Applying the Archetypal Spiral to Narcissistic Patterns, Borderline Patterns and Complex PTSD: Mindful Flow in Clinical Contexts (Part 4)
- Dr. Francisco Flores
- 6 days ago
- 26 min read
This blog maps out how the Archetypal Spiral Model can relate to different psychological problems/presentations and in the context of psychotherapy. This is part 4 which focusses on 10. Narcissistic Patterns, 11. Borderline Patterns and 12. Complex PTSD. Part 1 covered 1. Depression, 2. Generalised Anxiety and 3. Trauma. Part 2 covered 4.Obsessive Compulsive Disorder (OCD), 5. Panic and 6. Social Anxiety. Part 3 covered 7. Relational Patterns, 8.ADHD and 9. Addictions.
For context on the Archetypal Spiral model. or framework, that we apply in this blog, please see previous blogs, such as The Spiral of Connection & Disconnection: Archetypes, Values, and the Journey Towards Wholeness and Mindful Flow - Utilising the Archetypal Spiral Model
You can also see and explore the interactive representation of the model here.
10. Narcissistic Patterns - The Idealised Self vs. the Real Self
Within the Spiral framework, narcissistic patterns represent a significant disintegration at the Recognition level - a developmental arrest often due to a lack of appropriate attunement and mirroring in infancy. When early caregivers fail to attune (to notice, understand, and respond appropriately to the child's emotional and developmental needs), the child receives no stable reflection of their authentic self, therefore self-recognition becomes dependent on others' approval of the false self. The result is that the child mistakes the false self with the real self - the psyche compensates by constructing an idealised version of self, which appears safer and more lovable than the vulnerable real self. This isn't just vanity or selfishness, but a survival strategy born from the terror of being truly seen and found inadequate. The narcissistic adaptation creates a protective shell around a wound so deep that acknowledging it feels like psychological death.
Stephen M. Johnson (1987) describes narcissism as a characterological style - a coherent survival adaptation that develops when the child discovers that approval can be earned only by embodying an exceptional, controlled, or “special” version of themselves. The idealised self gradually becomes more real than the felt self; the person spends their life attempting to actualise this image in the hope of achieving the Recognition they never received. In Spiral terms, this is a distorted form of Recognition: worth becomes conditional upon performance, admiration, or superiority rather than intrinsic dignity.
Clinical Example:
Marcus first appeared in childhood as a boy who “underperformed” at school. He was bright but had undiagnosed ADHD, struggled to complete assignments, and found refuge in friendships that helped him feel seen. His parents, ashamed of his academic difficulties, scolded him harshly and discouraged socialising - believing peers were a “bad influence.” Marcus learned he was lovable only when he met expectations, and that showing uncertainty or need invited criticism. At school, he acted confident; at home, he hid his perceived inadequacies. The seemingly competent, impressive, unflappable boy began forming alongside deep self-doubt and self-judgment.
All three archetypal forces, Truth, Courage, and Love, become distorted to maintain their image.
Truth becomes Denial - reality bends away from lived experience toward the constructed image. Reality becomes whatever supports the grandiose self; anything threatening this narrative is denied, projected, or attacked. The person cannot afford to see themselves clearly because accurate self-perception would mean confronting the original wound of being unworthy of love as they are.
Courage turns into “Fawning” survival response behaviour, channelling its energy into maintaining and defending the false self - this appears as perfectionism, impressive achievement, charm, or emotional dominance. Vulnerability feels dangerous; the person cannot risk showing the real self, so they defend the image at all costs.
Distorted Love rescues through admiration-seeking attachment to the glow of others' approval rather than genuine mutuality. Others exist primarily as mirrors or sources of "narcissistic supply" (Kernberg, 1975). They cannot love themselves because they do not know themselves; they cannot love others fully because genuine connection threatens the fragile façade.
Theoretical Perspectives: Kernberg, Kohut, and Horney
Otto Kernberg (1975) describes pathological narcissism as identity diffusion - the person oscillates between idealised and devalued self-representations without integration. In Spiral terms, this represents inability to hold Recognition; the person's image is driven by avoiding self-rejection. They swing between grandiosity (false Recognition) and shame (Recognition wound), never finding the middle ground of genuine dignity.
Kohut (1971) introduced the term transmuting internalisation: the process by which empathic failures are repaired by caregivers who allow the child to discover themselves as loved, separate, and imperfect. In therapy, the missing developmental function is mirrored empathically - not to inflate the client but to stabilise the self through accurate, grounded reflection. This developing more integrated self is what the client is working towards.
Horney (1950) framed the “search for glory” as a neurotic substitute for genuine growth: a compulsive striving to embody an unreal ideal rather than to develop one’s real self - the energy of development shifts into compensatory striving rather than authentic becoming.
