Live Event: STARTTS Masterclass
Borderline Personality Traits in Traumatised Refugee Presentations: Implications for Assessment and Treatment
8 May 2019 | 6.00pm – 8.00pm AEST
This Clinical Master Class will look at presence of borderline personality traits among clients with a refugee trauma background in the context of treating symptoms of post-traumatic stress. It will reflect on the barriers clinicians often encounter, such as a reluctance to explore childhood experiences, and the relational complexities that become evident in transference and countertransference.
Dr Anthony Korner will further explore the origins of borderline personality traits and adapting treatment to suit the client’s needs, aiming at managing borderline personality traits alongside with managing PTSD.
Borderline Personality Disorder is a 20th Century construct although one with resonances to earlier diagnoses such as ‘hysteria’. In the 21st Century, the DSM 5 decision to make Personality Disorder and “Axis 1” disorder adds weight to its recognition as a medical disorder. Arguably this has moral implications with respect to the duty to treat. In this talk BPD will be considered with attention to the contexts in which BPD is more likely to develop. The question will be raised as to whether the construct can be understood as a ‘within-the-individual’ phenomenon. From the perspective of the Conversational Model, BPD reflects a disorder of self often related to traumatic impingement and neglect in early life. Dissociation is often a prominent feature and needs to be considered in assessment. Effective treatment requires engagement with self in addition to the processing of the trauma. The conditions required for growth of self will be discussed.
The complexity of ‘borderline states’ will be discussed from a philosophical perspective with reference to two books, Reinterpreting the Borderline (Paul Cammell) and Mapping the edges and the in-between (Nancy Nyquist Potter). Particular attention will be paid to the idea that the anger of people in ‘borderline states’ needs to be given uptake (Potter). Clinicians sometimes walk a fine line in providing containment while encouraging full expression of the patient’s experience.
Dominica Dorning will illustrate this with a case study of a client from a refugee background.
Borderline personality disorder (BPD) is often associated with a history of traumatic experiences and/or exposure to an invalidating environment. In the trauma field many researchers and clinicians acknowledge that Post Traumatic Stress Disorder (PTSD) is limiting diagnostically in capturing the complex symptom presentations for some individuals who have experienced cumulative and prolonged exposure to trauma, as is common for many refugees and asylum seekers. In order to address this gap expert trauma clinicians have developed criteria to fit more appropriately with the presenting problems commonly exhibited by survivors of severe and cumulative trauma and the diagnostic category of Complex Post Traumatic Stress Disorder (CPTSD) has emerged. Refugee and asylum seeker clients with significant and prolonged trauma histories at times present with prominent symptoms of emotion dysregulation, reduced ability to tolerate distress, interpersonal difficulties and unstable identity concepts, which may be consistent with aspects of both BPD and CPTSD criteria. Through an exploration of a case study of a male asylum seeker, this presentation will demonstrate the potential for overlap between CPTSD and BPD presentations, the challenges of working with such a client within an environment of invalidating refugee status determination processes and the importance of a staged therapeutic approach with an emphasis on validation, non-judgement and skill development.
Free to attend in person with RSVP
Free to watch the live webcast (no need to RSVP)
The event will be available as a Live Event on Owl Talks. Make sure your are a registered user, a link to the event will appear on the main menu shortly before the event commences.