--- title: "Meaning & Key Takeaway of: ... as Herman (1992b) cogently noted two…" description: "\"“... as Herman (1992b) cogently noted two decades ago, these personality disorders can be iatrogenic, causing harm to individuals as an inadvertent res..." image: "https://sms4smile.com/quotes/i/dfb/christine-a-courtois-31916_borderline-personali_as-herman-1992b-cogently-noted-two-decad_962913.jpg" --- # ... as Herman (1992b) cogently noted two decades ago… ![“... as Herman (1992b) cogently noted two decades ago, these personality disorders can be iatrogenic, causing harm to individuals as an inadvertent result of the social stigma they carry and the widespread (but not entirely accurate) belief among professionals and insurers that those with Cluster B…” quote by Christine A. Courtois](https://sms4smile.com/quotes/i/dfb/christine-a-courtois-31916_borderline-personali_as-herman-1992b-cogently-noted-two-decad_962913.jpg) [Download](https://sms4smile.com/quotes/i/dfb/christine-a-courtois-31916_borderline-personali_as-herman-1992b-cogently-noted-two-decad_962913.jpg) [Open image](https://sms4smile.com/quotes/i/dfb/christine-a-courtois-31916_borderline-personali_as-herman-1992b-cogently-noted-two-decad_962913.jpg) > ““... as Herman (1992b) cogently noted two decades ago, these personality disorders can be iatrogenic, causing harm to individuals as an inadvertent result of the social stigma they carry and the widespread (but not entirely accurate) belief among professionals and insurers that those with Cluster B personality disorders (especially borderline personality disorder\[BPD\]) cannot be treated successfully, cannot recover, and are a headache to practitioners. For example, the BPD diagnosis continues to be applied predominantly to women often, but not always, in a negative way, usually signifying that they are irrational and beyond help. Describing posttraumatic symptoms as a personality disorder not only can be demoralizing for the client due to its connotation that something is defective with his or her core self (i.e., personality) but also may misdirect the therapist by implying that the patient's core personality should be the focus of treatment rather than trauma-related adaptations that affect but are distinct from the core self. In this way, both therapists and their clients may overlook personality strengths and capacities that are healthy and sources of resilience that can be a basis for building on and enhancing (rather than "fixing" or remaking) the patient's core self and personality.”” [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) ## About This Quote This interpretation was drafted with AI assistance. It is one reading of the quote, not the author's own explanation. Labeling personality disorders as untreatable can cause stigma, demoralization, and misdirected treatment, overlooking resilience and strengths. **In simple terms:** Stigma harms patients and misguides therapy. Key Takeaway Recognize strengths, focus on trauma adaptations, not core personality. Themes stigma misdiagnosis resilience therapy gender bias Mood concerned reflective Type clinical educational When to use this quote - clinical assessment - therapeutic planning - patient empowerment - gender-sensitive practice Key Concepts iatrogenic harm clinical bias trauma-informed care Questions to Reflect On - How can clinicians balance diagnostic clarity with avoiding stigma? - What strengths can be leveraged in treatment? A Different Perspective Stigma may persist despite education; systemic change is slow. ★ ★ ★ ★ ★ No ratings yet [Borderline Personality](https://sms4smile.com/quotes/about/borderline-personality/) [Borderline Personality Disorder](https://sms4smile.com/quotes/about/borderline-personality-disorder-2/) [Childhood trauma](https://sms4smile.com/quotes/about/childhood-trauma/) [Complex-ptsd](https://sms4smile.com/quotes/about/complex-ptsd/) [Complex-trauma](https://sms4smile.com/quotes/about/complex-trauma/) [Patience](https://sms4smile.com/quotes/about/patience/) [Personality disorder](https://sms4smile.com/quotes/about/personality-disorder/) [Personality disorders](https://sms4smile.com/quotes/about/personality-disorders/) ## Related quotes > [ “Sadly, psychiatric training still includes far too little on the very serious psychiatric sequelae of childhood trauma, especially CSA \[child sexual abuse\]. There is… ](https://sms4smile.com/quotes/joan-coleman/sadly-psychiatric-training-still-includes-far-too-little-on-the-very/) Joan Coleman > [“Many survivors of relational and other forms of early life trauma are deeply troubled and often struggle with feelings of anger, grief, alienation, distrust,…](https://sms4smile.com/quotes/christine-a-courtois/many-survivors-of-relational-and-other-forms-of-early-life-trauma-are/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Thus