In the Drama Triangle:
The Persecutor dominates, attacking anything that threatens the idealised self - including others who fail to provide what they consider “adequate mirroring”. This persecution can be overt (rage, devaluation) or covert (withdrawal, contempt). The person becomes their own harshest critic while projecting this criticism onto others.
The Victim emerges when narcissistic injury occurs - when reality punctures the grandiose bubble. The collapse can be catastrophic: "If I'm not special, I'm nothing." This victim position often remains hidden, defended against through rapid return to grandiosity or persecution.
The Rescuer may appear as the charming, generous, or helpful persona - but only when it enhances the idealised image. The narcissistic person may rescue others to feel superior or to ensure dependency - it's another form of supply-seeking.
The Mentalisation Deficit
Fonagy and Bateman's (2006) work highlights how narcissistic structures involve reduced mentalisation under threat - the ability to consider other people’s intentions and mental states. Others become objects - either affirming or threatening. There is limited capacity to hold two minds in mind simultaneously, leading to:
The Three Non-Mentalising Modes
These modes are seen as developmental failures. When a person is stressed, their ability to mentalise breaks down, and they may revert to one of these less sophisticated modes of processing reality:
Psychic Equivalence: The internal world is experienced as equivalent to external reality. Thoughts and feelings are taken as absolute facts. This leads to concreteness of thought and a suspension of doubt.
Example: "I feel hurt so you must be criticising me”.
Pretend Mode (Pseudomentalising): Thoughts and feelings are entirely disconnected from external reality - mental bubbles without genuine emotion or action. Example: "I don't need to attend the meeting because these discussions are intellectually beneath me - the theoretical framework they're using is outdated and my time is better spent on research" (avoiding the real fear of being questioned).
Teleological Mode (or Teleological Thinking): Mental states and intentions are understood only through observable physical actions or concrete outcomes - there is a difficulty in tolerating ambiguity.
Example: "You say you love me, but you didn't physically embrace me when I arrived, so you must not love me."
In narcissistic patterns, these modes interact dynamically: psychic equivalence makes criticism feel like annihilation, pretend mode enables elaborate self-justification, and teleological mode demands constant proof of worth through achievement.
Clinical Presentation:
Marcus, now a successful surgeon, sought therapy as he lost interest in his wife, like in his previous marriages and wanted to see if he could save the marriage.
In therapy it was recognised that Marcus needed constant affirmation of his brilliance and generosity. When his wife expressed needs that didn't centre on him, he experienced this as indifference towards him. When she wanted emotional intimacy, he felt suffocated. He would fantasise about being idealised; any request for mutuality felt like criticism.
Beneath the confident exterior was a terrorised child who learned that only perfect performance earned attention. His surgeon father had ignored him unless he excelled; his depressed mother used him as emotional support, praising him for being "her little man." His true self - playful, sensitive, sometimes uncertain - was never welcomed. Surgery became his arena for maintaining the idealised self - he was God-like, in control, unquestionably competent.
Acknowledging Marcus's courage the first time he cried when feeling vulnerable - by saying something like “Something real is emerging, this takes courage” - is a response that is neither inflated ("You're so brave!") nor deflated ("Everyone cries"), but one that recognises the genuine risk he was taking.
A Mindful Flow Check-In for Narcissistic Patterns
This can be used in therapy or independently:
Persecutor → Challenger (Truth)
"Am I performing or relating?"
"Which part is leading right now - the idealised self, the critic, the child?"
Therapy begins by gently naming the cost of maintaining the façade: exhaustion, isolation, emotional poverty. Challenges target the pattern, not the person, preserving dignity while loosening the grip of the idealised self.
Victim → Creator (Courage)
"What small truth can I risk at this moment?"
"Can I stay present without inflating or collapsing?"
Authenticity grows through tiny risks: admitting not knowing, allowing imperfection, accepting ordinary dependency. Each act of real self-exposure becomes evidence that vulnerability is survivable.
Rescuer → Coach (Love)
"How can I meet this part without contempt?"
"What does the younger part in me need to feel safe right now?"
Stable, non- inflating recognition allows the person to feel seen without collapsing into shame. Done repeatedly, these check-ins build meta-awareness and soften the rigidity of the old self-system.
The Restoration of Recognition
The upward spiral:
Truth: Gradually acknowledging the false self as construct rather than identity. "The surgeon is something I do, not who I am."
Courage: Taking risks to show vulnerability. Marcus began admitting mistakes in session, then with trusted colleagues.
Compassion: Developing genuine empathy - first for the wounded child within, then for others as separate beings with their own pain.
Justice: Recognising the unfairness of what happened ("I shouldn't have had to be perfect to be loved") without using it as an excuse for insensitive behaviour and being overly critical towards others.
