Complex and developmental trauma has long been linked with personality disorders, but is increasingly understood as being critical to their origin. In this talk, we propose a new model for understanding personality disorders, which links early relational trauma to the basic interpersonal responses to threat (fight, flight, seeking a protector). We aim to show how personality disorders are fundamentally about having a restricted set of options for relating to others, usually as a consequence of complex trauma.

We anticipate that this model will help practitioners and clinicians to make better sense of clients who suffer from personality disorders, more so than focusing on their symptoms which can sometimes feel perplexing or frustrating. Using the analogy of ‘keys’ as representative of relational strategies to get needs met and ‘locks’ as relational responsiveness to specific strategies used by others, we can better understand the effects these clients have on others, including ourselves as professionals.  

The authors have applied this model across contexts including inpatient and outpatient mental health services as well as out of home care, working with complex young people and their families. The model is helpful in demystifying the effects of complex trauma on relationships, not only in those with a diagnosable personality disorder, but also where the effects are milder but still cause distress and reduced interpersonal flexibility. It also sheds light on the ways that trauma may be passed through generations via relationships. In the process we hope to destigmatise those who suffer from personality disorders.

Delivered by a multi-disciplinary group, this talk is aimed at practitioners and clinicians across contexts who wish to practice more effectively with complex presentations in their current work.