BPD Complex ptsd vs. bpd

[Lucycat]

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.

But surely you can define 'trauma' yet not everyone goes on to develop PTSD. Likewise not everybody who endures complex trauma will get PTSD let alone CPTSD. We are forgetting resilience and vulnerability.

I don't think anyone is suggesting that if you trauma is complex you must be diagnosed with CPTSD.

 

[anthony]

In my honest opinion, I believe those researching complex trauma screwed up royally by trying to make vastly different symptoms fit into a PTSD category. They should have ALWAYS gone for unique, and possibly today we would have an official diagnosis under the new trauma category, instead of rejection and chaos within the industry.

It honestly just baffles me that people so smart, have been so dumb, all at once (those key researchers in complex trauma).[DOUBLEPOST=1398154928][/DOUBLEPOST]Sorry @Lucycat I fixed your prior mistake obviously as you were reposting.

 

[shimmerz]

@Pencil, yes I agree with what you are saying. I believe Judith Herman did some groundbreaking work by defining a distinction and Van der Kolk continued on with his Development Disorder work. I think that I am sensitive to this blanket PTSD with co morbidity template as here in Ontario there is no wiggle room for how things are treated. PTSD involves treatment A. Period. That is really all they will endorse unless you go to a private psychologist who usually knows much more than the psychiatrists as to the implications of your past and the treatment that will get you where you need to go. So yes, I am not fighting for a CPTSD diagnosis but am searching for a better system breaking down the needs of people with further complications in development or the effects of brutalization after brutalization.

@anthony, yes I believe that calling it CPTSD will still not cover it. I keep remembering though that these people who research see it - they don't feel it. I think there is nothing like experience and because we are considered 'mentally ill' few people listen to the experience and ask how it is that we have been able to progress. There is such a stigma attached and regardless of education many people have no concept nor do they honour their patient's experiences in healing. That might be helpful....

@Lucycat, I agree with you. Certainly not everyone with complex traumas show the sign of PTSD nor 'CPTSD'. But those of us who do need to be able to determine how to progress into a more functional lifestyle should have this information available to us so that we can continue on a path that we feel is good for us. It has been my experience that doctors locking us into a simple PTSD box out of ignorance has not proven to be an effective form of healing. I feel it is damaging quite a few of us by pushing us too quickly or demanding that we do something we are simply not capable of at that time.

 

[Pencil]

@lucykat:
"I don't think anyone is suggesting that if you trauma is complex you must be diagnosed with CPTSD"

What is being suggested then?

 

[Butterflywings]

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? Well, that's not my experience, not in the least. Maybe there are better resources around me, I don't know, but it seems like mental health providers are currently aware that single trauma PTSD is different than ongoing childhood trauma PTSD and as such they know that it must be approached differently. I think that perhaps the label is being given a lot more weight than it is potentially worth. I don't think that a new and separate diagnosis is going to bring about a lot of change that many think it will. Well, for the simple fact that the underlying symptoms that are being presented will still be the same. In the end, you treat the symptoms, not necessarily the umbrella disorder. That is, beyond the basics of processing the trauma in one way or another, the symptoms need to be approached individually.

If that's asking me? No not at all. What I'm saying is anyone labelled borderline usually gets bad treatment. Even those who have no trauma at all. 5+ years ago there were many professionals who automatically labelled anyone who self harmed as "borderline". Since a lot of those with PTSD from childhood trauma self harm, they get mislabelled as BPD. And unfortunately, a lot of professionals think BPD is untreatable and that sufferers are just attention seekers and that denying them treatment is somehow the "treatment" for BPD. Some "professionals" still have this backward view. For those who actually have another disorder (PTSD, bipolar etc), it means they are denied treatments that are known to work (eg EMDR for PTSD, mood stabilisers for bipolar etc), and for those who really do have BPD there are treatments known to work such as DBT etc.

I think the separate CPTSD diagnosis would be helpful in helping suffers of PTSD from complex trauma not be mistaken for having BPD. Yes there is actually a lot of overlap in the correct treatments for both, but there is so much stigma amongst mental health professionals about those labelled "borderline" that even if someone is misdiagnosed as having PTSD when they really have BPD, they're guaranteed to get treatment that works. However if someone has PTSD but are diagnosed as borderline, they generally will cop a lot of negative and little or no treatment. It's not because one diagnosis is worse than the other in severity, it's because of the stigma surrounding BPD. If all professionals got rid of the stigma around BPD, there wouldn't be a problem.