polyvictimization or complex trauma are "developmentally adverse interpersonal traumas" (Ford, 2005) because they place the victim at risk not only for recurrent stress…](https://sms4smile.com/quotes/christine-a-courtois/thus-polyvictimization-or-complex-trauma-are-developmentally-adverse/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Therapy must begin with empathy - not a patronizing sympathy, but instead one that is unflinching (Marotta, 2003). Empathy of this sort is highly…](https://sms4smile.com/quotes/christine-a-courtois/therapy-must-begin-with-empathy-not-a-patronizing-sympathy-but/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“If the therapist understands and does not take mistrust as personal affront, the therapeutic relationship can evolve gradually. The client can begin to recognize…](https://sms4smile.com/quotes/christine-a-courtois/if-the-therapist-understands-and-does-not-take-mistrust-as-personal/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“...some adolescent survivors describe feeling special, powerful, and sometimes entitled. This is especially true of those for whom excessive attention was part of the…](https://sms4smile.com/quotes/christine-a-courtois/some-adolescent-survivors-describe-feeling-special-powerful-and/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Trust of others is in short supply for many adult survivors, as complex trauma generally involves major relational betrayal. It is, therefore, expectable (although…](https://sms4smile.com/quotes/christine-a-courtois/trust-of-others-is-in-short-supply-for-many-adult-survivors-as/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“With regard to complex trauma survivors, self-determination and autonomy require that the therapist treat each client as the "authority" in determining the meaning and…](https://sms4smile.com/quotes/christine-a-courtois/with-regard-to-complex-trauma-survivors-self-determination-and/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [I think it's particularly clear in borderline personality disorder (BPD) that there's a strong association between early environmental deprivation and neglect and abuse and…](https://sms4smile.com/quotes/simon-baron-cohen/i-think-it-s-particularly-clear-in-borderline-personality-disorder/) [Simon Baron-Cohen](https://sms4smile.com/quotes/author/simon-baron-cohen/) > [“Kaffman (2009) described childhood victimization as a "silent epidemic", and Finkelhor, Turner, Ormrod, and Hamby (2010) reported that children are the most traumatized class…](https://sms4smile.com/quotes/christine-a-courtois/kaffman-2009-described-childhood-victimization-as-a-silent-epidemic/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“The act of consciously and purposefully paying attention to symptoms and their antecedents and consequences makes the symptoms more an objective target for thoughtful…](https://sms4smile.com/quotes/christine-a-courtois/the-act-of-consciously-and-purposefully-paying-attention-to-symptoms/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“The development of a working alliance is crucial because it addresses a psychic phobia associated with relationships that is common in complex trauma clients.…](https://sms4smile.com/quotes/christine-a-courtois/the-development-of-a-working-alliance-is-crucial-because-it-addresses/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“... every therapist must develop enough personal maturity, clinical wisdom, and capacity for good judgment to effectively and safely conduct psychotherapy, an imperative that…](https://sms4smile.com/quotes/christine-a-courtois/every-therapist-must-develop-enough-personal-maturity-clinical-wisdom/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“... the silent client may be experienced as withholding, oppositional, and sulking or as holding the therapist "hostage" in ways that elicit resentment and…](https://sms4smile.com/quotes/christine-a-courtois/the-silent-client-may-be-experienced-as-withholding-oppositional-and/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“The overarching principle of a therapeutic relationship is that therapists should be ever mindful of a variant of the Hippocratic oath and, to the…](https://sms4smile.com/quotes/christine-a-courtois/the-overarching-principle-of-a-therapeutic-relationship-is-that/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) ## More by Christine A. Courtois > [“The overarching principle of a therapeutic relationship is that therapists should be ever mindful of a variant of the Hippocratic oath and, to the…](https://sms4smile.com/quotes/christine-a-courtois/the-overarching-principle-of-a-therapeutic-relationship-is-that/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“... the