CPTSD vs. NPD/BPD

[Phoebes]

The only diagnosis I have ever actually officially had was PTSD. I explained to that therapist about CPTSD and she said yes well this is the only thing like that we have here in the US. That is frustrating that this is a well-known problem and we are behind in acknowledging it here.

Anyway, the more I listen, or learn about all of these things, sometimes I hear the information, as maybe I have BPD or NPD, or both. What I previously thought was CPTSD. I a therapist who has a channel HEAL NPD, and he said CPTSD is in the borderline spectrum. So sometimes I hear I have CPTSD and other times it seems I may have borderline or NPD traits, that they are really the same thing.

The difference I feel is that I care how I treat people, I don't want to have these issues and try to figure them out and change them. Sometimes I feel myself doing things that I don't seem to be able to stop. I'm not verbally abusive, but, for instance, I may talk too much or reveal too much, and I'm worried I have annoyed people. And then when they don't call or reach out, I feel extreme shame about it. I had a good friend fall away and I know that it was because I was self focused in that I had a lot going on, was sick and over explaining , why I haven't been available to do the normal activities. I know we could probably talk and I do own my part but I also am overwhelmed by her impatience and lack of empathy with me. So I've just never reached out which I'm sure seems like I've ghosted her.

Anyway, it's just another source of shame to feel that I may be BPD, or NPD, as well as have CPTSD. I know it's all on a spectrum, but i've become more isolated and lonely, and all of this does not motivate me to form new relationships.

[Bermuda]

Oh Phoebes, that is such a heavy weight to carry and sometimes sharing a burden that is too big to carry alone just isn't oversharing at all. We can be self-centred, and it's okay. Everyone is. Someone pulling away when you share feelings could be seen as self-centred, but it's okay too. It's okay to need, to be needy, or to set boundaries. There is no fault.

I know that these disorders occur from the same mechanism, but calling it a spectrum feels wrong to me. I'm no ürofessional but I think someone with NPD also has the shame much in the way you express, but the difference is how the protective instincts react. You may break down, isolate, or try to self-correct to no end, whereas someone with one of the other disorders may protect themselves with deflecting or much worse. It's not the same reaction to a lesser degree. It's a different reaction. If this doesn't describe you, please ignore me.

I don't know about you, but I don't think I treat people super well. There is a huge disconnect. Sometimes I just forget to ask someone how they are because I am just so overwhelmed by the questions they ask me and preoccupied with formulating answers. It's not a lack of caring or consideration. It's not to get ahead or to build a narrative. It's exhaust. I feel shame and guilt when someone calls me out, and I see the flaws in myself. Lots of flaws.

[NarcKiddo]

When I read Understanding The Borderline Mother I immediately diagnosed myself as a Hermit Narcissist of the highest order. It took my therapist a while to talk me down from that one. She said that even if I have some traits that may seem narcissistic, and will have picked up some behaviour patterns from my mother over the years (because how could I not?), she does not think it correct to label myself with NPD because I don't actually fit. A big part of that is recognising that I have issues and wanting to learn about them and change my unhealthy coping mechanisms.

I think a big part of the problem you are having is that CPTSD is not currently a recognised diagnosis in the US, so they try to find other boxes to put you in. It's not helpful.

[tryingtokeepmoving]

Phoebes, What you're going through sounds very difficult, not knowing which way to look or to believe when trying to understand your own behavior. I relate to the feeling of trying to get to the bottom of my behaviors and being unsure of what to believe. And the horror thinking I might have more in common with my abusers than I'd like.

I think that cptsd survivors are often susceptible to self deceptions, or rather our perceptions have previously been so manipulated that it seems difficult for us to pin down a 'truth', or at least for me it is. I wonder if it's 'fleas' or is it a pd, it's difficult to parse through what has been put onto us and what is a part of us.

When I read Understanding The Borderline Mother I immediately diagnosed myself as a Hermit Narcissist of the highest order. It took my therapist a while to talk me down from that one.

I have been struggling with this idea of labels recently too, I too have brought pd diagnoses to my therapist in worry that 'this might be what's wrong with me', though she says I don't fit she also asks what it is I would get out of having a diagnosis. I find I look at diagnoses like a hypochondriac, I read even a slight similarity in my own behavior and I start to panic, thinking oh no that's me, I am a manipulative monster who has no empathy.

Maybe it's just another way of catastrophizing, or a form of hypervigilance, assuming the worst of ourselves. Perhaps the only sure way to address our problems is to reflect and analyze or try to understand them as they arise. While a diagnosis is a valuable tool, the right one doesn't always exist or isn't always available.
Easier said than done though. 

 

[Kizzie]

One thing I can say about NPD is that no N I have ever met is self-reflective - it's always everyone else that has the problem. You are very self-reflective and concerned about hurting others so IMO you can wipe that right off the list of diagnoses.

BPD does have some overlap with CPTSD from what I've read but there are important distinctions - here's an example from https://psychcentral.com/ptsd/how-ptsd-cptsd-and-bpd-can-impact-relationships.

Another major difference between CPTSD and BPD is how they attempt to regulate their emotions. People with either condition often struggle to regulate emotion. However, people with CPTSD will often over-regulate their emotions. This means that they tend to numb their emotions by withdrawing or dissociating. People with BPD, though, can often under-regulate their emotions, causing their emotions to explode out of them in fits of anger or even self-harm.