 

[Butterflywings]

@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 I don't work for the legal system or an insurance company. I work as a health professional. I don't care what the legal system or insurance companies do or don't do. CPTSD is used as a diagnosis frequently by health professionals here. As mentioned, I've seen one of the best (if not the best) psychiatrist here (sorry I'm not comfortable giving the details of what state I live in due to my own privacy, other than to say is it's not Victoria) and been diagnosed with CPTSD. Yes, CPTSD isn't a DSM diagnosis or an ICD diagnoses, but lots of psychiatrists do use it. It's more common in the private system in the public system as private psychiatrists aren't as tied to government control.

Would it make you more comfortable if people called it "PTSD with the trigger being a complex trauma"? That recognises that 1. the diagnosis is PTSD 2. that the trigger is complex trauma, while 3. not claiming that complex trauma always leads to PTSD.

 

[anthony]

@Butterflywings can you post here the diagnostic criterion that your psychiatrist uses please? Also, if you could get the associated documentation used that helps them align to that diagnosis, I would honestly like to read it here.

 

[shimmerz]

I get the reason to know what the criterion is. I believe in complex trauma but I would be interested in true criterion as well. I know I liked Judith Herman's take on the difference between singular trauma and complex trauma and I always felt that complex trauma was what a holistic healer asked me when I told him I suffered from trauma. Put quite simply he asked 'so are we talking a really horrendous thing that happened to you one day or being beat the sh*t out of you emotionally or physically on an ongoing basis? THAT is what I thought was going to be the differential diagnosis in the DSM V when they were speaking of adding it prior to it's update.

 

[anthony]

The thing is, is that the DSM V and ICD already cover being beaten the shit out of ongoing via multiple diagnoses applied depending on each persons unique presenting problems.

 

[anthony]

People love to play on the "affect / regulation" of the proposed CPTSD, ok... so why isn't depression part of PTSD? More people with PTSD suffer depression symptoms than not, so why don't we change the diagnosis to also encompass that? Where do the experts stop the craziness? Where is the line drawn? Do we really start adding what can be normal behaviour into diagnoses, such as mood affect / regulation, when there are mood disorders already existent? Just as there are depression disorders!

If Judith Herman or Van der Kolk ever read anything here about this... then I hope they take the smartest route away from this, being to stop trying to push a term of CPTSD down everyones throat and instead, create a diagnostic term befitting of the very different criterion they propose. It was moronic of them to try and link it to an existing name, yet have vastly different proposed criterion. Even the ICD 11, at this time, has the term CPTSD proposed for 2017, but actually links off to another personality based diagnosis. I don't think people are really going to be happy with what the ICD11 currently has proposed to people please the issue. You still won't really be able to say you're diagnosed with CPTSD IF they go ahead with leaving the term linked in as they do, because the actual diagnosis will be a different name, where the criterion is listed. Thus... it still won't exist and still won't have recognised criterion, it will just be a link to an actual diagnosis.

The diagnosis linked to in the proposed ICD 11 isn't close to the proposed diagnosis by Herman et. al. That means those labelled with it, still won't be getting what is proposed by Herman et. al. I actually think it will steer a lot of people away, because it is more aptly based on personality concerns.

 

[shimmerz]

Yes @anthony but my diagnosis is PTSD with DDNOS (NOS = Not Otherwise Specified). I could be considered DESNOS as well although my t-doc called it Severe Chronic Complex PTSD.

Any 'NOS' type disorder is basically ignored by psychiatrists here as there is not a set treatment that is covered by our 'superb' health care here in Ontario for NOS issues. Therefore I am treated as someone with cookie cutter PTSD that is not appropriate and harmful to me.

The only people I have encountered here who prescribe to specific measurement and treatment of NOS diagnosis are psychologists. They are extremely expensive. When our health care system does not take seriously a NOS designation, it impedes ones ability to get help as most of us cannot function in such a way that we can afford psychologists.

 

[shimmerz]

More people with PTSD suffer depression symptoms than not, so why don't we change the diagnosis to also encompass that?

I luckily don't suffer from depression but have a very firm diagnosis of PTSD. The diagnosis was put in place because I fit the criterion for PTSD. I feel like depression is a symptom and not part of a criterion. I may be off kilter here and apologize if I am but I believe a criterion can be set for a complex set of traumas as opposed to a singular traumatic issue as opposed to development trauma. The benefit to this is that it would help psychiatrists determine an appropriate course of treatment for each.