Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 30184
Treatment or Re-Victimizing the Victims

Authors: Juliana Panova


Severe symptoms, such as dissociation, depersonalization, self-mutilation, suicidal ideations and gestures, are the main reasons for a person to be diagnosed with Borderline Personality Disorder (BPD) and admitted to an inpatient Psychiatric Hospital. However, these symptoms are also indicators of a severe traumatic history as indicated by the extensive research on the topic. Unfortunately patients with such clinical presentation often are treated repeatedly only for their symptomatic behavior, while the main cause for their suffering, the trauma itself, is usually left unaddressed therapeutically. All of the highly structured, replicable, and manualized treatments lack the recognition of the uniqueness of the person and fail to respect his/her rights to experience and react in an idiosyncratic manner. Thus the communicative and adaptive meaning of such symptomatic behavior is missed. Only its pathological side is recognized and subjected to correction and stigmatization, and the message that the person is damaged goods that needs fixing is conveyed once again. However, this time the message would be even more convincing for the victim, because it is sent by mental health providers, who have the credibility to make such a judgment. The result is a revolving door of very expensive hospitalizations for only a temporary and patchy fix. In this way the patients, once victims of abuse and hardship are left invalidated and thus their re-victimization is perpetuated in their search for understanding and help. Keywordsborderline personality disorder (BPD), complex PTSD, integrative treatment of trauma, re-victimization of trauma victims.

Keywords: borderline personality disorder (BPD), complex PTSD, integrative treatment of trauma, re-victimization of trauma victims.

Digital Object Identifier (DOI):

Procedia APA BibTeX Chicago EndNote Harvard JSON MLA RIS XML ISO 690 PDF Downloads 1294


