28th National Clinical Education Symposium Presentation Abstracts

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PP-18 From Trigger to Trust: Utilizing the Family System to Heal Attachment Wounds in Borderline Personality Disorder

PP-18 From Trigger to Trust: Utilizing the Family System to Heal Attachment Wounds in Borderline Personality Disorder

Ümmühan Özkal1

1. University of Health Sciences, Sancaktepe Sehit Prof. Dr. Ilhan Varank Training and Research Hospital, Department of Psychiatry, Istanbul, Turkey

DOI: 10.5080/61upk.ozt511 Page 216
OBJECTIVE Borderline Personality Disorder (BPD) involves emotional dysregulation, fear of abandonment, and unstable relationships, often rooted in early attachment trauma. This poster presents a treatment case of an adopted woman with BPD, showing how systemic family therapy can address these core wounds. CASE A 26-year-old woman with self-harm, unstable relationships, and fear of abandonment (linked to learning of her adoption at age six) participated with her adoptive parents. Written consent was obtained. They completed 18 sessions of systemic family therapy with integrated individual skill-building over six months. The patient was not on psychotropic medication. The Borderline Symptom List-23 (BSL-23) tracks BPD symptom severity. Her score dropped from 2.8 (high) at intake to 1.1 (low) post-therapy. The Experiences in Close Relationships-Revised (ECR-R) assesses attachment anxiety and avoidance. Her scores moved from 5.2 to 3.4 on anxiety and from 4.8 to 3.1 on avoidance, indicating a shift towards greater security. DISCUSSION Therapy resulted in reduced self-harm, improved emotional control, and a more stable self-image. This dual approach allowed the family system to heal attachment injuries while individual skills managed acute symptoms. The BSL-23 and ECR-R provided objective, data-driven monitoring. Lasting recovery in complex BPD may depend on repairing the relational matrix while strengthening individual self-regulation. Keywords: Borderline Personality Disorder, systemic family therapy, attachment trauma, adoption, BSL-23, ECR-R.