Borderline Issues in Indianapolis, IN
Psychologists and psychiatrists have been disagreeing for decades about whether or not the diagnosis of borderline personality disorder (BPD) is trauma-based. Some say "yes", and some say "no." Evidence exists that supports both sides.
An article by Kwon (2022) in the Scientific American deals with this conflict and lends more support to the argument that BPD is trauma-based.
Kwon (2020) reported that between 30 and 80 percent of people with BPD have experienced trauma but do not meet the criteria of post-traumatic stress disorder (PTSD). The criteria for trauma for PTSD includes only severe trauma experienced in-person or vicariously during a limited time period. She called this trauma "capital T" trauma. But how about "little t" trauma? This less severe but more continuous trauma has been proposed as criteria for a new diagnosis called "complex PTSD" that is not a personality disorder but a stress-related disorder.
Kwon (2022) credited Judith Herman, a psychiatrist at Harvard University, with this potentially new diagnosis of complex PTSD. Dr. Herman saw it as the result of persistent little t trauma, such as verbal abuse, neglect, invalidation, bullying, and poverty. Neuroimaging studies support the diagnosis. Such studies of people with little t trauma, happening especially during childhood and adolescence, show marks in the limbic brain similar to those with capital T trauma.
Experimental programs have begun in Germany and Canada to combine treatments for BPD and complex PTSD (Kwon, 2022). The hope is that the combination will offer quicker change and recovery than just one of the treatment types alone.
Reference: Kwon, D. The long shadow of trauma. Scientific American, 2022, Vol. 326, No. 1, pp.48-55.