silent client may be experienced as withholding, oppositional, and sulking or as holding the therapist "hostage" in ways that elicit resentment and…](https://sms4smile.com/quotes/christine-a-courtois/the-silent-client-may-be-experienced-as-withholding-oppositional-and/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Type II trauma also often occurs within a closed context - such as a family, a religious group, a workplace, a chain of command,…](https://sms4smile.com/quotes/christine-a-courtois/type-ii-trauma-also-often-occurs-within-a-closed-context-such-as-a/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Therapy must begin with empathy - not a patronizing sympathy, but instead one that is unflinching (Marotta, 2003). Empathy of this sort is highly…](https://sms4smile.com/quotes/christine-a-courtois/therapy-must-begin-with-empathy-not-a-patronizing-sympathy-but/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“If the therapist understands and does not take mistrust as personal affront, the therapeutic relationship can evolve gradually. The client can begin to recognize…](https://sms4smile.com/quotes/christine-a-courtois/if-the-therapist-understands-and-does-not-take-mistrust-as-personal/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“...some adolescent survivors describe feeling special, powerful, and sometimes entitled. This is especially true of those for whom excessive attention was part of the…](https://sms4smile.com/quotes/christine-a-courtois/some-adolescent-survivors-describe-feeling-special-powerful-and/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Trust of others is in short supply for many adult survivors, as complex trauma generally involves major relational betrayal. It is, therefore, expectable (although…](https://sms4smile.com/quotes/christine-a-courtois/trust-of-others-is-in-short-supply-for-many-adult-survivors-as/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“The act of consciously and purposefully paying attention to symptoms and their antecedents and consequences makes the symptoms more an objective target for thoughtful…](https://sms4smile.com/quotes/christine-a-courtois/the-act-of-consciously-and-purposefully-paying-attention-to-symptoms/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Kaffman (2009) described childhood victimization as a "silent epidemic", and Finkelhor, Turner, Ormrod, and Hamby (2010) reported that children are the most traumatized class…](https://sms4smile.com/quotes/christine-a-courtois/kaffman-2009-described-childhood-victimization-as-a-silent-epidemic/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“With regard to complex trauma survivors, self-determination and autonomy require that the therapist treat each client as the "authority" in determining the meaning and…](https://sms4smile.com/quotes/christine-a-courtois/with-regard-to-complex-trauma-survivors-self-determination-and/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Their experiences led them to create assumptions about others and related beliefs about themselves such as "this is my lot in life" and "this…](https://sms4smile.com/quotes/christine-a-courtois/their-experiences-led-them-to-create-assumptions-about-others-and/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“The development of a working alliance is crucial because it addresses a psychic phobia associated with relationships that is common in complex trauma clients.…](https://sms4smile.com/quotes/christine-a-courtois/the-development-of-a-working-alliance-is-crucial-because-it-addresses/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“... every therapist must develop enough personal maturity, clinical wisdom, and capacity for good judgment to effectively and safely conduct psychotherapy, an imperative that…](https://sms4smile.com/quotes/christine-a-courtois/every-therapist-must-develop-enough-personal-maturity-clinical-wisdom/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Thus polyvictimization or complex trauma are "developmentally adverse interpersonal traumas" (Ford, 2005) because they place the victim at risk not only for recurrent stress…](https://sms4smile.com/quotes/christine-a-courtois/thus-polyvictimization-or-complex-trauma-are-developmentally-adverse/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) > [“Many survivors of relational and other forms of early life trauma are deeply troubled and often struggle with feelings of anger, grief, alienation, distrust,…](https://sms4smile.com/quotes/christine-a-courtois/many-survivors-of-relational-and-other-forms-of-early-life-trauma-are/) [Christine A. Courtois](https://sms4smile.com/quotes/author/christine-a-courtois/) [Explore all 16 Christine A. Courtois quotes ](https://sms4smile.com/quotes/author/christine-a-courtois/) ## More Borderline-personality