BPD Could bpds be npds with ptsd?

[alt]

For those of you who have PTSD after narcissistic (NPD) or borderline (BPD) abuse, you will possibly understand my idea with this, at least with a bit of explanation.

I have done a lot of research on NPDs and BPDs and other cluster B disorders in a desperate attempt to understand after dating a narcissist for a short period in my late 30ies (with terrible consequences).

When reading van Kolk's book, I think he mentioned that about 50% of the people diagnosed with BPD in the US, in reality should have had a PTSD (or rather c-PTSD) diagnosis, and that "real" cluster B BPDs are different from these traumatized people. The distinction: "real" BPDs are predators, the (c-PTSD)BPDs are victims.

A thought just dawned on me. Could emotional dysregulation be a symptom of PTSD, rather than of BPD?

And could these "real" (for a lack of a better word) BPDs (the cluster B BPDs) in reality be narcissists (NPDs) with PTSD? As in, if an NPD suffers trauma, they develop into what is BPDs?

I feel like somebody should study this. :p

 

[Ronin]

The same sy is not a disorder exclusive AFAIK.

Does not make it a part of a different disorder just for being a part of one. Because it is not about one symptom, or trait, only. The whole darn diagnosis.

Trauma can lead to many results, I am not sure how do you mean about someone with one personality disorder, once traumatized, developing another one?

I think people DO study this stuff, with less pokemon mutations thrown in.

Edited to add: It does not, ultimately, matter what personality disorder an abuser has, people with pds can be non abusive, and abusers can evolve their tactics not because of changes in diagnosis, but because they are abusers, who work at what they do and like what they do.

Edited to add II: I dont think that quote means how you are reading it, but atm short on words to explain it. Basically he was not speaking about predators, whole, rather that in borderline population, there is a difference between dysregulation because of trauma, and one to mess with people for the kicks of it.

That quote is applicable only to studying borderlines. It has zero relevance about other groups, or abusers in general.
I would do better explaining this one on Venns diagrams, seriously. <facepalm>

 

[alt]

The same sy is not a disorder exclusive AFAIK.

Does not make it a part of a different disorder just for b...

I'm not sure I understood your answer, but I'll try and elaborate a bit.

People with PTSD often get emotional dysregulation problems, both PTSD and c-PTSD sufferers, if there is even a difference (?).

Cluster B personality disordered people are typically lacking empathy.

BPDs are very similar to NPDs (they engage in splitting, manipulation, projections, etc), but in addition have a problem with emotional dysregulation.

I believe that a lot of those people who have been diagnosed BPDs are not really personality disordered, but have suffered childhood abuse resulting in PTSD.

I further believe that there are other people diagnosed BPD who actually are NOT lacking empathy, but just have the emotional dysregulation issue after childhood abuse. I believe these people may be misdiagnosed, and in reality are c-PTSDs.

This is supported by van Kolk, I believe?

So, what I'm saying is that "emotional dysregulation" may be a symptom of trauma, rather than of a personality disorder. And that those who are diagnosed BPDs and really are lacking empathy (about 50% according to van Kolk), in reality are NOTHING BUT NPDs, but that they in addition have suffered trauma.

It's an inverted way of looking at it all, I know, but just because the BPD diagnosis came first, and then the PTSD diagnosis, doesn't mean that BPD is a valid diagnosis. I suggest that we MAYBE could take it out of the cluster B package all together. And divide the people who now have a BPD diagnosis in two groups:
- PTSD sufferers (c-PTSD) = those 50% of BPDs that van Kolk wanted to rediagnose as c-PTSD-sufferers, and not personality disordered individuals (the victims), and
- NPD (those who engage in splitting, manipulation and lacking empathy) with trauma (so, NPDs with PTSD)

Hope that made it clearer?

I believe that if my theories above are correct, this could mean a LOT to those who are diagnosed BPD but in reality are PTSD sufferers, and it could mean a LOT for those who suffer from PTSD, as emotional dysregulation and anger issued could be researched better as a trauma symptom rather than a personality flaw. It's anyway just a thought, and I'm not a researcher. I just felt the hypothesis should be put out there, as some might find it an interesting idea.

 

[Friday]

Could emotional dysregulation be a symptom of PTSD, rather than of BPD?

It is a symptom of PTSD.

Aaargh. I can’t pull up my PTSD CritA-H DSM5 list at the moment @joeylittle, do you have that handy? Or anyone?

That’s why we have a Dysregulation Forum, here on the site.

It’s also a symptom of many other disorders. A single symptom does not a disorder, make. You have to have the entire constellation of symptoms present.

