Understanding Complex PTSD and Borderline Personality Disorder

Psychiatry & Psychotherapy Podcast

David J Puder

Science, Health & Fitness, Medicine

4.8 • 1.3K Ratings

🗓️ 14 June 2024

⏱️ 70 minutes

🔗️ Recording | iTunes | RSS

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Summary

The purpose of this episode is to provide a clear and simple guide for clinicians on the diagnosis of complex PTSD (C-PTSD) and how it differs from post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD). It is intended to complement and add to recent episodes on attachment and trauma: 213: Reflective Functioning, 203 and 204 on adverse childhood experiences.

In today’s episode of the podcast, we are joined by Dr. Adam Borecky. Dr. Borecky is a psychiatrist and therapist who helped author the Connection Index and is part of Dr. Puder’s core team. His practice utilizes a holistic approach towards therapy and medication management.

Transcript

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0:00.0	All right. Welcome back to the podcast. I am joined today with Dr. Adam Bereki. He is a psychiatrist who does psychotherapy,
0:24.0	psychiatry in California, and he works with me in our practice. I'll take care of patients, and he
0:34.0	is coming on to discuss with me complex PTSD, borderline personality disorder, PTSD, where they intersect,
0:43.2	where they are different. As some of you may know, complex PTSD is not in the DSM-5, but is in the
0:52.6	ICD 11. 11? 11, yeah. And we will talk about that. We will talk about what is uniquely complex
1:04.4	PTSD? Is this a good, new diagnostic term that is discrete and separate from BPD and PTSD?
1:14.5	We will discuss how these patients present, what makes them different, what makes them unique,
1:22.0	potentially how to help them. This is a good episode in continuum with the two episodes I've
1:28.0	done on adverse childhood experiences and reflective function. Episode 213 reflective function,
1:35.3	I think relates to this quite a bit. And so if this one's of help to you, you can go back and
1:40.8	listen to those. This one will stand alone. So Adam Bereki, welcome to the podcast.
1:46.1	David, great to be here. Thank you for the invite. Why don't you start by describing a little
1:51.3	bit about complex PTSD? So what complex PTSD is trying to do? It's trying to capture a subset of
2:00.0	individuals that just don't quite fit the full criteria of traditional PTSD, as well as the
2:07.0	adjustment disorders, as well as the complicated bereavement, as well as the BPD, the borderline
2:12.5	personality disorder. So that's kind of broad strokes kind of where we were coming with this.
2:18.4	Yeah, I think I think one of the general sort of ideas is complex PTSD is more of an avoidance,
2:29.2	like trauma has led to you wanting to avoid interpersonal relationships and a very sort of
2:39.0	negative self-concept. Whereas borderline personality disorder, there's the cutting, the self-harm,
2:46.4	there's a paranoid ideation, meaning like people are critical of me, people are looking at me
2:54.8	critical. There's, and with PTSD, there's more of the classic nightmares, flashbacks to a specific
3:03.2	event. Yeah, I don't know, would you, just kind of as we kind of paint the broad picture,
	...

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