Cover Image: Complex Borderline Personality Disorder

Complex Borderline Personality Disorder

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Member Reviews

I work in the mental health field and work closely with people who are diagnosed with BPD. In my experience these people often have a co-morbid diagnosis. This is a good resource for people to turn to when they are looking to educate themselves on their condition. I have recommended it to my clients.

The tasks are easy to follow and really help. While the author goes through a number of co-morbidities such as ADHD, depression etc, parts wont apply to everyone but there is something for everyone

I received an arc of this book via NetGalley in exchange for an honest review. All thoughts and opinions are my own.

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I recommend this book for clinicians seeking to better help clients and patients who have borderline personality disorder traits. Since most of them have other conditions, the strategies discussed in this book are very helpful.

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ARC audiobook provided by NetGalley and the publisher in exchange for an honest review.

“Complex Borderline Personality Disorder” explores borderline personality disorder (BPD) with a focus on living with BPD and co-existing conditions such as bipolar disorder, depression, psychotic symptoms, attention-deficit hyperactivity disorder (ADHD), post-traumatic stress disorder (PTSD), or Complex PTSD (C-PTSD). The author identifies this co-existence as complex BPD (C-BPD).

The book is broken down into chapters that commence with a discussion about BPD and C-BPD and are followed by a breakdown of a sampling of co-existing conditions as noted herein. The book follows a formula in which each chapter is broken down essentially into three parts: (1) a sampling of a case study involving a patient pre- and post-diagnosis and the struggles and successes relevant thereto; (2) a more clinical discussion of the co-existing condition and how it manifests in conjunction with BPD; and (3) an exercise for the reader to participate in.

As someone who lives with BPD and a co-existing condition, thereby making me a C-BPD patient, I was intrigued by the premise of this book. I have read plenty of material regarding both BPD and my co-existing condition, but never a book that explores what the combination of the two looks like. The topic was excellent, and the foundational format of each chapter the book (case study, clinical discussion, reader participation) was perfect. Unfortunately, I don’t think the format was executed as well as it could have been. The author places a large portion of each chapter on the case study, and the clinical discussion seems more like an afterthought. The reader participation exercises were a fantastic idea, but I felt that it could have been executed better.

Overall, I found this book to be more of a middle-of-the-road examination of C-BPD. The premise was strong, and the format was excellent. However, the execution was mediocre. I have read a lot of material, both clinical and not, about BPD and my own personal co-existing condition. I felt the majority of these other materials surpassed this book. The book had the potential to be a great read if only it spent a bit more time on the clinical aspect of each chapter and improved the reader participation exercises somewhat. I feel this book might best relate to someone who is new to BPD and a co-existing condition diagnosis. It seems like an appropriate starter work for people who haven’t really read any other materials on the topic. However, if the reader is more experienced and familiar with other texts on the subjects, it might not be worth their time. All in all, I loved the premise of this book but felt the execution was lackluster.

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Highly informative
For anyone suffering from CBPD, or anyone living with someone suffering from CBPD, then this book could be for you. It could also be used to assist health care workers treating CBPD sufferers. The book offers a very clinical and complex analysis of the condition, an in-depth look at the condition with examples of the different ranges of symptoms. It has some wonderful strategies for self diagnosis as well as some great ideas to help yourself and your loved ones in managing and dealing with the various issues. I particularly loved the journaling and multiple choice questions/quiz profiling. It’s not very easy to read and absorb, I had to concentrate to be able to take it all in. I found it easier to highlight/write notes on the things that were relevant to me, and then skim/speed read over certain other things. All that said, it was an extremely insightful read.

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Complex Borderline Personality Disorder by Daniel J. Fox is aimed at people who have borderline personality disorder along with a co-occurring mental disorder. It describes how these combinations can present and how to manage them.

The co-occurring conditions that it addresses are bipolar disorder, depression, psychosis, ADHD, and PTSD/complex PTSD. The author refers to BPD in combination with any of these other disorders as complex BPD, or CBPD. For each combination, there’s a chapter that focuses on symptoms followed by a chapter that focuses on management of the conditions. There’s an emphasis on gaining awareness of and insight into your symptoms, and the book guides readers through teasing apart what symptoms related to what. There are exercises throughout the book, and the author encourages readers to start a journal to make notes and do the exercises in.

The author describes personality disorders this way: “Personality disorders are best defined as the inability to adjust your thoughts and behaviors based upon the environment you’re in.” He explains that CBPD is very common among people with BPD, but without a systematic approach to assessment, the chances of missing a co-occurring disorder are over 50%.

The book differentiates between surface structure content and core content. Core content “makes up the internal part of yourself that represents how you think and feel about yourself, others, and your world,” while “Surface structure content are the behaviors or symptoms that rise to the surface as a result of the core content.” The author explains that medications can help to manage surface content but not core content.

The section on depression talked about differentiating major depressive episodes from what the author referred to as BPD depressive episodes, which are short and intense, with an identifiable trigger. The interplay between these was described in terms of the relationship between core content and surface content.

The section about psychosis wasn’t diagnosis-specific, and it included quasi-psychotic symptoms (which sounds like what I’ve heard referred to as micropsychosis in the context of BPD), dissociation, and dissociative identity disorder (DID). The case study that was given involved an individual who developed a brief psychotic disorder in response to significant stress rather than someone with a chronic psychotic disorder. To me, this section was the weakest, as I found it vague and a bit too much of a hodgepodge.

The chapter explaining PTSD and complex PTSD (C-PTSD), on the other hand, I thought was quite well done. It involved case studies of a war vet with PTSD, someone who had C-PTSD related to childhood abuse, and someone with combined C-PTSD and BPD. I thought the author did a good job of distinguishing the different features and identifying what overlapped and what didn’t.

Overall, I found this book quite interesting. I liked the emphasis on building insight and teasing apart symptoms. Probably most readers aren’t going to have all of the CBPD combinations that the book covers, but I think most readers with BPD will find at least some bits that are more broadly relevant throughout the whole book. This is the first book I’ve come across that deals with BPD and co-occurring conditions, and it’s an important subject area to address.

The author also brings his own conceptualizations to this book; the term complex BPD is his own, and from what I can gather from Google, he’s also come up with the distinction of core content and surface structure content. This offers readers a perspective that’s different from what they’ve read in other books, and I think that’s a good thing. I also think readers will find the book quite validating, and they'll come away from it with a greater understanding of their condition.

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This book explores a newly coined term: Complex Borderline Personality Disorder. Dr. Daniel J. Fox describes what he calls 'CBPD' as when a person has a diagnosis of borderline personality disorder as well as one or more co-morbid mental health conditions. This book in particular explores BPD in combination with five other disorders: bipolar disorder, depression, psychosis, ADHD and PTSD. Each disorder has two chapters dedicated to it, reading both will help you to understand that particular type of CBPD as well as some suggestions of how to cope with it.

As someone who lives with borderline personality disorders and more than one co-morbid condition, I found this book to be incredibly insightful. I even left it with a few new coping mechanisms and insights into my mental health, and at this point in my recovery especially with BPD, I usually find content to be very surface-level and very rarely containing any new coping skills for me. I highly recommend this for anyone experiencing BPD in conjunction with any of the five disorders listed above, it definitely helped me gain some insight!

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