Other PTSD vs C-PTSD vs personality disorders...?

[Ecdysis]

"do you obey the law" or "would you lie to get what you want" etc. Mine showed a schizoid-typical pattern of both narcissism and ASPD, but in schizoid it's different. I don't obey the law because I don't give the law any authority. I obey my own moral code. I would lie to get what I want but what I want is peace and quiet.

So, I've been thinking about these examples... and I'm kind of wondering about them...

I'm not sure that either of those answers to me would be indicative of a PD.

First of all, I think most "normal" people both do and don't obey the law. Most of us have jay-walked, done some cash-in-hand work, driven above the speed limit without getting caught, driven home from a party where we think we could be one or two drinks over the legal limit, or whatever... I think the only people that obey the law 100% of the time, or who *try* to obey the law 100% of the time are OCD types.

Most people obey the law most of the time, but not all of the time. And they do so, for a variety of reasons. There are some laws that resonate with my personal ethics and I follow that way of behaving, but I would behave that same way, even if it wasn't the law. There are other laws that I find non-sensical or annoying and sometimes I look for ways to avoid following those laws. At the same time, I will still adhere to those laws, even if I think they're daft, if the risk of getting caught/ getting fined is something that seems unwarranted/ not in my interests. For example, in the towns near where I live, there's a ton of ridiculous rules about where/ when/ for how long you're allowed to park your car. If the risk of getting caught was minimal, I'd probably ignore those laws, some of the time if it was practical. But there's acutally quite a lot of traffic cops handing out tickes for parking violations, so nearly everyone in town adheres to these (silly) parking laws quite strictly.

There are some situations where I'm "scared" of the legal authorities... but mostly I'm not. I'm lucky to live in a democracy where the law is mostly upheld in a decent way and there's not really much police violence etc to speak of. I guess some other people follow the law out of a greater "fear" or "respect" of authority... I'm not sure. I was raised to think independently and to make up my own mind about things.

However, all of the above is not indicative of some kind of "personality disorder" to me. And I find your answer to that question @Weemie to be quite rational too and not really indicative of a personality disorder. But maybe that's just me... maybe I'm weird. I have no idea what a "super mentally healthy" person would answer to that question...???

As for "would you lie to get what you want"... well, first of all, every kid lies to get what they want some of the time... There's actually a specific developmental stage where they LEARN to lie... cos when kids are very little, they don't even understand what a lie IS. And some children, who have developmental or cognitive problems DON'T learn to lie, because they just don't "get it". So I'm not sure that lieing in and of itself is a "problem" or indicative of a personality disorder either.

We all lie a million little white lies each day... When people ask us "how are you" we mostly say "fine thanks". At work, if our boss is wearing something really unflattering, we don't blurt that out... we either say nothing or say something nice... Those are normal social skills... that's not people being devious and deceptive and "being liars". I think it's a matter of degree - do you lie MORE than you tell the truth, are you fake MORE than you are authentic... and the sitautions matter... and your motivations matter... Are you lieing so as not to hurt someone's feelings? Or are you lieing to manipulate someone?

Again, I don't see this as indicative of a personality disorder. I would be super, super sceptical of anyone who says they lie 0% of the time or 100% of the time... And I would be weirded out by someone who's a compulsive liar... but I don't see lieing in a normal day to day way as part of a personality disorder diagnosis...

 

[Weemie]

I'm not sure that either of those answers to me would be indicative of a PD.

I agree, actually. I made sure to clarify this during the questionnaire as well. It can indicate a pattern of violating the rights of others or exploiting them ("yes, I frequently disobey the law because I don't care and the laws don't apply to me" vs "I don't care about the law, but I don't harm other people because of my moral code" or "yes, I lie to others to get what I want and what I want is to take advantage of them" vs lying for regular, normal reasons). But there are non-exploitative answers to those questions, which I believe mine classified as. The whole entire questionnaire as a whole did work to indicate actual personality impairments, when taken altogether. Specifically the answers around emotions, sociality, friendship, other people, etc.

 

[Weemie]

Reminds me a bit of Gabor Mate’s hypothesis that every addiction stems from trauma.

I think Gabor Mate is probably speaking from personal experience here. Because a lot of addiction is caused by trauma, and he probably saw that. But it's not a scientific conclusion, in my opinion, to presume that every single addiction is caused by trauma when there are also addictions that are just caused by neurodivergence. People with ADHD for example are more likely to be addicts, because of how their brain is formed, and that can happen without trauma.