[1] American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders - 4th ed. (DSM-IV). Washington, DC.: American Psychiatric Association
[2] Beck, A. T., Freeman, A. & Associates (1990). Cognitive therapy for personality disorders. New York: Guilford Press.
[3] Bierer, L.M., Yehuda, R., Schmeidler, J., Mitropoulou, V., New, A.S., Silverman, J.M., Siever, L.J. (2003). Abuse and neglect in childhood: relationship to personality disorder diagnoses. CNS spectrums. Oct; 8 (10), pp. 737-54.
[4] Black, D.W., Blum, N., Pfohl. B., Hale, N. (2004). Suicidal behavior in Borderline personality disorder: prevalence, risk factors, prediction, and prevention. Journal of Personality Disorders, 18, (3): Special issue (2004): 226
[5] Bradley, S. J. (2000). Affect regulation and the development of psychopathology. New York: Guilford Press.
[6] Brodsky, B. S., Cloitre, M. D., Rebecca, A. (1995). Relationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder. American Journal of Psychiatry, 152 (12), 1788-1792.
[7] Brown, D. P. & Fromm, E. (1986). Hypnotherapy and Hypnoanalysis. Lawrence Erlbaum Associates, Publishers: Hillsdale, NJ
[8] Coccaro, E.F. (1998). Clinical outcome of psychopharmacological treatment of borderline and schizotypal personality disordered subjects. Journal of clinical Psychiatry, 59 (1), 30-35.
[9] Connors, M. E. (2001). Integrative treatment of symptomatic disorders. Psychoanalytic Psychology, 18 (1), 74-91.
[10] Conterio, K. & Lader, W. (1998). Bodily Harm. The breakthrough healing program for self-injurers.: Karen Conterio, Wendy Lader, and Jennifer Kingson Bloom: Hyperion, New York, NY. p.71
[11] Dallam, S. J. (1997). The identification and management of self-mutilating patients in primary care. The Nurse Practitioner. 05-01.
[12] Dean, M. A. (2001). Borderline personality disorder. The later assessment and treatment strategies (Second edition). Compact Clinicals: Kansas City: MO.
[13] Demitrack, M.A., Putnam, F.W., Brewerton, T.D., Brandt, H.A., Gold, P.W. (1990). Relationship of clinical variables to dissociative phenomena in eating disorders. American Journal of Psychiatry. 147:1184-1188.
[14] Driessen, M., Beldo, T. Reddemann, L., Rau, H., Lange, W., Silva, A., Berea R.C., Wulff, H., Ratzka, S. (2002). Is the borderlinepersonality disorder a complex post-traumatic stress disorder? - The state of research. Der Nervenarzt, Sep; 73 (9), pp. 820-9.
[15] Ellman, S. J. (1991) Freuds techniques papers. A contemporary perspective. Jason Aronson, Inc.: Northvale, NJ.
[16] Fenton, W.S. & McGlashan, T.H. (1990). Long term residential care: Treatment of choice for refractory character disorder? Psychiatric annals, 20:1, 45-49.
[17] Figueroa, E., Silk K.R., (1997). Biological implications of childhood sexual abuse in borderline personality disorder. Journal of personality disorders, 11(1), 71-92.
[18] Fraser, K., & Gallop, R. (1993). Nurses confirming/disconfirming responses to patients diagnosed with borderline personality disorder. Archives of Psychiatric Nursing, 7, 336341.
[19] ɪɨɣɞ, (1991). ɟɬɨɞɢɤɚ ɢ ɬɟɯɧɢɤɚ ɧɚ ɩɫɢɯɨɚɧɚɥɢɡɚɬɚ. ɜɪɚɡɢɹ ɛɚɝɚɪ.: ɨɮɢɹ, ɴɥɝɚɪɢɚ.
[20] Gabbard, G. O., (1994). Psychodynamic psychiatry in clinical practice: The DSM-IV Edition. American Psychiatric Press, Inc. Washington DC.
[21] Gabbard, G. O. (2001). Psychodynamic psychotherapy of borderline personality disorder: A contemporary approach. Bulletin of the Menninger Clinic, 65, (1).
[22] Gitlin, M.J. (1996). The psychotherapists guide to psychopharmacology. Second Edition.The Free Press, A Division of Simon & Schuster Inc.: New York, NY.
[23] Guthrie E, Moorey, Margison F, Barker H, Palmer S, McGrath G, Tomenson B, Creed F, (1999). Cost-effectiveness of brief psychodynamic-interpersonal therapy in high utilizers of psychiatric services. Archives of General Psychiatry; (56), p.519-526
[24] Hammond, D. C. (1998). Hypnotic induction & suggestion,American Society of Clinical Hypnosis: Chicago, IL.
[25] Herman, J. L. (1997). Trauma and recovery. Basic Books, New York, NY
[26] Herman, J. L., Perry, J. C. & Van der Kolk, B. A. (1989). Childhood trauma in borderline personality disorder. American Journal of Psychiatry, 146, 490-495.
[27] Hirschfeld, R.M. (1997) Pharmacotherapy of borderline personality disorder. Journal of Clinical Psychiatry, 58 (14), 48-52.
[28] ɘɧɝ, (1995). ɚ ɨɫɧɨɜɢɬɟ ɧɚ ɚɧɚɥɢɬɢɱɧɚɬɚ ɩɫɢɯɨɥɨɝɢɹ.ɚɜɢɫɬɨɤɫɤɢ ɥɟɤɰɢɢ. .: ɥɟɜɟɧ
[29] Kernberg, O. (1975). Borderline conditions and pathological narcissism. New York: Jason Aronson.
[30] Kroll, J. (1996). Psychotherapy of borderline patients. In M. Rosenbluth & I. D. Yalom (Eds. ), Treating difficult personality disorders (pp. 81-106). San Francisco: Jossey-Bass.
[31] Langs, R., (1994). The technique of psychoanalytic psychotherapy: Volume I. Jason Aronson Inc.: Northvale, NJ.
[32] Leichsenring, F. Leibing, E. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders. The American Journal of Psychiatry. Vol. 160 (7), p. 1223.
