Working with Borderline Personality Disorder (BPD) and Sexual Diversity: Presented by Julian Nolan
Depression Symptoms and BPD: Presented by Dr Lukas Cheney.
A brief introduction to Radically Open DBT (RO DBT) and case vignette Presented by Anna Banfai and Tanya Gilmartin
Working with people with a diagnosis of BPD who identify as queer or non-conforming (LGBTIQA+) presented by Mahlie Jewell
Psychiatric Aspects of BPD & Chronic Pain: presented by Dr. Srirekha Vadasseri
BPD and Co-Occurring Substance Use: presented by Carol Addicoat & Peter Fairbanks
In December the Vic Branch ran a webinar where Julian Nesci from Spectrum and Tanya Gilmartin from CEED discuss strategies to conceptualise and work with co-occurring personality disorders and eating disorders.
Unfortunately we were unable to record this. However Tanya and Julian have done a very similar presentation which is available on the CEED Vimeo Channel
Presented by Julian Nolan
A number of studies have reported data suggesting significantly higher rates of sexual diversity (attraction, sexual relations or romantic relationships other than heterosexual) in people diagnosed with BPD than in people with other psychiatric diagnoses or from the wider community. This is encapsulated by the acronym LGBTQIA+. This presentation will draw upon findings from two studies investigating the basis, if any, of an association between sexual diversity and a diagnosis of BPD to provide clinicians and other professionals with a deeper understanding of, and how to work with to better address, the needs of people with BPD and who identify as sexually diverse or simply wish to explore their sexuality. The intent of this work is to help de-pathologise sexual diversity and promote wider acceptance and understanding of what is widely understood to be part of normal human behaviour.
Julian Nolan is a psychologist works part-time in private practice, and is returning to study in 2020 to complete a Graduate Certificate in Family Therapy.
Presented by Dr Lukas Cheney
This presentation discusses research completed at Spectrum and will touch upon the challenges involved in diagnosis and the flexible responses needed to support people living with BPD.
About the speaker: Dr Lukas Cheney is a consultant psychiatrist with Spectrum Personality Disorder Service. As part of his work with Spectrum, Lukas has a particular interest in people with complex presentations.
Presented by Anna Banfai and Tanya Gilmartin
Part 1: is the presentation of slides outlining the case vignette where straight DBT has not been a good fit and the client is excited about information available about this alternative approach which seems a better fit.
Part 2: starts at about the minute mark. Tanya Gilmartin introduces the key underlying principles of RO-DBT and outline some of the research behind the treatment, as well as explain how to conceptualise clients from an RO-DBT perspective.
An evidence-based approach to "overcontrol" in a spectrum of disorders such as depression, anorexia, obsessive-compulsive personality disorder, severe anxiety, perfectionism, autism, etc.
RO DBT significantly differs from other treatment approaches, most notably by linking the communicative functions of emotional expression to the formation of close social bonds and via skills targeting social-signaling and changing neurophysiological arousal. RO DBT treatment centers around five OC themes: inhibited and disingenuous emotional expression; hyper-detailed focused and overly cautious behavior; rigid and rule-governed behavior; aloof and distant style of relating; and high social comparison and envy/bitterness.
Psychological health or well-being in RO DBT is hypothesized to involve three core transacting features:
1. Receptivity and Openness to new experience and disconfirming feedback in order to learn.
2. Flexible-control in order to adapt to changing environmental conditions.
3. Intimacy and social-connectedness (with at least one other person) based on premises that species survival required capacities to form long-lasting bonds and work in groups or tribes.
About the speakers:
Anna Banfai is a Clinical Psychologist in private practice. She has recently retired from the public mental health system where she worked part-time for over 30 years, specialising in BPD and complex presentations. She has had a part-time private practice for 25 years in which she provides treatment for people with BPD and complex needs. Having also been trained in family therapy and having co-facilitated the peer support group for people who are supporting someone with BPD at MIND Australia for 5 years, she continues to provide support and counselling for family members of people with BPD and complex needs in her private practice.
