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How to recognize the punitive parent during a session

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The patient talks about herself in a very negative way

The aggression is directed at herself

The content of the messages is black and white

The patient seems not to hear what the therapist says

The patient repeats the negative message over and over again

The tone of voice in which the patient talks with the therapist is harsh, but not loud (like an adult voice)

The patients feel shame or guilt

The patient's self‐talk is characterized by words like “stupid,” “foolish,” “dumb,” and so on

The patient engages in counterfactual thinking, as if she knew beforehand how things would end

The patient attributes negative experiences as if she intended them and does not show understanding of the concept of bad luck. Thus, she seems to live in a world where everything happens intentionally, with the source of the bad intentions being her.

Schema Therapy for Borderline Personality Disorder

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