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Cited by 181Personality Disorders and PsychopathologyPersonality Traits and PsychologyPsychoanalysis and Psychopathology Research

Borderline personality disorder, complex trauma, and problems with self and identity: A social‐communicative approach

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Luyten, Patrick, Campbell, Chloe, Fonagy, Peter·2020·Journal of Personality
DOI 10.1111/jopy.12483
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Abstract

Borderline personality disorder (BPD) is a relatively highly prevalent psychiatric disorder that is associated with very high personal and socioeconomic costs. This paper provides a state‐of‐the‐art review of the relationship between complex trauma and key features of BPD, with a focus on problems with self‐coherence and self‐continuity. We first review evidence for the high prevalence of complex trauma in BPD patients. This is followed by a discussion of emerging knowledge concerning the biobehavioral mechanisms involved in problems related to self and identity in BPD. We emphasize three biobehavioral systems that are affected by complex trauma and are centrally implicated in identify diffusion in BPD: the attachment system, mentalizing or social cognition, and the capacity for epistemic trust—that is, an openness to the reception of social communication that is personally relevant and of generalizable significance. We formulate a new approach to personality and severe personality disorders, and to problems with self and identity in these disorders, rooted in a social‐communicative understanding of the foundations of selfhood. We also discuss how extant evidence‐based treatments address the above‐mentioned biobehavioral systems involved in identity diffusion in BPD and related disorders, and the supporting evidence. We close the paper with recommendations for future research.

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  • BPD is characterized by impulsive, intrusive, and angry enmeshment in, rather than only detachment from, primary relationships in reaction to a combination of a terror of abandonment and a fragmented and unstable sense of self, which is acted out as hostile and impulsive demands in relationships.

    “BPD, by contrast, is characterized by impulsive, intrusive, and angry enmeshment in, rather than only detachment from, primary relationships in reaction to a combination of a terror of abandonment and a fragmented and unstable sense of self, which is acted out as hostile and impulsive demands in relationships [30, 108, 127, 144].”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [108]

  • BPD involves emotion dysregulation associated with deficits in social cognition related to dichotomous thinking, paranoia, aggressive attributions, and increased attention to, but impaired recognition, understanding, and empathy for, the emotions, thoughts, and intentions of others.

    “BPD also involves emotion dysregulation associated with deficits in social cognition related to dichotomous thinking, paranoia, aggressive attributions, and increased attention to, but impaired recognition, understanding, and empathy for, the emotions, thoughts, and intentions of others [30, 108, 127, 144].”

    From Complex PTSD and borderline personality disorder (2021) · cites this paper as [108]

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Authors
Luyten, P., Campbell, C., & Fonagy, P.
Affiliations
  • University College London (GB)
  • Research Department of Clinical, Educational and Health Psychology University College London London UK
Corresponding author
Luyten, Patrick
ORCID
Venue
Journal of Personality
Publisher
Wiley
Published
2019-05-23
Volume
88
Issue
1
Pages
88-105
ISSN
  • 0022-3506 (ISSN-L)
  • 1467-6494
DOI
10.1111/jopy.12483
OpenAlex
W2944747977
Cited by
181
References
167
Citations by year
2026: 17 · 2025: 29 · 2024: 39 · 2023: 26 · 2022: 28 · 2021: 26 · 2020: 13 · 2019: 2
FWCI
2.72
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Personality (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • Lirias (KU Leuven) (submittedVersion, other-oa)
Funders
National Institute for Health and Care Research (NF-SI-0514-10157)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
  • Social Sciences › Psychology › Clinical Psychology › Personality Traits and Psychology
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
borderline personality disorder, complex trauma, identity diffusion, self-coherence, self-continuity, attachment system, mentalization, social cognition, epistemic trust, social communication, biobehavioral mechanisms, severe personality disorders, evidence-based treatment
MeSH terms
Psychological Trauma, Borderline Personality Disorder, Ego, Humans, Object Attachment, Personality, Self Concept, Social Perception

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