In this behind-the-scenes episode, I take you inside my clinical thinking as I explore what actually drives borderline emotional dysregulation. We look at how failures in internal holding and object constancy lead to external regulation through relationships, why this creates intense relational dynamics marked by rage, splitting, and blame, and how early trauma collapses the past into the present. I close by sharing a clinical stance — how to stay grounded in the person’s lived experience without retraumatizing them, while still gently widening reality. 

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Dr. Anthony Mazzella is a psychoanalyst and psychodynamic psychotherapist specializing in narcissism, personality disorders, and relational dynamics.