Borderline Personality Disorder (BPD) and Sexuality


In several of my previous posts on the topic of borderline personality disorder (BPD), I have referred to how those who suffer from this serious condition tend to be highly impulsive, and, as might be anticipated, research now shows that this tendency towards impulsivity is likely to extend into sexual behaviours.

Indeed, many empirical studies have been conducted (some of which I will briefly refer to below) showing that, in connection with impulsive sexual behaviour, those who suffer from BPD are, in statistical terms  (there are of course individual exceptions as each case of BPD is unique) and as a group :

–  significantly more preoccupied with sex than average

– have had earlier sexual experience than average

–  are more likely to be sexually assaulted (including by both ‘date rape’ and attack by strangers, due to sexual impulsivity putting the BPD sufferer in vulnerable positions – for example, going back to the home of a stranger after a drunken night out

– are more promiscuous / have more casual sex than average

– are more likely to have homosexual sex (impulsivity makes experimentation more likely)

– are more likely to have unprotected sex

– are more likely to be coerced into having sex


Many studies have been conducted which provide evidence for the above, but I will restrict myself to providing a few brief examples here :

Hull et al assessed a group of seventy females who suffered from BPD and found that just under half of them had had experience of casual sex – a significantly higher proportion than in the average population.

Neeleman conducted research demonstrating that those who suffered from BPD were significantly more likely to have had experience of homosexual sex than average.

Lavan et al conducted research into the sexual histories of four hundred teenagers and found that those who had symptoms of BPD were significantly more likely to have had unprotected sex than those who were relatively symptom free

Whilst some studies have NOT found significant differences related to aspects of sexual behaviour in those who suffer from BPD compared to those who do not, such studies are in a tiny minority.


It is now becoming increasingly recognized that, in the light of such research findings as detailed above, treatment for BPD should include checks on the sufferer’s sexual health (in connection to sexually transmitted diseases) and, when appropriate, education about safe sex.


As some of the above information suggests, those with BPD are more likely than average to be sexually victimized. It has been hypothesized that, because those with BPD are more likely than average to have been victimized in childhood, there is an unconscious ‘repetition compulsion’ at play.





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David Hosier BSc Hons; MSc; PGDE(FAHE)

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Childhood Trauma and Obsessive Love Disorder

childhood trauma and obsessive love disorder

Obsessions are a symptom of an underlying anxiety disorder and materialize as a result of great stress such as severe emotional injury during childhood. In order to escape a world of intolerable psychological pain, the person suffering from obsessive love disorder escapes into a world of fantasy and obsession.

obsessive love disorder

obsessive love disorder

The disorder can come about as a result of having experienced a childhood in which the sufferer had chronically emotionally unresponsive parents, and, thus, did not have his/her emotional needs fulfilled when young. In essence, then, the sufferer has, in childhood, frequently been starved of emotional nurturance, love and acceptance.

However, the object of the ‘obsessive love’ is idealized and misperceived as someone who can supply the emotional nurturance that the sufferer was denied as a child.

obsessive love disorder

obsessive love disorder

A typical dysfunctional childhood the sufferer of the condition may have experienced is to have been rejected early on in life by his/her mother, causing intense psychological pain, and, very often too,to have had a father who was critical and disapproving. As a result of this, the neglected child grows up feeling worthless and inadequate. Indeed, so great is the experience of childhood trauma that psychological and emotional development has frequently become arrested at an early stage (so that, as an adult, the individual still has the emotional needs s/he did at the time his/her development became arrested).

Therefore, as an adult, the emotionally damaged individual is very likely to experience constant failure when trying to form close relationships. Due to the instability of his/her realtionship with his/her parents when a child, s/he will tend to be anxious and fearful in relation to  attempts to form intimate bonds with others.

A preoccupation with ‘ideal love’ may then develop and the sufferer of the condition can then become fixated on unavailable and emotionally inaccessible objects of this idealized love.


– sufferer experienced lack of nurturing and attention when young

– sufferer feels profound inner emotional pain

– sufferer is frequently isolated and detached from the rest of his/her family

– sufferer mistakes ‘intensity’ for ‘intimacy’ in connection to relationships

– sufferer compartmentalizes relationship, thus keeping it separated from, and unitergrated with, other aspects of his/her life

– sufferer has driven, desperate and intense personality and is prone to being ‘dramatic’

– the sufferer has a need of others to relieve his/her psychological pain

– the sufferer is prone to severe depression

– the sufferer has an insatiable need for close emotional attachment as s/he was denied this when young and is likely to be developmentally emotionally arrested at a stage in childhood when close, dependable emotional attachment was desperately needed (so the need remains unfulfilled)

– sufferer feels an inner rage over the lack of emotional nurturing s/he received as a child

– sufferer very likely to have other addictions/obsessions

– sufferer has a deep inner sense of worthlessness


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David Hosier BSc Hons; MSc; PGDE(FAHE).

