BPD Need help understanding borderline personality disorder(bpd)

[Meadowsweet]

Here is a link to the NICE (national institute for clinical excellence) guidelines for PTSD diagnosis and treatment in the UK.

It uses the ICD 10 and DSM IV diagnostic criteria for PTSD.

It mentions that some PTSD sufferers may display "features" of "enduring personality changes after catastrophic experience" or the "corresponding concept of DESNOS (complex PTSD)". And that "the guideline therefore takes into account that these features need to be considered when treating PTSD"

But there is no recommendation for UK clinicians to use the term CPTSd. It is absolutely not a recognised diagnosis in the UK.

There was a review carried out of the guidelines in 2011, and there will be no change until they are reviewed again in 2014. The 2014 review will consider the new criteria of DSM V.

You can read the rest of the guideline here: ']http://www.cbo.gov/sites/default/files/cbofiles/attachments/02-09-PTSD.pdf

Here is the NICE guidelines for BPD: [DLMURL="http://guidance.nice.org.uk/CG78/NICEGuidance/pdf/English"]http://guidance.nice.org.uk/CG78/NICEGuidance/pdf/English (keeping thread on track)[/DLMURL]

In the UK, the NICE guidelines are published for our clinicians to use. So whatever medical problem you experience, they are really useful to read.

 

[anthony]

Exactly... ICD 11 beta currently has the term "Complex Post Traumatic Stress Disorder" sitting there, with nothing assigned. It awaits to see what the DSM does first before it will move in that area. I would be shocked if the ICD didn't follow exactly as the DSM has, to keep global standardisation, with complex trauma being recognised as a sub-type of PTSD. That is expected in 2015, with final draft approximately 2014. So in 2014 we will know whether the ICD is going to go with CPTSD or the sub-type. Just as we had to wait until this year to see whether the DSM was going to go with it or not. The ICD, funnily enough, has also moved PTSD out into a trauma & stressor category, from its anxiety disorder cluster. Both authorities aren't know for reinventing the wheel when they actually work together on most things. They do like to have their quirks though to be that little indifferent... so in a couple of years it will be known whether that diagnosis ever exists in that term or not. But right now... it doesn't. It is purely speculative, perpetuated, and has ZERO diagnostic criterion for it to even be used.

Anyone claiming they have CPTSD is incorrect. You have PTSD + .... regardless the country you live within.

 

[anthony]

I think what I find weird is your use of the word 'legal' beside definition. The diagnosis is used in current practice. I know you quote the DSM and ICD, and they don't recognise Complex PTSD, but it is still used here as a formal diagnosis.

Lucy, I use "legal" because this is medicine. It doesn't matter how you want to try and swing it. Emotional, sympathetic, or any other view. The end result is the same. Mental health diagnosis is medicine. Medicine is a legally binding field. Current practice does not formally use CPTSD. A select demographics within the field "choose" to tell their clients they have it, with no legal medical basis, with zero legal medical diagnostic criterion.

Put any one of these persons in court or sending documents to insurance or medical agencies, and they will change their stance to use the correct medical diagnosis for their client that has identification numbers, being PTSD + .... Don't confuse a personal opinion of a treating physician with medical fact. The UK is no different, sorry to say. I've had UK persons here fight the same thing. Upon going to their physician and clarifying, they come back with the exact answer stated here... PTSD is the official diagnosis they must use for medical purposes for insurance and legal. Why? Because their opinionated, perpetuated myth, doesn't medically exist in any legal medical context. One could even argue they are legally deceiving their clients by making such a statement, when no diagnostic criterion exists to make such a medical diagnosis in the first instance.

Contrary to a persons belief, specific medical practitioners don't get to define medicine in their country. Mental health was medical last time I checked.

This is a mute argument, because it doesn't exist, not even in the UK. You, nor any other, has CPTSD, because there are no diagnostic criterion to make such a diagnosis to date.

 

[Shellbell]

The ICD, funnily enough, has also moved PTSD out into a trauma & stressor category, from its anxiety disorder cluster.

This makes a lot of sense, a necessary diagnostic element of PTSD having to be trauma induced. Where anxiety alone is not.

 

[anthony]

This makes a lot of sense, a necessary diagnostic element of PTSD having to be trauma induced. Where anxiety alone is not.

