General "Game Playing" With PTSD?

[upstream]

This thread is split from : [DLMURL]http://www.ptsdforum.org/thread6719.html[/DLMURL]

As I mentioned, we've had an extremely stormy relationship: we get close, he pulls away, or acts like a complete jerk. We started talking again right after Thanksgiving - he said that he was lucky to have had me and he wants another try; said that he's a happier, calmer person now, and wants to be happy with me. He flew me down there and we had an amazing time. He was kinder, and sweeter than ever. I was so proud that he was getting help and could see the difference. But, over the past couple weeks, he's gradually started pulling away again. Gone are the sweet texts during the day. Which has me wondering if he's just playing games. But, this behavior is also consistant with ptsd.

Blueeyedgirl... what you describe in this post and the subsequent ones does not sound like a relationship with someone with PTSD, it sounds like a relationship with someone who has borderline personality disorder. I can not say for sure one way or the other from your posts, but may be worth doing some research on the topic...

Playing games isn't a symptom of PTSD...

 

[anthony]

I beg to differ.... its not about "intentionally" playing a game with you, it is through severe anxiety that you feel the ups and downs, which you likely perceive as playing games. I have done similar things before, I know many personally who have PTSD and have done similar things also within relationships. Its not because they wanted too, they just didn't know which way was up a lot of the time. When anxiety calmed you will likely see the rational them, when their anxiety is peaking you will likely see the not so rational them.... which can easily be viewed in a relationship as "playing games."

 

[upstream]

I beg to differ.... its not about "intentionally" playing a game with you, it is through severe anxiety that you feel the ups and downs, which you likely perceive as playing games. I have done similar things before, I know many personally who have PTSD and have done similar things also within relationships. Its not because they wanted too, they just didn't know which way was up a lot of the time. When anxiety calmed you will likely see the rational them, when their anxiety is peaking you will likely see the not so rational them.... which can easily be viewed in a relationship as "playing games."

Granted it can be perceived as "playing games," but as you said it was far from intentional. I don't prescribe to the idea that "Someone is a game playing jerk, therefor they have PTSD." This goes back to our discussion on mis-diagnosis and confusing symptoms. Based on the information we have, we can't say for sure that his behavior is due to PTSD or something else. I've been romantically involved with someone who was diagnosed as borderline and I empathized with what she wrote.

The key phrase in her post was "stormy relationship" as well as descriptions of him pulling her close, pushing her away, then repeating. This is what Borderlines are known for. Check out the DSM IV Diagnostic Criteria for Borderline Personality Disorder, especially numbers 1,2, 6, and 9

DSM IV Criteria for Borderline Personality Disorder:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. frantic efforts to avoid real or imagined abandonment. Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

2. a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

3. identity disturbance: markedly and persistently unstable self-image or sense of self

4. impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating). Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

5. recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

6. affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

7. chronic feelings of emptiness

8. inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

9. transient, stress-related paranoid ideation or severe dissociative symptoms

 

[blueeyedgirl]

Wow. Now I'm confused. This does sound like him.... when he's unhealthy that is. And couldn't those things also be associated with PTSD? Thing is, he's been professionally diagnosed with PTSD. He could have been misdiagnosed simply because of his tours in Iraq. But, wouldn't a trained psychiatrist notice the difference?

Another question - in either case, BPD or PTSD, is the person aware of their behavior patterns? Meaning, is he aware that he's pulling away because of stress (if he does have ptsd)?

 

[Kathy]

It is most unwise to attempt a diagnosis when one is not a professional. Some of the features of personality disorder may seem similar to what your boyfriend experiences, however if he has already been diagnosed with PTSD by a professional, I would trust that diagnosis. You are correct; all of the above could also be associated with PTSD. In fact, many people, diagnosed with a disorder or not, could look at the list provided by Upstream and find that they relate in some respects - for example, those diagnosed with clinical depression may also experience many of the above symptoms. Having similar symptoms or features does not necessarily mean the same diagnosis. When making a diagnosis, professionals look at many factors. The extent of the problem, number of criteria, duration and severity of symptoms, past history (including whether trauma is present or not - trauma is not a requirement for the diagnosis of a personality disorder), exclusion of other disorders and so on. Do be careful to not jump to any conclusions.

