BPD Complex ptsd vs. bpd

[shimmerz]

So what you're saying is that everyone is getting sh!tty treatment if they have childhood trauma and that a separate diagnosis would eliminate this problem?

Not sure if this was directed at me @Solara but it felt like it so I will respond. It sounds horrible and I trusted the system originally, but yes it is very difficult to find someone who knows what they are doing where I am. I have come up with some wonderful therapists but they are good for me because I did my research and found out what I was working with and chose them rather than took whoever was assigned to me. They were damaging me. Badly.

 

[Lady of Longbourn]

As a child sexual and physical abuse survivor I do believe I did not get adequate help for

....

So maybe there should be a separate diagnosis.

I do not understand the connection between 'getting help for' and 'separate diagnosis'. Why would that make a difference in treatment? Your psychologist/therapist/mental health doctors knows about more then one trauma.

Again, it just sounds like 'my trauma(s) are more important then yours'. I have had many traumas but never once have I thought my PTSD was worse then people with less traumas then me. It's all just PTSD; same disorder, same issues.

It just really looks like comparing IMHO.

 

[Notsowild]

@Ayesha ... Definetly Not the "same issues" How a child's development is affected as compared to an adults is drastically different. And thus diagnosis and treatment should be also.

 

[Lady of Longbourn]

I think then maybe you should look at complex trauma @Notsowild.

Solara nailed it.

Practitioners aren't stupid. Please don't assume that those of us with childhood trauma are lost without proper care and that we're receiving the wrong treatment as it's geared toward single incident trauma survivors. A differential diagnosis isn't going to suddenly blow open the scope of treatment options for those with long term trauma.

 

[shimmerz]

@Ayesha I haven't noticed a ton of 'my trauma is worse than yours' on this board. As a matter of fact I notice a very respectful attitude is prevalent here. I think some of us are just trying to say that therapies can damage if they are introduced too early and I feel like we are getting caught up in the word 'complex'.

Maybe if we step away from that word and say that if trauma occurred during in a developmental stage or in a sense where it was repeated ad nauseum and we were captive to it, that information would most likely be of great benefit and to be taken into consideration when deciding on a treatment modality.

If I wasn't able to speak when the majority of my trauma occurred (which is true) then it is pointless to get me to talk about it as I didn't know words then. That churns up emotions that I cannot process. Therefore, my therapist needs to be able to read my somatic responses to get to the bottom of those and then teach me to apply adult words to them so I can learn to cope in an adult manner to my responses.

It is my experience that most professionals, when presented with someone with PTSd go for CBT first where I am, and exposure therapy which is not appropriate for the situation I was in at the age that the damage occurred.

 

[anthony]

I think a lot of you need to actually go and really learn about what CPTSD is trying to be, and where it is today, because some of the nonsense I'm reading is just funny, to say the least.

CPTSD has nothing to do with childhood trauma, and is not even specific to it. Anyone who has that belief, is seriously misguided. CPTSD is being applied to childhood trauma and adult trauma.

The criterion are not even close to the same, which is just another reason why CPTSD has struggled to gain any momentum as an off-shoot to PTSD. If they were close, sure... but they aren't, and continue to fall further apart with more hypotheses presented on complex PTSD. PTSD is not complex or complicated more than another, which is another failing. PTSD is merely a categorical index of symptoms that occur based on a biological change within the brain. Trauma is the cause. There is simple trauma and complex trauma, no doubt about that one. PTSD does not get simple or complex though, and that is misguided.

People seriously wonder why this hasn't gained traction in official diagnostic circles... when many fail to look at the issues surrounding the proposed diagnosis being compared to an existing diagnosis.

@Butterflywings I am in Australia, Melbourne actually, and CPTSD does not exist as any type of official diagnosis in Australia either. You of all people would know you couldn't send such a thing to an insurance company or use it in court, when it has no official diagnostic criterion or legality, being within the medical industry. You know the documents require a diagnostic number for reference, and one doesn't exist for it because it doesn't exist legally here, or elsewhere in the world.

 

[anthony]

Oh, and if you have PTSD with dissociative symptoms and no personality disorder, then the DSM V does now clearly recognise this diagnosis as PTSD with Dissociative Symptoms (Depersonalisation / Derealisation) as applicable. That exists, legally, which covers some of the claims in this thread. It isn't called CPTSD, it is officially now called PTSD with Dissociative Symptoms (PTSD-DS). It is real, right now, and official...

Added: This removes this stigma of people with trauma who are heavily dissociated from being diagnosed with PTSD + DID, specialists claiming multiple personality types by enduring their clients to state such, and instead highlights that your heavy dissociative states are attributable in your case to your trauma, thus PTSD-DS.

 

[Lady of Longbourn]

@anthony You always say the things I wish I had the knowledge or thought process to say and in some cases the courage...

 

[shimmerz]

I guess I am not looking at insurance issues specifically as I am not covered, but am attempting to heal. So perhaps I am seeing this from a different angle. Bessel Van der Kolk et al prescribe to the relationship of developmental trauma and complex trauma as noted in this link. There is a ton of information here. It may not be official yet but it takes time to do studies and to make something mainstream. No disrespect intended but my personal opinion is that they are on to something here and have been for quite some time.
http://www.traumacenter.org/products/publications.php contains a listing of many studies. It may seem overwhelming to some but picking and choosing what calls out (if anything does) may help.

