Understanding Complex PTSD and Borderline Personality Disorder
Jun 14, 2024
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Dr. Adam Borecky, a psychiatrist specializing in complex PTSD and borderline personality disorder, discusses the distinctions between C-PTSD, PTSD, and BPD, emphasizing trauma history and affective dysregulation. The podcast explores intersections of BPD and C-PTSD, highlighting the importance of accurate diagnosis for effective treatment. It delves into trauma symptoms, mental illness severity indicators, and the value of reflective functioning in therapy for BPD and C-PTSD.
Complex PTSD distinguishes trauma with avoidant attachment style from BPD.
Distinct symptom clusters aid accurate diagnosis of PTSD, C-PTSD, and BPD.
Reflective functioning enhances therapy outcomes by improving attachment dynamics.
Deep dives
Complex PTSD, BPD, PTSD Intersection and Differences
Complex PTSD aims to capture individuals who don't fit traditional PTSD or BPD criteria, presenting trauma with avoidant attachment style. Symptoms like emotional numbing, affective dysregulation, and negative self-concept hint at complex PTSD distinctness from BPD. Identifying long childhood traumas, neglect, or severe events like kidnapping can point to complex PTSD.
Diagnostic Validation through Symptoms Relationship
A study validates PTSD, complex PTSD, and BPD as distinct categories with unique symptoms. The relationship between symptoms affirms internal consistency within each category. Factors like emotional numbing link to complex PTSD, while externalizing behaviors are more characteristic of BPD. Understanding specific symptom clusters aids in accurate diagnosis and treatment planning.
Reflective Functioning and Treatment Outcomes
Reflective functioning, essential in therapy outcomes, can enhance diagnostic clarity. Patients with higher reflective function engage better in treatment, showing improvement in attachment dynamics and understanding childhood trauma effects. Therapists with high reflective function facilitate better outcomes, highlighting the importance of interpersonal therapy and understanding transference-countertransference dynamics.
Unified Classification Proposal and Severity of Illness
The Unified Classification Proposal suggests a spectrum approach to trauma diagnoses, ranking PTSD as least severe, complex PTSD intermediate, and BPD as most severe. Challenges arise in defining severity based on diagnostic categories, as reflective function and functional capacity play pivotal roles in treatment success. Understanding the individual's goals and experiences can guide personalized therapy approaches.
Reflective Functioning and Therapeutic Alliance
Therapeutic alliance effectiveness is linked to reflective functioning levels, impacting treatment outcomes. Higher reflective functioning therapists exhibit better client engagement and transference understanding, fostering cohesive therapeutic narratives and promoting personal growth. Reflective function improvement through therapy aids in navigating attachment dynamics and developing healthier relationships.
The purpose of this episode is to provide a clear and simple guide for clinicians on the diagnosis of complex PTSD (C-PTSD) and how it differs from post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD). It is intended to complement and add to recent episodes on attachment and trauma: 213: Reflective Functioning, 203 and 204 on adverse childhood experiences.
In today’s episode of the podcast, we are joined by Dr. Adam Borecky. Dr. Borecky is a psychiatrist and therapist who helped author the Connection Index and is part of Dr. Puder’s core team. His practice utilizes a holistic approach towards therapy and medication management.
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