The Impact of Childhood Trauma on the Development of Personality Disorders

By:  Jamie Sedgwick, LCPC, NCC

EMDRIA Consultant & EMDRIA Basic Trainer

Early on in my career as a mental health therapist, I got training in Dialectical Behavior Therapy (DBT). As a result, clients were frequently referred to me for meeting criteria for Borderline Personality Disorder (commonly referred to as “BPD”). I found these clients to be insightful with high levels of emotional intelligence. However, they commonly experienced difficulty identifying the events that would trigger high levels of emotional distress and render all of their DBT skills inaccessible and unhelpful. As I worked more with these clients to help them understand and manage their symptoms, I recognized a common thread: everyone was reporting experiences of attachment wounding or relational trauma during critical developmental stages in their lives. As I began connecting the dots between these traumatic experiences and Borderline Personality traits in adulthood, I realized I needed to get training in an evidence-based trauma treatment modality in order to fully help my clients heal. This is how I found Eye Movement Desensitization and Reprocessing (EMDR) Therapy and was given the opportunity to grow into a role that would allow me to teach other mental health providers about Borderline Personality Disorder as a trauma diagnosis. I’m passionate about sharing what I have learned to help destigmatize BPD in an effort to make treatment more accessible for those experiencing symptoms.

Types of Childhood Trauma Associated with Borderline Personality Disorder

Individuals presenting with BPD traits in adulthood often identify at least one of the following traumatic experiences during critical developmental stages of their childhood or adolescence: attachment wounding, attunement wounding, and relational trauma. It is important to note that these are experienced with primary attachment figures and impact how individuals view others and function within relationships.

What is Attachment Wounding?

Attachment wounding occurs during early childhood development when a child and the primary caregiver are not able to form a secure attachment. With “wounding,” I consider this to be “something was missing that we needed.” 

Many factors can contribute to attachment wounding including but not limited to: caregiver mental health, caregiver substance use, caregiver physical health, caregiver experiencing a high amount of situational stressors in order to provide basic needs. Ultimately, the caregiver is not able to provide healthy attachment early on in childhood development and the child learns that the primary attachment figure is not trustworthy, consistent or emotionally safe. In adult relationships, the individual that experienced attachment wounding is likely to have difficulty feeling emotionally safe in relationships and may find it difficult to trust others. They may (either consciously or unconsciously) engage in behaviors to “test” others’ level of reliability and emotional safety.

It is important to note, for some individuals entering therapy, they may not recognize that they experienced attachment wounding or even anything out of the ordinary during their early childhood. They may still have close relationships with primary attachment figures and feel protective towards them. Challenging a primary attachment figure’s ability to provide early attachment needs too early in the therapeutic relationship may cause a significant rupture.

What is Attunement Wounding?

Attunement wounding typically occurs in late childhood or adolescence and is the lack of appropriate response to an individual’s internal experience. For individuals experiencing symptoms of BPD, they have often experienced this with primary caregivers as well as later in life in friendships and intimate partner relationships. Individuals will often identify feeling invalidated emotionally and having difficulty trusting their own emotional responses as a result. In adulthood, this can lead to what is often referred to as the “push-pull” dynamic experienced in relationships with individuals experiencing symptoms of BPD. What individuals often misunderstand is that a “push” occurs after a relational rupture has occurred, likely in the form of attunement wounding. 

It is important to take time to build a strong therapeutic rapport so these dynamics can be addressed and discussed in a safe, healthy way. This allows for a sense of safety to develop as the client also learns how to communicate using effective interpersonal skills.

What is Relational Trauma?

Relational Trauma takes place when there are harmful dynamics present in a relationship. These are often what people think of as “Big T” traumas: physical abuse, sexual abuse, and emotional abuse. Essentially, something was there that should not have been. As a result of these Big T traumas in early childhood, individuals' early experiences with relationships and how to function were based on maladaptive behaviors and communication. As an adult, they may continue to utilize maladaptive means to get emotional needs met. As a result, their adult relationships may become tumultuous and abusive. 

It is important to provide psychoeducation about these relational dynamics in a way that does not pathologize symptoms or induces shame responses. Instead, psychoeducation can focus on validating why maladaptive skills were developed with a focus on the hope for healing as an individual learns new, more adaptive ways of functioning in relationships as they also work to simultaneously heal the traumatic experiences underlying the maladaptive skills.

Take the Time to Know the Individual

It is important to understand that not everyone who experiences attachment wounding, attunement wounding, or relational trauma will develop symptoms of Borderline Personality Disorder as an adult. Instead, utilize the information about attachment wounding, attunement wounding and relational trauma to inform intake assessments and therapeutic rapport building.

One More Thing

If you are interested in learning more about providing trauma-informed treatment or increasing your therapeutic skill set to include EMDR Basic Training, please visit traumaspecialisttraining.com to take a look at our various training options including trainings for mental health professionals that are not EMDR trained, EMDR Basic Training and EMDR Advanced Trainings. 

If you are already trained in EMDR and want to learn more about how to utilize it to help individuals heal the underlying trauma contributing to symptoms of Borderline Personality Disorder, check out my training: EMDR as an Effective Treatment Modality for Borderline Personality Disorder.