psychology question - BPD diagnosed instead of PTSD

Many people with borderline personality disorder also have PTSD, but it also seems to be common for BPD to be misdiagnosed when only (untreated) PTSD is present.

Can anyone point me at research identifying differences which would indicate whether BPD is present alongside PTSD, or whether PTSD only is present?

One that comes to mind is age at onset: BPD is normally evidence by late teen years, symptoms do not just appear later in life. PTSD can be delayed onset so some time after the trauma occurs (sometimes, years).

Links to research would be really helpful, I have the DSM-IV and DSM-V criteria already.

I am not sure. Symptoms seem to overlap so much. I know depression can often be a symptom of PTSD and they focus on the depression when really they should go after the PTSD.

If you think PTSD is the primary problem than you have a right to take part in your treatment and request that that be the focus in therapy. Medication wise I am not sure what difference there would be.

I couldn't find much research. They can be concurrent or comorbid conditions like PTSD and depression can be. In my opinion not enough research has been done on these things.

NIMH · Post Traumatic Stress Disorder Research Fact Sheet

http://psychiatryonline.org/data/Jou...?resultClick=1

https://www.harvardpilgrim.org/porta..._schema=PORTAL

While it's possible, because of the overlap I think there is more likely usually a question of which construct is a better fit for an individual's set of symptoms.

You may find this video of key researcher Bessel van der Kolk giving a talk at Yale on the differences between BPD, PTSD, and CPTSD to be helpful. I found it so compelling that I've watched the whole thing more than once, and it got me sorted out on which happens to be the accurate construct for me, better understanding now the whole array of constructs and the evidence for each.

I think this is really interesting. I just started seeing a new therapist and she said I have PTSD. I have already been diagnosed with BPD...my therapist thinks maybe the PTSD is more pronounced than the BPD...I don't know if I agree though.

It seems to me that if you take a psychologically healthy young mother and her psychologically healthy children and suddenly subject them to overwhelming trauma, as happened to a friend's mother in Germany in the thirties, you have a good chance of producing PTSD in the mother and any of the personality disorders in her children, as well as "attention deficit". You could also get "organic" mental illness like bipolar and schizophrenia. Which pd the kids get will depend on personality traits, genetic predilections and age of trauma.

A lot of people prefer to have PTSD rather than BPD for a variety of reasons, among them that no one really wants to think about having been traumatised as a dependent little child.

Go with the diagnosis you are given. Each category is only a constellation of symptoms and traits. The categories are manmade, just conveniences. Good practitioners know that borderlines are frozen in overwhelming toddlerhood in the same way ptsd is frozen in overwhelming adult trauma. Bad practitioners...get away from them. But give each dx and treatment a try. Bpd isn't the diagnosis of doom some borderlines imagine it to be. It's not a greater defect than PTSD which implies an underlying weakness unbefitting adults. Says me with chronic ptsd.

vonmoxie, I especially like the end where the difference in brain activity was shown. I had tried so many times to explain how what happened to me overwhelmed me so much that I could not function. At first all the PTS symptoms were only about the loss of what I had, and my witnessing it as well as my neighbor continuing to intrude.

I really believe that had I had the right treatment right away that I would not have suffered full blow PTSD as I developed and still suffer from now. I have suffered greatly from losing time, and disassociating more and more, as well as experiencing more and more negative reactions when trying to interact with my horses and ponies again. I could not understand "why" I grew more and more debilitated by just being around them, even when I did not want that to happen.

I wanted to "tell my story of occurance" and the fact that I also struggled with a lawyer who was mentally declining and failing to do his job, really aggrivated the PTSD and I could feel the affect it was having on my brain, at times I suffered headaches that I had never experienced before in the frontal part of my brain. However, at times it felt like my entire brain was being squeezed like a sponge too. It has been seven years now and I have not been able to tell my story and now my brain seems to shut down whenever I go near all my files that are a mess on the floor. There is no such thing as going back to revisit the trauma with me because I have never been able to be "away" from it. My "only" time away from it was the psych ward that only traumatized me even more.

