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Psychiatric Impact of Childhood Sexual Abuse: Life on the Borderline

Delve into the prevalence and behaviors of individuals with borderline features, arising from early life abuse and neglect. Learn about the unique challenges faced and possible outcomes for survivors.

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Psychiatric Impact of Childhood Sexual Abuse: Life on the Borderline

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  1. Psychiatric ImpactofChildhood Sexual Abuse:Life on the Borderline Survivors of Abuse – Access to Justice Information Seminar, 14 May 2004 Ian Curtis MBBS FRANZCP FAChAM

  2. Borderland(author BV, with permission) The sand stings The Wind is Howling Of pain past. I know nothing The sand in my eyes Of pain present.

  3. I just exist Ask me who “I” am No answer. Gritting sand Prevents looking where The I is. Can’t be heard The Wind is Howling Lonely and worse.

  4. Isolate So as not to feel Contact causes hurt. The Wind is Howling When will I be Whole? (BV)

  5. Prevalence ofBorderline Features • General population 1-2% • Outpatient mental health clinics 10% • Psychiatric inpatient clinics 20% • Special Clinic Populations involving personality disorders 30-60%

  6. The Damage

  7. Aetiology Early life Physical and Sexual Abuse, Neglect, Hostile Conflict, and early Parental Loss/Separation are more common in the Childhood histories. (Source: Diagnostic and Statistical Manual Mental Disorders, 4th Edition, p708)

  8. General Behavioursof the Borderline • Ambivalence • Emptiness • Anger • Instability • Impulsivity and Recklessness • Deliberate Self-Harm • Immaturity

  9. Frantic efforts to avoidreal or imaginedabandonment

  10. Ambivalence:alternating betweenextremes of idealisationand devaluation

  11. Pattern of unstable and intense interpersonal relationshipsalternating between extremesof idealisation and devaluation

  12. Identity disturbance:unstable self-imageor sense of self

  13. Hopeless-Helpless:chronic feelings of emptiness

  14. Instability:affective instability due toa marked reactivity of mood

  15. Anger Management Problemsinappropriate, intense angeror difficulty controlling anger

  16. Self-Harming:impulsivity in at least two areas that are potentially self-damaging(eg spending, sex,substance abuse etc)

  17. Suicidality:recurrent suicidal behaviour, gestures, threats,self-mutilating behaviour

  18. Psychotic Border:stress-related paranoid ideationorsevere dissociative symptoms

  19. And Drug Abuse • Self-treating • Fill emptiness • Isolate interpersonally • Pseudo-closeness • “Control emotions” • Obscure anger • Self-harm

  20. Unique Difficulties Bipolarities Ambivalence Embraced Failure (Abandoned Hope)

  21. AbuseImpaired OverAchievement Achievement

  22. Vulnerability

  23. Transition to AdulthoodFailed Stalled Over Compensated

  24. Adult OutcomesSerious AdultImpairment Success

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