Personality disorders are among the most controversial and misunderstood diagnoses in mental health. The stigma attached to terms like “borderline” or “narcissistic” often shuts down deeper exploration, leaving clients trapped in cycles of shame and isolation—and therapists uncertain about how to intervene effectively. Yet beneath these labels lie patterns of adaptation to trauma, relational wounds, and developmental disruptions that can feel unyielding but are not immutable.

For therapists, recognising and working with personality disorders is unavoidable.
These clients are not rare—they are already in your therapy room. You may recognise them in:

• Volatile emotional reactions: A client who lashes out in anger or retreats in silence when you try to connect, leaving you uncertain about how to proceed.
• Deeply ingrained mistrust: A sense of wariness that makes building a therapeutic alliance feel like an uphill battle.
• Confusing relational dynamics: The quicksilver push-pull pattern of idealisation to devaluation where a client clings desperately one moment and withdraws the next, leaving you questioning your ability to help.

These dynamics can leave both therapist and client feeling frustrated and stuck. Yet understanding the roots of these behaviours can transform therapy into a space for genuine healing and growth.

Drawing on her extensive experience as a forensic psychotherapist, Dr Gwen Adshead brings a unique lens to understanding personality disorders. Her work with individuals in high-risk, complex settings—where relational trauma, societal judgment, and psychological vulnerability collide—offers profound insights into the hidden dynamics that often go unnoticed in everyday clinical practice. Through illustrative case studies and reflections from decades of therapeutic work, she will provide practical strategies for approaching these challenges with both compassion and clarity.

Evening 1: The Diagnosis Debate
Personality disorders often come loaded with controversy. Diagnoses are criticised as stigmatising, yet they offer a framework for understanding patterns that might otherwise seem incomprehensible. This session explores:

• Controversy and Stigma: Understanding why PD diagnoses remain contentious and how these debates affect clients and therapists alike
• The Roots of Disorder: How trauma, relational dynamics, and neurobiology intersect to shape disordered patterns of thinking and behaviour
• Evolving Perspectives: New approaches to diagnosis that prioritise relational and dimensional frameworks over rigid categorisation
• Beyond Hopelessness: Research that challenges the myth of untreatability and opens doors to therapeutic possibility

Evening 2: Living the Disorder, Working the Therapy
For clients, living with disordered personality patterns is a daily struggle. For therapists, navigating these dynamics requires both clinical skill and emotional resilience. This session focuses on:

• Understanding the Experience: What it feels like to live with a personality disorder and how it affects relationships and therapy.
• Building Therapeutic Trust: Strategies to create safety, foster collaboration, and repair ruptures in challenging therapeutic dynamics.
• Evidence-Based Therapies: A focused overview of NICE-recommended approaches like DBT, MBT, and schema therapy, tailored for practical application.
• The Therapist’s Reflection: How working with PD clients impacts therapists and strategies to maintain empathy, boundaries, and resilience.

WHY THIS WORKSHOP MATTERS

This workshop provides a much-needed opportunity to rethink the stigma, clarify the science, and deepen your therapeutic approach. You’ll leave equipped with a richer understanding of personality disorders, practical tools to enhance your clinical work, and a renewed sense of purpose in working with this complex client group.

LEARNING OBJECTIVES
By the end of this workshop, participants will be able to:

1. Reframe Personality Disorders: Understand personality disorders as adaptive responses to trauma and relational disruptions, rather than static or stigmatising labels.
2. Identify Clinical Patterns: Recognise common presentations of disordered personality patterns, including emotional volatility, mistrust, and relational instability.
3. Explore Relational Origins: Connect these patterns to early-life experiences, attachment disruptions, and neurobiological factors.
4. Apply Evidence-Based Approaches: Gain practical insights into how therapies like DBT, MBT, and schema therapy can be tailored to meet the unique needs of clients with personality disorders.
5. Navigate Relational Dynamics: Learn strategies to build trust, repair ruptures, and foster collaboration in even the most challenging therapeutic relationships.
6. Reflect on Therapist Impact: Develop tools to maintain empathy and emotional resilience while working with complex relational dynamics.
7. Challenge Myths and Stigma: Understand the evolving perspectives on PD, including the shift toward relational and dimensional models, and their implications for clinical practice.
8. Engage with Case Examples: Use illustrative case studies to translate theory into actionable practice.

Working with clients who carry the weight of personality disorder diagnoses demands more than clinical knowledge—it calls for curiosity, courage, and a willingness to look beyond the surface. This workshop offers the tools to do just that. Through a blend of theory, case insights, and practical strategies, you’ll gain fresh perspectives on patterns that once seemed unchangeable. You’ll leave with a deeper understanding of your clients, renewed clarity in your therapeutic approach, and the confidence to navigate even the most complex relational dynamics—with compassion, clinical insight, and resilience.

© nscience UK, 2025 / 26