@Michael McCarthy posted:I respect van der Kolk and Judith Herman's destigmatizing of borderline personality disorder- which was, and still is, over-diagnosed in especially women who have significant trauma histories. His contention that CBT (with 30-plus varieties) is ineffective in ludicrous. He engages in cherry-picking of research (what is known to people like myself, with years of training as a scientist-practitioner knows as "confirmation bias"). I could go into a lot more, but there is ongoing litigation and as a person from a family full of attorneys, I'm not going into any details on their advice. I've never said van der Kolk made no contributions. I'm saying a New York Time's bestseller does not meet the rigors of science. I wlth stating that I was socialized with the value that the custodian deserves as much respect as a Nobel winning scientist. How we treat others is a great indicator of the contents of our soul. van der Kolk's contention that the relational aspects of therapy are insignificant says more about him, than the reams of extant research to the contrary.
It's not possible to end child adversity or create a peaceful, non-violent world without understanding what the developing infant and child needs to form a secure personality and without providing these developmental requirements to every infant and child. Children develop a secure personality through a compassionate, responsive, reciprocal, empathic relationship with parents and other adults. When this doesn't happen, we develop personality structures that aren't compatible with a peaceful world (Borderline, Narcissistic, Psychopathic, Avoidant, Histrionic, Schizoid).
Babies need what babies need in order to develop prosocial personality organization. There are no convenient shortcuts.
These personality organizations, whether characterized by society at large as good or bad, are transmitted generation to generation to generation unless there is some intervention. The totality of experience creates dynamic epigenetic changes in the organism which lead to changes in structure and function of the developing human including through neurons that "wire together and fire together." This process is essentially learning. Every developing human is learning through dynamic epigenetic switches which are turned on or off by characteristics of the environmental what he or she needs to know to best survive the environment (including the parents) that he has been born into.
"A picture emerges of a developmental pathway characterized by the confluence of effortful control and other self-regulatory skills arising in the context of a nurturing and securely rhythmic and predictable relationship between child and caregiver. The interaction of the benevolent, empathic, and attentive caregiver with the child yields growing self-regulation, the predominance of positive over negative affect, the beginnings of conscience, and increasingly smooth interactions with peers. This path of normal development is disrupted by an environment characterized by physical or emotional neglect and physical or sexual abuse. In such cases the child demonstrates negative affect, poor self-regulation, disruptions in conceptions of self and others, and disturbed relations with peers. No developmental studies of patients with borderline personality have yet been conducted, but this emerging picture resembles the adult presentation of BPO with its identity diffusion, preponderance of negative affect, poor self-regulation, and compromised relations with others."
PSYCHOTHERAPY FOR BORDERLINE PERSONALITY Focusing on Object Relations