News 14 Safeguards For Therapists

[KwanYingirl]

My therapist has a chart showing PTSD at the bottom. Lines go out around it to show the effects of trauma. The personality disorders are there as well as other subtypes. In other words, recognize the PTSD and teach the client that all roads lead to PTSD. If I'm feeling wiggy as in Borderline world, he just goes over the chart with me. It is comforting.
I don't think I would work with the author of that article.

 

[Deleted member 29920]

I'd love to see her replies if some people from here comented on the article :roflmao:

"Christine, you chose the wrong career."

"thank you for your comment."

Cold-hearted so and so.

 

[Weemie]

jesus f*cking christ. this is terrible. what a horrible article. way to highlight everything that is wrong with the psychiatric community.

 

[Stickler]

Um, maybe this explains why my guy is afraid of therapists.

 

[StellaBlue]

My therapist has a chart showing PTSD at the bottom. Lines go out around it to show the effects of trauma. The personality disorders are there as well as other subtypes. In other words, recognize the PTSD and teach the client that all roads lead to PTSD. If I'm feeling wiggy as in Borderline world, he just goes over the chart with me. It is comforting.

I would love to see your chart. I struggled (and still do occasionally) with fearing that I'm Borderline. I had a psychiatrist "dismiss" me after a 15 minute interview (in which he also took a 5 minute phone call) as Borderline - told me there was no hope, no cure - and prescribed me a cocktail of meds that almost killed me. That was years ago but it still haunts me.

Since then I've had one therapist who actually walked me through the DSM criteria to show me that I wasn't and a second one who explained that EVERYONE exhibits some of these symptoms when they're stressed. When I'm being truly mindful of what's going on, I am able to recognize that those "wiggy" feelings and thoughts mean that I've been triggered.

Honestly, I wish they would just do away with this diagnosis. I think it's has been used inappropriately to label "difficult" clients (especially women) and stigmatize them.

Regarding the author of the blog - it looks like she's a fairly new LMHC. Her "practice" consists of two more fairly new counselors with a focus on Christian counseling (not that that's necessarily a bad thing - but something she posted [either on her blog or her professional site] has a Focus on the Family endorsement]).

 

[scout86]

focus on Christian counseling

Her attitude will go a long way towards giving Christianity a bad name.

As far as the labels go, my T has a speech he gives regarding labels that says all these traits exist in a continuum and everyone shows more or less of them.(It just happens I show a few more of some than the people who dwell in the center of the bell shaped distribution). He says he won't really be happy with labels until they are precise enough that we each get our own. The labels are just descriptive shorthand and convenient. They aren't real boxes that people should be expected to fit into.

 

[The Albatross]

I think that's a bit of a stretch as Christianity has no shortage of sources for getting a bad name anyways.

I think though that the attitude with which she presents herself is a liability to both Christian and therapeutic service institutions. Hopefully her peers will sort her out.

 

[Ronin]

I don't think it's a terrible article.

She's urging caution. And she's not caught up in oh-woe-person-with-personality-disorder, but considering the community they're influencing first and foremost. That takes a lot of critical thinking skills if nothing else, going against the individualism crowd & recognizing impact on everybody else aside of the client.

And she wasn't judging personality disorders. She says it is important to get the diagnoses & stories straight. She recognizes say ASPD is not much alike BPD. She recognizes bad end of both can mean an abusive bastard up someone's home & hella lot of trouble she shouldn't be feeding into. She's being realistic.

 

[scout86]

She says it is important to get the diagnoses & stories straight.

I missed that somehow.

What I got was that she thinks all people with personality disorders are liars, so you can't believe a client you think has ANY PD. You should just treat what they tell you as "entertainment".

As far as getting the stories straight...... I agree that it might be important. I also know that my T would get a MUCH different version of reality if he talked to my family, or my ex, than what he gets from me. Then, I guess, he'd have to sort it out. Which might be hard. I think HE could probably do it. This woman? Nothing there gives me much faith that she would because it sounds like she's already decided the client is "wrong".

 

[Ronin]

I missed that somehow.

Right at the first point:

When possible, obtain psychologic testing confirming the type of personality disorder. The co-morbidity rate is high on personality dysfunctions

Stating co-morbidity is high isn't stating there's causation, just correlation, and it doesn't link all of the diagnoses together, it acknowledges there are common traits, from the way I'm reading it.

Edited to add: That article isn't aimed at PTSD / abuse population as a general. The advice is for entirely different population, it's not even personality disorders arising from trauma specified, it's for personality disorders as is. TLDR, she's not talking about us.

 

[Eleanor]

Context determines meaning. I thought it seemed pretty sensible and conservative actually - if read with the assumption that she is talking about treating ABUSERS. Granted in the following list: "Borderline, Narcissism, Schizotypal, Paranoid, and Anti-Social mandate nearly all of the following safeguards. Histrionic, Avoidant, Obsessive-Compulsive, Dependent, Schizoid, and Passive-Aggressive require far less." I think "borderline" is a much more problematic category than the others in its category.

I guess I come at life from a kind of Hercule Poirot "My dear, everyone lies about one thing or another" point of view. So the assertion that the client (aka "human being") is lying seems to me tautologous. Of course the client lies. Everybody lies. The crucial bit is figuring out what they are lying about and why they are lying. And compounding the problem some people aren't, strictly speaking, lying but fabricating or just reporting the result of cognitive distortions. When my H claims that I am not attracted to him, he is not telling the truth, but he is not lying either. He genuinely believes this, despite the reality. It doesn't really help to "believe" him in the sense that we then proceed as if I am not attracted to him. Because that is false. The problem is not in the reality, the problem is in his perception/interpretation of reality. If we are a bit sloppy in how we speak (as natural language always is) then he is lying. But in a more precise way, he is not. The point is that the T cannot take as "an accurate evaluation of reality" the clients' reports. It is always more complicated than one person's take can encompass. In one way, that's what we pay T's for. That seems pretty uncontroversial and not at all disturbing to me. I don't WANT my T to just swallow everything I say. I WANT her to point out when I am likely misinterpreting.

And given how easy it is to get taken in by people who have "Narcissism, Schizotypal, Paranoid, and Anti-Social" disorders, and the great harm they can do to others (including the T and by using the T) I think caution is appropriate. Obviously a T who assumes EVERY person who walks into the office is in one of these categories is not going to be a very effective T. These are not the only categories of personality disorder...

If I was a T I don't think I'd be brave/something enough to try to treat people with full blown "Narcissism, Schizotypal, Paranoid, and Anti-Social" personality disorders who've found their way into therapy because they need it for some court something or other.

P.S. A lot of the symptoms of borderline overlap with c-PTSD and even more from structural dissociation. I would guess that is one of the things that makes finding a good T such a crapshoot.

 

[illusionist]

From my experience of knowing people who have worked/ work with criminals in the system diagnosed with mental health problems....these precautions have been told to me in one way or another. Told to me by very good, caring people....it is a realistic view imo.

Without these safeguards we would have more dangerous people walking our streets than we have already.

I've seen the effect of the wool being pulled over the eyes of a gullible therapist...not good for her or society.