Responsibility: Owning the impact of narcissistic behaviours on others while understanding their origin.
Forgiveness: Releasing the impossible standard of perfection - forgiving the self for being human.
Recognition: The pivotal transformation - discovering inherent worth independent of achievement. Marcus described this as "learning I matter even when I'm not saving lives."
Gratitude: Appreciating others not as mirrors but as separate beings who choose to connect.
Love/Oneness: Moving from needing to be special to recognising shared humanity.
The Mentalisation Bridge
Throughout treatment, developing mentalisation capacity is crucial. Marcus learned to hold multiple perspectives: his need for recognition and his wife's need for intimacy; his fear of ordinariness and his exhaustion from performing; others' criticism and their care. This capacity to hold complexity without splitting into idealisation/devaluation represents the development of psychological flexibility.
Towards the end of therapy, he commented: "I realise that my wife wasn't attacking me when she asked for emotional connection, and I now also recognise her bids for connection as well as her own narcissism - when she just wants to talk at me rather than to connect with me, which I am starting to see in myself too. We are still not all the way there, but we are both learning to communicate our needs while recognising each other's humanity."
This mutual recognition - seeing both self and other as complex beings capable of both narcissistic defense and genuine connection - represents the movement from splitting to integration, from object-relating to subject-relating.
Integration: From Glory to Dignity
The journey from narcissistic patterns to authentic selfhood involves being sensitive enough not to deflate grandiosity into shame but to accept and foster self-acceptance and help build the path towards dignity. The person learns they are neither as special as the false self claims nor worthless as the wound believes. The idealised self turns into what Horney refers to as actualising the real self; the wounded self is seen and supported with compassion and recognition and is integrated in each act of recognition.
Marcus's recovery wasn't complete - narcissistic patterns (neural networks) over decades don't disappear, but reconnect in newer ways. He developed what he called a " narcissism radar": the ability to notice when he was performing rather than being, when he was using others as mirrors rather than seeing them. Most importantly, he learned that the terrified child within mattered simply because he was. Moreover, he also recognised that he at times had fallen for the trap of feeling narcissistic about his own recovery and feeling righteous, but he recognised this as narcissism as he also began thinking of his real self not as his ego, but the awareness that witnesses both the grandiose and wounded parts - the oneness he feels when he truly connects with himself and others without needing to be special or fearing he's nothing.
11. Borderline Patterns - The Fragmented Self and the Terror of Abandonment
Note on terminology: I use the term “borderline patterns” rather than Borderline Personality Disorder (BPD) because the diagnostic label is widely experienced by many clients as pathologising, stigmatising, and implying a fixed defect in personality, when the evidence shows these difficulties usually arise from early relational trauma, attachment disruption, and overwhelmed nervous-system responses rather than from an inherently “disordered” personality. Research and service-user accounts consistently show that many people feel dismissed, blamed, or stereotyped once the term BPD appears in their notes, even though the underlying experiences - intense emotions, fear of abandonment, rapid shifts in self-state, and difficulties maintaining cohesion - are understandable adaptations to earlier environments. Describing these as patterns allows us to focus on the psychological processes involved, acknowledge the wide spectrum of severity, reduce stigma, and reflect modern trauma-informed and developmental perspectives, while still honouring that some people find the formal diagnosis helpful.
Within the Spiral framework, what we call "borderline" patterns represent not a border between neurosis and psychosis (as historically conceived) but a profound fragmentation at the level of Recognition and Love - a developmental disruption so early and pervasive that the very capacity to hold a stable sense of self and other becomes compromised.
Where narcissistic patterns construct an idealised false self to defend against Recognition wounds, borderline patterns never developed sufficient cohesion to maintain even a false self consistently. The person oscillates wildly between contradictory self-states, each feeling absolutely real in the moment, with little continuity between them.
This is consistent with Melanie Klein’s description of the paranoid–schizoid position, where the infant initially splits self and other into “all good” and “all bad” objects, unable to integrate ambivalence (Klein, 1946/1975). In healthy development, caregivers’ sufficient attunement and repair allow movement towards the depressive position, where loved others are experienced as whole - both good and “bad” (the famous phrase “good breast and bad breast”. In borderline organisation, repeated ruptures, trauma, or misattunement arrested the development of Self and perception of others’ in a chronic oscillation between these poles . Partners, therapists, and the self are experienced either as perfect saviours or malevolent persecutors, with limited capacity to hold mixed feelings.
