CPTSD versus Borderline Personality Disorder (BPD)

[Candid]

We are very sensitive, very insecure, very down on ourselves, very confused about how to get on in this world. We are afraid, lonely, isolated, and we feel misunderstood. Our depression and anxiety might make us unreliable or neglectful sometimes in our relationships, and we might shy away from people a lot,

but we are not overtly abusive like BPD individuals have the tendency to be.

Thank you, shoshannah. I'll take that from a Psychology major any day!

[Wife#2]

I like the explanation that all of us with damaging childhoods have the potential to turn out either BPD or cPTSD. The fork in the road comes down to some point at which the person either digs in their heels and shouts, "I'M FINE!" or looks in a mirror and shouts, 'WHAT'S WRONG WITH ME?". The first are either so injured or so determined to 'tough this thing out' that they warp their personalities to fit what they understand of reality. The second group reflect on it all and begin seeing things that don't make sense in their own behavior. BPD vs cPTSD.

Yes, I do believe all of these groups suffer. I believe the self-delusion of the PD world cracks often and the sufferer becomes very aware of their own pain and the pain they have caused others. During those times they rock the pendulum - loving, bitter, caring, demanding, etc... That confuses the people in their world further - the seeming inconsistency of personality. This is why DBT therapy can help and why it's considered an emotional regulation disorder. If the person can HOLD their emotions still long enough to stop the pendulum, they can learn to feel the pain of their self-awareness and still live. All the empathy and other parts of their personality can have a chance at emerging.

I know my mother suffers tremendously. I know she regrets many things she did and said to her ex husband and all her children. I know she suffered at the hands of her own Narc mother. I know she suffered other incidents along the way that pushed her further down the uBPD/Narc road. Her moments of total awareness are wonderful and angering at the same time - because we want it to be consistent. When that vanishes and she's back to her (I estimate and Dad agrees) 12-year-old self, I want to scream!

I know my husband suffers horribly. I live with him and his pain every day. Does knowing he's in constant pain help? Honestly, as his wife, no. He's emotionally 17. His life was destined for cPTSD, but it started so young and it was so harsh that he ended up in uBPD/Narc territory. He has fewer self-aware moments. He really believes he has a good handle on all of his emotions. His pendulum rides last for less time lately, that is good. But, he is completely unaware when he's back on the negative, abusive side. And making him aware is to encourage his wrath.

Both my mother and my husband have had therapy. One (mom) decided she'd just live on Prozac. The other, rejected all antidepressant drugs and therapies, and discourages me from either - they're being weak and dependent on an outside source for our well-being. All while freaking out if I get low on my thyroid medicine.

I really don't think the PD's in my life are malevolent. I'm so sad for those of you who do suffer malevolence. It is easier to deal with when I know my Mom is so badly misguided by her brain, but that she really, sincerely loves me as much as her damaged brain can. My husband also loves me to the capacity that word is real inside his reality. Once I identified his emotional age as about 17, understanding his warped vision has become much easier. I don't agree or condone, but I do understand.

[Candid]

the person either digs in their heels and shouts, "I'M FINE!" or looks in a mirror and shouts, 'WHAT'S WRONG WITH ME?". The first are either so injured or so determined to 'tough this thing out' that they warp their personalities to fit what they understand of reality. The second group reflect on it all and begin seeing things that don't make sense in their own behavior. BPD vs cPTSD.

Neat distinction, Wife#2.

I believe the self-delusion of the PD world cracks often and the sufferer becomes very aware of their own pain and the pain they have caused others.

Do you have any evidence for this? I'd love to think my mother even once thought oh dear, how horribly I treated Candid!

I know she suffered at the hands of her own Narc mother. I know she suffered other incidents along the way that pushed her further down the uBPD/Narc road.

That might make the difference. My M manages to be lovely to everyone but me. I don't believe there was any trauma in her life. I'm sure she would have mentioned it!