She has had extensive training in Dialectical Behaviour Therapy and Acceptance and Commitment Therapy/Wise Choices and has recently undertaken an introductory training day in RO DBT.
Tanya Gilmartin is a Clinical Psychologist with almost 10 years experience working as a DBT therapist. She has focused her clinical work on assisting clients with complex presentations, with a particular interest in personality disorders and eating disorders. In addition to her intensive training in DBT, she is one of only four people in Australia, and the only person in Melbourne, to be intensively trained in RO-DBT. She has been delivering this treatment in Melbourne since 2015 with the first RO-DBT program in Australia. As such, she works with the treatment developers and international trainers to promote and train clinicians in RO-DBT.
presented by Mahlie Jewell
Mahlie’s advocacy on the experiences of living with Borderline Personality Disorder, PTSD and brain injury have been published nationally. She is active social justice advocate and is currently working with Project Air and the NSW Department of Education concerning teenagers with self harm behaviours. Mahlie Jewell is a qualified counsellor, Intentional Peer Support worker and graphic artist. She has worked in the NFP community services sector for over 10 years and now specialises in design and campaign work. She designed the National 2018 BPD anti-stigma campaign for the BPD Awareness Week Collaboration Group.
Speaking from a lived experience as a person with a diagnosis of BPD who identify as queer, Mahlie will be sharing experiences of discrimination, homophobia and micro-aggressions within the mental health systems and providing solutions and techniques for clinicians to work better with members of the LGBTIQA+ community. This will include; explanations of acronyms, slang and common terms, how to be respectful of gender identity, how LGBTIQA+ identity sits within the "identity criteria" of BPD, how to allow queer clients to control their own treatments, LGBTIQA+ rights to treatment within community, increased suicide risk and chronic suicidality in LGBTIQA+ communities, issues with carers and families (domestic and family violence, safety, confidentiality and understanding our chosen family structures).
presented by Srirekha Vadasseri
Dr. Vadasseri is a psychiatrist and a pain specialist with a unique set of qualifications. She is a Fellow of the Royal Australian and New Zealand College of Psychiatrists. In addition, she also holds a degree in Master of Psychological Medicine from Monash University. She is also a Fellow of the Faculty of Pain Medicine of the Australian and New Zealand College of Anaesthetists.
By way of background, Dr Vadasseri obtained her MBBS medical degree in 1987. She completed training as a consultant anaesthetist in 1991 overseas, before transitioning to psychiatry.
She is a specialist in psychological aspects of chronic pain. She has a keen interest in working with people who have chronic pain, psychological difficulties and mood and personality disorders.
Please click here to access the slides from the evening
presented by Carol Addicoat and Peter Fairbanks
There is a high incidence of dual diagnosis in mental health services, even higher for those who have a diagnosis of bpd, this has implications for engagement and treatment for clinicians and family. Understanding the bi-directional impacts of mental health and substance use and maintaining a positive focus are important.
Carol and Peter introduced some dual diagnosis tools, interventions and principles currently used at the eastern dual diagnosis service focusing on the spirit of motivational interviewing, reasons for use scale and working through dilemmas.
Some of the tools discussed can be downloaded from here
presented by Flick Grey
Flick was first offered a diagnosis of Borderline Personality Disorder in 2005. Since then she has been dedicated to exploring this diagnosis (despite receiving 8 other diagnoses since then, BPD has continued to be the most intriguing).
Her wanderings have led her through the BPD world (she was a speaker at the 2011 International Society for the Study of Personality Disorders (ISSPD) Congress, and helped organise the inaugural BPD Awareness Day, her work is published in a well-respected mental health text book (Mental Health in Australia), and she was employed as the inaugural Consumer Consultant at Spectrum in 2015-6) into the wider world - the international consumer/survivor movement and the Alternatives movements.
