TFP and neurodevelopmental issues?

How many autistic women in analysis have been misdiagnosed with BPO, had TFP started, and declined because it’s not appropriate?

I hear many stories from women with autism about how they were misdiagnosed as borderline in various settings, including psychodynamic therapy, and then were essentially tortured.

Why is there not a section in the TFP manual or literally anywhere in diagnostic or treatment manuals warning practitioners to carefully weed out neurodevelopmental issues like autism (especially in women) before making the BPO diagnosis. I’m not saying they can’t co-exist, but (1) care needs to be taken and (2) even if co-existing, I imagine treatment should be modified.

Confrontations with an autistic folk sounds like a great way to cause confusion and overwhelm the nervous system. It seems to me much better interpretations would involve an explanation of the patients behaviour and why the confrontation, if any, is being made - yet, some with ASD in inappropriate TFP report that when they asked what the confrontation meant, the response was that their question was intentional evasion and they already knew.

It sounds like the situation has the potential to be borderline abusive and is not okay? Why no warning or discussion on TFP books or the like?

Posted Jun 3, 2026, 1:52 AM UTC

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