 

[Ronin]

Hope that made it clearer?

No, not really, for the following points>

A. As Friday said, emotional dysregulation in different disorders is already on a criteria list for them, specifically.
B. Similar traits do not make for the same diagnosis. Doing the same thing, for very different reasons. Surface similarity is not sameness. NPD and BPD are not the same, and are not PTSD.
C. It is dangerous to go the Well, they are not reaally lacking empathy route.... on people diagnosed... as having a disorder with not having empathy.

Because you are not defending a victim, there.
That ends up in defending a potential bastard, who will victimize others, instead of own up.

It is one thing to speculate the what ifs where the whole thing is harmless.
It is whole another thing where you are talking about diagnoses that, also, come paired with cruelty to other people.

Edited: It is counter productive. It not only denies something already there, but working with it before schtuff goes bad, or if already went bad, so it does not repeat.

D. It could be way easier to just scratch the borderline dx and rediagnose altogether, instead of muddle an already muddled diagnosis. (I am not a psychiatrist, hence the could, I have no idea and in hypotheticals there.)

 

[alt]

It is a symptom of PTSD.

Aaargh. I can’t pull up my PTSD CritA-H DSM5 list at the moment ...

Hmm.. yes, you make very good points. I definitely wouldn't want to help bastards escape the bastard group, but I'd like victims to be taken out of it.

BPD is renamed emotional dysregulation disorder by many therapists and in some countries, and I believe that is where my issues with the disorder started - it is TOO symptoms based, it is just a "borderline" diagnosis - not a REAL diagnosis, or something.

When in addition - according to experts - about 50% of those diagnosed BPD in reality are c-PTSD sufferers, I feel bad about them meeting REAL cluster Bs in support groups thinking they are "the same". Ugh... Talk about putting victims and predators together in a way that would be really bad for a c-PTSD-sufferer. So is it really a personality disorder at all, was what I though, or just a bunch of symptoms, that may or may not be caused by personality disorders? When we in addition know that most of the BPDs have suffered childhood trauma, I start getting a feeling that their emotional dysregulation is based on an HPA-axis imbalance (caused by stress over time) and not caused by the personality disorder. That does not mean they can't have a personality disorder IN ADDITION, but would they ever seek help for that anyway? The c-PTSD sufferers ARE victims and the REAL cluster Bs FAKE being victims.... The diagnosis will never change that.

I by no means believe it should be a free card from considering personality disorder if emotional dysregulation is present.

Anyway, I liked your answer, and it made me think you may be right.

Now I'm wondering if c-PTSD should be a diagnosis? Isn't c-PTSD just PTSD?
My therapist said that even if my official diagnosis is PTSD (as c-PTSD isn't a diagnosis), I rather have c-PTSD, since to my trauma lasted for months (she said PTSD is used about single event traumas rather). But I don't see my symptoms as different from those with PTSD? So why the distinction? I mean, the PTSD diagnosis with it's symptoms was originally used on war veterans, and they definitely have c-PTSD if the definition is "long-lasting trauma" (vs. single event) as they normally are exposed to traumatizing circumstances for long periods. I do have emotional flashbacks more often than visual flashbacks, at least as the years go by. But I'd kind of say that is an effect of PTSD over time... I mean who'd not get c-PTSD by PTSD if not healed. It's pretty traumatic in and of itself and it definitely lasts for longer periods.

Please be patient with me if I'm talking about things that "I should have known" by now. I very recently took an interesting in learning about PTSD (I deliberately didn't read about it for the first 4 years), as I feared that negative information would discourage me).

 

[EveHarrington]

....so this all boils down to not wanting perpetrators and victims to have the same diagnosis?!?!

Why can’t perps and victims have the same diagnosis?

You’re going about this the wrong way if the catalyst for all of your research is the misguided belief that perpetrators and victims can’t have the same diagnosis. This is not how the diagnostic manual works, not now, nor ever.

 

[alt]

A. As Friday said, emotional dysregulation in different disorders is already on a criteria list for them, specifically.
B. Similar traits do not make for the same diagnosis. Doing the same thing, for very different reasons. Surface similarity is not sameness. NPD and BPD are not the same, and are not PTSD.
C. It is dangerous to go the Well, they are not reaally lacking empathy route.... on people diagnosed... as having a disorder with not having empathy.
.

Oh, yes, I agree with A and C. My point was NOT to put all the real BPDs in a victim box, god NO! They're freaking me out, so I definitely didn't mean to give them a way out. God forbid.