I think we're going to see a lot of changes coming towards how trauma is categorised, in the coming years. The APA nor WHO leap buildings to publish this stuff. It takes a decade for a diagnosis to change nowadays, let alone two for one to truly evolve in the first instance. I think having a trauma category in both publications is going to see some interesting developments, no doubt about it.

The ICD 11 may even stick with CPTSD, as they do like to have their quirks, as the APA do, so both can say they're independent. WHO may reprint the DSM 5 diagnosis with the sub-type and call it CPTSD. Time will tell. That would be significant for the WHO compared to the DSM version, as the DSM normally also sticks close with the ICD... stranger things have happened. Right now... PTSD is what we "all" have until officially legislated otherwise.

 

[Shellbell]

Right now... PTSD is what we "all" have until officially legislated otherwise.

I'm okay with it being PTSD, but I see the anxiety aspect as just one of so many that should also be present, but trauma being the most significant and the necessary cause. And for a correct diagnosis of PTSD being the trauma be of a severe enough impact. I understand the injury argument too. Yes, a lot could change, but slowly no doubt.

 

[ericaboo]

I couldn't read all of these posts because they were too close to home. So please excuse me if I'm being repetetive to what other poeple have said. Still - I want to put in my two cents back to the OP.

I was married to and also have a parent with a personality disorders. It is very hard to find information because there is so much conflict in opinions and ignorance on how to approach these relationships. I still found many websites to be informative and help me to make my own decisions on how to set boundaries.

Bottom line: IT IS POSSIBLE to set up boundaries without disrespect or vengefulness. If you can't do that, you and that person are not healthy to be around each other, and should not do so - IMHO.

Here's a link for you: Link Removed
I have another excellent link somewhere - I will post it when I find it...

It's so important to learn how to take care of your own needs in these situations. Once I started to do that, I ended up (guiltily) with divorce and a very limited relationship with my family. Due to having my boundaries tromped on for so many years, I am currently too vulnerable to be exposed to boundary impaired individuals for any length of time. I'm working to build myself up and be stronger.

I am far from figuring out "the" answers on this. There is a lot of anger and venting on the internet from people who feel victimized, and a lot of love and compassion coming from supporters who have the colossal strength to be there for their personality disordered loved ones.

I have much understanding for both sides of that street, and thankfulness for the people who have shown compassion for my illnesses. (PTSD & AD/HD)

Best Wishes,

-Erica

 

[Shan]

After reading the book "Surviving a Borderline Parent" I know without a doubt My Mother was to the extreme degree! I called her Dr. decades ago to ask her if she could possibly evaluate her...I was very concerned she had caused so much turmoil and upheaval in my life and had a knack for being one seemingly functional person at work and morphing into another on her drive home to me! Of course the Dr. told her that I called and it all blew up in my face like a volcano...

I was and still am walking on eggshells always trying to avoid the stepping next landmine. I have learned just recently to only discuss on phone calls the weather, dancing with the stars, american idol and all her hair and Dr. appointments etc....nothing personal, don't have any emotion or feeling (I was never allowed) or get berated with rage and then slams the phone down!

It took me till my late 40's to realized this and she is and never has looked out for my own best interest nor wanted anything good for me. I can never really tell her how I "feel" about anything or have an opinion, without a raging attack. So I keep it very general and vague.

It took me till I was in my late 40's to realize this. Life has been a lot less stressful without her manipulating and controlling it...no wonder I always felt like I was still a child! She was so afraid that I was going to have the life (normal) that she always hoped and dreamed of.....she destroyed every relationship I ever had by ...oh never mind way to much pain to go there right now. Still trying to pick up the pieces, now at 52 y/o, overweight, penniless and in isolation. She sure got her wish!!!

 

[Anna]

The problem is, with family you tend to put up with a lot more than you would with friends or co workers. If someone did that to you, you would probably break ties with them. With family we keep trying, especially the mother child bond which can be so strong.

I have found, especially with emotional abuse, the bond can be even stronger which is so twisted in so many ways.

You have to learn to protect yourself. We have one life only. Do not let someone else destroy it or make you feel bad.

As you say Shan, do not discuss anything personal or emotional with your mum. Best way is to pity her, the fact she cannot handle emotions. I had a volatile mother as well, maybe she had BPD too which explains why I have it? Who knows? I learned to handle her as well. She also caused one hell of a lot of damage. My BPD tended to channel inwards and the only person I hurt was myself.