As with narcissistic patterns, this fragmentation stems from a breakdown in the development of mentalisation - the capacity to understand self and others as having minds with thoughts, feelings, and intentions. When early attachment relationships are characterized by fear, unpredictability, or what Main and Hesse (1990) call frightened/frightening caregiver behavior, the child faces an impossible dilemma: the source of comfort is also the source of threat. This creates what Main and Solomon (1986) term disorganized attachment - a collapse of coherent self–other representation that forms a core foundation of borderline personality organisation (Liotti, 2004).
The Spiral's Perspective: When Love's Container Never Formed
In borderline patterns, the absence of early containing love prevented the development of the psychological structures (Truth as self-cohesion, Courage as agency) that would allow Love to flow in regulated ways. The person experiences Love as an overwhelming need rather than nourishing connection because they lack the internal architecture that parental love should have helped build.
In borderline patterns, the absence of early containing love prevented the development of the psychological structures - Truth as basic self-cohesion (“I am someone”) and Courage as agency (“I can act”) - that would allow Love to flow in regulated ways. Love’s distortion is experienced as Protector / Rescuer in “firefighter mode” experiencing raw attachment panic: desperate need fused with terror of loss.
This helps explain why many people with borderline patterns enter or remain in abusive or chaotic relationships - not because they “like drama”, but because unpredictable, intense relating is what their nervous system recognises as love. Familiarity is what’s closest to safety - it becomes the template.
The therapeutic task becomes providing the containing love that was missing - not just interpretation or skills, but a consistent, boundaried relationship within which Truth and Courage can finally develop. The therapist temporarily functions as auxiliary container until the client can begin to internalise this function.
In this process, the client may idealise the therapist (“You’re the only one who understands me”) or attack/denigrate them (“You’re just like everyone else; you don’t care”). A helpful therapeutic stance, drawn from mentalisation-based treatment (Bateman & Fonagy, 2006), involves:
Staying steady and non-defensive
Naming the pattern gently (“It seems I’m sometimes in the role of perfect and sometimes in the role of enemy”)
Keeping both experiences in mind, modelling integration: “Part of you feels deeply seen here; another part feels let down and angry.”
The therapist avoids retaliating, rescuing, or withdrawing, and instead maintains curiosity and connection - embodying the Empowerment Triangle’s Coach and Challenger roles.
When hurtful comments are made: “I want to stay connected with you, and I’m noticing I feel a bit hurt by how that was said. I’m here, and I’m not going anywhere - but I need us to slow down so we can understand what’s happening together.”
When the client shouts or becomes verbally aggressive: “I can hear how distressed you feel, and I want to stay with you. I also need you not to shout at me, because it makes it harder for me to stay present and really understand what you’re going through. Let’s see if we can bring the intensity down just a little so we can keep talking.”
These responses do several things simultaneously:
Truth (Spiral Level 1): The therapist accurately names the relational reality- not to shame, but to bring shared reality into the room.
Courage (Spiral Level 2): The therapist remains present in the relationship rather than withdrawing, retaliating, or placating.
Love (Spiral Level 3): The therapist expresses care for the connection and for the client’s emotional state, setting a boundary to protect both.
Recognition (Spiral Level 7): The therapist recognises the client’s distress without collapsing into their emotional storm.
Justice + Responsibility (Levels 4–5): The boundary models fair, reciprocal relating - “Your feelings matter, and so do mine.”
Unlike narcissistic patterns where Recognition is distorted but sought through performance, in borderline patterns Recognition itself is unstable - "Who am I?" shifts moment to moment based on relational context. The person might feel completely different with different people, not as conscious adaptation but as genuine identity confusion. One client described it: "I don't know if I'm pretending to be different people or if I actually become them. When I'm alone, it’s as if I didn't exist."
The Drama Triangle on Fire
While narcissistic patterns involve relatively stable (if maladaptive) Drama Triangle positions, borderline patterns involve rapid, intense cycling through all three roles - sometimes within minutes:
The Victim experiences genuine terror of abandonment: "Everyone leaves me, I'll die alone, I'm too much for anyone to love." This isn't manipulation but felt reality - the person truly experiences annihilation anxiety when facing separation.
The Persecutor emerges with shocking intensity when abandonment seems imminent: "You never loved me, you're just like everyone else, I hate you." This rage isn't calculated but explosive - a desperate attempt to destroy the other before being destroyed - an enactment of the paranoid–schizoid split.
The Rescuer appears in frantic attempts to merge: “I’ll be whatever you need; I’ll save you; we’re meant to be together.” This is survival-driven enmeshment - if I become indispensable, perhaps I won’t be abandoned.
The key distinction with narcissistic patterns lies in cohesion and mentalisation capacity:
narcissistic patterns maintain a relatively stable (though false) self that requires specific conditions (admiration, control) to sustain. The person can mentalise when not threatened. Their relationships are exploitative but organised around consistent goals (maintaining the idealised self). Whereas, borderline patterns lack even this stability. The self fragments under stress into contradictory parts and mentalisation collapses under perceived threat. Relationships are genuinely chaotic; the person cannot hold a consistent view of self or other.