When I saw the pictures of how the brain of PTSD is affected YES I have been trying to discribe that for "years" now. When they talked about being in the "now" and how that can help, I have not been able to do that, because I cannot get the past to actually "be" in the past. For "years" I have to remember, remember for when the time comes of being questioned about it. I DON'T WANT TO REMEMBER IT ALL, anymore, and what is sad is that my case is purposely prolonged in hopes I will grow weary and give up or settle for so little, IT IS WORKING, however this has "hurt my brain". When it showed how the brain of someone with PTSD functions, "yes" that is how I respond now to my ponies/horses and farm now. I never imagined how something I used to love so much, enjoy so much would become such a source of pain the way it is now for me.

OE

Yeah, the brain scans and brain wave activity charts are pretty amazing; validating. The one about cortical timing that is basically a picture of how the startle reflex is shorted out in PTSD is something I've struggled to explain -- most people have never had occasion to consider the importance or even the existence of a healthy startle reflex -- and especially interesting to me is the way that the right brain tries to make up for the diminished waves in the left brain creating sort of a mock, or alternate, reflex. It makes perfect sense to me, because the reactions I have now don't feel anything like ones I had before and for the better part of my lifetime, which I think has contributed to feelings of depersonalization, that I am trying to operate a person I don't recognize.

His explanation and scans about dissociation and depersonalization, and contemplation of the self/body are really compelling too, and a good quantification for the usefulness of yoga and other body-oriented techniques.* He just gives so much really useful background information in this talk. I just watched it again! I can't seem to watch only a few minutes of it. (I also find his humanity to be kind of on the adorable side. =P)

His mention of the Cloitre-Stovall study was significant to me as well, with its demonstration that the relative warmth of practitioners had little to no effect on positive outcome for trauma victims. He suggests it was a surprise to the researchers who conducted the study, but for me it made perfect sense and was wholly validating, because of all the therapy I've had which seemed to me to be providing warmth as a primary method of trying to help me (lots of nodding and "yes I can see how that would be hard") but to no avail has especially frustrated me because of the blame that's ended up in my court as a result, that I'm not trusting the process enough, or whatever. The process of having aimless but concertedly warm conversations twice a week, and awful inapplicable drug therapy..

If I was in the Boston area I'd probably be at the guy's doorstep by now. =P

I misspoke a bit in my last post with my reference to the word overlap -- because I'm reminded in re-watching this talk that the symptom sets and intensities differ quite significantly, which is what makes the diagnoses quite separate. I'd certainly be wary of the same set of symptoms being analyzed as one diagnosis versus another, as it suggests that some misdiagnosis or some less than well measured diagnosis has occurred somewhere along the line -- which certainly creates some potential for disaster, depending on what treatment that doesn't help could ultimately hurt. With Complex PTSD never having made it into the DSM, some practitioners may have indeed suggested BPD as the closest diagnostic "fit" available, if only for simplified insurance and billing purposes and also if they have not have not been avidly doing the same trauma research I now find essential just for my own basic understanding.

I actually whole-heartedly recommend at least very careful review and assessments of diagnoses given by others, because without my own efforts I'd currently still be being treated for the wrong thing (not BPD, but depression and ADHD; not false assessments but really not getting to the heart of my most affective issues), with the wrong drugs (where do I begin), and just getting into worse shape all the time. As I live in the New York City area one would think that I would have run into a competent practitioner at this point; my chances at doing so should theoretically be better based on numbers alone. But I have not had the "luck". Dr. van der Kolk's reference to the 1975 psychiatric textbook description of early childhood sexual trauma is a good reminder of what we are up against in the field though, in terms of its institutional knowledge and culture. Perhaps the greatest psychotherapeutic decision-making mistake I've made in all this time has simply been not seeing a practitioner under the age 50..? =P



"None the worse"! Shoot me now..

------------------------------------
*Quoting/borrowing from a related presentation document Dr. vdK has posted on his own site, I liked this bit, which does point to the treatment applicable to trauma crossing over multiple constructs, BPD etc.:

Traumatized people need to have physical & sensory experiences to:

• Unlock their bodies,
• Activate effective fight/flight
• Tolerate their sensations,
• Befriend their inner experiences
• Cultivate new action patterns.