quotes > [“The theologian Paul Tillich wrote that "loneliness can be conquered only by those who can bear solitude." Because the borderline finds solitude so difficult…](https://sms4smile.com/quotes/jerold-j-kreisman/the-theologian-paul-tillich-wrote-that-loneliness-can-be-conquered/) Jerold J. Kreisman > [“There weren't as many layers between her and the world as there were with the rest of us.”](https://sms4smile.com/quotes/anonymous/there-weren-t-as-many-layers-between-her-and-the-world-as-there-were/) [Anonymous](https://sms4smile.com/quotes/author/anonymous/) > [ “Sadly, psychiatric training still includes far too little on the very serious psychiatric sequelae of childhood trauma, especially CSA \[child sexual abuse\]. There is… ](https://sms4smile.com/quotes/joan-coleman/sadly-psychiatric-training-still-includes-far-too-little-on-the-very/) Joan Coleman Browse all 4 Borderline-personality quotes ```json { "@context": "https://schema.org", "@graph": [ { "@type": "Quotation", "text": "“... as Herman (1992b) cogently noted two decades ago, these personality disorders can be iatrogenic, causing harm to individuals as an inadvertent result of the social stigma they carry and the widespread (but not entirely accurate) belief among professionals and insurers that those with Cluster B personality disorders (especially borderline personality disorder[BPD]) cannot be treated successfully, cannot recover, and are a headache to practitioners. For example, the BPD diagnosis continues to be applied predominantly to women often, but not always, in a negative way, usually signifying that they are irrational and beyond help. Describing posttraumatic symptoms as a personality disorder not only can be demoralizing for the client due to its connotation that something is defective with his or her core self (i.e., personality) but also may misdirect the therapist by implying that the patient's core personality should be the focus of treatment rather than trauma-related adaptations that affect but are distinct from the core self. In this way, both therapists and their clients may overlook personality strengths and capacities that are healthy and sources of resilience that can be a basis for building on and enhancing (rather than \"fixing\" or remaking) the patient's core self and personality.”", "creator": { "@type": "Person", "name": "Christine A. Courtois" }, "isPartOf": { "@id": "https://sms4smile.com/quotes/#website" }, "url": "https://sms4smile.com/quotes/christine-a-courtois/as-herman-1992b-cogently-noted-two-decades-ago-these-personality/", "about": { "@type": "Thing", "name": "Borderline-personality" }, "@id": "https://sms4smile.com/quotes/christine-a-courtois/as-herman-1992b-cogently-noted-two-decades-ago-these-personality/#quotation", "image": { "@type": "ImageObject", "@id": "https://sms4smile.com/quotes/i/dfb/christine-a-courtois-31916_borderline-personali_as-herman-1992b-cogently-noted-two-decad_962913.jpg", "contentUrl": "https://sms4smile.com/quotes/i/dfb/christine-a-courtois-31916_borderline-personali_as-herman-1992b-cogently-noted-two-decad_962913.jpg", "url": "https://sms4smile.com/quotes/i/dfb/christine-a-courtois-31916_borderline-personali_as-herman-1992b-cogently-noted-two-decad_962913.jpg", "width": 1080, "height": 1080, "caption": "“... as Herman (1992b) cogently noted two decades ago, these personality disorders can be iatrogenic, causing…” — Christine A. Courtois", "creditText": "SMS4Smile Quotes", "creator": { "@id": "https://sms4smile.com/quotes/#organization" } } }, { "@type": "BreadcrumbList", "itemListElement": [ { "@type": "ListItem", "position": 1, "name": "Home", "item": "https://sms4smile.com/" }, { "@type": "ListItem", "position": 2, "name": "Quotes", "item": "https://sms4smile.com/quotes/" }, { "@type": "ListItem", "position": 3, "name": "Christine A. Courtois", "item": "https://sms4smile.com/quotes/author/christine-a-courtois/" }, { "@type": "ListItem", "position": 4, "name": "“... as Herman (1992b) cogently noted...", "item": "https://sms4smile.com/quotes/christine-a-courtois/as-herman-1992b-cogently-noted-two-decades-ago-these-personality/" } ], "@id": "https://sms4smile.com/quotes/christine-a-courtois/as-herman-1992b-cogently-noted-two-decades-ago-these-personality/#breadcrumb" }, { "@type": "WebSite", "@id": "https://sms4smile.com/quotes/#website", "name": "SMS4Smile Quotes", "url": "https://sms4smile.com/quotes/", "publisher": { "@id": "https://sms4smile.com/quotes/#organization" } }, { "@type": "Organization", "@id": "https://sms4smile.com/quotes/#organization", "name": "SMS4Smile Quotes", "url": "https://sms4smile.com/quotes/", "logo": { "@type": "ImageObject", "url": "https://sms4smile.com/quotes/wp-content/themes/sq/assets/icons/icon-512.png", "width": 512, "height": 512 } } ] } ```