A narcissistic person might think: "I need you to admire me so I can maintain my sense of superiority." A borderline person might think: "I need you to exist so I can exist, and I'm terrified you'll destroy me by leaving."
Clinical Presentation: Living in Emotional Fire
Maria, 28, sought therapy after her second psychiatric hospitalisation following a suicide attempt when her partner threatened to leave. Her history revealed a childhood of chaos: an alcoholic mother who oscillated between smothering affection and rageful rejection, a father who sexually abused her while telling her she was "special," and multiple placements in foster care where she experienced further abuse.
Maria described her internal experience as "living without skin" - every emotion was excruciating, every relationship felt like life or death. She would meet someone and within days feel they were her soulmate, only to decide weeks later they were evil and trying to destroy her.
She self-harmed not for attention but for regulation. "Physical pain is more bearable than emotional pain. It’s like seeing my emotions leak out as blood - then tending to the wounds feels like self-care.”
Her sense of self shifted dramatically: with her therapist, she was a wounded child seeking care; with romantic partners, she alternated between seductive adult and helpless infant; when alone, she felt anxious or numb - like "static on a TV - not even nothing, just noise."
The Mindful Flow Adaptation: Building Structure in Chaos
Standard Mindful Flow practices (e.g., reflective check-ins) can easily overwhelm someone with a borderline personality structure in crisis. Asking “What am I feeling?” when emotions are already at 110% is like asking someone caught in a tornado to describe the wind.
The approach therefore needs sequencing and titration:
Grounding Before Awareness (Modified Truth)
When dysregulated, asking “what's true?", starts with "What can I see, hear, touch right now?" Sensory anchors are essential before attempting emotional awareness. "My feet are on the floor" before "I feel abandoned".
Micro-Dosing Action (Modified Courage)
Instead of "What action aligns with values?", the first step is:“What can I safely do in the next five minutes?” For example: “I will not act on this urge for five minutes.” “I will text my therapist / crisis line instead of my ex.” “I will hold an ice cube / do paced breathing.”
Borderline patterns involve future-blindness during dysregulation; Courage must be scaled to immediate, achievable acts.
Co-Regulation Before Self-Soothing (Modified Love)
Asking “How can I be kind to myself?” can feel impossible when the internal world is dominated by contempt and shame. The earlier developmental step is: “Who can I reach out to who feels safe enough?” and, “Can I let them know I’m struggling without asking them to fix everything?” Trusted friends, partners, or crisis services can serve as temporary external regulators, alongside the predictable rhythm of weekly therapy sessions. (Some DBT-informed therapists offer limited crisis coaching between sessions, though this is not universal and must be clearly defined during initial contracting so expectations remain safe and boundaried.) Over time, through repeated experiences of being held with steadiness rather than abandonment, the client gradually internalises co-regulation. From this foundation, genuine self-compassion can begin to grow.
EMDR, IFS, and the Spiral: Working with Parts and Trauma
Given the high prevalence of complex trauma in borderline presentations, EMDR and IFS can both be powerful - provided there is enough stabilisation.
IFS helps map the internal system: Exiles holding abandonment, shame, and terror; Managers trying to control relationships (people-pleasing, testing, pushing away); Firefighters using self-harm, substances, or rage to shut down intolerable affect.
From a Spiral lens, therapy supports the emergence of a Self/Level-10 witness capable of Truth (“these are parts”), Courage (approaching rather than exiling them), and Love (compassionate inner leadership). EMDR, once parts feel safer and stabilised, can target key traumatic memories,abandonments, humiliations, abuse episodes that drive current reactivity. Bilateral stimulation allows the nervous system to process these events while anchored in present safety, gradually weakening the link between present triggers and past terror. In combination, IFS and EMDR can help the system move from recurring, unintegrated flashbacks (emotional or somatic) to narrative continuity: “This happened to me; it was not my fault; it is over now; I am here.”
The Path Through: From Fragmentation to Integration
Given the depth of developmental disruption, healing borderline patterns often requires what Kernberg (1984) calls structural change = the building of psychological capacities that never fully developed. In Spiral terms, the work gently reactivates and sequences the levels:
Safety Before Truth (Level 1 – Truth / Reality) Establishing enough external stability - consistent therapy, predictable contact, sometimes medication - for the person to begin observing internal states without drowning in them. This is Clarkson’s (1995) reparative relationship: the therapist providing what the parent could not - reliable attunement, limits, and care.