**bla bla bla and bla. I do go on, and I apologize!

That feeling of shut-down.. it's brutal, and I absolutely relate. I almost think that additional re-traumatizations can end up being worse on the body and mind than the original traumas, and when people talk about being walked into what is ultimately exposure therapy with practitioners, but feeling hesitant about it, I just want to say RUN! Because I happen to mostly doubt whether practitioners are approaching it in a way that not only helps, but that doesn't further injure, such as referenced in the video. That certain things have to be in order for the person first, so that the experience will not be re-traumatizing. I remember my last therapist just willy-nilly asking me heavy-duty questions about my trauma, specifics that I recall perfectly well but have no desire to re-experience. Not even a "how do you feel about talking about this" or "I think examining your trauma in more detail could be valuable if think you're ready", just right in there with the most intimate details of one the most unimaginable things a 4 year old could be made to go through, and that anyone would ever want to chat about in full technicolor detail.

I just think there's a huge difference between horrific experiences simply "needing to be revisited" which is something I hear said all the time, and horrific experiences being revisitable in a healthy way at the right time, which I think resides within a far slimmer region of possibility than many practitioners generally bother to address.

I wish I'd known before. Even a tenth of what I know now could have saved me from the place I instead find myself currently. Which is very shut down.

I have tried to explain what happens to me to my therapist and that I don't know how to fix it. His reply was that it was like a phobia and that I had to work through it. It doesn't work, it's like whatever is supposed to be there is missing somehow.

~It's so different from anxiety or phobia though, isn't it? For instance, I don't leave the house as much as would be good for me these days, but I don't think it's the result of being agoraphobic or even any kind of phobic. I'm not afraid to go, and I don't have anxiety when I do; I just don't do it. It's that feeling of being shut down... I'm neither afraid nor unafraid; I'm just neither. Neither fight nor flight.

Yes, it's not a phobia IMHO, I find that whatever used to be there the desire and confidence to engage something is missing. The way they discribed the brain's inability to connect to a certain part is probably what I am struggling with that I can't seem to explain in words.

I find that when I go out to take care of my ponies/horses I often get overwhelmed and begin feeling like I am running a marathon and I don't "think" to react that way, it just comes over me. I have not worked with them in training them nor have I been able to give lessons, even going into that riding ring is so hard in a way I have yet to be able to truely articulate. The only part of my business I have been able to do is "off premises" and no big functions like I used to do. I feel so guilty about it too. Also because I had been so invalidated for what was truly lost, not only in a physical sense but also in my brain somehow, I feel that was so wrong, cold, mean, wrong.

OE

This is the essential difference between developmental trauma and ptsd. Something that was meant to develop was not able to develop after childhood trauma. It is not there because trauma prevented it from coming info existence.

Trauma that assaults the adult self does not cause that degree of overwhelm. The sense of self os intact. It may even be stronger because the self has suffered losses...and learned "i am not my child, he can die and I remain. I am not my legs. I lose them and I am still me. I am not my land and my social position, my society is erased and scraped and here I am in LA still somehow who I always was". It is developmental trauma that causes a person to feel completely annhiliated by real or symbolic losses.

Teacake, I understand what you are saying, but I had a lot of capabilities before, a lot of coping capabilities and what I experience with PTSD is very different than what I had been before. I do not have Borderline Personality Disorder and I don't have NPD, I have not been diagnosed with any kind of personality disorder, just PTSD. I did have other traumas but I did have a "caring adult" in my life.

That being said, I do understand what you mean by "something missing" , however, it is important to review it in a more "complete" way and not diagnose another person based on "some" of the things they discuss here in this forum. It doesn't even matter what you know either, not even if you could practice either, because you are still "only" getting "some" of the information shared here in this forum and you are not seeing anyone here in a "personal way" where you can get to know that person in all the ways you "should" know the person "if" you were a true professional.

If you listen to that information given in that link, this was discussed and mentioned that it is important that "time" be taken with a patient "before" handing out a diagnoses. You were confused about your own diagnoses for a while, even confused NPD with "narcissistic traits" which are two very different things. Personally, I don't see you as NPD, however I would say from what I have seen that you have "narcissitic traits" because you definitely have strong opinions about things, not the same as NPD at all, in fact having narcissistic traits is not unhealthy.

I think it is important to "take care" in making sure that when we discuss different diagnoses that no one in these forums feels like they are suddenly being diagnosed because a person will begin to not feel safe and we don't want that to take place if we can help it here. The PTSD forum is a challenge, anyone can get triggered here depending on where they are in their healing and overall understanding of their challenge.

