rather than an identity — are harder to over-identify with, and instead open up a patient's sense of choice in how they respond to their patterns.
5. Treatment Is Built Into the Story Unlike a diagnostic label, which often requires a separate step of matching to an evidence-based protocol, an interpersonal case formulation tends to make the treatment direction visible within the formulation itself. If a patient's self-hatred is understood as something learned from a rejecting caregiving relationship, the therapeutic task — relearning self-regard, reworking that relational narrative — is already implied.
6. Alliance Ruptures and Enactments in the Room Ken and Eliza close by discussing why therapeutic alliance is especially difficult — and especially important — when working with personality pathology. Because these patterns are fundamentally interpersonal, they tend to show up directly in the therapy relationship itself, not just in a patient's outside life. Understanding a patient's prototype helps clinicians recognize enactments and countertransference pulls as expected features of the work rather than personal affronts.
📚 References Mentioned in Episode:
Benjamin, L.S. (2003). Interpersonal diagnosis and treatment of personality disorders. Guilford Press.
Critchfield, K. L., & Benjamin, L. S. (2024). Structural analysis of social behavior: A primer for clinical use. APA.
Curious how interpersonal prototypes could reshape your case formulation? Listen to the full episode of Loving Differently, and catch up on the rest of the personality disorder prototype series if you missed earlier installments. Interested in formal training? Learn more at www.irtinstitute.com/trainings
Episode 009 - Interpersonal Harmonics Mini Series Ep 1 - Avoidant, Dependent, and Obsessive Compulsive Personality Disorders
Learn how avoidant, dependent, and OCPD patterns develop through Interpersonal Reconstructive Therapy (IRT). Explore trauma, attachment, and treatment insights.
🎙️ Episode Overview:
Episode 009 of the Loving Differently Podcast begins our Interpersonal Harmonics miniseries with a deep dive into Cluster C personality disorders through the lens of Interpersonal Reconstructive Therapy (IRT).
We explore avoidant, dependent, and obsessive-compulsive personality patterns, focusing on how these presentations emerge from developmental trauma, attachment relationships, and interpersonal learning histories.
Rather than relying solely on DSM-5 diagnostic criteria, this episode highlights how interpersonal patterns provide a more meaningful, humanizing framework for understanding personality disorders.
Avoidant patterns reflect a fear of rejection paired with a desire for connection. Dependent patterns develop from extended nurturance and control, resulting in learned incompetence. Obsessive-compulsive personality patterns center on perfectionism and fear of imperfection.
Using IRT concepts like copy process, SASB, and the gift of love, we outline how these patterns are formed and how they show up in therapy.
We also discuss clinical implications, including how to build alliance, avoid reinforcing shame or criticism, and tailor interventions based on case formulation.
This episode is designed for clinicians seeking a deeper understanding of personality disorders beyond symptom checklists, offering a compassionate and practical framework for treatment.
(00:00) – Launching the Interpersonal Harmonics miniseries
(02:00) – Why Cluster C personality patterns first
(04:30) – Avoidant personality: beyond anxiety
(06:30) – Fear of rejection, humiliation, and longing for connection
(09:00) – Developmental origins and criticism
(17:30) – Therapy stance with avoidant patients
(43:30) – Transition to dependent personality
(45:00) – Developmental pathways to dependency
(52:00) – DSM vs interpersonal patterns in dependency
(01:01:00) – Transition to obsessive-compulsive personality
(01:03:00) – Perfectionism and fear of imperfection
(01:08:00) – Living in the courtroom
(01:14:00) – Therapy stance for OCPD
(01:24:00) – Experiencing life beyond perfectionism
(01:28:30) – Summary of Cluster C
🧩 Major Themes and Discussion Points:
- Personality disorders are adaptive interpersonal patterns shaped by developmental trauma
- Avoidant patterns involve fear of rejection and defensive withdrawal
- Dependent patterns reflect learned incompetence and reliance on others
- OCPD is driven by perfectionism and fear of imperfection
- Case formulation is essential for effective treatment
- Therapy requires avoiding criticism and working within attachment systems
📚 References:
Benjamin, L.S. (2003). Interpersonal diagnosis and treatment of personality disorders. Guilford Press.
Episode 008 - Personality Disorder through an Interpersonal Lens – Validating Lorna Benjamin’s Approach
In this episode, Ken and Eliza explore a new paper on the interpersonal diagnosis of personality disorders, highlighting how Interpersonal Reconstructive Therapy and SASB offer a dimensional, hopeful framework for understanding and treating personality pathology.
🎙️ Episode Overview:
In this episode of the Loving Differently Podcast, we (Dr. Ken Critchfield and Dr. Eliza Stucker-Rozovsky) dive into a newly accepted paper examining the interpersonal diagnosis of personality disorders through the lens of Interpersonal Reconstructive Therapy (IRT). Using the SASB model, we explore how longstanding debates in the DSM-5—categorical versus dimensional models of personality disorder—can be reframed through interpersonal patterns and developmental histories.
We discuss how personality disorders are best understood not as fixed traits, but as learned relational strategies that once served adaptive purposes in difficult environments. Drawing on empirical findings from Panizo et al. (2025), we examine interpersonal hostility, comorbidity, and how overlapping personality disorder features emerge naturally when viewed dimensionally. We also explore how interpersonal case formulation offers clinicians greater empathy, specificity, and hope for change.
Throughout the episode, we connect theory to clinical practice—highlighting how IRT helps clinicians move beyond symptom management toward helping patients reconstruct deeply ingrained relational patterns rooted in developmental trauma. We also preview an upcoming series focused on specific personality disorder prototypes and their interpersonal harmonics.
(00:00) – Introduction and context for the Panizo et al. paper
(02:30) – Why personality disorders remain a central clinical challenge
(05:00) – Categorical vs dimensional models in the DSM-5
(08:30) – How SASB conceptualizes interpersonal patterns
(12:00) – Developmental trauma and adaptive origins of personality patterns
(16:00) – Interpersonal hostility as a core feature of personality disorders
(20:00) – Understanding comorbidity through interpersonal overlap
(25:00) – Five interpersonal clusters identified in the research
(32:00) – Clinical implications of interpersonal diagnosis
(40:00) – Hope, change, and reconstruction in IRT
(48:00) – Bridging DSM language with interpersonal case formulation
(55:00) – Preview of upcoming personality disorder series
(63:00) – Final reflections on empathy and clinical relevance
🧩 Major Themes and Discussion Points:
Categorical versus dimensional models of personality disorder
Interpersonal patterns as the core of personality pathology
Developmental trauma and adaptive origins of symptoms
Comorbidity explained through interpersonal overlap
Empathy and hope in personality disorder treatment
Clinical relevance of IRT and SASB
Reconstruction and long-term change in therapy
📚 References (click for the file):