Borderline Personality Disorder (BPD) is often narrowly categorised as an emotion dysregulation disorder, yet it extends far beyond this definition. Similar to Complex PTSD (cPTSD), BPD involves multiple dysregulated systems, including disorganised attachment (Liotti, 2006), structural dissociation with multiple emotional parts (Van der Hart et al., 2006), and unprocessed childhood trauma. However, interventions frequently address only one domain at a time, failing to integrate the full spectrum of dysregulation.

BPD is not just about emotional instability; it is a hyperarousal disorder (Schmahl et al., 2004), an attachment disorder marked by fear of abandonment and unstable relationships (Fonagy et al., 2015), and a dissociative disorder, where individuals may experience depersonalisation, derealisation, and identity fragmentation. The DSM-5 (APA, 2013) acknowledges that people with BPD may report a "felt presence"—a sensation of someone being nearby without visible confirmation, further reinforcing its overlap with trauma-related dissociative experiences (Lanius et al., 2010). I myself do believe in the presence other beings, and have supported people to come back into full regulation and have complete control over their experience in this world.

I apply a specialized mapping system that does not merely target emotion dysregulation but identifies and regulates the overlapping systems within BPD. This includes:

• Disorganized Attachment → Correcting maladaptive relational patterns.

• Structural Dissociation → Addressing emotional parts with therapeutic integration (Van der Hart et al., 2006).

• Hyperarousal & Trauma Responses → Regulating the nervous system through bottom-up and top-down interventions.

• Unprocessed Trauma → Processing unresolved childhood experiences for long-term stabilization.

Another underrecognised feature of BPD and cPTSD is hypersensitivity to energy—often dismissed in clinical settings but commonly reported by individuals with complex trauma. Many trauma survivors exhibit heightened emotional attunement, leading to paranoia, hypervigilance, and sensory overload (Ogden et al., 2006). In my approach, I incorporate strategies to help clients harness this sensitivity as a self-regulation tool rather than a source of distress.

If the storm inside you is churning, it does not mean you are broken—it means you have not yet had the right treatment. A comprehensive intervention that acknowledges the attachment, dissociative, hyperarousal, and trauma-based components of BPD makes true regulation and healing possible.

References

• American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: APA.

• Fonagy, P., Luyten, P., & Bateman, A. (2015). "Borderline Personality Disorder, Mentalization, and the Neurobiology of Attachment." World Psychiatry, 14(1), 5-11.

• Lanius, R. A., Bluhm, R. L., & Frewen, P. A. (2010). "How Understanding the Neurobiology of Complex PTSD Can Inform Clinical Practice: A Social Cognitive and Affective Neuroscience Approach." Acta Psychiatrica Scandinavica, 120(5), 1-15.

• Liotti, G. (2006). "A Model of Dissociation Based on Attachment Theory and Research." Journal of Trauma & Dissociation, 7(4), 55-73.

• Ogden, P., Minton, K., & Pain, C. (2006). Trauma and the Body: A Sensorimotor Approach to Psychotherapy. W.W. Norton & Company.

• Schmahl, C., Vermetten, E., Elzinga, B. M., & Bremner, J. D. (2004). "Magnetic Resonance Imaging of Hippocampal Volume in Women With Borderline Personality Disorder With and Without Childhood Abuse." Biological Psychiatry, 55(6), 759-765.

• Van der Hart, O., Nijenhuis, E. R. S., & Steele, K. (2006). The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization. W.W. Norton & Company.