Calling Troll On New Posters

[BlueOrange]

@Sighs , thank you for your patience in trying to help me to understand what you're trying to say & I'm sad that this patience seems to have reached a limit. (In other words: I appreciate your replies and would like them to continue - I respect your right to say 'that's enough'.) Thank you for the recent hair-loss metaphor, I think it helps me to understand. I recognize that one reason why it can be useful to exclude people from an environment like this one is because explaining "OK, that works for you, but it really doesn't work for me" can get exhausting. (I think that's related to what you're saying.)

While I do find parts of this conversation threatening, I don't think that anyone has actually issued anyone with a threat - this is my stuff coming up, I have no complaints to make.

 

[Friday]

At least a couple of previous posts discuss excluding undiagnosed people. Obviously this would effect me personally, but beyond myself, there are many folks here without access to somebody who could diagnose them- financial reasons, a shortage of specialists in their geographical area, etc. etc. Then there are those who are afraid of doctors and mental health professionals, those who are unable to speak their story, most likely those who are unable to leave their homes altogether.

While I'm hoping you don't mean my posts / one of the things I really like on here is the diversity of not just trauma but that the site specifically has ....sufferer/ supporter/ undiagnosed/ other... The catering allows for a really diverse and useful conversation to take place. :D For people on all sides. But while I say that a ton? I think it somehow gets missed. Which is probably on me.

Proper diagnosis is so dang important, just vitally important in so many different ways, but it's also very different from an official diagnosis. I think I do a bad job at differentiating the two when I'm speaking. If so, that's my mistake, and I apologize. Shall work on it.

 

[Queen Boudica]

If its any help to you @BlueOrange I also get that threatening vibe too. Difficult. I find when people get emotional and worked up or that they think their opinion is absolutely correct I start to feel threatened (narcissistic mother who was always right about everything). I do find some of the comments or the way things are worded quite confrontational personally. Yet I can get emotional and worked up and not intend to be 'threatening' or pushing maybe but I must do judging from some others reactions and then I go through this whole conflict of was I too much or is it their problem??? I find myself being more blunt now because, I have been very passive at other times in my life and am trying to work out the balance. Finding the balance is hard and if you start thinking about it too much you end up never saying anything. This criterion A thing and PTSD diagnosis thing really does make me feel very scared, the way people talk about it. I guess I do feel it is like you don't belong if you don't agree and fit the category. But then I have problems with feeling that I belong anywhere, so as soon as people start talking like that I think it applies to me. So never sure could be me, others or a whole load of things. But I think you are right to have your say @BlueOrange and I definitely relate to this.

I also feel if anyone had asked me about Criterion A diagnosis when I joined I would not have understood what they were going on about and it would have put the bejeavers into me. Whole load of dissociation and not understanding what I had at the beginning. Bad enough having all the other stuff going on without being questioned about your diagnosis. That I think is quite personal. I've really struggled with all of that side of accepting mental illness whatever flavour it is. Complex trauma is again one of those areas, that you just never feel you belong anywhere (well I do anyway). I don't know. Complicated.

 

[BlueOrange]

Thanks @joeylittle for the supportive response, and for the wonderful illustration of what can happen. I think silly examples are often the best examples and that touch of humour helped me to settle. I agree completely with the message that I received from it.

So, to orient myself on where the conversation is at, and where it might go:

1. We seem to have agreed that this is a well-run (albeit imperfect) place, and nobody has come up with a serious proposal for changing how disruptive people should be handled. We've agreed that disruptive people are handled as well as they realistically could be.
2. A parallel conversation has focussed on Criterion A. @stenni (if I understand correctly) said 'Should we really be asking people to defend the statement that they have PTSD?' - this reminded me of previous problems where I perceived established people here as being more interested in disproving a claim of 'having PTSD' than they were in having a constructive conversation.

And I guess that the point I've been unable to articulate until this point is this: if a person says "I have PTSD because I don't like the taste of grapefruit" (to take a silly and obviously impossible cause) and they also say "I have recurring nightmares where monsters shove grapefruit into my mouth" then the reality is that I value compassion over truth in this case. While it would be true to say "You can't have PTSD for that reason" I think it's more productive and good to say something useful about coping with nightmares. Ideally, the person replying would address both of those points.

We may eventually discover that there is actually a Criterion A event that the person has dissociated from that involves the taste of grapefruit - digging for that event while they're unable to cope with it is going to do more harm than good. We may also discover that the poster claims to be the Fairy Princess of Coastal Poland, and is unwilling to have anything but pure acceptance on that matter - in which case banning would certainly be appropriate.

I think that there are occasions where the frequent problem of people saying "You've said something false and I'm going to force you to recognize that" drowns out the alternative conversations that would be more useful for everyone involved. And I think that there are people who arrive in a fragile state and aren't able to have the useful conversation while they're feeling threatened about the false thing that they've said.

These 'things that I don't like' that I describe are not things that I've seen recently. Perhaps that's because they went away. Perhaps it's because they never happened in the first place (although the fact that someone else has raised it as an issue makes me think it's a perception that has some legitimacy). I don't really want to investigate and find a case study, although I'm not unwilling to do that (being specific often helps to defuse things). I believe that it will happen again, and my plan is to 'take the good and leave the bad'. There's plenty of good here, we'll see if the plan works.