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Childhood Trauma and Obsessive-Compulsive Disorder (OCD) Treatment


childhood trauma and obsessive compulsive disorder treatment



In the last 2 posts on this condition I explained what OCD is. In this post, Part 3, I want to consider how it may be treated.


Experts in the field of the treatment of OCD generally recommend cognitive-behavioural therapy (CBT) which is made even more effective if it is combined with medication – usually the medication will be an anti-depressant, although sometimes a benzodiazepam may be used.

Generally speaking, the anti-depressant is a long-term treatment, eg given for perhaps a minimum of a year, and up to a whole life-time, even if symptoms significantly improve (this is done in order to minimize the chances of a relapse occurring).

On the other hand, if the individual with OCD is prescribed a benzodiazepam, this will generally only be taken over a short period of time (eg a period when the symptoms are very acute) in order to minimize the risk of the individual with OCD becoming physically and/or psychologically dependent upon them (as they are addictive).


If studies on the effectiveness of anti-depressants for the treatment of OCD are looked at as a whole, on average individuals with OCD who undergo such treatment significantly improve around about 45% of the time. Whilst any improvement is obviously extremely desirable, in general the improvements individuals make by taking anti-depressant medication are not great enough to eliminate the need for other treatments being given alongside.

As has already been referred to, cognitive-behavioural therapy (CBT) is usually the type of therapy to be used alongside medication – in fact, it is a specific type of CBT which is known as EXPOSURE WITH RESPONSE PREVENTION (which I’ll henceforth refer to as EWRP). As has also been mentioned, if symptoms are extremely severe then benzodiazepam may be prescribed over the short term before the EWRP can take place.


We have already looked at  how sufferers of OCD have obsessive thoughts which cause them distress. What EWRP is designed to do is to help the individual TOLERATE SUCH DISTRESS. For, example, one common way in which OCD manifest itself is by making the sufferer inordinately and irrationally fearful of germs. Therefore, s/he may constantly be acutely anxious that his/her hands are ‘dirty’ and that this is potentially ‘highly dangerous’ – this, in turn. leads to constant compulsions to wash their hands in order to relieve their distressing and acute anxiety. However, the sense of relief is extremely ephemeral and the compulsion returns, perhaps leading the afflicted individual to wash his/her hands 100 times a day.

In the above example, the approach EWRP takes is to help the person tolerate the distress that his/her perception of having ‘dirty’ hands causes him/her by encouraging him/her not to wash them for a given period of time. As the person becomes better and more used to the anxiety caused by not washing them, the period of time can be gradually increased. The idea is that the person will become desensitized to the anxiety associated with unwashed hands.

On top of this, CBT can be used to help the individual challenge irrational thoughts which are connected to his/her OCD. For example, in the case described above, the individual could be helped to challenge thoughts such as ‘having any dirt on my hands is highly dangerous’ and to understand that the thought is an enormous exaggeration of any objective danger.



David Hosier BSc Hons; MSc; PGDE(FAHE).

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Link Between Childhood Trauma and Drug/Alcohol Addiction – Infographic.


I have already written an article about the link between childhood trauma and the later development of alcoholism. Below is a graph which visually illustrates this link, together with one illustrating the link to drug addiction. As can be seen, the greater the number of traumatic childhood experiences (represented along the x-axis), the more likely a person is to suffer from substance abuse/addiction later on in life.

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link between childhood trauma and substance abuse

link between childhood trauma and substance abuse

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Childhood Trauma: The Link with Future Gambling.

Research suggests that childhood trauma increases the likelihood of future addictions, including gambling. This gambling may become pathological. The types of childhood trauma that were experienced in pathological gamblers include violence, sexual abuse and loss. For instance, Jacobs (2008) conducted research demonstrating that childhood trauma greatly increased the risk of addictions in later life.

It has been hypothesized that gambling helps the individual cope with their childhood trauma through the psychological process known as DISSOCIATION (whilst intensely involved with gambling the individual ‘goes into another world’, blissfully disconnecting, for a time, from painful reality).

Pathological gambling is closely connected to impulse and control disorders; indeed, such disorders frequently express themselves in conditions linked to childhood trauma (such as borderline personality disorder).Pathological gambling may involve:

– an overwhelming preoccupation with gambling
– lying to others to cover up the extent of the gambling
– a failure to stop gambling even when the individual strongly wants to do so

The profile of the pathological gambler is often a complicated one as the individual often suffers from an array of other psychological disorders such as depression and anxiety (Abbot et al., 1999).

Studies estimate that about 2% (although the figure varies somewhat from study to study) of the U.S. population suffers from pathological gambling.