Co-Regulation Before Courage (Level 2 – Courage) Learning to use relationships for soothing, not solely for fusion or attack. The client experiments with expressing feeling (“I’m scared you’ll leave”) without escalating into threat (“If you leave, I’ll hurt myself”) and experiences that the relationship can survive. Over time, this builds earned security (Bowlby, 1988; Fonagy et al., 2015): a gradually internalised sense that others can be stable enough and that the self can survive disappointment.
Compassion and Justice (Levels 3–4 – Compassion and Justice/Fairness) As stabilisation grows, the client begins to see their history through a more compassionate lens: “No child should have had to endure what I endured.” “It makes sense that I react this strongly.”
Justice here is not about blame but about accurate apportioning of responsibility: recognising both the reality of harm done and the limits of what can now be changed.
Responsibility and Forgiveness (Levels 5–6). When Compassion and Justice are processed, Responsibility can safely emerge: taking ownership of one’s behaviour without collapsing into shame; making reparative choices in relationships; practising alternative responses to triggers.
Forgiveness may eventually extend both to self (“I did what I could with what I had”) and, cautiously, to others - not as excusing harm, but as releasing the grip of resentment on the nervous system.
Recognition, Gratitude, Love/Oneness (Levels 7–9) As the sense of self stabilises, the client can begin to experience Recognition: “I am someone; I have continuity; I matter.”
Gratitude may emerge - not for the trauma (except for in Post-traumatic growth as explained previously), but for the strength that endured it and the relationships that made healing possible. Love/Oneness appears in moments where self and other are experienced as separate yet deeply connected: intimacy without fusion, conflict without annihilation.
12. Complex PTSD — When Trauma Becomes Identity
In practice, Complex PTSD (CPTSD) and borderline presentations often look and feel very similar. Both can involve intense affect, unstable relationships, dissociation, and profound shame. For many clients, the path to healing - rebuilding trust in experience (Truth), reclaiming agency (Courage), and relearning connection (Love) - is essentially the same. This is why, in day-to-day therapy, the distinction can be more theoretical than practical.
That said, there are two differences that sometimes matter for formulation, pacing, and therapeutic emphasis.
First, people who meet criteria for CPTSD often present with a more persistent, global negative identity: not “I keep becoming different selves depending on who I’m with,” but “I know what I am: broken, dirty, unlovable.” In borderline organisation, the sense of self tends to fracture and swing with relational context; in CPTSD, identity is more stable but globally self-condemning. This is not absolute - many clients show features of both - but it can guide where we begin.
Second, in CPTSD there is frequently a long history of repeated, inescapable trauma during development (Herman, 1992; van der Kolk, 2014), often accompanied by chronic invalidation and enforced silence. Over years, this “living curriculum” teaches the child that their perceptions are unsafe, that endurance is the only courage available, and that “love” is fused with fear, obligation, and self-erasure. By adulthood, meanings have been learned - not just reactions - and much of the work involves gently re-teaching what Truth, Courage, and Love actually are. (None of this rests on caregiver “intention”; it describes outcomes over time. And yes: many clients with a BPD diagnosis have lived through the same conditions.)
Within the Spiral model, this gives CPTSD a particular starting stance. In borderline presentations, we often stabilise a fragmented self and help mentalisation hold under abandonment threat. With CPTSD, we more often start by unlearning an identity authored by trauma: helping Truth become trustworthy again, helping Courage expand beyond stoic survival, and helping Love disentangle from trauma-bonded templates. The overlap is enormous - but these emphases can change the order and pace of the work.
Mindful Flow for CPTSD: restoring Truth, enlarging Courage, relearning Love
As with people living with Borderline Personality Disorder (BPD), Mindful Flow still means the moment-to-moment alignment of Challenge × Skill × Value Congruence × Awareness, but the challenge is calibrated to prevent overwhelm. Rather than pushing to “feel more” or “go deeper,” we begin by making Truth safe enough to approach, Courage small enough to choose, and Love boundaried enough to trust.
Truth as safety, not exposure
We privilege reality-testing that is immediately stabilising. Two anchors:
“What do my senses confirm right now?” In session: “Feet on floor; back on chair. I see the window, the plant, your pen. I hear the fan. My heart’s fast; breath is moving.” Out of session (queue/train): “Three things I can see (red sign, yellow bag, door), two I can feel (phone in hand, shoes on toes), one I can hear (announcements).”
“What support is available in this room?” In session: “You’re here; we agreed we can pause. Water’s on the table; door’s unlocked; I can ask for a break.” At home/work: “Phone is charged; I can message Sam for a five-minute check-in; there’s a quiet room I can step into; kettle, garden, shower are options.”
