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1877 - Jean-Martin Charcot, at the Salpêtrière Hospital in Paris, was the leading physician of his day working on nervous disorders and, in particular, hysteria (he has also been called the founder of modern neurology). He was the first to make the link between hysteria and underlying trauma (Lectures on the diseases of the nervous system: Delivered at La Salpêtrière, 1877). 1894 - Charcot's work on hysteria was taken up and much developed by his pupil, Pierre Janet, who laid down the foundation stones of trauma theory which are still sound today. Through extensive study, observation, and the use of hypnosis, Janet concluded [...]

'Borderline' and 'Narcissistic': The problem with terms The influential American diagnostic manual, the DSM, provides diagnostic criteria for what it terms 'narcissistic personality disorder' and 'borderline personality disorder', yet the whole concept of regarding personality traits as 'disorders' has met with fierce criticism in recent years, amongst both patients and analysts. Some regard the concept of psychological 'disorders' as reinforcing an unnecessary and inappropriate medical diagnostic model; some see it as being rooted in a limiting post-Enlightenment ideology of rigid classification and marginalisation of anyone not deemed to be suitably socially acquiescent (see Richard Bentall, 2004; Foucault, 1961); and many patients [...]

The main treatment for individuals with borderline and narcissistic personality traits is centred on various forms of psychotherapy, including Cognitive Behavioural Therapy (CBT) and Dialectical Behaviour Therapy (DBT). Contemporary treatments commonly involve mentalization-based therapy, transference-focused psychotherapy, and schema-focused psychotherapy. Individual and group psychotherapy may be also useful in helping people with narcissistic and borderline personality disorders. Indeed, the success of psychotherapeutic treatments for individuals with borderline and narcissistic personality traits is one of the most striking developments that has happened in the analytic world since Freud's original formulations in 1914. Whereas Freud regarded narcissistic traits as largely untreatable in the psychoanalytic [...]

The causes and aetiology of both borderline and narcissistic personality traits are complex and not fully agreed on. They involve genetic, brain, environmental, and social factors. However, both are strongly linked with insecure attachment (particularly disorganised attachment), early developmental issues, and issues of identity formation and 'personality' (see McWilliams, 1990). Developmental and relational aetiology In his pioneering book Into the Darkest Places: Early Relational Trauma and Borderline States of Mind (2016), Marcus West describes borderline personality states as being rooted in "early relational trauma", and therefore require "an integration of analytic theory, trauma theory, and relational theory" for successful treatment. Similarly, while [...]

Narcissistic and borderline personality traits are rooted in a particularly unstable or 'fragile' sense of self, as the title of Phil Mollon's classic 1993 work on these specific types of personality suggests (The Fragile Self: The Structure of Narcissistic Disturbance'), one that is often organised around early forms of disorganised attachment. This sense of internal and relational instability can manifest as rapidly alternating emotional moods and behaviours, with the individual characteristically switching between states of idealisation and denigration of others, and feelings of both grandiosity and emptiness. Often these disruptive moods and behaviours centre on, or are triggered by, underlying issues [...]

This that holds your eyes is nothing save The image of yourself reflected back to you. It comes and waits with you; it has no life; It will depart if you will only go. - Ovid, Metamorphoses 'Narcissus and Echo' The idea that there are distinct personality or character 'types' goes back at least to ancient Greece. The Greek philosopher Theophrastus described 29 character types that he saw as deviations from the norm, while the Greek physician and philosopher Galen developed a theory of personality types based on the concept of the 'four humours' proposed by Hippocrates, promoting a theory and typology of human temperaments that was [...]