 

[Sideways]

I don't see this as indicative of a personality disorder.

On its own? No. There’s no one (or even 2) questions in the standard personality inventories pdocs use that is going to confirm (presence or absence) of a PD.

The series of questions of questions, taken together, identifies patterns which typically appear in particular PDs.

So, even a very comprehensive inventory, on its own (and some of them are loooooooong!!) isn’t conclusive. They’re designed to be incorporated with a specific type of structured clinical interview.

Sorry Google, your “Do I have NPD?” search results won’t, actually, answer that question for me!

I would be super, super sceptical of anyone who says they lie 0% of the time or 100% of the time.

Here’s the really fun thing - the good ones actually weed this out. In that, people who consistently answer especially high, or especially low, on particular patterns of questions, the results will also flag those, separately to identifying patterns consistent with PDs.

For example, I did one while I was hospitalised for active suicidality, and the results picked up that even for a person who was profoundly depressed, my answers indicated a problem with the way I was answering questions about my mood and self harm. Without the accompanying interview, the results would have indicated that my answers on those questions were unreliable (which can be for a myriad of reasons - over-stating, underselling, lack of insight, not taking it seriously, not understanding the questions, poor concentration, and on and on…). But with the structured interview (that was guided by, and needed to address, those weird responses) it put it all in context, and voila! This person genuinely intends to top themselves and is statistically likely to if you discharge them today!!!

Rest assured, no one question is going to lump you with a label. And while a pattern of extreme answers will be caught by the results, it also doesn’t offer any conclusive finding about your personality:)

 

[Weemie]

The series of questions of questions, taken together, identifies patterns which typically appear in particular PDs.

These inventories like MMPI also specifically test for how the person is answering the questions. If too many of them are chaotic, it will say you're not paying attention, etc. Too many "too positive" or "too negative" answers will receive a faking bad score or faking good score, etc. The best way to answer the test for me, was by explaining exactly why I answered the way I did.

For example a couple of the questions had things like "I enjoy making friends" or "I'm good at making friends." So I answered that no, I don't enjoy making friends. But yes, I am normal at making friends if I wanted to make friends. With that interview those answers were consistent, but without the interview they could be seen as contradictory.

My therapist also took that into consideration as I am sure otherwise it would have come across as highly divergent. When taken into consideration with how I interpreted the questions, I got mostly consistent answers. The test was able to see the difference between narcissism in NPD and narcissism in schizoid - as there are also normal levels of both narcissism and antisocial behaviors.

 

[Ecdysis]

Enduring personality change after catastrophic experience (EPCACE)

T emailed me back suggesting this diagnosis (F62.0)

I'm cool with that.

I replied saying that diagnosis is fine by me and let's discuss it at the next appt.

Somewhat bizarrely he also replied that "there are no diagnostic questionnaires to determine a personality disorder diagnosis" in response to me asking him to send me some/ go through them with me.

Hmmmmm....???

 

[Friday]

Somewhat bizarrely he also replied that "there are no diagnostic questionnaires to determine a personality disorder diagnosis" in response to me asking him to send me some/ go through them with me.

That’s because the multiphasic etc. tests can only indicate the possibility. That, last time I was in school, was only “correct” (mitigating circumstance) about 1:4. The actuality has to be decided on by a person. So it’s an incredibly subjective process.

 

[LunaticOnTheFritz]

Aren't personality disorders the result of enduring all that comes with the PTSD?

 

[Rose White]

personality disorders the result of enduring all that comes with the PTSD?

My understanding is that personality disorders are, for about half the people afflicted, related to grossly negligent/abusive relationships with caregivers. For the other half of the population with personality disorders they are related to genetics, family culture, or random variation of personality expression.

 

[dart.cree]

I have a relatively new trauma therapist and we're doing a weird mish-mash of treatment while me also trying to get him updated about my entire past history, which at nearly 50 years of age, is a lot.

We're currently dealing with the issue of diagnoses and he said something weird at the end of the last session, that I'm trying to get my head around.

I understood him as saying: PTSD is really only an appropriate diagnosis for "single event" type traumas - for example, experiencing a sexual assault as an adult.