Courage as choice, not endurance
Many clients are heroic endurers. We pivot Courage into agentic micro-action - chosen, specific, tolerable:
Micro-boundaries: “I need a five-minute pause.” / “I’m not able to discuss this now; let’s return to it tomorrow.”
One-minute ignition: open the document; write the title; put one plate away; step outside for two breaths.
Impulse containment: “For the next five minutes I will not act on this feeling; I’ll text my safe person instead.”
Body-led approach: stand; feel soles on floor; one slow lap round the room; two extended exhales (4–6).
Each act is small by design. Courage is chosen movement, not white-knuckled endurance.
Love as consent, not appeasement
Connection is practised with reciprocity and limits - compassion with boundaries:
Consent-based asks: “I’m struggling - could you sit with me for ten minutes on the phone? No advice needed.” / “Could we sit side-by-side quietly?”
Boundaried care (for self and other): “I care for you, and I’m not able to lend money.” / “I want to keep talking, but I need a five-minute break first.”
Therapy frame as Love: “We can slow down; we don’t have to go deeper today.” / “If this spikes, we’ll ground first.”
Self-talk that doesn’t appease the inner critic: “Of course this is hard - and I’m here with me. We’ll take this in sips.”
Practised this way, Love becomes trustable: connection that honours limits rather than requiring self-erasure.
These shifts keep the system within a tolerable window, allowing Flow to arise from congruence, not compulsion.
EMDR, IFS, and Sequencing: What to Emphasise in Complex Presentations
In complex trauma presentations, the tools are familiar - phase-oriented work, EMDR, parts-informed therapy, and compassion-based regulation - but their order, pacing, and framing matter more than usual. The clinical priority is to make Truth safe enough to contact, broaden Courage from endurance to choice, and let Love be practised as consent and co-regulation before deeper processing. This section sets out how that looks in practice and how it interfaces with the Spiral’s movement from disconnection toward coherence.
Phase-oriented pacing
Stabilisation is not a prelude; it is a primary therapeutic goal. Before trauma memory networks are approached, we establish foundational truth and predictable containment: sensory anchoring (“Feet on floor; back on chair; breath is moving”), environmental checks (“Water is here; door is unlocked; we can pause”), and brief state-shifting practices (extended exhale; bilateral taps) are rehearsed until they are dependable habits. Only when the client can find the present on demand do we proceed. This is classic phase-based care (Herman, 1992; Cloitre et al., 2012) and dovetails with the Spiral: Truth as orientation, Courage as micro-choice, Love as boundaried care.
Therapeutic stance. Session structure and boundaries carry as much weight as techniques: clear start/stop times; explicit permission to slow or stop; collaborative agendas; and written safety plans that translate into daily life. Compassion is framed as nervous-system permission (“You are allowed to rest.” “You are allowed to take up space.”), not as an abstract virtue.
EMDR: targets, titration, and meanings that must change
With EMDR, target selection leans toward moral injury, silencing, and enforced meanings rather than only those that peak fear. Prototypical targets include “It was my fault,” “This is love,” “No one will believe me,” or the first time a boundary was punished. The intent is not catharsis but accurate attribution and self-forgiveness: Truth restored to the event; responsibility placed where it belongs; dignity re-claimed (Shapiro, 2018).
Processing is titrated: short sets, frequent returns to present anchors, and explicit choice points (“Do we stay, pause, or resource?”). The “dual attention” inherent in EMDR parallels the Spiral’s oscillation: brief contact with disconnection, immediate return to connection, then back again until coherence emerges. When abandonment terror or shame floods, we switch lanes to resourcing (as outlined in the earlier trauma section) rather than pushing through. Attachment-focused EMDR methods (resource development/installation; compassionate imagery; time-line repair) are particularly useful where early caregiving failures dominate the landscape (Parnell, 2013, 2019).
IFS: mapping protectors and negotiating new roles
Parts-mapping reliably reveals loyal protectors that equate boundaries with danger and visibility with punishment. We honour their historic intelligence - “You kept me alive” - before we negotiate a contemporary brief: protecting sleep, deciding who is ‘safe enough,’ guarding the calendar, cueing the “pause and check” script. Persecutory inner critics are reframed as anxious Challengers whose function can be upgraded from attack to discernment. Exiles are approached indirectly and briefly, anchored by present-day resources and the therapist’s steady co-regulation (Schwartz, 2013).
In Spiral terms, the Persecutor → Challenger, the frantic Rescuer → Coach, and the collapsed Victim → Creator who takes one chosen step. Where borderline features are prominent, the IFS work stays tighter to the edges: more time with protectors, shorter windows with exiles, and frequent mentalisation prompts (“What might your part be feeling? What might their part be feeling?”) in line with guidance already given in the Borderline Patterns section.