This one I find very relevant to this discussion.
http://www.traumacenter.org/products/pdf_files/SpecialIssueComplexTraumaOct2006JTS2.pdf

I am not certain that it answers the 'here and now' that you are asking about @anthony but I see that work is being done by professionals who are dedicated to trauma related issues and respected in their fields.

 

[anthony]

This has been around a long time @shimmerz and even your above link cites "complex trauma" within it. Complex trauma is very real, and they (the team who study complex trauma) have always been onto something, and in fact are some of the worlds experts on trauma. That doesn't change their claim for CPTSD. Complex trauma does not make CPTSD, and trauma should not be immediately established with PTSD, period.

The idocracy of this debate is that I've read from people here diagnosed, claimed, as CPTSD, yet those very people will also argue that PTSD should not be the first point of call when trauma is mentioned. The team that study complex trauma have done this exact thing, in trying to take pieces of multiple different diagnoses and lump them as complex PTSD. They should have never gone this route IMHO, and should have always tried to establish themselves for a unique diagnosis, because complex trauma can create unique problems, however; even though complex trauma creates unique problems than what PTSD is, it still does not negate that existing diagnoses already exist which can be used as comorbid diagnostic application to a primary diagnosis.

I often get the very impression from anyone labelled with CPTSD, that they desire to hold onto something that doesn't exist, is unique because it doesn't exist, and try and fight the reality of mental health diagnosis.

People think I'm closed to CPTSD, when in fact I'm anything but... however; I don't perpetuate nonsense. It wouldn't matter what diagnosis you tossed my way, if it is purely conjecture, zero officially agreed upon diagnostic application for trial purpose, then I would say the same thing. Medicine has a physicality to it, so when something new comes along, they have some physical and tangible to make their claim. Mental health... they don't. It is all based on what a person says, which could be anything, an interpretation a specialist has who is listening, then really all just best guess / statistical data to any type of majority basis for some type of credibility to be established.

This is why mental health doctrine changes so much. Social pressures see mental health diagnoses dropped, added and changed, where medical doesn't because of that physical correlation to substantiate validity. Mental health practitioners who have created a standardised model for the world are trying atleast to provide that standardisation, so mental health stops being laughed at. This nonsense with CPTSD just continues to perpetuate what a joke the mental health industry still is today. It isn't just CPTSD, there are lots of other diagnoses making it a continuing joke.

For those of us who suffer mental health, we all continue to garnish stigma from society as a result, because the very people trusted to bring credibility, also bring disharmony due to their unique causes. Mental health is trying to work as a collective, when still there are so many factions within it that create disharmony.

 

[shimmerz]

Medicine has a physicality to it, so when something new comes along, they have some physical and tangible to make their claim. Mental health... they don't. It is all based on what a person says, which could be anything, an interpretation a specialist has who is listening, then really all just best guess / statistical data to any type of majority basis for some type of credibility to be established.

@anthony, I absolutely agree with this. The nature of the beast complicates things greatly. As every new DSM comes in, we must adjust to the new guidelines. It can be confusing. I understand where you are coming from and respect what you are saying. As administrator especially you have to be very careful as you have a great responsibility to follow guidelines that exist now.

I know that Van der Kolk has helped a ton in my being able to understand why certain things did or did not help me in the beginning and although I don't agree with all that is said I do go with what resonates with me. I walked in blind to my situation as nobody told me what had happened to me and I had no memories of it so I had to piece it together. Once I found Herman and Van der Kolk et al, much made sense as to my behavours and I am grateful for what i have learned. I feel it has helped to make me a better person. If I had the choice I would not have missed this opportunity in life. I have grown much.

 

[Pencil]

I'm a recent convert to the 'there is no CPTSD diagnosis' stance.

I agree, @shimmerz , with the following:
"Van der Kolk has helped a ton in my being able to understand why certain things did or did not help me in the beginning and although I don't agree with all that is said I do go with what resonates with me. I walked in blind to my situation as nobody told me what had happened to me and I had no memories of it so I had to piece it together. Once I found Herman and Van der Kolk et al, much made sense as to my behavours and I am grateful for what i have learned."

The relief of finding insight - after decades and much disaster, was overwhelming. Consequently I advocated the CPTSD view at first.

The interesting thing is that the term CPTSD was suggested by Judith Herman as a replacement for BPD (a rose by another name). Will anyone who wants to claim CPTSD be happy to be diagnosed with BPD? Some individuals who claim CPTSD would be classified as BPD, others not. And immediately the CPTSD "diagnosis" is in trouble. CPTSD can't include BPD, which is a personality disorder, as well as complex trauma, where there is no personality disorder. And this explains why CPTSD can never be a diagnosis.

I'm still trying to get my head around it all, but I have to admit that I'm not putting much effort into the process, but this is what I see:

@anthony says in virtually every post: "CPTSD does not exist, complex trauma does." His dismissal of CPTSD as a diagnosis does not mean he rejects the reality of childhood / prolonged situational trauma.

I'm not trying to extend the shelf life of the debate, but if it does goes on, it might be a good idea to define CPTSD and then see if all of us who underwent complex trauma would fit neatly into that category. My bet is that we wouldn't. Nobody, including the DSM panel of experts, disagrees that there is a difference between a) an individual with a relatively normal upbringing who suffers a discrete traumatic event, and b) an individual who had a damaging upbringing, whose very upbringing was traumatic. But a lot of fine tuning and re-definition is needed.