Personality Structures and Chronic Childhood Relational Trauma: Psychodynamic and Attachment based Perspectives that Challenge the Restricted Diagnosis of Personality Disorder

Abstract

With the imminent publication of DSM V growing ever closer, the author suggests that headline diagnostic categories, such as narcissistic personality, histrionic personality or the ubiquitous borderline personality may actually be unhelpful to the clinician, who wishes to reach a deeper understanding of the factors shaping character pathology. The proposed revision of diagnostic criteria for personality disorder, in the forthcoming DSM V, to further emphasise traits within nosographical personality categories, appears to remain limited in conceptual scope. The psychoanalytic concept of personality structure is considered more malleable, from a conceptual perspective, in that it may enable the clinician to both describe and situate current psychological conflicts more appropriately, within a developmental context. It is suggested, in this paper, that such a conceptual progression is necessary in order to accommodate the rich seam of object relations, and attachment based approaches that have further shaped our understanding of personality development and personality difficulties, over the last two decades.