Also, it is possible that a person can have childhood traumas and other challenges that can predespose the person to develop PTSD from a big life changing trauma too. It is a very delicate psychological ladder we all are climbing in these forums, so we all have to go slowly as we interact and share here. You misunderstood what you quoted in what I was saying. When I saw the brain activity shown in the link provided, it helped me understand that "missing" that I had been trying to articulate when it showed what is not functioning correctly in the PTSD brain.

OE

The harm that comes from trying to raise the prestige of people with early childhood trauma by renaming developmental.trauma disorders."PTSD" is that the issues of PTSD are very different from the issues of devwlopmental trauma and the treatment os very different as well.

PTSD as describes ny the DSM is not nearly as "delelicate" as developmental trauma. We are all extremely delicate in childhood as we are developing. Anything that disrupts out development leaves spaces of interrupted development, tender spaces, where we are still at levels or childhood development. I have seen this very clearly in a fifty year old accountant (very high functioning, professionals) who had literall infantiles rages. He also had toddler rages. These are fearsome to see. All mothers have seen leas emergent forma of this rage in tiny bodies.

I think confusing developmental trauma with ptsd runs ptsd out of the Forum. In the real world that confusion runs us out of treatment. When I was suicidal a lot of the drama I faced was that everytime I met a new hospital staff or ER doctor I had to wait around for them to figure out on their own that I have ptsd, not developmental trauma someone called ptsd so I wouldn't feel defective. They could easily see The difference in time but that meant as I was seriouslyusly unstable I had to wait adound for docs to sort out what I wasn't that always announces it is ptsd from what was, which happensd to be ptsd.

Definitional drift has made everything ptsd now. This raises the perceived prestige and honor of people who felt insulted by being dxed with narcissistic disorder in hospital...but what does it do to the people who are just plain ptsd? It gets Is viewed as borderlines and narcissists get viewed, which has never been fair to them but isn't made better by tarnishing ptsd with their reputation.

The adult refugees I taught deserved to have their ptsd addressed without belittled by being treated like people with personality disorders or other developmental deficits. But then we would have to admit that our warring harms innocents. Better to redefine ptsd as bad parenting.

^It's an interesting perspective you have, and I absolutely understand the concern about accurate treatment being available for those with adult onset PTSD, and as it could be affected by potential stigma that could be perceived by persons who neglect to comprehend what the terminologies actually mean. And I've never looked into the reasons why they started referring to what was once called developmental trauma disorder as complex PTSD, but my own experience does lead me to draw some conclusions about it, including that my condition is indeed primarily the result of the effects of trauma -- and not the existence of a development "deficit" as you suggest and as the former name could imply. I'm simply scarred, both similarly and dissimilarly to those with adult onset PTSD.

But because it occurred during my developmental years it got stored deep, imprinting me in an extra-significant way and resulting in additional effects. As such, if the term developmental trauma disorder implies what you are suggesting, that it belittles the condition it is describing as being only the result of parenting gone awry, and not as serious or something, then yeah -- I don't think that it does aptly describe the condition.

Not from my own experience anyway. I've been taken out at the proverbial knees at this point. Is it "merely" the result of my parents' actions, that my father didn't care to discern the difference between consensual sex and making aggressive use of tiny children as sex toys, laughing all the way through the horrified screams of children not even yet in school? I personally don't call that bad parenting or even parenting. He was a psychopath and a criminal. Successfully inflicting trauma behind the safe cloak of the American family unit, where no one could hear me scream. I was harvested, and when I was no longer of use he tried to kill me.

It absolutely pre-conditioned me to be extra-terrorized by traumas I endured later in life. It's not as though I was triggered one day while standing in line at the grocery store. I've quite literally had guns to my head, and I don't even consider that my worst day. But, had I lived the life of ease that people so oddly at times imagine, without suffering subsequent trauma in my adult life, I certainly could have contained the effects of my early trauma without much issue, as I had for some time. I may never have had to know what any of this PTSD stuff is even about. So I don't think it's at all safe to assume that adults who are suffering effects that result in some part from early trauma, are in any better shape or less needing or deserving of treatment and regard than those with strictly adult onset or single-incident PTSD.

