TRAUMA


BODERLINE PERSONALITY DISORDER, CHILDHOOD TRAUMA AND STRUCTURAL DISSOCIATION

Borderline personality disorder and dissociation are strongly related. DSM-IV-TR criteria of BPD, for instance, include isolated dissociative symptoms (APA, 1994). Two thirds of BPD may be diagnosed of a dissociative disorder (Korzekwa, Dell and Pain, 2009). Both diagnoses have been related with high rates of childhood trauma. The close relationship between trauma, dissociation and borderline features can be understood from the perspective of the theory of structural dissociation of the personality (Van der Hart, Nijenhuis & Steele, 2006/2008) which transcends the traditional approach of describing "comorbidity". In this article we will review the empirical data which support the relation between early traumatizing and attachment disruption situations, and both borderline and dissociative symptoms. Borderline personality disorder will be explained in terms of structural dissociation of the personality. Leer más en este archivo.


NARCISSISM AS A CONSEQUENCE OF TRAUMA AND EARLY EXPERIENCES

The pathological self-centeredness of individuals with narcissistic personality disorder is different from the normal narcissism of childhood. In normal narcissism, childrens’ need for dependence and admiration is fulfilled by the age-appropriate attention they receive, and they are able to acknowledge nurturing with reciprocity and gratitude. Children with a narcissistic pathology deny their dependence. They receive nurturance with a sense of entitlement and do not reciprocate or experience any sense of gratitude (Kernberg et al., 2000). The devaluation of self and others is a relevant issue in the field of trauma and dissociation but therapy usually focuses on a victim-abuser perspective where we tend to pay attention to victims and their symptoms. From this perspective, victims are described as depressed, submissive, vulnerable and usually trapped in learned helplessness. Although this picture describes some situations related to maltreatment and abuse, it can be simplistic and minimize or overlook internalization of some abuser features by victims (e.g., the presence of perpetrator-imitator parts in DID). Leer más en este archivo.


TRASTORNO LIMITE DE PERSONALIDAD. TRAUMA EN LA INFANCIA Y DISOCIACIÓN ESTRUCTURAL

El trastorno límite de personalidad (TLP) y la disociación están fuertemente relacionadas. Los criterios DSM-IV-TR del TLP, por ejemplo, incluyen síntomas disociativos aislados (APA, 1994). Dos tercios de los TLP podrían diagnosticarse como trastornos disociativos (Korzekwa, Dell y Pain, 2009).   Ambos diagnósticos se han relacionado con altas tasas de trauma infantil. La estrecha relación entre trauma, disociación y rasgos límite puede entenderse desde la perspectiva de la teoría de la disociación estructural de la personalidad (Van der Hart, Nijenhuis & Steele, 2006/2008) que va más allá de la perspectiva de describir “comorbilidad”. En este artículo revisaremos la evidencia empírica que apoya la relación entre traumatización temprana y situaciones de disrupción de apego, con los síntomas límite y disociativos. El trastorno límite de la personalidad se explicará en términos de disociación estructural de la personalidad.   Leer más en este archivo.