It sounds to me like you over-regulate versus have outbursts and the like. There are other differences too - lots of info about that if you Google something like "what are the differences between CPTSD and BPD?"

FInally, you were given the diagnosis of PTSD which in and of itself points toward Complex PTSD, it's just that T's in the US can't or won't use CPTSD because then insurers that go by the APA DSM won't pay for sessions.

[Blueberry]

I'm sorry you're struggling with these thoughts atm Phoebes. You're not alone with such thoughts.

On top of everything else that has been said, I've been told that these neat little diagnosis boxes are OK for physical problems but not psychological. The psychological are far too complex.

A lot of stigma is attached to certain psychological diagnoses, in different countries possibly different diagnoses - this is my impression. For instance in my country, it's "psychosis" that you don't want to have. But does anybody really understand these diagnoses? I mean anybody who doesn't actually live with the diagnosis. Years ago I was told by a specialist in trauma that I have npd not cpstd. I was rather shocked, but she explained that npd turns out quite different in women than in men. Before then and since then everybody has said cptsd, no more talk of npd. But even if that doctor had been correct, I'd still be me, looking for healing, trying to heal, with an awful childhood.

Over the years I have fairly consistently been given 2 diagnoses from personality disorders: obsessive-compulsive and anxious-avoidant. I was inpatient last year and the year before, same place both times, same trauma T both times. The first time I got given both those diagnoses, the second time, my trauma T said: everybody has personality traits... Who's to say it's a personality disorder and not just your personality? Which was interesting. Years ago I read that a personality disorder meant you were so badly treated from early childhood on that it had a lasting, destructive effect on your personality for which you are not at fault. That sounds very much like the origin of cptsd to me. In my country particularly young women get diagnosed with bpd. In another inpatient place, younger female patients were in the bpd group one year and in the trauma group the following year... Not always of course, but often enough for it to be noted among patients. And bpd patients were in with us in some trauma-informed groups... I didn't find them scary, unpleasant people.

There was a mbr on here for a good few years who openly wrote on the forum that she had cptsd and bpd.

I don't like labels very much myself. I know for some people on the forum it's helpful. But for some besides me maybe not. In my FOO I think there are/were at least 2 further examples of cptsd - M and GrM. Maybe also B1. M and B1 went the angering, violent route and me the depressive. But even so it's more complex than that on both sides. Where I like to differentiate is: Willing to look at self? Willing to make some changes and not just spew anger around? Willing to listen (even to a therapist)? My FOO doesn't score too high on any of that. Depending on context, I haven't always been able to either (which is probably one reason that ptsd specialist said I had npd), but you can find contexts in which I grow and which I can feel empathy even with people I have difficulty with.

Hope some of this was useful.

[Phoebes]

Reading your very well expressed personal talked on this subject, I'm already feeling a lot calmer about this. I really hear what each of you are saying. I think once I recognize something in me that fits, I'm horrified that I have a trait like that. For instance, I knew I have trouble connecting to others like other people around me. Like I always feel like I hear a bunch of gibberish when in a group and like everyone is laughing and enjoying the conversation, and I can't even hear what anyone is saying, nor think what I do hear is funny. lol. Now to lear that narcissists can't connect with people, I've been down on myself.

I also feel I used to connect well until person after person betrayed me in some way. I now understand it likely had more to do with the "home" like vibe of abusive people I was drawn to for friendship and partners.

Anyway, I digress. Yeah, I don't believe the label themselves are the important things, but understanding these behaviors are not "our fault. And having a framework to understand helps a lot. I do self reflect and see things in myself, and while that may discount NPD, it's still disturbing! And, if I DO have traits of NPD, all I can do is recognize them and do my best to change them as I go. And so what if I'm deemed self focused by some. Maybe I am due to trauma on trauma. Many people don't even try to figure it out, so, what's wrong with trying?

 

[Armee]

I was raised by a single parent with BPD. From my data point of 1 I believe very firmly that BPD and CPTSD are very different adaptations though of course there is overlap. But in the actual expression of the "disorders" there is a world of difference.

I recall how my mom would manipulate us to get her way but lie the whole time. It was a very confusing thing to grow up with. I feel like the people I've met with cPTSD do not manipulate others. They may duck and dodge and avoid situations (classic ptsd avoidance) but they aren't going to manipulate others. To me a big difference is in how the behavior manifests in how others are treated.

[Blueberry]

Armee, thanks for adding your first-hand knowledge / lived experience to the debate.

[Phoebes]

Thanks, Armee..yeah, I don't manipulate, at least not purposely. But I don't think I do. I would be mortified to do the things my NM does to manipulate. I still feel mortified over things I said or did years ago sometimes, things that don't come close to the damage done by every day comments and actions of my NM. For instance, NM was very PA to me regularly. When I was around 6 I remember smacking a dog in the face to get it to behave. I have been mortified at myself ever since, and hope that somehow my soul will connect with that dogs soul in th elect life so I can apologize and hug it. My NM doesn't think she owes me any apology for a while hood of PA and lifetime of EA, and smearing me to my family.