Over 80% of people diagnosed with Borderline Personality Disorder have a history of abuse, neglect, or early relational trauma.
And yet, time and again, services default to describing these individuals as “disordered,” “manipulative,” or “too complex” — rather than as survivors of unsafe beginnings.
John Gunderson, often seen as the architect of the BPD diagnosis, said:
“Reframing the patient’s experience as a consequence of childhood trauma is essential.”
And still, in clinical settings, this trauma lens is too often ignored.
In 2009, I co-authored an article in OT News with colleagues Brown and Shankar that offered a different lens: a sensory integration perspective.
We showed how the very behaviours that get labelled as disordered, emotional dysregulation, rapid state shifts, identity confusion, can also be understood as sensory integration and processing differences, shaped by developmental trauma and nervous system adaptation. Read more here: https://lnkd.in/eiw5iHPD
It wasn’t easy to get that article published. It took multiple submissions, and the resistance was palpable. And yet today, 16 years later, we still have the same conversations.
We must stop reducing trauma responses to personality defects.
We must centre the body, the senses, and the lived story behind each person’s presentation.
I want to thank Keir Harding ( https://lnkd.in/emVCz2WJ?) from @Beam Consultancy for continuing to push this dialogue forward — especially in his work highlighting the flaws in how services respond to complexity. His honesty about the systemic gaps is part of what keeps this work alive.
Let’s be clear:
What some call “difficult” or “disordered” is often a person doing the very best they can with a sensory system shaped by fear, loss, and survival.
We can do better.
TraumaInformedCare #SensoryIntegration #BPD #ComplexTrauma #KierHarding #JohnGunderson #MentalHealth #OTNews #BrianShankarSmith #AyresSensoryIntegration #OccupationalTherapy #PersonNotLabel #SensoryLadders #Neuroscience #CompassionateCare #CoProduction