Borderline Personality Disorder (BPD) is among the most challenging and widely misunderstood presentations in therapeutic work. Often labelled, stigmatised, or pathologised, clients with BPD are frequently those who have endured profound relational trauma. But what if we reframe this condition not as a personality disorder, but as a complex adaptation to chronic misattunement, abandonment, and fear?

In this comprehensive bundle, two clinical giants — Dr Gwen Adshead and Dr Janina Fisher — offer complementary perspectives that bring both compassion and clarity to the therapeutic process. Gwen Adshead explores the developmental and attachment-based underpinnings of emotional instability, and introduces the concept of epistemic trust, hostile/helpless states of mind, and disorganised attachment. Janina Fisher expands the view with a body-based, parts-informed model that treats BPD as a trauma-related condition, using interventions from Sensorimotor Psychotherapy, IFS, TIST and mindfulness-based therapies.

Across both trainings, you’ll discover how to reduce reactivity, stabilise clients in crisis, build the capacity for mentalisation, and reframe ‘borderline’ presentations as manifestations of unresolved relational trauma. This is not just a technical toolkit — it is a reframing of how we see some of our most vulnerable clients.

What’s Included:

• Attachment Perspectives on BPD: Implications for Therapy — Dr Gwen Adshead (5 CPD / 5 CE)
• Borderline Personality Disorder and Traumatic Attachment — Dr Janina Fisher (10 CPD / 10 CE)

Who It’s For:

• Therapists working with emotionally dysregulated, trauma-affected clients
• Clinicians looking to move beyond the diagnostic frame and toward a relational understanding of BPD
• Practitioners across modalities who want to better manage transference, splitting, and client impulsivity

What You Will Learn:

• How insecure and disorganised attachment styles underlie BPD presentations
• Why clients with BPD often distrust therapy and struggle with therapeutic rupture
• Ways to reduce emotional overwhelm using grounding, parts work, and somatic stabilisation
• How to differentiate trauma responses from personality traits
• How to approach splitting, suicidal ideation, and shame with relational attunement and clarity
• Techniques to reframe identity-based suffering into parts-informed narratives that support healing

Course 1

Attachment perspectives on Borderline Personality Disorder:

implications for therapy

Dr Gwen Adshead

CPD/CE credits: 5

Attachment theory provides useful perspectives on emotionally unstable or borderline personality disorder (BPD); both in terms of how the disorder develops and in terms of therapy. Both clients and therapists may struggle with trust, high levels of negative affect, and therapeutic ruptures. Attachment needs in such clients are highly aroused and often extremely difficult to assuage. Understandably, BPD clients can not only struggle to participate in the therapeutic alliance, but can also view therapists as aloof, uncaring, antagonistic or unsympathetic.

At this practical workshop that would be relevant for psychotherapists, clinical psychologists, counsellors and psychiatrists, Dr Gwen Adshead will use a perspective based on attachment theory and the tenets of mentalisation to explore:

• How the psychopathology of emotional instability develops
• Hostile, helpless states of mind and epistemic trust
• The relationship with disorganised attachment and its sequelae
• How this understanding informs our therapeutic approaches
• How this understanding influences the way we think about families and their therapeutic needs
• Language and threat: use of why questions, silence and poor mentalising
• Preventing and managing attachment anxiety

Workshop Schedule

Session 1: Attachment and personality development

In this first session we explore:

• Brief overview of attachment theory and personality development
• Attachment and Affect Regulation – developmental studies and fMRI findings
• Insecure attachment and personality disorder: with emphasis on affect dysregulation
• Mentalising and affect regulation

Session 2: Clinical implications

• Why do people with PD struggle with therapy
• Activation and deactivation of attachment systems
• Repetition of Toxic attachments and lack of Trust
• Mentalising strategies for therapists

Session 3: Psychotherapeutic implications

Our third session of the day builds on and continues the theoretical bases considered so far and illustrates practical therapeutic implications for practitioners. Clinical vignettes will be discussed here. Specifically, we consider:

