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Originally Posted by ChipperMonkey
Thank you X 1,000 for this! IMHO a lot of people have been labeled borderline when it's really complex trauma.
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Welcome.
While a person could technically qualify for both diagnoses, being treated for or labeled as BPD would provide little constructive utility for someone with CPTSD "only"; likewise, addressing only CPTSD symptoms in a person with BPD would also be a disservice. Looking at the constructs as being interchangeable doesn't help anybody, and neither does looking at one as being a subset of the other, as a rule:
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It is unlikely that cPTSD occurs only as a BPD sub-type. Although comorbidity frequently occurs in BPD cases, BPD is a relatively uncommon comorbidity of other psychiatric disorders. Most cases of Axis I and II disorders do not have comorbid BPD: the highest BPD comorbidity rates are 50% for eating disorders, 30-35% for SUD or bipolar disorder, and 25-50% for paranoid, avoidant, dependent, and schizotypal personality disorders. BPD comorbidity is typically found in less than 10% and at most 15-20% of Axis I or II disorders. Similarly, cPTSD often is accompanied by multiple psychiatric comorbidities, but occurs only rarely as a comorbidity in samples of adults with severe mental illness, SUD, and Axis I disorders including PTSD. In cases where either BPD or cPTSD is a comorbidity of another psychiatric disorders, it is likely that there is a history of the types of intra-familial childhood adversity that have been most consistently found to confer severe impairment related to psychiatric morbidity: “parental mental illness, substance disorder, criminality, family violence, abuse, neglect”. Thus, cPTSD may serve as a sub-type of BPD in which profound developmental trauma causes, or creates a vulnerability to, a range of symptoms and impairments that, in the DSM, results in multiple comorbid diagnoses. (BioMed Central study)
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It's also worth making the distinction between
trauma, complex and otherwise, and
traumatic stress disorders. Not everyone who experiences traumas has the same reaction, and as a result people who've been through even moderate trauma and haven't had any signs of PTSD or other disorders in their own life are apt to think that anyone referring to a disorder that they don't experience as "trauma" is just a lot of whining.
I'm sure there are professionals out there who say the labels don't matter.. but if that's true, it's just as easy to get it right and get on the right path!
Why incur confusion in an already difficult recovery?