WORKSHOP DESCRIPTION:
Integrating developmental, relational, and neurobiological perspectives, this workshop moves beyond diagnostic silos toward a coherent, plain-language understanding of complex presentations. Many clients do not arrive neatly labeled; instead, they show overlapping experiences — impulsivity, fast mood shifts, attention that drifts or “goes offline,” dissociation (feeling unreal, going blank, shutting down), sensory overload, and recurring relationship crises. Others present with multiple labels related to neurodiversity, personality, or trauma, and billing and authorization systems often require selecting a “primary” diagnosis while the rest are coded as “comorbidities.”
The patterns we observe in these presentations often take shape within relational and developmental contexts (inconsistent caregiving, adverse childhood experiences) and interact with each person’s biology and life history. Rather than treating every overlap as “comorbidity,” we approach these as shared, brain–mind–body processes that can look similar across ADHD, borderline personality, PTSD, and dissociation — and are often mislabeled as separate conditions.
What often looks the same across these conditions
• Impulsivity and urgency (acting fast to stop discomfort)
• Emotional surges and quick flips (shame/anger/collapse that resolves just as quickly)
• Attention changes (losing the thread vs brief protective “check-outs”)
• Dissociation signs (far away/unreal, time gaps, blanking, autopilot)
• Interpersonal turbulence (push–pull, testing, all-good/all-bad under stress)
• Rejection/abandonment alarms (outsized reactions to lateness, distance, ambiguity)
• Sensory load and body shutdowns (overwhelm, freeze/collapse, numbness)
• Sleep/circadian strain and fatigue (downstream hits to mood, pain, attention)
• Somatic complaints (headaches, GI distress, chest tightness, often with normal lab results)
• Identity wobble and masking (self-image shifts across settings, people-pleasing then backlash)
• Coping — but harmful — behaviors: self-harm, substance use, eating dysregulation — short-term relief with long-term cost
• Hidden drivers: intrusive memories, shame, and conditioned expectations that mimic inattention or trigger acting-out.
While these clusters look similar, there are useful nuances. We’ll keep the language plain and operational, so these distinctions are usable across inpatient, outpatient, coaching, and school settings.
Impulsivity in ADHD is often tied to distractibility and task-escape; in PTSD it can show up as reckless/risk behaviors under trauma load; in borderline personality it may appear as self-destructive acts during intense distress. Inattention may be ADHD-style drifting, but it can also reflect intrusive trauma thoughts or destabilizing affect. Relationship strain likewise varies: PTSD is often marked by trust difficulties after trauma, while borderline patterns lean toward intense/unstable bonds with abandonment alarm. We will name these distinctions in language accessible to practitioners of various therapeutic modalities, so formulation stays clear.
We use the “iceberg” model to make sense of these overlaps. Surface behaviors (inattention, anger, quitting, self-harm, shutdowns) rest on submerged signs and symptoms: sleep/circadian strain, sensory load, chronic stress and shame, expectations about others (attachment alarms), body signals (interoception), and prediction habits (“what my system expects will happen next”). While often showcased for ADHD, this iceberg applies just as well to borderline personality and PTSD: beneath the waterline we also see shared relational patterns (abandonment alarm, masking, and difficulty holding a steady self-image under stress) and shared bodily signs and symptoms (over- or under-sensing, rapid shifts in arousal). We will treat these “iceberg” phenomena as with the Freudian iceberg metaphor of the psyche: what is unconscious has to become conscious, so we can work with it and integrate it.
Current research echoes this picture. Reviews of adult ADHD and borderline personality consistently identify impulsivity, emotional dysregulation, and interpersonal difficulties as shared features; and these patterns are difficult to separate in practice. They also point to shared early-life adversity and suggest that what used to be a simple “early-onset vs late-onset” split is less clear than once thought — supporting a NEURO-developmental, dimensional view. In short, the same person can look “comorbid,” but what we’re often seeing are overlapping processes that matured along different paths.
Functional PsychoNeuroBiology® (FPNB®): Core Concepts We’ll Use
We’ll use these FPNB® concepts to build one shared, plain-language map that clinicians can apply across ADHD, borderline personality, PTSD, and dissociation — linking surface behaviors to the brain–mind–body layers that drive them.
1) Brain–Mind Dyad
The brain and mind form one psychobiological system. They co-shape each other from the womb onward: experience changes neural organization, and neural organization shapes experience. This is the anchor for treating various behavioral presentations as brain–mind–body processes, not fixed labels.
2a) Paul MacLean’s Triune Brain (a working template)
Think of a three-story house:
- Ground floor (reptilian): safety, fight/flight/freeze foundations.