His life was destined for cPTSD, but it started so young and it was so harsh that he ended up in uBPD/Narc territory.

Do you mean child abuse leads to having a PD? Are there any born PDd people?

I really don't think the PD's in my life are malevolent.

That would help. My M was malevolent towards me. Jury's out on Nsis, who may just be suffering from copycat syndrome. If she is, and wakes up to it, she might be worth knowing.

Hmm. So many questions.

[Blackbird]

I would like to chime in with a couple of things here on this convo... Throughout my life I've dealt with all sorts of PDs, Narcs, BPD, Sociopaths, Psychopaths, Conduct disorder in my teens, etc. I was diagnosed with BPD when I was a teen (wrong therapist to diagnose, really) and later changed to Schizophrenia (wrong psychiatrist), then Schizoaffective disorder (same psychiatrist) and finally Bipolar Disorder (right psychiatrist). I had all the classical symptoms of BPD all the way until I was 27 years old. Then all of a sudden I changed, I'm mellow now and only emotional when severely triggered.

I'm completely confident my mother has a form of BPD and my uncle is a Narcissist, I've talked extensively about this with my current therapist that is to be trusted. They both have specific traits, like manipulation, cunningness, lack of empathy, etc. 

So, some PDs can be caused by severe trauma in childhood, but not all BPDs have traumatic childhoods, for example. One of my closest friend is BPD and she didn't have a traumatic childhood, still has all the symptoms as if she did.

I've met a person with sociopathic traits with a traumatic childhood that treats his children in a good way, even close to kind in his own way, but in no way abusive.

My grandfather was a psychopath, cunning, the stare, the lack of empathy, the manipulation, the treating his kids like dirt (mother and uncle).

I'm not sure but my grandmother showed signs of BPD as well.

So, my take on this, and the several years I've had dealing with diagnoses and psychiatrists is that if we have a cluster of symptoms we fit a certain box, that doesn't mean we are that label, or that we can't change (exception of psychopaths that have their brain wired in a certain way). My diagnosis has changed so many times that I've lost count, each time I would research about said disorder and say "this fits like a glove" after a certain time, because I would meet the criteria for certain boxes. But people are more varied than that, we are more holistic. Some react a certain way because they were taught to, not because they are wired that way. Some have symptoms of disorders, like mood swings that can be both from BPD or cyclothymia, but not meet the criteria for either one.

What matters is treating the symptoms, and in all cases, if the person is willing to receive treatment.

Don't know what others have to say about this.

[radical]

I've read that there is a a part of the anterior cingulate cortex in the brain, in which lack of grey matter and also lower connectivity (white matter) is associated with lack of, or lowered empathy, and other traits associated with cluster B symptoms (including high hypocrisy). 

Loss of connectivity in the AC and throughout the brain, but particularly the frontal cortex, hippocampus and limbic system is typical of a brain damaged by trauma. 

What I'm fumbling to try and say is that traits of all kinds can be part of a wider picture of trauma, and/or they can be characteristics of a genotype.

It seems to me, that what we call a PD, is likely to usually be a phenotype made up of a genetic profile + trauma and other environmental influences that intensify each other, and become extremely resistant to further influences that might change or modify it.  PD-like traits can also be primarily caused by trauma, and where this is the case, they are amenable to healing, when whole brain networks respond to appropriate treatment, or other environmental infuences, once the individual is no longer experiencing brain-damaging levels of stress.

[Hazy111]

I dont wish to repeat myself but i think its worth saying. PDs arent born, there is no genetic input. Its nuture not nature.

Dont get bogged down with the differences with PD and C-PTSD.

The origins of mental illness such as PD is an emotionally traumatic abusive childhood..  The earlier it starts, the degree, type and the longer it lasts all play a role in the outcome. They also suffered what is now called C-PTSD.

Its important to remember that no parent treats each child the same,( even emotionally healthy ones). Some get full blown PD some dont. All are damaged to a degree some suffer PTSD symptoms but do not develop PD.

