NEI Podcast E272 - Our Most Downloaded Episode of 2025: Borderline Personality Disorder with Dr. Carla Sharp
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Dec 31, 2025 
Dr. Carla Sharp, a distinguished clinical psychologist from the University of Houston, dives deep into borderline personality disorder (BPD) with Dr. Andy Cutler. They dissect the challenges in diagnosing BPD and explore the latest APA guidelines. Carla highlights how framing BPD as a treatable condition can reduce stigma. The conversation spans the importance of therapy approaches, such as DBT and mentalization-based therapy, as well as the impact of genetics and trauma on BPD. Listeners gain valuable insights into effective treatment strategies and the necessity of early intervention.
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Core Shift In BPD Diagnosis
- The alternative DSM-5 model reframes BPD from nine traits to maladaptive self and interpersonal functioning.
- Look first for problems managing identity and relationships when identifying BPD.
Personality Disorders Are Syndromic
- Moving personality disorders into the main diagnostic axis normalizes them as treatable syndromes.
- BPD fluctuates over time and responds to treatment similarly to depression or anxiety.
Dimension Over Category
- The alternative model rates personality functioning on a continuum from healthy to unhealthy.
- This dimensional view destigmatizes BPD and highlights shared human variation.