- Second floor (mammalian): emotion and sensory meanings.
- Third floor (human/cortical): planning, reflection, and integration.
FPNB® uses this as a clinical template for explaining why state shifts happen and how integration restores choice.
2b) Triune Brain Plus® (the autonomic bridge to the body)
Triune Brain Plus® connects the three floors to the body’s autonomic and interoceptive systems. It explains: “memories in the body,” why breath/posture/tempo change state, how self-regulation and co-regulation work, and why psychosomatic symptoms, emotional, body, and relational regulation are inseparable.
3) Brain Laterality Principle (Left and Right — together)
Health assumes integration of left-brain style (language, sequencing) and right-brain style (embodiment, context, affect) processing. When both hemispheric modes are recruited and coordinated, people experience a more coherent sense of self and steadier relationships.
4) Synaptic Pruning (neural gardening)
Experience continually builds new synaptic connections. Pathways that are used and rehearsed are stabilized and strengthened; pathways that are rarely used are pruned — selectively trimmed back, like cutting a plant so the active, healthy branches can receive more nutrients and flourish. Pruning doesn’t “clear a path”; it reallocates resources (metabolic support, receptor expression, glial/vascular support) to the circuits you use most. Clinically, this explains why long-rehearsed shortcuts are so accessible — and why newly practiced patterns become increasingly robust over time as neglected detours wither.
5) “Don’t Use It — Lose It!” (use-dependent biology)
Functions that are not rehearsed fade. This normal, economical principle motivates brief, frequent practice of desired patterns so they stick.
6) “Fire Together — Wire Together” (Hebbian pairing)
Events and emotions paired in time become linked via Hebbian plasticity (cell assemblies); later, a small cue can trigger the learned sequence.
Practice makes pathways — what we rehearse gets easier and more available under stress.
7) “Wire Together — Mature Together” (co-development)
Networks that work together develop together. Strengthening one pathway (e.g., body awareness) can lift allied functions (e.g., emotion labeling, impulse pause), supporting development across domains rather than piecemeal.
8) The Beholder’s Share (meaning-making)
Perception is co-created by brain and biography. Culture, education, prior experiences, and current state (including body state) shape the unique lens through which each person understands the world. Recognizing the Beholder’s Share normalizes differences in how events are appraised and frees meaning making from the constraints of others’ opinions, supporting creativity, personal growth, and individuality. Meaning-making matters — we use everyday language to help clients link sensations, memories, and stories without shame, comparisons, or self-doubt.
9) The Iceberg Phenomenon (overt ↔ submerged)
What’s visible “above the waterline” are overt symptoms and stated motivations—inattention, anger, quitting, self-harm, shutdowns, urgency, people-pleasing. These often mask or foreshadow what is submerged: unconscious or out-of-awareness feelings (shame, fear, grief), attachment expectations/alarms (abandonment, mistrust), self-worth evaluations, interoceptive patterns (numbness or hyper-reactivity), and prediction habits (“what my system expects will happen next”). FPNB® psychoeducation provides a shared, plain-language way to bring the submerged to the surface — so clients can work with previously hidden processes in therapy, coaching, or on their own. The aim is not just symptom reduction but expanded choice and agency as overt and submerged levels become integrated.
Many roads, more choices — the brain can re-route; building new “roads” (responses) means old emergency routes no longer have to be the only option.
We’ll also introduce key elements of neuro-organization (e.g., the reticular activating system for arousal/alerting; large-scale networks like default mode, salience, and central executive; connectome/cognitome as maps of wiring and functional organization) and core neuro-processes (self-directed neuroplasticity and neurointegration, bottom-up ↔ top-down modulation, autonomic regulation, and interoception) to keep the brain–mind–body map practical across settings.
Part 1 includes a short practice guide to try between sessions; we’ll debrief what worked in Part 2.
In addition, in this workshop, we treat dissociation as a protective developmental process — useful in the moment, limiting when it becomes the only habit — and we show how the same map clarifies attention problems and intense relational alarms. We include lived-experience perspectives and concrete “what to say/what to do” moments you can use the next day.
This two-part training stands alone (no prerequisite). The aim is not to add more labels, but to widen choices — so clients can rely less on emergency strategies and more on skills that support presence, connection, and stability.
In support of improving patient care, this activity has been planned and implemented by Amedco LLC and Object Relations Institute for Psychotherapy & Psychoanalysis. Amedco LLC is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
This course is co-sponsored by Amedco and Object Relations Institute for Psychotherapy & Psychoanalysis. Amedco is approved by the American Psychological Association to sponsor continuing education for psychologists. Amedco maintains responsibility for this program and content. Maximum of 