As I'm reading through the thread, I think I should modify my opening post statement and say that "emotional dysregulation" may be a symptom of a HPA-axis imbalance (not of "PTSD")

As for your point B, I do think the BPDs and the NPDs have the same reason, actually... They both want to defend against perceived slight. So if they perceive that somebody slighted them, they engage in SPLITTING (they refuse to see something in themselves and project onto the person that slighted them in for example vengeful and/or defensive ways). They also both idealize, devalue and discard partners and other victims after they are "used up" - often in very callous ways, and they lack empathy and exist only for themselves. I believe these real BPDs are nothing but NPDs using emotions to manipulate. Both are empty inside and need to fil their voids by controlling others and seeing THEM react emotionally.
I agree that the PTSD sufferers reasons are very different from that.

 

[alt]

....so this all boils down to not wanting perpetrators and victims to have the same diagnosis?!?!...

Hmm... I agree with the idea that victims and perpetrators can have the same diagnosis.

I don't agree with people who do not have personality disorders being diagnosed with personality disorders. I base that assumption on Bessel van der Kolk's book "the body keeps the scores" where he argued that a lot of c-PTSD sufferers were wrongly diagnosed BPD. I don't know if he is right, but if he is, that sucks.

 

[alt]

I'll add one more point to the previous answer:
Borderline Personality Disorder vs. Narcissistic Personality Disorder Differences

Narcissists and Borderliners are extremely similar. The difference is basically mostly that SOME BPDs express shame after rage attacks while some don't, and some BPDs keep their rage internally and other don't, whereas NPDs don't feel shame and don't turn rage on themselves. I believe that the BPDs that are shameful may coincide with those that in reality suffer from PTSD and not BPD, and those that do not feel shame are in reality nothing but (often female) NPDs.

 

[Ronin]

They both want to defend against perceived slight.

No, not really.
A perceived sense of grandiosity and not appreciating someone enough, which needs deefense vs. a sense of perpetual abandonment and everything shaky as reasons for defense are very different mental spaces to come from, to that defense.

One is not like the other.
Reasons for the perceived, or actual, hurt, and acting on them, matter. If for nothing else you cannot put all fires out with water. One would not want to be toast as actual firefighting, interpersonal fires are similar.

 

[mumstheword]

I see some validity in your reasoning @lillesnille . I was misdiagnosed with BPD after being on the receiving end of much abuse for 37 years. The diagnosis has since been overturned and my official diagnosis is c-ptsd.
I am nothing like a BPD person but when I was subject to all the abuse I think I was mirroring elements of the abuse I had received, as well as being brainwashed to believe that I was the abuser and "the crazy one".

Neither my primary long term abuser (my mother) or my second long term abuser (the father of my children ) have ever been diagnosed and I doubt they would ever be accountable enough or honest enough to receive an accurate diagnosis.

However, I strongly suspect that my mother fits, to a T, the profile of a Histrionic personality disorder and my ex is very much NPD /or male expression of BPD (it's a spectrum and he fits traits of both, as well as "anti-social personality disorder" and "addictive personality disorder. Let's just say he's a bit of a socio or psychopath. Yes, I've read extensively about this lack-of-empathy spectrum.

He manipulates to receive admiration, to never be criticized, in a cult-leader like fashion. He likes to get people addicted to drugs that he can control them with and supply them with. He gaslights and is an extremely adept pathological liar who seems to be able to convince himself that his lies are truth and he projects all his "shadow side" abuse and dishonesty traits onto those who call him to account (me being a primary threat and focus, in this regard).

Both of these people discarded me when I was most in need and no longer able to be controlled by them and have slandered me and influenced other family members to think ill of me and shun me, I believe, to try to protect their "smoke and mirrors" reputation. Both play the victim very convincingly, but act as if nobody but themselves are really important or right.

Both these abusers experienced neglect and abuse as children (so they tell me, anyway), but both were also spoilt as young children before they lost the attention that gave them status (this is only really a theory though, from what I've picked up from other family members and stories).

I don't know if this helps.

I was told that I shouldn't tell local public mental health service providers that I had c-ptsd as they would simply think that was synonymous for BPD, which is not only inaccurate but detrimental, so I avoid all these erroneous services and seek treatment in the private system, that is trauma informed.

I am overly endowed with empathy, it seems, but would rather be like this than treat others badly. I have, however, had to do a lot of work to stop treating myself badly.

I still suffer "dysregulation" and my brain/nervous system/body is overly reactive to stresses and perceived threats. I also am subject to "developmental trauma," and am often stuck in child and adolescent "parts" or "modes".