[33] Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
[34] Markham, D. and Trower, P. (2003).The effects of the psychiatric label borderline personality disorder on nursing staffs perceptions and causal attributions for challenging behaviours. British Journal of Clinical Psychology, 42, 243256.
[35] McLean, L. M., Gallop, Ruth. (2003). Implications of childhood sexual abuse for adult borderline personality disorder and complex posttraumatic stress disorder. American Journal of Psychiatry 160, no. 2, p. 369-371.
[36] Naumberg, M. (1966) Dynamically Oriented Art Therapy: Its Principles and Practice. New York.: Grun & Stratton, Inc.
[37] Paris, J. (1990). Completed suicide in borderline personality disorder. Psychiatric Annals. 20(1), 19-21.
[38] Paris, J. (2004). Is Hospitalization Useful for Suicidal Patients with Borderline Personality Disorder? Journal of Personality Disorders, 18, (3): Special issue (2004): 240
[39] Perry, J.C., Herman, J.L., Van Der Kolk, B.A., & Hoke, L.A. (1990). Psychotherapy and psychological trauma in borderline personality disorder. Psychiatric Annals, 20(1): 33-43.
[40] Shapiro, S. (1987). Self-mutilation and self-blame in incest victims. American Journal of Psychotherapy, 41:46-54.
[41] Shearer, S.L. (1994). Phenomenology of self-injury among inpatient women with borderline personality disorder. Journal of Neurology & Mental Disorders. 182(9):524- 26.
[42] Silk, Kenneth R; Lee, Sharon Hill, Elizabeth M Lohr, Naomi E. (1995). Borderline personality disorder symptoms and severity of sexual abuse. American Journal of Psychiatry v152n7, 1059-1064.
[43] Smith, M. A. (2000). The use of poetry therapy in the treatment of an adolescent with borderline personality disorder: A Case Study. Journalof Poetry Therapy, 14, (1): 3-14 (12 pages)
[44] Soloff, P. H., Lynch, K.G., Kelly, T.M. (2002). Childhood abuse as a risk factor for suicidal behavior in borderline personality disorder. Journal of Personality Disorders. 16(3): 201-14
[45] Soloff, P.H. & Millward, J.W. (1983). Developmental histories of borderline patients. Comprehensive Psychiatry, 24, 547-588.
[46] Steven R. G., R. Boutilier, L. R. (2002). Nontraumatic pathways to borderline personality disorder. Psychotherapy: Theory/Research/Practice/Training, 39, (2)
[47] Swales, M., Heard, H. L., Williams, J. M. (2000). Linehan's Dialectical Behaviour Therapy (DBT) for borderline personality disorder: Overview and adaptation. Journal of Mental Health. Vol. 9 (1), p7, 17p.
[48] Terr, L. (1994). Unchained Memories. Basic Books: New York, NY.
[49] Veheul, R., Van Den Bosch L.M., Koeter, M.W., De Ridder, M.A., Stijnen, T., Van Den Brink, W. (2003). Dialectical behavioral therapy for women with borderline personality disorder: 12-month, randomized clinical trial in the Netherlands. British Journal of Psychiatry, 182, 135-40.
[50] Van Den Bosch, L.M., Verheul, R., Langeland, W., Van Den Brink, W. (2003). Trauma, dissociation, and posttraumatic stress disorder infemale borderline patients with and without substance abuse problems. Australian and New Zealand journal of psychiatry Oct; 37 (5), pp. 549-55.
[51] Wadeson, H. (1980). Art psychotherapy. John Wiley & Son, Inc.: New York, NY.
[52] Wilkins, T.M. & Warner, S. (2001). Women in special hospitals: understanding the presenting behavior of women diagnosed with borderline personality disorder. Journal of Psychiatric and Mental Health Nursing 8, 289297.
[53] Yalom, I. D. (2003). The gift of therapy. An open letter to a new generation of therapists and their patients. Parennial: HarperCollins Publishers Inc.: New York, NY 10022. p.xiv
[54] Yen, S., Shean, M.T., Battle C.L., Johnson, D.M., Zlotnic, C., Dolan-Sewell, R., Sanislow, C.A., Grilo, C.M., Skodol, A.E., Gunderson, J.G., McGlashan T.H., Zanarini, M.C, Bender, D.S., Rettew J.B. (2002). Traumatic exposure and posttraumatic stress disorder in borderline,schizotypal, avoidant, and obsessive-compulsive personality disorders: findings from the collaborative longitudinal personality disorders study. Journal of Nervous and Mental Diseas. Aug; 190 (8), pp. 510-8.
[55] Yen, S., Shean, M.T., Sanislow, C.A., Grilo, C.M., Skodol, A.E., Gunderson, J.G., McGlashan T.H., Zanarini, M.C, Morey, L.C. (2004). Borderline personality disorder criteria associated with prospectively observed suicidal behavior. American Journal of Psychiatry, Jul; 161(7), pp 1296-8.
[56] Zanarini, M. C., Frankenburg, F. R., Reich, B. D., Marino, M. F., Lewis, R. E., Williams, A. A. & Khera, G. S. (2000). Biparental failure in the childhood experiences of borderline patients. Journal of Personality Disorders, 14 (3), 264-273.
[57] Zanarini, M. C., Williams, A.A., Lewis, R.E., Reich, R.B., Vera, S.C., Mario, M.F., Levin, A., Yong, L., & Frankenburg, F.R. (1998). Reported pathological childhood experiences associated with the development of borderline personality disorder. American Journal of Psychiatry, 154(8), 1101-1106.