 

[StellaBlue]

I don't believe empathy and compassion should give way to honesty and truthfulness.

I don't think these are mutually exclusive.

When I see a rape victim talking in this place about self-harming thoughts, I don't give a damn about the rape, I care about the self-harm. Rape is a horrible bad thing, but it's in the past and there's nothing I can do about it. Self-harm, nightmares, dissociation, eating problems, violent impulses, compulsion to re-enact the trauma - these are evils that I have an opportunity to address.

@BlueOrange, I believe you are coming from a compassionate and helpful place and while I think addressing self-harm, nightmares, dissociation, etc. can be helpful, it's like giving a person in cardiac arrest a band aid. As I said earlier, at least for me, all of these behaviors were symptoms, maladaptive coping mechanisms, stemming from the trauma. Until I started seriously started working with the trauma, it was like playing symptom Whack-A-Mole - ok, I've got the eating disorder under control, but now I'm drinking like a fish...ok, I've got the drinking under control, but now I'm dissociating constantly and back to puking...ok, I've got...well, you get the picture.

I also believe that trauma comes in many flavors and degrees - and I believe that there are probably biological factors that make one person more susceptible to developing PTSD than another person who may have had a similar (or "worse") trauma. And I am definitely not in to "my trauma is worse than yours" (I call it "Trauma Olympics").

I don't think any one here is denying that any trauma (even a hangnail) is...well...traumatic. What I think folks are saying is that there is a concrete definition of PTSD ( as "concrete" as mental health definitions can be :) - but I can go even more off topic there) - and it's the "D" that is important to distinguish a temporary maladaptive adjustment to trauma vs a full blown disorder - and that serves as the common denominator for discussions here. For now, it's the Criterion A that serves to make that distinction.

If I was a cancer sufferer, and someone who had the symptoms of cancer (but didn't have cancer) wanted to join my self-help group, I'd be glad to have them on board. Because they might know a useful trick for managing nausea. Because they might have question about hair loss that sparks a useful discussion. They'd be worthless for treating my cancer, but that's what my doctor is for. Comparing their 'not cancer' to my 'cancer' is not the point.

As a cancer survivor (and, interestingly, even though I almost died, it didn't traumatize me or even trigger my symptoms - in fact they went away while I was under treatment) - I would have been a little taken aback by a non-cancer sufferer joining a cancer self-help group. I would have questioned their motivations...unless maybe (just maybe) they joined and said "I don't have cancer, but I have nausea and am at my wits end trying to figure out how to resolve this - does anyone have any suggestions?" I would be offended if a non-cancer sufferer came to the group and said, "Well I had hair loss and here's how I cured it" (I'd probably be less offended if they said "I have hair loss and here's how I kept my head warm" ;)).

I hope I haven't added to your fear and anxiety @BlueOrange.

 

[BlueOrange]

@StellaBlue , I am not triggered or stressed by your post :)

What I think folks are saying is that there is a concrete definition of PTSD ( as "concrete" as mental health definitions can be :) - but I can go even more off topic there) - and it's the "D" that is important to distinguish a temporary maladaptive adjustment to trauma vs a full blown disorder - and that serves as the common denominator for discussions here. For now, it's the Criterion A that serves to make that distinction.

This quoted phrasing is interesting because it seems to simultaneously agree and disagree with the point that I'm trying to make.

I think we agree that:

1. PTSD is not the same thing as (say) adjustment disorder
2. That if someone with adjustment disorder thinks they have PTSD, they can get tied in all kinds of stupid knots, and their contributions here could be disruptive and counter-productive
3. This community has a right to protect itself, Anthony has a right to set policy for this community, it's going pretty well and has been for some time
4. Diversity of views is good

However:

1. Criterion A does not distinguish between adjustment disorder and PTSD. Presence of a stressor that satisfies Criterion A does not rule out adjustment disorder - criteria B, C, F and G are far more relevant when it comes to this distinction. (see DSM 5 criteria for PTSD ) (Criteria D and E are also features of adjustment disorder, and therefore don't help with differential diagnosis.)
2. Well-regarded and recent research into treatment for PTSD and other dissociative responses to trauma indicates that attempting to recall and process traumatic events when coping skills are not established tends to be counter-productive.

If we agree that the 'D' (the disorder) is the important bit, then we should also recognize that Criterion A is specifically about the T (the traumatic event).

I therefore submit that:

1. a person is 'in the right class' if they have a disorder of structural dissociation that was caused by trauma. (PTSD and also DD-NOS or DID, noting that there is widespread use of the CPTSD label to refer to DD-NOS and DID.)
2. My preference (this is not a request to change site/moderation policy) is that when someone uses the term PTSD inaccurately, members consider the upsetting impact of 'de-labeling' someone and avoid giving undue emphasis to the inaccurate terminology.