We can't know what karmic load others are carrying, and it's fallacious to make assumptions about how easy anyone might theoretically have it. I seem to be an outwardly graceful woman, by some strange unprovoked miracle; people think that I come from money, that I am loaded with it, that I take great care of myself, that I must have gotten by in life quite effortlessly on my good looks. None of it is particularly true, which makes the disdain people have for what they perceive as the silver spoon I must have been sipping from all my life quite comical indeed; albeit a joke I am mostly only sharing with myself these days.

I'm also not sure that any disorder, post-traumatic or otherwise, can be deemed even relatively prestigious, or any more so than any other affliction. I personally find it more condemning; it saddles me with people's inclinations to want me to quantify my trauma, to justify my condition, which for me is exhausting and in most situations quite beside the point. My horrendous details. Its less than stellar prognosis seems to me to also add to an ultimate reduction in "prestige"; I haven't met a mental health professional yet who had any idea how to deal with trauma history and it effects, and likewise had any idea how to react to it in a way other than ultimately condemning since they feel inadequate to help. But most of all, the suggestion that any of it has comparative prestige seems like an unfortunate idea to support at all, for all involved. All these conditions deserve attention in their own right. Are some people going to be misdiagnosed? Of course. That's true of every condition under the sun for which there are not affordable diagnostic tests. All we can do is keeping talking about what these things are. And definitely not continue the punishment of those who never had a voice as children, by suggesting that their trauma doesn't count, or makes them delicate (I'm about as far from that as can be imagined), or is lesser or even needs to be compared. Although I confess that's already my general experience of people's perceptions. I'll likely be re-punished for the rest of my natural born life for having been a helpless victim; a 4-year old who somehow could not protect herself from a six-foot psychopath with a cultural license to abuse. If only I could re-bury the history deeper in my body, since the likelihood of anyone caring enough about it to be of help at this point is little to none, but.. sadly it's quite chronic for me now. There's just nowhere left to put it. Tipping point reached.

Of course that's just my individual perspective, which clearly cannot help but be colored by my all-too-colorful personal experience. But, I'm sure I'm not alone in being someone for whom CPTSD represents the result of considerable trauma. I've never had a personality disorder, and my complex PTSD is just that.. some very complex and difficult post-traumatic stress disorder, with 40 years of shrapnel embedded and trapped in my body.

I can certainly imagine some nudnik suggesting I had a personality disorder along the way, in lieu of having been able to accurately figure anything out. People love to be right about things, so it's a miracle I haven't been more misdiagnosed. I suppose I should consider that blank gaze most psych practitioners have given me over the years to have been a blessing.

Teacake, I have been "triggered" by your need to diagnose me as narcissistic/ BPD. I have talked about "your need" to do so with my PROFESSIONAL TRAUMA THERAPIST, who has told me YOU ARE WRONG.

I shared some things about me here and I deserved to feel "safe" and talked about being "misdiagnosed" by a psychiatrist from India who spoke with a heavy accent. This psychiatrist has made the "error" with other patients as well because he is "not" culturally sensitive. He doesn't have a good reputation especially with those in the field of "Trauma".

Do children get hurt from childhood abuse? Yes, infact children can also develop PTSD too. The other thing that can happen is "delayed onset of PTSD" too.

The problem I have with your need to tell others that they have a personality disorder and "not" PTSD is that it is not fair to a person who "is" experiencing "real PTSD". Real PTSD is nothing like a personality disorder with GAD. People with personality disorders don't experience "flashbacks and the crippling/ often debilitating PTSD cycles".

It seems to me that you find it very important to rise above all the other members here and tell others they don't have "real PTSD" and YOU are the only one that does. You are not anyone's therapist or psychiatrist here.

I fit the diagnostic criteria for PTSD, "unfortunately".

I cannot stress enough that members here are not allowed to diagnose other members. Most of the members here are working with "professionals" that specialize in "trauma work with their patients".

There is nothing wrong with talking about different challenges here, but not to suggest other members have these other challenges instead of what the professional they are seeing has told them, even more than one in some cases that has diagnosed them with PTSD.