The PD person has a false self , one giant lie of an individual, the true self never emerges.

When people say they had a happy childhood etc but they have BPD or whatever it is not possible. They are in denial and most probably dissociated and still are.

Overwhelmingly most people find it hard to think about their parents negatively. We all want to believe our parents loved us unconditionally.

I was like this at 17, when my symptoms first emerged and still find it hard at 52 to accept this. I dissociated. I have no really bad memories of childhood, nor do i have good ones, nothing. no memories.  it was all wiped to preserve my then sanity.  It wasnt until i read "Understanding the Borderline Mother" when i was about 47 everything started to make sense, the scales fell. At last.

It is also very hard for a parent to think they have damaged their child in any way, especially a PD one.

The false self PD person who uses projection as nearly all do,  projects their own pain, shame, guilt etc into the child and thereby the child has the problem, It isnt theirs. It didnt happen Its easier to blame the victim, no guilt. A lot of the time they disassociate too so they cant remember inflicting any pain anyway. This is the false self at play.

They continue to do this as adults, hence our frustration and rage when we realise its them not us!!

Hazy

to all you sufferers. It wasnt fair, it just wasnt fair!!

[Blueberry]

So if I read radical, wife#2 and Blackbird correctly (even though you are all writing slightly different things) and then add my own spin  , diagnosis of BPD, or other PDs, and differentiation from CPTSD or even where they may overlap is really complex and should maybe only be done by specialists + ? Not by us in our armchairs, unless we're diagnosing ourselves, of course. Because if we're honest with ourselves and it seems that CPTSD-ers are brutally honest to the point of self-castigation, then we can assume we have CPTSD if the symptoms fit or even possibly a PD, again if symptoms fit.

But neither we nor therapists/psychiatrists ought to be throwing PD diagnoses around as accusations. "He / she is difficult, therefore BPD or NPD." Nor should we be saying that PDs all act like this or that or can't/won't heal. Quite possibly other people (possibly even over on OOTF, where I read too) say all CPTSD-ers do x and y. We know on here that we share many symptoms, but we don't all have all the same symptoms. There's also a difference between whether we say something about ourselves and our own Beast or if some non-affected person (who isn't a doc or similar) says this. Well, it makes a difference to me anyway. Probably because FOO threw unfounded accusations around about my state of being (rather than my state of health.)

+ though even specialists make mistakes. In my country BPD is apparently a diagnosis which is too readily given to a patient who seems 'difficult'. So back to 'treatment resistant', which was being discussed on another thread.

[Blueberry]

, 'WHAT'S WRONG WITH ME?"

I've been asking myself this since the age of 7. Almost 4 decades. In the last few years, less questioning because I know why.

[Wife#2]

I've written and removed this post so many times, it's silly. I want to sound smart, but when I read my post, I sound pompous or like a know-it-all. I'm hopefully not the first and certainly too ignorant to be the second.

I do believe that PD's are sometimes self-aware. I think some just can't make the change they know they need permanent. I think others are mean - turning those 'icky' feelings into negative action to those who 'made' them feel bad. Why some are mean and others aren't - I haven't a clue. I just want to rescue those who suffer at the hands of the mean ones. I do count myself fortunate that my PD's aren't mean (jury still out on my stepmother).

That's why I have a hard time saying that PD's have no empathy. I believe most do have it. It's just severely stunted or completely submerged in the personality. Not all - some I do believe have no empathy and no remorse for wrongdoing. I haven't experienced that myself, so I can't speak to that.

I can say that I understand why the psychiatric community have such a hard time diagnosing between BPD and CPTSD. It really does seem to be just motivation that differentiates. Like I said earlier - BPD are usually sure they are right and you are wrong. cPTSD are usually sure they've got something wrong (or missed the 'how to be a human' handbook as I used to describe it) and seek help about it. But, many of the ways both play out in life (mood swings, weak or missing sense of self, emotional - sometimes far beyond what the situation calls for) are just the same. So, when checking boxes and taking tests, BPD's who end up at a cPTSD conclusion may actually get help (they were searching for something when they took the test), but cPTSD's may sometimes come to the conclusion they are BPD and feel even worse - unless they see that BPD answer and reject it, continuing their search. Who is right, who is wrong? I don't know. I'm glad I don't have to be the psychiatrist who has to decide these things!