Blueeyedgirl, have you read the following article? It is one of the best on the forum, at describing the stress of PTSD, and how it makes our loved ones behave. I found it extremely helpful in my personal understanding of PTSD. I highly recommend you read it, if you haven't already:

[DLMURL]http://www.ptsdforum.org/thread2296.html[/DLMURL]

 

[batgirl]

Another question - in either case, BPD or PTSD, is the person aware of their behavior patterns? Meaning, is he aware that he's pulling away because of stress (if he does have ptsd)?

Mum (Kathy) asked me to come on and answer this, as I have PTSD. I can only speak for myself, others with PTSD might have a different experience. But personally, self-awareness is something I didn't have a lot of when I was really ill and not in treatment. Most of the time I didn't realize the effect my actions had on others. The few times when I did realize, I didn't really care. That sounds selfish, but I was in so much pain at that point that I had nothing to give to anyone else. I was just trying to survive, and trying to avoid as much pain as I could, if that makes any sense.

Even now that I've partly recovered and worked on a lot of my issues, I still go through bad periods, where the stress gets to be too much for me and I can't see how my actions effect others. The past couple of days in fact, I had a major stressor which has made me ill. I have attempted to pick fights with and hurt my family and one friend here over and over again during these two days. But I only realized how nasty I was being for the first time yesterday. I was about to send yet another nasty email to my friend (who was being very patient with me) when I suddenly realized what I was doing. Until that point I hadn't realized. When I get very stressed and ill, it is very difficult for me to see where I am wrong and hurting others. I don't think clearly during those times due to the amount of pain I am experiencing. I am getting better with working on myself, but it is a long painful process.

 

[blueeyedgirl]

Thank you Kathy and Batgirl for your replies.

Batgirl, my heart goes out to you for having the strength to face your issues and work through them. Thank you for your insights, as I was truly unaware of whether he saw he behavior as inappropriate or not. I'd point things out to him, and of course he'd deny that he was behaving in a particular way, but I wasn't sure if it was just out of defense, or if he really didn't believe he was in the wrong.

Thanks again

 

[batgirl]

My family and friends point out things to me too, and when I'm ill I don't see their point of view at all. I'm getting better at taking their word for it, because I trust them, but it's still hard sometimes. The past couple of days I've felt attacked by them, though as I say I mostly trust them now and try to be honest with myself. It's much better though if I am able to figure out for myself where I've gone wrong.

 

[blueeyedgirl]

So I guess he's going to see me as irrational and emotional, then. Oh, well. Guess it doesn't matter in the long run. As I've decided to just let it go.

 

[batgirl]

Well I'm just one person though, not everyone with PTSD is going to be like me. But if he's not willing to be honest or upfront with you about what's going on, then it's kind of hard for you to know what to do really. You're not a mind reader.

 

[ruddy]

I guess my experience is a bit different than Evie's. I realize that I am pushing people away and will (sometimes) tell people that I need/want to be alone. Unfortunately I can't usually explain why so it must be equally frustrating for loved ones.

 

[anthony]

I agree with what Kathy said. I will add this... when I had PTSD uncontrolled I can read the personality disorder and fit near every criterion. Does that mean I had a personality disorder? No... and I certainly do not fit the criteria today. A diagnosis stems further than the theory criterion... it encompasses physical and behavioural attributes which are not covered in the theory diagnostic criteria. You CANNOT read a diagnosis and apply it to a person, because if you go and read most diagnosis you could fit them too most of sufferers with PTSD uncontrolled.

PTSD proves symptoms of many disorders, including personality disorders, but it is not that, it is what PTSD actually is. PTSD is not created equally..... PTSD is PTSD, however; the levels of symptoms and range of symptoms are different to each person and their trauma. This is why you must trust your professional that they truly know what they are talking about, and not just out to slap you with labels or just have no idea and under diagnose. I would even recommend people to always seek two professional opinions, if both match then you take the physician who best suits you and stick with them for medication checks, as that is all a shrink does after the diagnosis.... therapists do all the chit chat work.