OE

"I'm also not sure that any disorder, post-traumatic or otherwise, can be deemed even relatively prestigious, or any more so than any other affliction. I personally find it more condemning; it saddles me with people's inclinations to want me to quantify my trauma, to justify my condition, which for me is exhausting and in most situations quite beside the point." quote from vonmoxie

I feel the same way vonmoxie. There is nothing "prestigeous" about PTSD or complex PTSD over any other challenge.

There is a big difference between GAD and PTSD too. While they are both anxiety disorders, one can experience GAD without having a major trauma or traumas. Some guy who has a big job may have a problem with his temper, maybe never learned how to control it, but that is very different from the anger that takes place with PTSD. People who struggle with PTSD are not manipulative, they don't "lie" either, infact they "hate" lies and manipulative people.

There was a desire from those in the field of psychiatry to have a separate category for "complex PTSD", however, it was decided that the symptoms are the same so kept it as just PTSD.

Here is another link:
http://bpd.about.com/od/relatedcondi...mplex-PTSD.htm

So BPD and C-PTSD are the same. They have the same symptoms only one is considered organic the other traumatic?

In which case how can anyone with a traumatic childhood be diagnosed with BPD without a brain scan to back it up?

It seems to me that the purpose of C-PTSD is to validate those with trauma histories. I'm inclined to think of C-PTSD as more of a combination diagnosis? Attachment disorder (BPD) + PTSD.

Attachment disorder <> Complex PTSD <> BPD; nor are subsets of one another.

Despite having various commonalities among them, they are all very separate constructs, and I do personally think that the aforementioned article is leaning towards some unfortunate oversimplification by suggesting that Complex PTSD simply be treated as BPD. It's not necessary to collapse concepts in order to share some treatment possibilities. I suppose I also see the effort to do so as a marriage of convenience amid proponents in the psych industry, since they are all areas in which there is still a struggle to provide consistently useful treatment.

I personally see many ways in which they are different -- even besides the very basic reasons of one being a development disorder, one being a stress disorder, and one being a personality disorder.

I myself don't have the symptoms of Attachment Disorder or of BPD. Perhaps miraculously in both cases considering my upbringing of intense neglect in an environment of Cluster B disordered individuals (both NPD and BPD). Maybe the exact configuration of the exposure gave me some odd type of immunity to the personality and relationship related effects.

No, borderline personality disorder is not necessarily what is meant by complex PTSD though. Complex PTSD was used in preference to other terms such a "rolling PTSD" and "cumulative stress.

Here is a link that explains "complex PTSD" and that it is not the same as a personality disorder.

Complex post traumatic stress disorder (complex ptsd, pdsd, shell shock, nervous shock, combat fatigue), symptoms and the difference between mental illness and psychiatric injury explained

Here it explains "complex PTSD" from the link I posted.

It's widely accepted that PTSD can result from a single, major, life-threatening event, as defined in DSM-IV. Now there is growing awareness that PTSD can also result from an accumulation of many small, individually non-life-threatening incidents. To differentiate the cause, the term "Complex PTSD" is used. The reason that Complex PTSD is not in DSM-IV is that the definition of PTSD in DSM-IV was derived using only people who had suffered a single major life-threatening incident such as Vietnam veterans and survivors of disasters.

NOTE: there has recently been a trend amongst some psychiatric professionals to label people suffering Complex PTSD as a exhibiting a personality disorder, especially Borderline Personality Disorder. This is not the case - PTSD, Complex or otherwise, is apsychiatric injury and nothing to do with personality disorders. If there is an overlap, then Borderline Personality Disorder should be regarded as a psychiatric injury, not a personality disorder. If you encounter a psychiatrist, psychologist or other mental health professional who wants to label your Complex PTSD as a personality disorder, change to another, more competent professional.

It seems that Complex PTSD can potentially arise from any prolonged period of negative stress in which certain factors are present, which may include any of captivity, lack of means of escape, entrapment, repeated violation of boundaries, betrayal, rejection, bewilderment, confusion, and - crucially - lack of control, loss of control and disempowerment. It is the overwhelming nature of the events and the inability (helplessness, lack of knowledge, lack of support etc) of the person trying to deal with those events that leads to the development of Complex PTSD. Situations which might give rise to Complex PTSD include bullying, harassment, abuse, domestic violence, stalking, long-term caring for a disabled relative, unresolved grief, exam stress over a period of years, mounting debt, contact experience, etc. Those working in regular traumatic situations, eg the emergency services, are also prone to developing Complex PTSD.

