What is the Difference Between Borderline Personality Disorder and Complex PTSD (C-PTSD)?

hello this is dr. grande today's question is what is the difference between borderline personality disorder and the concept of complex post-traumatic stress disorder so borderline personality disorder is a mental health disorder in the DSM and complex post-traumatic stress disorder is not but has been proposed to be a disorder in the ICD which is another manual that's similar to the DSM so I'm going to go over some of the elements we see with C PTSD and then look at some of the areas of overlap between C PTSD and borderline person is order and then some symptoms that we really only see with borderline personality I also talk about some of the different theories about the relationship between C PTSD and borderline personalities or like the idea that C PTSD should replace borderline personality disorder or C PTSD as a subtype of borderline personality so first let's start with the concept of C PTSD so with complex PTSD we see really all of the same symptom criteria as we see with PTSD except the trauma is conceptualized as complex trauma so a trauma that occurred repeatedly usually in someone's childhood as opposed to one single event we also see a few other characteristics that are associated more so with C PTSD than PTSD like emotional regulation difficulties with anger and areas of sensitivity with dissociation and again of course this occurs with PTSD but it's considered more severe in C PTSD difficulty with self perception like shame guilt a negative concept of self a distorted image of the perpetrator so a preoccupation with revenge or focus on that relationship with the perpetrator interpersonal relationship difficulties like distrust and isolation and of loss of meaning like hopelessness so when we look at the areas of overlap between C PTSD and borderline personalities or we see a number of symptoms we have mood dysregulation of emptiness loneliness increased sense of guilt increased difficulties with anger and decreased self-worth so some characteristics and symptoms we see with borderline personally see with see PTSD or we don't see them to the same extent would be the self-harm and suicidal behavior component with borderline personality the attempts to avoid abandonment the fear of abandonment paranoia impulsivity the love-hate cycle that we sometimes see a borderline personality idealization and devaluation and the unstable sense of self now at sea PTSD there is a negative sense of self as I mentioned with borderline personality or we think of it more as an unstable self-concept so somebody a borderline personality disorder could have a negative self-concept one day and a positive self-concept the next so really the unstable component makes it a bit different than what we see with see PTSD now in terms of the treatment of borderline personality versus see PTSD the treatment is actually quite similar there are some differences with borderline personality disorder there's more of an emphasis on decreasing the dependency on other people and improving the stability of the sense of self as well as avoiding self-harm and suicidal behavior what see PTSD we see more of an emphasis on decreasing social avoidance interpersonal avoidance creating a positive self-concept and restoring a sense of power and control so empowerment so with all these similarities between borderline personality and see PTSD and some differences there's a lot of controversy over what the relationship between see PTSD and borderline personality disorder is and go over a few of the popular points of controversy so one is that see PTSD should replace borderline personality so at this theory borderline personality disorder never should have been a mental health disorder and this whole time along it was really see PTSD so in essence the group that believes this is saying that see PTSD better explains the symptoms then does borderline personality or now I can appreciate many of the elements of this argument but there are some difficulties with it and the primary difficulty of this argument is that trauma is considered ideological for both borderline personality and see PTSD it's fairly easy to see how it could be ideological for see PTSD complex trauma it makes sense that complex trauma could lead to the symptoms we see with PTSD and evidence tends to support that now with borderline personality the story is quite a bit different many individuals who have borderline personality disorder do have a trauma in their history and a lot of times that is complex trauma however about ten to twenty percent of individuals of borderline personality disorder have no trauma history at all also we know that with borderline personality or there's a substantial genetic component its heritable forty-two percent of the variance and the symptoms of borderline personality can be explained by genetics that's a substantial portion another part of this argument with C PTSD replacing borderline personality with comorbidity and here we're using figures with PTSD because of course C PTSD is not a mental health disorder so with individuals who have borderline personality fifty-eight percent of individuals would also qualify for a diagnosis of PTSD now that's a large percentage for certain however eighty six percent of individuals of borderline personality disorder would also qualify for a diagnosis of major depressive disorder sixty-two percent a diagnosis of substance use disorder and 54 percent a diagnosis of one of the eating disorders so we see a lot of comorbidity with borderline personality or not just a strong relationship with peak yes tea another theory as to the relationship between si PTSD and borderline personality is that si PTSD is a subgroup of borderline personality and this subgroup is a way to better understand individuals with that particular grouping of symptoms meaning if we use si PTSD as a subgroup of borderline personality it would inform treatment because that subgroup is distinct not distinct enough to warrant an independent classification but distinct enough to include under borderline personality to offer some treatment that's specialized the last Theory we see is that si PTSD is distinct from borderline personality and that we need both mental health disorders we need both classifications available the main argument here is that the treatment is substantially different the needs for individuals that have si PTSD are greatly different or substantially different than the needs we see of individuals who have bored line person is order this is a bit of a controversial issue as I mentioned and if you look at the literature you see a number of opinions some individuals believe that we don't need si PTSD at all others believe it's an interesting concept that we should continue to study and it can inform treatment and still others believe that it must be a distinct construct there are a number of other beliefs as well so with all this evidence and all these different interpretations what do we do with this relationship between si PTSD and borderline personality and the short answer is I don't know but I'd like to see continued research I think when I look at all the research and I weigh it together I am convinced that si PTSD is distinct I'm not sure it's distinct enough to be its own classification but I can certainly see that argument and I think I lean more toward that argument than this idea that we should have it at all or it's a subtype of borderline personality disorder and I certainly think that the argument that si PTSD is distinct from Borland personally sorter is stronger argument than the idea see PTSD replacing borderline personality order so I'll be interested to see which further research reveals about these two constructs in the meantime it's important to remember that just because see PTSD isn't a separate mental health disorder right now and it may never be it doesn't mean that the symptoms that we see with see PTSD can't be the focus of treatment if an individual comes into a practice or an agency and they have PTSD and they also have symptoms of see PTSD the treatment plan and the therapy can address that similarly if somebody has borderline personality and they also have symptoms of see PTSD a treatment plan can be designed to address those issues so we don't necessarily need to get hung up on what is or is not a mental disorder of course classifications are important what's more important is we're providing good treatment and addressing the symptoms and the goals of the clients that we treat I hope you found this description of borderline personality disorder and complex post-traumatic stress disorder to be interesting thanks for watching

Channel: Dr. Todd Grande

Views: 262,385

Keywords: borderline personality disorder, complex posttraumatic stress disorder, C-PTSD, cptsd, ptsd, borderline, personality disorder, borderline personality, borderline vs. cptsd, DSM, complex, posttraumatic stress disorder, ICD, complex PTSD, self-perception, shame, guilt, negative self-concept, distrust, isolation, loss of meaning. mood dysregulation, feelings of emptiness, loneliness, anger, self-worth, controversy, trauma, complex trauma, counseling

Id: aUv-_3aiNTc

Length: 9min 59sec (599 seconds)

Published: Tue May 15 2018