This led Flick to London, where she studied Open Dialogue (a form of systemic family therapy from Finland) for three years. In 2015, she received the SANE Hocking Fellowship to explore the intersection between peer work and Open Dialogue. She is currently the Lead Intentional Peer Support Trainer for the Expanding Post-Discharge Support Initiative (DHHS-funded), Peer Support Manager at PartnerSPEAK and project worker at the Self Help Addiction Resource Centre, as well as regularly lecturing at various universities, speaking at international conferences, and maintaining a private practice as an Open Dialogue practitioner, supervisor and consultant.
Amongst all of this, she identifies as a unicorn and a Mad academic who has child parts, radically challenging the construction of distress as “personality disorder”. In this evening workshop, she will explore with you some alternative understandings of BPD that open up radically different relational spaces.
Flick's powerpoint is available for download here
presented by Pip Bradley
In this session Pip will discuss:
A brief review of the biosocial theory of borderline personality disorder, with a transactional focus
Current approaches to treatment, including common features of effective therapies and effective ways of working with people with BPD
*Managing intense emotions in clients including anger
*Treatment in a community setting
*Managing risk including risk of self-harm / suicidality
*Managing clinician feelings and risk of burnout
Pips slides are available for download
Presenter bio: Pip Bradley has a background of 20 years’ experience in mental health nursing, most of those specialising in the treatment and management of borderline personality disorder and working in specialist personality disorder services. She is currently a senior clinician at Spectrum the Personality Disorder Service for Victoria.
Pip provides therapy, training and consultation regarding complex presentations and therapeutic risk management to public and non-government sectors. She has predominantly specialised in Dialectical Behaviour Therapy, and works as a DBT therapist and trainer. Pip is committed to providing effective and therapeutic treatments for people with borderline personality disorder and developing effective service delivery.
For more information and to register your interest in the Victorian Borderline Personality Disorder (BPD) Mental Health Professionals’ Network visit
presented by Anna Banfai
In this presentation Anna looks at the challenges for services and the principles for working with families/carers who are supporting someone with BPD.
Anna's slides are available for download
Anna Banfai is a Clinical Psychologist. She has recently retired from the public mental health system where she worked part-time for over 30 years, specialising in BPD and complex presentations.
She has had a part-time private practice for 25 years in which she provides treatment for people with BPD and complex needs. Having also been trained in family therapy and having co-facilitated the peer support group for people who are supporting someone with BPD at ARAFEMI (now MIND) for 5 years, she continues to provide support and counselling for family members of people with BPD and complex needs in her private practice. She has had extensive training in Dialectical Behaviour Therapy and Acceptance and Commitment Therapy (evidence-based practices for BPD and people with features of BPD).
presented by Jayashri Kulkarni
BPD is a serious, often chronic and highly prevalent (5.9%) psychiatric disorder. The core features of BPD are dissociation, mood lability, self-harm, anger, and problems with self-identity. A common antecedent for many women with this condition is early life trauma. Current psychological treatments are expensive and difficult for patients to access, whilst no clearly designated pharmacotherapy is known to be specifically effective to treat BPD. Therefore, there is an urgent need for a new approach to this disorder.
The noted correlation of high rates of polycystic ovarian syndrome in women with BPD appears to be related to dysregulation of both the HPG and HPA axes.
The glutamatergic system, in the CNS, particularly, the N-methyl-D-aspartic acid (NMDA) subtype receptor, is increasingly recognised for its role in BPD, with recent neurobiological research linking stress, immune system alterations and neuroendocrine dysregulation observed in BPD with glutamate excitotoxicity.
Estradiol treatment is noted to be a neuroprotective approach and may assist women with cyclical fluctuation in their BPD symptoms.
In this presentation, new approaches to the aetiology, possible preventative strategies and treatment of this prevalent and poorly understood psychiatric condition will be discussed
Bio: Jayashri KULKARNI commenced her appointment as Professor of Psychiatry, The Alfred and Monash University in 2002. She directs a large psychiatric research group, the Monash Alfred Psychiatry Research Centre (MAPrc), with approximately 150 staff and students. The Centre is dedicated to discovering new treatments, new understanding and new services for people with a range of mental illnesses.