A key feature of Complex PTSD is the aspect of captivity. The individual experiencing trauma by degree is unable to escape the situation. Despite some people's assertions to the contrary, situations of domestic abuse and workplace abuse can be extremely difficult to get out of. In the latter case there are several reasons, including financial vulnerability (especially if you're a single parent or main breadwinner - the rate of marital breakdown is approaching 50% in the UK), unavailability of jobs, ageism (many people who are bullied are over 40), partner unable to move, and kids settled in school and you are unable or unwilling to move them. The real killer, though, is being unable to get a job reference - the bully will go to great lengths to blacken the person's name, often for years, and it is this lack of reference more than anything else which prevents people escaping.

It sure as heck doesn't make me feel particular fancy! My needs are actually so basic at this point... I don't need to be validated, or ego-stroked. Just doesn't do it for me. (Would that it did! I could get a need like that satisfied easily enough without the help of psych practitioners.)

With regard to preferentialism, certainly various practitioners are going to exhibit some inadvertently, where their confidence and motivation to treat various conditions is concerned, but I think it very much varies from person to person. One pdoc I worked closely with for many years showed the most sympathy and regard for schizophrenics simply because she had worked with so many of them over the years, and had developed a more particular empathy for what is common to their situation, as well as a strong professional competency toward providing them with effective treatment.

I concur about the value placed on "straight talk" by those on the PTSD spectrum; I notice it right here in this forum, that while there is a healthy element of our reaching out to one another for support, I don't see the same types of issues cropping up around the interpretation of statements that I've seen occur more often for those with other primary conditions.

I feel like I may have expressed something like the following somewhere on PC before so apologies in advance to anyone who has heard this particular sentiment of mine already, but: I'd personally rather have a therapist who spoke freely with me even if I didn't like something they had to say once in a while (I am a big girl..) and could likewise take the things I share at reasonably close to face value, than be dealing with lip service that I neither need nor can do anything with. My grip on reality is just not the issue, and my barometer for sincerity is really strong. I'd need a therapist with at least the acting chops of a Marlon Brando for that to work for me. I've found it a sadly infrequent occurrence though, to find people in the industry who can fully understand and respect that need though.

Quote:

Originally Posted by Open Eyes Here it explains "complex PTSD" from the link I posted. It's widely accepted that PTSD can result from a single, major, life-threatening event, as defined in DSM-IV. Now there is growing awareness that PTSD can also result from an accumulation of many small, individually non-life-threatening incidents. To differentiate the cause, the term "Complex PTSD" is used.

I question their use of the phrase "many small individual non-life-threatening incidents" -- not only because it does not describe my own experience (neither the "small" nor the "non-life-threatening"), but because besides its not being the definition, it seems to be an unfortunate perception held by many, that those with CPTSD as the result of trauma that happened to occur in childhood are somehow having an overreaction to "smaller" events. If only. I can't speak for everyone. But if that's true, then I guess I don't fit into any construct, as my symptoms are not the result of a single incident, nor the result of small/non-life-threatening incidents.

It's okay, I don't need a label. But I'm not particularly impressed that the DSM folks couldn't even get it together to agree on the significance of existing data in order for it to have had some kind of entry in the last edition, leaving it and its sufferers to flounder for understanding amid the confusion created by their omission. It's just irresponsible.

I understand how you would see it that way, however, that is not what their statement means. What the meaning of that statement is trying to say is that there can be a history that doesn't include physical or severe abuse, but could still pose a "threat" to a person or child that can create complex PTSD too. For example being bullied by another sibling or by other children is enough to create enough "stress" for a child to where that child or an adult can develop what they are calling "complex PTSD". They have broadened the circumstances in which the person can endure "stress and a kind of captivity" to where they can develop "complex PTSD".

It just could be phrased better. The composition of that sentence set suggests that the differentiation of Complex PTSD exists specifically to provide for those for whom that particular set of circumstances exists. I get and respect that it was likely not their intent to suggest an exclusion of those with a history of life-threatening childhood trauma though.