Factors other than childhood trauma which make an individual more at risk of developing pathological gambling inclue:

– being male
– being young
– having other mental health problems

Polusny et al (1995) suggested that addictive behaviours help the individual avoid both the memories of their childhood trauma together with the deeply painful feelings and emotions associated with it. Therefore, because activities such as gambling reduce the emotional distress connected with childhood trauma, the individual is driven to repeat the gambling experience again and again, due to the reward it provides of reducing psychological pain (this is technically known as negative reinforcement). It is my contention that, on some level, the benefits of reducing psychological pain must outweigh the financial losses; as losses can be enormous this gives some indication of the level of psychological pain the individual is in and the strength of the internal drive to reduce it. Of course, this can only be helpful in short-term bursts and, overall, it goes without saying that the individual’s pain and suffering are compounded.


This model proposes that there is an underlying biological state (ie an abnormal resting arousal state) together with a psychological state which is painful for the individual (for example, by creating a feeling of unbearable anxiety) often caused by childhood trauma to which activities such as gambling provide an ‘escape route’ (temporarily). The individual becomes addicted to this short-term relief (although often he will not realize this is the fundamental reason he continues to gamble, the drive frequently being unconscious).

Addictions which alleviate extreme stress in this manner are known as MALADAPTIVE COPING STRATEGIES; they are, essentially, learned defences against UNRESOLVED TRAUMA-RELATED ANXIETY (Henry, 1996).

Studies have revealed that up to 80% of pathological gamblers have suffered extreme childhood trauma. Further studies suggest that the more severe and protracted the trauma, the higher the risk is that the individual will develop pathological gambling behaviour and the YOUNGER the individual will be when he starts to use gambling as a coping strategy. Indeed, I myself started playing fruit machines at the age of twelve (many places weren’t strict about the age of the person playing them in the late 1970s) and I can remember quite distinctly the pleasant relief it gave to my already depressed and anxious emotional state.


It seems likely, then, that childhood trauma which remains unresolved is likely to elevate the risk of pathological gambling in individuals. When treating pathological gamblers, therefore, it is important to assess the degree of trauma the individual might have suffered and to consider appropriate psychological interventions which could be implemented to help the individual resolve the trauma. It is the psychological pain which underlies the compulsion to gamble which it is necessary to address.

I hope you have found this post of interest. You may, if you wish, click on ‘FOLLOW’ if you would like to follow this blog. New posts are added at least twice per week.

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Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

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Childhood Trauma: The Link with Alcoholism.

When childhood trauma remains unresolved (ie. it has not yet been worked through and processed with the help of psychotherapy), alcoholism may result (together, frequently, with aggressive behaviour).

Indeed, it has been suggested that unresolved traumatic events are actually the MAIN CAUSE of alcoholism in later life. The trauma may have its roots in:

– the child having been rejected by the parent/s
– too much responsibility having been placed upon the child

As would be expected, it has also been found that adult risk of both alcoholism and depression increases the greater the number of traumatic events experienced and the greater their intensity.

Children who grow up in alcoholic households have also been found to be at greater risk of becoming alcoholics themselves in adulthood, but this appears to be due to the fact that, as children with alcoholic parent/s, they are more likely to have experienced traumatic events than children of non-alcoholic parents, rather than due to them modelling their own behaviour regarding drinking alcohol upon that of their parent/s.

Furthermore, the more traumatic events experienced during childhood (of a physical, emotional or sexual nature), the more intensely symptoms of ANGER are likely to present themselves later on.

In research studies on childhood trauma, the degree of trauma experienced (and it is obviously not possible to quantify this with absolute precision) is often measured using the CHILDHOOD TRAUMA QUESTIONNAIRE (Fink et al., 1995) which identifies EMOTIONAL INJURIES and PARENTAL NEGLECT experienced during childhood and adolesence.

Studies suggest that an alcoholic adult is about ten times more likely to have experienced physical violence as a child and about twenty times more likely to have experienced sexual abuse. Lack of peace in the family during childhood is also much more frequently reported by adults suffering from alcoholism, as are: EMOTIONAL ABUSE, NEGLECT, SEPARATION AND LOSS, INADEQUATE (eg distant) RELATIONSHIPS and LACK OF PARENTAL AFFECTION.


Psychotherapy to help the individual suffering from alcoholism resolve his/her childhood trauma may improve treatment outcomes and reduce the likelihood of relapse. Further research is being conducted to help to confirm this.

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If you would like to view an infographic of the relationship between childhood trauma and substance abuse/addiction, please click here.

For another infographic, which focuses just upon the link between childhood trauma and alcoholism alone, please click here.

I hope you have found this post of interest. New posts are added to this site at least twice per week, and, you are, of course, welcome to sign up to follow it or leave a comment.

Best wishes, David Hosier BSc Hons; MSc; PGDE(FAHE).

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Copyright 2013 Child Abuse, Trauma and Recovery