My therapist doesn't use a diagnosis as I don't use insurance for therapy, but he is a psychoanalyst and doesn't use the conventional diagnoses anyway. They can use stuff like anxiety and depression and PTSD too, which my therapist has acknowledged I have, but they use 'character' designations and everyone is at 1 of 2 levels: (neurotic, borderline). I thought psychotic might have been one but maybe that is only when decompensating, as i can't remember clearly right now.
The DSM lists more behavioral symptoms although it's changed a bit recently, where character is about behavioral manifestations too, but it's personality based; more about inner world, relationships/attachment, sense of self, how one views the world, defenses, etiology, etc. I don't think I like the term character as it seems labeling too.
Hysterical and OCD personalities are usually at the neurotic level, for example. Avoidant can be too, I think. Hysterical character is a version of histrionic that is at the neurotic level instead of the borderline level. Even though the name has changed for obvious reasons, but i think therapists (both male and female) still use the term 'hysterical' for someone with a histrionic character at the neurotic level, and histrionic for someone who functions at the borderline level. There are 2 types of narcissistic character. Someone with that label can be either at the neurotic or borderline level, but I think can decompensate to the psychotic level. They are mostly fixed but I think can fluctuate with life stressors etc. as there are never perfect categories for anything. I think paranoid might include both the borderline and psychotic level. Here's a list of them all:
https://sites.google.com/a/icdl.com/...le-of-contents
I feel bad for all those feeling stigmatized or labeled - MH practitioners don't have to use an axis II diagnosis. They can use the axis I if the want to. I think it's f*d up when they mark an axis II in someone's record (unless they have a really good reason to), and they know it.
Here's one organization's take on it:
Quote:
PERSONALITY DISORDERS
Although most survivors report symptoms consistent with PTSD or complex PTSD, the diagnosis more typically assigned to survivors is of a personality disorder (see Herman, 1992). A personality disorder is a pervasive and enduring disruption of the ability of a person to function normally (Millon, 1991; cited in Walker, 1994). However, the question of what is 'normal' within the mental health context is the subject of much debate.
The diagnosis of borderline personality disorder (BPD) is not unusual for women with symptoms resulting from childhood or adult violence or trauma (see Sansone, Sansone, & Wiederman, 1995). A diagnosis of BPD for survivors has traditionally implied likely failure to recover (Candib, 1995). Candib (1995) argues that the label of BPD is stigmatising and ignores the link between abuse, trauma and a survivor's response. She argues that this diagnosis may result not only in an inappropriate or fragmented approach to treatment, but to broader ramifications such as losing custody of children or inability to secure health insurance.
Personality disorder diagnoses can result in inadequate and even harmful treatment for abuse survivors. Survivors attest that the symptom-focused, diagnosis-based, therapist-as-authority figure framework that guides many health providers often harms adult survivors (Harper et al., 2007; O'Brien, Henderson, & Bateman, 2007). The power structure of the medical model recreates a situation of dependence associated with danger, pain and betrayal for survivors of childhood abuse (Linehan, 1993a).
A study by Harper et al. (2007) found that the quality of survivors' relationships with their therapists was negatively impacted when participants perceived that their therapists viewed them as 'mentally ill', rather than as suffering the effects of repeated traumatic experiences (Harper et al., 2007). The fear participants held that they would be perceived as needing psychiatric hospitalization inhibited their ability to share their thoughts and feelings (Harper et al., 2007).
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Treatment models - different therapeutic approaches
And I can't sleep so am posting probably meaningless dribble so my mind isn't activated too much...