Jayashri Kulkarni completed her MBBS degree in 1981 at Monash University and worked mainly in Emergency Medicine before deciding to specialise in Psychiatry. She became a Fellow of the Royal Australian and New Zealand College of Psychiatrists in 1989 and was awarded a PhD from Monash University in 1997 for her thesis “Women and Psychosis”. Jayashri has pioneered the novel use of estrogen as a treatment for schizophrenia and is internationally acknowledged as a leader in the field of reproductive hormones and their impact on mental health. Jayashri is the President of the International Association of Women’s Mental Health, a role she commenced in 2017.
For more information and to register your interest in the Victorian Borderline Personality Disorder (BPD) Mental Health Professionals’ Network Click here
presented by Prof Andrew Chanen
Andrew discusses the potential harm in not diagnosing under 18's with BPD and the role of CAT (Cognitive Analytic Therapy) in treating BPD. He also talks about the HYPE (Helping Young People Early) program run at Orygen Youth Health.
Professor Andrew Chanen is Deputy Research Director at Orygen, the National Centre of Excellence in Youth Mental Health and a Professorial Fellow at the Centre for Youth Mental Health, The University of Melbourne. He is also Director of Clinical Services at Orygen Youth in Melbourne, Australia.
Andrew’s clinical, research and knowledge translation interests lie in prevention and early intervention for severe mental disorders, principally personality disorders, along with mood and psychotic disorders. He established and directs the Helping Young People Early (HYPE) program, a clinical, research and knowledge translation program investigating the understanding of and prevention and early intervention for severe personality disorder, particularly borderline personality disorder in youth. HYPE has been recognised with several awards, including the Victorian State Premier’s Award for advancing healthcare.
Andrew currently receives grant funding from the National Health and Medical Research Council (NHMRC), has over 85 scientific publications and a forthcoming book, Early Intervention for Borderline Personality Disorder, to be published by Cambridge University Press. Andrew serves on the Editorial Boards of Early Intervention in Psychiatry, Personality and Mental Health, Borderline Personality Disorder and Emotion Dysregulation, and Psychopathology. He is the Past President of the International Society for the Study of Personality Disorders (ISSPD).
He has served on numerous expert groups, including The Australian Government’s Expert Reference Group on Borderline Personality Disorder, the Development Group for the NHMRC Clinical Practice Guideline for Borderline Personality Disorder, and the ICD-11 Review Group for the Classification of Personality Disorders.
Unfortunately the audio cuts out at about the 50minute point. Apologies for any inconvenience.
presented by Dr. Peter McKenzie & Katerina Volny
1/ relational issues, triggers, attachments and traumas
2/ coordinating the service system to effectively respond to BPD
3/ facilitated reflection and sharing
Peter McKenzie (PhD, MA ClinFamTher) is an anthropologist, family therapist and academic. He currently holds the Carer Academic (mental health) position at The Bouverie Centre, School of Psychology and Public Health, La Trobe University, which focuses on families, caring & peer support. He has significant personal caring and professional experience in the mental health sector, including CMHSS and clinical services. His other currents roles at the Centre include principle research supervisor in the higher degree research program, family practice consultant in the mental health program and clinical family therapist. He has a particular interest in ethnographic research methods, as well as narrative therapy, mindfulness and complex trauma. His clinical work focuses on Borderline Personally Disorder and complex needs families.
Katerina Volny (B.Sc. Hons) is a Psychologist with 14 years experience working in public mental health and private practice. She has provided services to people with a diagnosis of Borderline Personality Disorder and their carers from the perspective of Dialectical Behaviour Therapy and Acceptance and Commitment Therapy frameworks. A key aspect of service provision in this area includes formulating specific treatment plans to enable the service system to respond effectively to the needs of people with Borderline Personality Disorder, that includes drawing on a range of public and private services.