Borderline Bodies, Interpersonal Trauma, and Sexual Identity Diffusion

At the roots of all severe borderline psychopathology, there is interpersonal, intergenerational trauma that interferes with the capacity for affect regulation. Affect dysregulation—fluctuation in moods, impulsivity, and destructiveness—is often directed against the body as a result of disconnection and dissociative alienation, influencing, among other things, feelings about sexuality and gender identification. For some borderline patients, complex interpersonal trauma thus leads to an instability of mood and self-image that interferes with the formation of gender and sexual identity, which I call “sexual identity diffusion”: the instability of feelings of belonging to one gender or embodying gender and sexual identities. The elaboration of traumatic experiences that have led to unconscious self-destructive and self-alienating feelings (resulting from the identification with one or multiple aggressors introjected and turned against the body-self) helps to free the mind-body system, allowing borderline patients to feel more comfortable in any gender or sexual position/identity resonating as true to themselves.