Borderline Personality Disorder: Splitting & Identity Diffusion with Mark Ruffalo
Psychiatry & Psychotherapy Podcast
David J Puder
4.8 • 1.3K Ratings
🗓️ 10 January 2025
⏱️ 104 minutes
🧾️ Download transcript
Summary
In this episode of the Psychiatry & Psychotherapy Podcast, Dr. David Puder is joined by Mark Ruffalo to dive deep into the complexities of borderline personality disorder (BPD). Together, they unpack Donald Burnham’s influential 1966 paper on splitting and identity diffusion, exploring themes of self-concept, relational dynamics, and the therapeutic challenges posed by BPD patients.
Learn how splitting impacts interpersonal relationships and therapeutic teams, the historical evolution of BPD from "pseudoneurotic schizophrenia" to a recognized DSM diagnosis, and the significance of psychodynamic and mentalization-based therapies in treatment.
Key topics include:
- The history of BPD diagnosis and theory
- Splitting and its effects on therapy teams and relationships
- Identity diffusion and its manifestations in gender, sexuality, and self-worth
- The role of childhood trauma, attachment, and genetic factors in BPD
- Practical insights for clinicians working with complex personality dynamics
Whether you’re a mental health professional, a student of psychiatry, or someone seeking a deeper understanding of BPD, this episode offers rich insights and evidence-based approaches for navigating this challenging and often misunderstood condition.
By listening to this episode, you can earn 1.75 Psychiatry CME Credits.
Transcript
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| 0:00.0 | All right, welcome back to the podcast. I am joined today with Mark Ruffalo. He is a person |
| 0:21.3 | that I've become friends with. He's local to Florida here. I would say he |
| 0:25.4 | drove out to be in person for this. I've let me say I met you through actually |
| 0:31.5 | the residents who had been on the book club a couple times and they were big |
| 0:37.3 | fans. They were like he is the best teacher. You got to meet this guy and then you |
| 0:42.3 | know we met on X formerly called Twitter., where I was like, man, this guy |
| 0:48.5 | knows a lot about BPD and I've been listening to your YouTube and I'm like, we got to get |
| 0:52.7 | together. I know you're a fan of the history of psychiatry. And so in this episode, we're |
| 0:56.8 | going to dive into borderline personality disorder before it was called borderline personality |
| 1:02.8 | disorder. I don't know. would that be fair to say? I think that's a pretty good description, yeah. |
| 1:07.2 | And specifically a paper called the special problem patient, victim or agent of splitting |
| 1:14.6 | by Donald Bernham in 1966. |
| 1:19.9 | And let me just say to you who are listening to this who are thinking like really a paper |
| 1:23.1 | from 1966, I don't think who are listening to this who are thinking like really a paper from 1966, |
| 1:25.3 | I don't think papers are written like this anymore. |
| 1:29.0 | And this is, am I right, your favorite? |
| 1:31.7 | This is one of my favorite papers |
| 1:33.6 | I think in the history of psychiatry. |
| 1:35.2 | I think Burnham does such a good job |
| 1:38.1 | of describing the syndrome |
| 1:41.4 | in a way that you really don't see |
| 1:43.8 | in the literature much anymore. |
... |
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