• Recognising when fragile mentalising capacities are overwhelmed by sudden surges of affect
• Helping our clients with self soothing and other strategies needed to reduce arousal
• Self-reflection and work with co-therapists

Course 2

Borderline Personality Disorder and Traumatic Attachment

Dr Janina Fisher

CPD/CE credits: 10

Research over the last thirty years has demonstrated a clear relationship between experiencing abuse in childhood and a later diagnosis of Borderline Personality Disorder. In the context of abuse and trauma, attachment failure is inevitable, leaving a lasting imprint on all future relationships.  Rather than experiencing others as a haven of safety, traumatized individuals are driven by powerful wishes and fears of relationship. Their intense emotions and impulsive behaviour make them vulnerable to being labeled ‘borderline’ and thus received with apprehension by the therapists from whom they seek help.

The borderline client is not at war with the therapist. He or she is caught up into an internal battle: Do I trust or not trust? Do I live or do I die? Do I love or do I hate? Understanding these clients as fragmented and at war with themselves transforms the therapeutic relationship and the treatment.

New approaches and interventions drawn from Sensorimotor Psychotherapy, Internal Family Systems, Trauma-Informed Stabilization Treatment (TIST) and mindfulness-based therapies can transform what it means to treat borderline clients. In this online course, Dr Janina Fisher draws on these approaches to address the impact of traumatic attachment on the ability of individuals to tolerate emotions (their own and those of others). She explains how ‘borderline personality’ can be best understood as a trauma-related disorder. Using theoretical constructs, videos and clinical case vignettes, she:

• Highlights how exploring the effects of traumatic attachment opens up new ways of working with clients who struggle to manage their traumatic and emotional responses
• Explores the impact of trauma on attachment behavior, the value of re-interpreting borderline personality as an attachment disorder, and how we can help clients make sense of their internal battles and better man  age their dysregulated emotional and autonomic states

Course Schedule:

• The effects of trauma on attachment formation in children
• • When parents are ‘frightened and frightening’
  • Trauma-related internal conflicts between closeness and distance
  • Disorganized attachment status in adulthood

• Understanding BPD as a trauma-related disorder
• • Differentiating personality disorder symptoms from trauma responses
  • Using psychoeducation to make sense of the symptoms

• Re-interpreting BPD as Traumatic Attachment Disorder: how does it change the therapeutic approach?
• • Transforming the focus from behaviour change to trauma resolution
  • Understanding splitting as dissociative, not manipulative
  • Transference and countertransference implications

• Stabilization of unsafe behaviour
• • “Waking up” the prefrontal cortex
  • Increasing client ability to be mindful rather than reactive
  • Re-interpreting impulsive behaviour as fight / flight responses
  • Helping clients dis-identify from suicidal beliefs and impulses

• Addressing issues of clinging, separation anxiety and anger
• • Working from a trauma-based parts perspective
  • Facilitating internal attachment relationships

• The use of mindfulness-based and body-centered interventions
• • Learning to observe rather than react
  • Using somatic interventions to calm the body and emotions

• A “right brain to right brain” approach to healing attachment wounding
• • Facilitating internal compassion
  • Helping clients ‘repair’ the past rather than remember it
  • Creating internal secure attachment

Overall Programme Learning Objectives for two sessions:

• Describe how the psychopathology of emotional instability develops and how to prevent and manage attachment anxiety
• Discuss the language and threat: use of why questions, silence and poor mentalising
• Analyse the relationship with disorganised attachment and its sequelae 
• Discuss how this understanding informs our therapeutic approaches and influences the way we think about families and their therapeutic needs
• Describe the effects of trauma-related attachment on affect regulation
• Discriminate symptoms characteristic of both borderline personality disorder and disorganized / unresolved attachment
• Identify the effects of disorganized attachment on interpersonal relationships
• Describe the Structural Dissociation model and its application to the treatment of BPD
• Employ right brain-to-right brain techniques to help clients tolerate and benefit from psychotherapy
• Apply body-centered and mindfulness-based interventions to help clients increase affect tolerance and decrease impulsive behaviour

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