 

[circe47]

Just my two cents-

While I agree that C-PTSD is not a formal diagnosis, I disagree that it SHOULD be. I also realize that what I want and what I am going to get are two entirely different things. Enough about that.

Whether a shrink or therapist can diagnose a person legally with this term, I feel, is really not the point. It's about VALIDATION of complex, multiple traumas that requires complex, long-term treatment by a caring, empathic T attuned to the suffering of the patient. IMHOP, even though a T does not have a listing for C-PTSD or numerical (IDC-9) code listed for a particular affliction, should not matter at the heart of it all. The art of diagnosis and treatment in psychology is really only based on data that has been accumulated over a little less than a hundred and fifty years, and put into text in the form of DSM. ICD-9 is predicated on that data, for the sake of billing purposes only. Data is only data, and subject to human input, lack thereof, and just plain old error. This doesn't mean the disorder isn't real....it simply means the data hasn't been listed, yet, by a community of shrinks who may, or may not agree, about it's validity. Perfect case in point: the strange phenomena of having several different diagnoses, by several different shrinks.

Personally, I think not listing C-PTSD in the DSM is extremely unfair, and because it IS NOT, TPTB do not do justice to people who have endured lifelong traumas at the hands of multiple abusers.

 

[anthony]

Personally, I think not listing C-PTSD in the DSM is extremely unfair, and because it IS NOT, TPTB do not do justice to people who have endured lifelong traumas at the hands of multiple abusers.

It is being listed in the DSM 5, but not by the recommended diagnosis that CPTSD formed from Judith Herman, or the DESNOS recommendation that Van Der Kolk recommended, instead, the dissociative and depersonalisation specifics relevant to those with complex trauma, have been added to the existing PTSD diagnosis as a new sub-type.

Thus... CPTSD will have a formally recognised term for what it was envisaged, being complex trauma, called: Posttraumatic Stress Disorder – With Prominent Dissociative (Depersonalization/Derealization) Symptoms (PTSD-DD).

That will be the official name for the proposed CPTSD, then DESNOS - PTSD-DD.

 

[Abstract]

I think this thread has brought up many interesting points which is great but I do feel a little sorry for Loveneverfails who was attempting to get ideas and possibly personal perspectives on how she can manage a relationship with her mother.

And I think it is helpful to know her mother was diagnosed BDP. I very strongly feel it is important to differentiate a human being from a personality disorder. BDP describes a set of long term patterns in the relationship the person has with others and with her/himself. It does not encapsulate all of who that person is. There are also mutiple criteria and not all those diagnosed will have the same combination. Therefore there can appear to be quite different behaviour from different people with the same diagnoses.

However, knowing that this was a diagnoses she had helps us have a little insight into the type of problems that may come up and I think that is helpful. I don't want to get sidetracked into debated BPD again although it is tempting and think it is much more helpful to concentrate on general ideas of what may help. This is also not about helping or changing LNF's mother and rather about helping her.

an adult I'm trying to understand how to deal with this person who I cannot entirely cut out of my life, without having my life entirely taken over by their wants and needs. ...Any help given is appreciated as I am relatively unsure on how to proceed. ...

Loveneverfails,
This sounds very hard and I commend you for wanting to find out more so that you can do this more safely and find a way to protect yourself.

What I will say is that part of what has helped me is to accept who the person is and isn't. I think a lot of pain comes from expecting different behaviour or thinking things have changed when there seems to be a breakthrough and then only to be hurt again. True acceptance comes with a certain amount of peace as well as making it easier to put down boundaries.

Boundaries are extremely important. Some with BDP can be very empathic but a lot not and from what you say it seems less likely your mother is able to see things from others perspective. So I think its important that take change of what you will and will not accept and always follow through with consequences if that is violated. One thing I do for example is that I have said I will not accept being insulted. If it starts happening in a phonecall I will calming state that this is not Ok and if it continues I will have to end the call. I follow through if it does not stop. I always do this calmly and assertively and avoid "you" words.

I also think its important to keep in mind that she is probably desperately going to want closeness and then find it intolerable. I think PTSD push and pull can be similar for some to an extent.

Anyway. Enough for now. It might help to post about typical situations that you find problematic. Either here or on a new thread. Knowledge is power.