If trauma occurs in childhood and goes on for any length of time (as opposed to a "single event" trauma) then it will *necessarily* affect the child's developing personality so will *always* entail a personality disorder.

This reasoning seems a bit off to me...

I asked whether it wouldn't be C-PTSD then, as oppsed to PTSD, but we agreed it's not an ICD / DSM diagnosis.

It was the end of the session, so no more time for asking for clarification, which I'll have to do at the next appt in 2 weeks time.

It strikes me as very over-generalised tho and I'm not sure I agree.

Also, I have a strong negative reaction to the words "personality disorder" whereas I don't have that kind of reaction to the words "PTSD" or "C-PTSD".

Why is that? Is there a much bigger stigma attached to personality disorders?

Does it sound like an insult to my subconscious if someone says "personality disorder"?

I'm not sure I even truly understand what a personality disorder is vs. what it's not.

I'm not sure about a full list of "all" personality disorders either.

I dunno... As a feminist, I feel a lot of resistance to how easily women are given the lable of a personality disorder in treatment.

I know a good psychiatrist who is very critical of personality disorder diagnoses because he says they're just used to lable people a therapist/ Dr views as "too challenging" for "simple treatments" to work.

I dunno... a lot of questions and a lot of resistance about those kinds of diagnoses being dodgy and wondering whether they're helpful...

Edit to add.... done some googling:

The DSM has 10 personality disorders:
1 paranoid
2 schizoid
3 schizotypal
4 antisocial
5 borderline
6 histrionic
7 narcissistic
8 avoidant
9 dependent
10 obsessive–compulsive

and also "unspecified personality disorder"

They're grouped into 3 clusters:

Cluster A (odd or eccentric disorders)​

Paranoid personality disorder, Schizoid personality disorder, Schizotypal personality disorder

- often associated with schizophrenia
- greater grasp on reality than those with schizophrenia
- can be paranoid
- unwillingness and inability to form and maintain close relationships

Cluster B (emotional or erratic disorders)​

Antisocial personality disorder, Borderline personality disorder, Histrionic personality disorder, Narcissistic personality disorder

- characterized by dramatic, impulsive, self-destructive, emotional behavior

Cluster C (anxious or fearful disorders)​

Avoidant personality disorder, Dependent personality disorder, Obsessive–compulsive personality disorder

- characterized by anxious and fearful behaviours (e.g. perfectionism, dependency, anxiety)

DSM sucks rocks.

It's done by a committee. What do you expect.

C-PTSD presents as a dissociative disorder. Read up on structural dissociation. Of the people, I've corresponded with all the the CPTSD folk really should be considered OSDD

Secondly: The european equivalent to DSM5 is ICD-11. It does list CPTSD and lists 3 additional traits.

But it's still bullshit.

Not all CPTSD folk have PTSD symtoms. I don't really have flashbacks, unless you count weird moods that come out of nowhere. I don't have avoidance behaviours about triggers. I don't really have triggers. When I mentioned this to my T she listed off a bunch of behaviours, like my reluctance to go to a mall, and asked me why. I gave what I thought was a good reason. "And you don't call that trigger avoidance?"

Even just dissociation is presented in the diagnostic manuals in the most extreme case. But they can be milder forms of this.

 

[Charbella]

Not all CPTSD folk have PTSD symtoms.

I’d call this bullshit. If you don’t have PTSD symptoms then you shouldn’t be diagnosed with CPTSD.

Now you denying a diagnosis that does actually fit you, that’s a whole other issue that most of us diagnosed with it can totally relate to. Feel free to start a thread on that and watch it blow up. It is also over diagnosed in the US in my opinion so maybe you don’t actually have it. In the US therapists are required to use a diagnosis code to bill your insurance which requires them to pick one when they aren’t exactly qualified.

 

[Ecdysis]

I’d call this bullshit. If you don’t have PTSD symptoms then you shouldn’t be diagnosed with CPTSD.

Now you denying a diagnosis that does actually fit you, that’s a whole other issue that most of us diagnosed with it can totally relate to. Feel free to start a thread on that and watch it blow up. It is also over diagnosed in the US in my opinion so maybe you don’t actually have it. In the US therapists are required to use a diagnosis code to bill your insurance which requires them to pick one when they aren’t exactly qualified.

Why so harsh? Why not allow a genuine, thoughtful discussion of this issue that may not entirely align with your point of view?