What is the Difference Between Borderline Personality Disorder and Complex PTSD (C-PTSD)?

This video describes the difference between borderline personality disorder and the concept of complex posttraumatic stress disorder (C-PTSD). Borderline personality disorder is a mental health disorder in the DSM and complex posttraumatic stress disorder is not, but C-PTSD has been proposed to be a disorder in the ICD, which is another manual that’s similar to the DSM. With complex PTSD, we see all of the same symptom criteria as we see with PTSD, except the trauma is conceptualized as complex, which is a trauma that occurred repeatedly and usually in someone’s childhood as opposed to one single event. We also see a few other characteristics that are associated more so with C-PTSD than PTSD, including difficulty with self-perception, shame, guilt, a negative concept of self, a distorted image of the perpetrator, a preoccupation with revenge, interpersonal relationship difficulties, distrust, isolation, and a loss of meaning. Areas of overlap between C PTSD and borderline personality disorder include mood dysregulation, feelings of emptiness, loneliness, increased sense of guilt, increased difficulties with anger, and decreased self-worth. There’s a lot of controversy over the relationship between C-PTSD and borderline personality disorder. One popular point of controversy includes the idea that C-PTSD should replace borderline personality disorder, so with this theory borderline personality disorder never should have been a mental health disorder and this whole time along it was really C-PTSD. In essence, the group that believes this is saying that C-PTSD better explains the symptoms than does borderline personality disorder. I can appreciate many of the elements of this argument, but there are some difficulties with it. The primary difficulty of this argument is that trauma is considered etiological for both borderline personality and C-PTSD. It’s fairly easy to see how it could be etiological for C-PTSD, however, with borderline personality the story is quite a bit different. Many individuals who have borderline personality disorder do have a trauma in their history and a lot of times it is complex trauma, however, about 10 – 20% of individuals of with borderline personality disorder have no trauma history at all. Also, we know that with borderline personality or there’s a substantial genetic component. Another theory as to the relationship between C-PTSD and borderline personality disorder is that C-PTSD is a subgroup of borderline personality disorder, and this subgroup is a better way to understand individuals with that particular grouping of symptoms. The last theory we see is that C-PTSD is distinct from borderline personality, and that we need both mental health disorders available. The main argument here is that the treatment is substantially different. The needs for individuals that have C-PTSD are greatly different or substantially different than the needs we see of individuals who have borderline personality disorder.

Source: Youtube