 

[Friday]

And I guess that the point I've been unable to articulate until this point is this: if a person says "I have PTSD because I don't like the taste of grapefruit" (to take a silly and obviously impossible cause) and they also say "I have recurring nightmares where monsters shove grapefruit into my mouth" then the reality is that I value compassion over truth in this case. While it would be true to say "You can't have PTSD for that reason" I think it's more productive and good to say something useful about coping with nightmares. Ideally, the person replying would address both of those points.

So this is where I get on my proper diagnosis schtick. Not official diagnosis, but proper diagnosis; treating the correct disorder.

Each and every single one of our symptoms are found in other disorders (with the exclusion that the event(s) that caused them has to have been real*). But the way that we treat them? Is PTSD specific.

While there is some overlap with some disorders? It's not like PTSD advice is panacea.

Let's flip this around so maybe it will be easier to see :

- A common nightmare trick that most of the neurotypical world uses is to insert reality: It's not real. That would never happen. How silly!!! Haha! A grapefruit. The things our imagination comes up with! ... In fact, using more serious subjects, to actually research how unlikely said terrible thing would ever happen. Nightmare about planes crashing? You have an equal statistical probability of being struck by lightning while being attacked by a shark (my fav stat, ever)... As being in an aircraft related accident. So a person is instructed to step by step and go through and debunk the nonsense their brain has decided to conjure.

... Know why we don't see that advice here? Right. Because they already did happen. Worst case scenario repeated denials that something could never happen are repressing memories/compartmentalization or suicidal despair at not being believed. And telling someone to go start researching their nightmares? Ummm... Trigger much? Okay. Let's take someone who is already having a post-nightmare anxiety attack and push them over the edge by triggering the f*ck out of them. Exposure therapy is one thing, but no one expects to be calmed down and their fears put to rest by doing it. Great way to take a bad situation and make it worse.

And that's just normal-people advice gone terribly wrong. If we started getting into how nightmares are best treated for other disorders and trying to implement them on PTSD? Things get really ugly.

The same is true when we take PTSD advice and unleash it on other disorders. Seriously bad juju. Especially for delusional disorders, but hardly limited to them.

 

[Friday]

We may eventually discover that there is actually a Criterion A event that the person has dissociated from that involves the taste of grapefruit - digging for that event while they're unable to cope with it is going to do more harm than good..

&

• My preference (this is not a request to change site/moderation policy) is that when someone uses the term PTSD inaccurately, members consider the upsetting impact of 'de-labeling' someone and avoid giving undue emphasis to the inaccurate terminology.

This is purely my opinion here... I find this incredibly insulting, at best. Denying the person has the intelligence or capability to take facts and apply them to their own life? Refusing a person the truth because -without ever having met them- we've decided that their intellectual capacity is so little, and ours so great... (Not to mention somehow divined their emotional state)... That instead of being honest we should withhold the truth from them for their own good? Not give them the opportunity to exercise their own agency and make choices in their own lives based on the best information available?

 

[anthony]

Criterion A does not distinguish between adjustment disorder and PTSD.

Do you mean acute stress disorder? Being the precursor to PTSD? Link Removed (DSM V version)
PTSD (DSM V version) Link Removed

Adjustment disorder does not have PTSD criterion A: Link Removed (DSM V version)

 

[Mallaky]

I hope I am not out of line, but reading this thread it occured to me that this is a very, very political thread. Quite fascinating. If one takes out the specifics, this reads as every other political discussion of people with differing point of views.

 

[BlueOrange]

Adjustment disorder does not have PTSD criterion A: Link Removed (DSM V version)

That is true. However, if you want to distinguish between adjustment disorder and PTSD, then PTSD criterion A is not terribly useful, because 'a stressor' (adjustment disorder) could be a stressor that matches criterion A (PTSD). Indeed, there are people who encounter a criterion A stressor and do not develop PTSD. General Patton rather famously slapped a hospitalized soldier in the face for saying he was shellshocked, so we can say that 'exposure to a PTSD criterion stressor' is no guarantee of a positive contribution.

 

[BlueOrange]

@FridayJones , I'm not saying that a person should be refused the truth. I don't object to people saying "That's not PTSD" if the person doesn't match the PTSD criteria (A, or any other). What I'm saying is that if a person says "I have CPTSD and I have these problems" that I (personally) don't like it if someone replies with 'CPTSD isn't a real diagnosis' and leaves it at that.

Also, I don't think it's insulting to suggest that someone might not be able to handle the truth all of the truth at once, especially if that person has PTSD. If we could always handle the truth, we wouldn't have PTSD, because we wouldn't meet criterion C (avoidance of 'thoughts and feelings' or 'reminders'). There are people who avoid the truth by getting angry when it's pointed out to them, and many of those people have PTSD or another dissociative disorder. Given that there is only so much truth that a person can handle at any given moment, my belief is that it's useful to prioritize and balance the way that you hand out the truth.

In domestic abuse and neglect cases "I was abused by my parents" is something that people avoid dealing with. Part of what was influencing my responses to this thread is that I had forgotten (dissociated from) the fact that my trauma includes very credible threats of serious injury that were immediate realities. It wasn't until I got really angry that I remembered some of that stuff. (Gosh I'm glad I used the 'delete key' instead of the 'post button' on some of my replies.)