As set out in Psychologists as expert witnesses: Guidelines and procedure (BPS, 2015): ‘An expert is a person who, through special training, study or experience, is able to furnish the Court, tribunal or oral hearing with scientific or technical information which is likely to be outside the experience and knowledge of a Judge, magistrate, convenor or Jury’. Experts may be instructed in the family courts when their expertise is necessary to make decisions in the case.
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Here are some key points about borderline personality disorder. More detail and supporting information is in the main article.
- People with BPD have problems regulating thoughts, emotions and self-image, can be impulsive and reckless, and often have unstable relationships with other people.
- Most cases of BPD begin in the early stages of adulthood, seem to be worse in young adulthood, but may get better with age.
- Experts do not yet know what causes BPD.
- Genetics, environmental factors and brain abnormalities are thought to play a role in the development of BPD.
- About 85% of people with BPD also meet diagnostic criteria for another mental illness, such and often suffer fromdepression, anxiety disorders, substance abuse, and eating disorders, along with self-harm, suicidal behaviors, and completed suicides.
- BPD and schizophrenia often co-exist, but the two are distinct conditions.
- A person can be diagnosed with BPD if they display at least five of nine recognized symptoms.
- Symptoms of BPD can be triggered by situations others find untroubling.
- As many as 80% of people with BPD go on to develop suicidal behavior, and 4-9% go on to commit suicide.
- BPD is commonly treated with psychotherapy, aided with medication and, occasionally, hospitalization.
- There is no cure for BPD, but symptoms can improve over time and many people with BPD find ways to manage their condition successfully to lead satisfying lives.
One of the foremost experts in personality disorders, Theodore Millon, describes the propensity for the narcissistic personality structure to decompensate into persecutory delusional beliefs under stress,
“Under conditions of unrelieved adversity and failure, narcissists may decompensate intoparanoid disorders. Owing to their excessive use of fantasy mechanisms, they are disposed to misinterpret events and to construct delusional beliefs. Unwilling to accept constraints on their independence and unable to accept the viewpoints of others, narcissists may isolate themselves from the corrective effects of shared thinking. Alone, they may ruminate and weave their beliefs into a network of fanciful and totally invalid suspicions. Among narcissists, delusions often take form after a serious challenge or setback has upset their image of superiority and omnipotence. They tend to exhibit compensatory grandiosity and jealousy delusions in which they reconstruct reality to match the image they are unable or unwilling to give up. Delusional systems may also develop as a result of having felt betrayed and humiliated. Here we may see the rapid unfolding of persecutory delusions and an arrogant grandiosity characterized by verbal attacks and bombast.”
The reenactment of attachment trauma is also documented in the clinical treatment literature,
“Reenactments of the traumatic past are common in the treatment of this population and frequently represent either explicit or coded repetitions of the unprocessed trauma in an attempt at mastery. Reenactments can be expressed psychologically, relationally, and somatically and may occur with conscious intent or with little awareness. One primary transference-countertransference dynamic involves reenactment of familiar roles of victim, perpetrator–rescuer-bystander in the therapy relationship. Therapist and client play out these roles, often in complementary fashion with one another, as they relive various aspects of the client’s early attachment relationships. (Perlman & Courtois, 2005, p. 455)
In response to three separate but interrelated psychological stresses associated with the divorce, 1) the threatened collapse of the narcissistic defenses against the experience of primal inadequacy that is triggered by the perceived interpersonal rejection inherent to the divorce (i.e., narcissistic personality processes), 2) the activation of immense anxiety fromsevere abandonment fears triggered by the divorce (i.e., borderline personality processes), and 3) the reactivation of attachment trauma networks when the attachment system becomes active to mediate the loss experience associated with the divorce (trauma processes), the narcissistic/(borderline) personality decompensates into persecutory delusional beliefs centering on the other parent’s “abuse” potential relative to the child.