Compassion as permissions
For many clients, “be kind to yourself” lands like an accusation. We translate compassion into operational permissions that the nervous system can enact:
“You are allowed to pause before answering.”
“You are allowed to say ‘not today’.”
“You are allowed to leave a room and ground.”
These permissions embody Love as consent with boundaries, not appeasement. They are practised first in session, then in low-stakes contexts at home, then in progressively braver arenas.
How the Spiral turns in complex trauma
The Spiral’s arc is recognisable - Truth, Courage, and Love iteratively integrating across the nine levels - but the first returns typically look like this:
Truth stops accusing and starts orienting: “What happened was wrong; my perception matters.”
Courage widens from stoic endurance to chosen micro-action: one boundary, one “no,” one self-care step.
Love decouples from fear and obligation, becoming consent-based care - for self first, then others.
Justice is reclaimed as accurate placement of responsibility - neither self-blame nor vengeance.
Forgiveness (if it comes) begins as self-forgiveness, never a bypass of accountability.
Recognition stabilises as dignity that does not require perfection or appeasement.
Gratitude emerges not for the trauma, but for the life that persisted, although as in PTSD in optimal cases it can develop into Post Traumatic Growth.
If this arc sounds close to that outlined for borderline patterns, that is deliberate: the lived work is largely the same. Where we notice a difference in complex trauma, it is chiefly tempo (longer on-ramps to restore trust in Truth) and emphasis (shifting Courage from endurance to choice). Once those foundations are established, the Spiral climbs in familiar ways.
Sequencing when presentations overlap (CPTSD/BPD or Borderline Patterns)
When complex trauma features mingle with borderline organisation, run two tracks in parallel and let arousal/mentalisation capacity determine which leads in any given session.
Stabilise the self (Track A): predictable frame and time-boundaries; brief, frequent grounding/orienting; explicit rupture – repair and limit-setting; simple mentalisation prompts (self/other/both); between - session containment plans and agreed crisis parameters. Prioritise “Truth as safety”, “Courage as choice”, “Love as consent”. (Bateman & Fonagy, 2006; Herman, 1992.)
De-programme trauma meanings (Track B): EMDR targets that reverse perpetrator logic (e.g., “It was my fault/This was love/No one will believe me”) with titrated sets and frequent returns to present safety; IFS negotiations that honour protectors and upgrade roles from survival to stewardship; graded practice of consent-based connection (small boundaries, chosen disclosures, safe refusals). (Shapiro, 2018; Schwartz, 2013.)
Switching rule: if dissociation, shame spikes, or abandonment threat appear → Track A; when dual awareness and mentalisation are intact → Track B.
The sequence is responsive: if abandonment threat collapses mentalisation, we return to stabilisation; if shame blocks responsibility-taking, we restore Justice before pushing Forgiveness; if exposure tips into overwhelm, we downshift to present-moment Truth.
A note on diagnosis, language, and what helps
Because phenomenology overlaps strongly, it is clinically sound to treat the CPTSD/BPD distinction as secondary to a shared formulation:
For instance, using three formulation questions across both CPTSD and borderline presentations to locate where the Spiral is breaking and to sequence the work:
Where has Truth become unsafe?
Forms: global self-bad (shame, self-attack), global other-bad (projection, devaluation), or rapid switching between them.
Move: Truth-as-safety — here-and-now sensory orientation; consensual reality checks (“What do I know for certain right now?”); gentle mentalisation prompts (“What else could be true?”); differentiate facts from trauma-authored meanings. If self-bad dominates, explicit shame work and self-compassion is recommended; if other-bad dominates, add accurate attribution and boundary clarification; if switching, slow arousal and stabilise perspective before any processing is likely the best option.
Where has Courage narrowed to survival?
Forms: crisis-only mobilisation; avoidance of ordinary choice.
Move: Courage-as-choice — agentic micro-actions (one boundary, one email, one hour of rest); proportionate risks; titrated exposure to feared cues.
Where has Love been learned as self-abandonment?
Forms: appeasement/fusion, or punitive withdrawal.
Move: Love-as-consent - limits and reciprocity; co-regulation without over-giving; compassion practices framed as permissions (“You’re allowed to pause/take space/ask for help”).
These answers don’t distinguish CPTSD from BPD; they pace the work (stabilise vs. process; skills vs. parts-work) and reduce re-traumatisation. The label still matters for access to care and a client’s felt recognition; in my opinion it's best to choose language that supports responsibility without shame, and movement without overwhelm.
This is part 4 of Mindful Flow in Clinical Contexts: Applying the Archetypal Spiral. The previous blogs covered Depression, Generalised Anxiety, Trauma, Obsessive Compulsive Disorder (OCD), Panic, Social Anxiety, Relational Patterns, ADHD and Addictions.
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