[Blueberry]

I've written and removed this post so many times, it's silly. I want to sound smart, but when I read my post, I sound pompous or like a know-it-all. I'm hopefully not the first and certainly too ignorant to be the second.

You don't sound pompous to me or like a know-it-all, neither in this post nor your one above. I'm interested to find a different perspective, or maybe better, differentiated perspective on people with PDs than for instance I read about on OOTF or even here. It's particularly interesting coming from you because you seem to have great understanding of and empathy for the PD sufferers in your own life. At the same time you don't go overboard with it. You still say what's hard for you about it.

I can say that I understand why the psychiatric community have such a hard time diagnosing between BPD and CPTSD. It really does seem to be just motivation that differentiates. Like I said earlier - BPD are usually sure they are right and you are wrong. cPTSD are usually sure they've got something wrong (or missed the 'how to be a human' handbook as I used to describe it) and seek help about it. But, many of the ways both play out in life (mood swings, weak or missing sense of self, emotional - sometimes far beyond what the situation calls for) are just the same. So, when checking boxes and taking tests, BPD's who end up at a cPTSD conclusion may actually get help (they were searching for something when they took the test), but cPTSD's may sometimes come to the conclusion they are BPD and feel even worse - unless they see that BPD answer and reject it, continuing their search. Who is right, who is wrong? I don't know. I'm glad I don't have to be the psychiatrist who has to decide these things!

In some of this description here, I used to be more like BPD. I've always wondered what was wrong with me or as a child more why my parents didn't seem to want me - but I think that was fundamentally the same question. OTOH I used not to be able to admit openly to any wrong, I'd blame somebody else right away, or just block. That was learned behaviour because admitting to doing something wrong in FOO was dangerous, it felt life-threatening.
e.g. I had a colleague who ended up sitting on the floor of the office crying on the phone to her boyfriend in total distress, because of me and my behaviour, and I was pretty unmoved by the whole scene. I felt a little uncomfortable, but basically felt it was her fault for being so weak and crying. We didn't get on well anyway. She was open and talked to everybody, tried to draw me out, I refused.    There was no way I was going to do anything to mitigate that situation.  I was acting pretty like M in that situation, no wonder really. I had developed no 'tools'  e.g. for compromise (because that doesn't exist in FOO) nor for setting my own limits or protecting myself and my own sense of security/well-being.  And I had been ridiculed throughout my childhood and teenage years and into my early 20's for crying and/or punished. It was labelled 'blackmail'. Not that it ever got me what I wanted, but I couldn't hold it back. But here I was in my late 20's passing that very stuff on to a colleague, not quite so actively or verbally, but still not nice.

17-18 years on, that's long since not been the case. Once people particularly in therapeutic settings started showing me compassion and when I started to discover that underneath all that bitterness and hardness there was a) a whole bunch of raw pain and b) actually a loving heart, I started to show other people compassion, be able to admit to mistakes and to apologise to people. But it did take an awful lot of therapy to get me to where I am now. Long-stay in-patient care, if you add it altogether, will be about 18 months within the space of about 13-14 years. So if I'd been living in a country where that's not available or not in the way it is here - I wasn't in psychiatric care, but psychological / psychotherapeutic -  I'd hate to think what kind of state I'd be in now. And with what diagnosis.

OTOH, unlike my M (who is possibly uNPD or uBPD, and probably uCPTSD), I have been doing soul-searching for years and since the time I started intensive T, I have never given up (for long), have always picked myself up, got going again, looking for some T or other doc or counsellor who'd believe me and believe in my ability to progress and heal and help guide me slowly the right direction. 

In my country when you read self-help forums for borderliners, some will say the diagnosis is a stigma for life; once you have the diagnosis it's not going to be removed from your file so to speak. Maybe they would have diagnosed me with BPD back then because of the way I acted towards other people, but I've been able to change so it wouldn't have been good to have that in my file.

Lastly, at my last inpatient treatment place for CPTSD, where I went twice, patients there in the trauma group, a lot of whom had been a number of times, joked about patients joining the borderline group and coming back the following year and being moved into the trauma group. It seemed to happen fairly often. For some sessions we were even occasionally together like for some grounding techniques and imagination exercises.

I'm not a pro on any of this either, these are just my thoughts based on my own experience and what I've seen/read/heard.

Sorry such a long post, not good at summarising. Topic expands itself as I write.

[Blueberry]

just found this on http://flyingmonkeysdenied.com/2016/06/23/root-causes-for-borderline-personality-disorder-most-likely-vary/   which fits our topic.

"people with Borderline Personality Disorder who do NOT have comorbid conditions like Narcissistic Personality Disorder can in fact control and improve their own social behaviors.

[It takes about two years of weekly Psychotherapy and a lifetime of dedication to working with Behavioral Specialists, but someone with BPD who is motivated to change can do it with the help of a tough-love style family and positive, non-toxic peer group support system.] "

[mourningdove]

I recommend this presentation by Bessel van der Kolk:

"Childhood Trauma, Affect Regulation, and Borderline Personality Disorder"
https://www.youtube.com/watch?v=N2NTADxDuhA

Bessel van der Kolk, MD, delivers the lecture "Childhood Trauma, Affect Regulation, and Borderline Personality Disorder" as part of the 9th Annual Yale NEA-BPD Conference.

What he doesn't say is as interesting as what he says, in my opinion.

[sensitivesoul]

Hey

I'm new here but I was diagnosed with BPD and then CPTSD- so thought I'd join in this discussion. I went through DBT (dialectical behaviour therapy) and noticed that I wasn't very similar to the most of the people in the group but did have lots of struggles that were the same. I don't have anger issues (aside from towards myself), I have high levels of empathy, get along well with others, and am extremely emotionally sensitive. The DBT didn't really help me, although I learned some skills that I hope I still use. Now I'm in psychotherapy talking through my upsetting memories and the personality disorder thing isn't mentioned at all.

It's hard to know if the initial diagnosis of BPD was correct or not. The thing is, a personality disorder isn't necessarily a life long condition anyway- so maybe I wouldn't meet the criteria now. BPD is hugely stigmatised and there are some horrific things I've read online. People say you should never be in a relationship with someone who has BPD, they are liars, reactive and have no empathy but that's just not true. I'm extremely kind, caring and loving, I just struggle with life because of my very difficult start in it.

I would be reluctant to declare the BPD label to people who know me but would be ok admitting the CPTSD, so I guess it mostly does come down to the aforementioned stigma. They are similar conditions in lots of ways.

[Blueberry]

I'm so glad you weighed in here with your own experience as somebody with a BPD diagnosis (even if as you say yourself it may not be correct). "I'm extremely kind, caring and loving, I just struggle with life because of my very difficult start in it." is what lots of us on here could probably say too. Though if you read one of my posts a bit further up in the thread, you'll see that I certainly have not always been "kind, caring and loving".

I think it partly goes back to what I wrote before: armchair diagnoses of BPD / NPD should be treated with caution, as should even an immediate diagnosis from a professional, e.g. "you had problems with your previous therapist? You must be BPD!" Nooooo. Not so straightforward and easy.

Hope to see you around the forum some more.

[Candid]

And I'm so glad you wrote this:

I certainly have not always been "kind, caring and loving".

... because it gives me hope that I can be all that again. It's beyond me now. I think I need to be able to defend myself and my needs before I will find out Who I Really Am.