Difference between PDs and CPTSD

[Compassion_accountable]

Thank you for the new forum!! I have a suggestion for an improvement though...I understand that many symptoms of mental health struggles are co morbid,  I read the what is cptsd and thought yep, that's me. And then I read symptoms of cptsd and thought is was similar enough to OOTF that it was more descriptive of a PD. those symptoms didnt really fit me but I could definitely identify with the other description of CPTSD. I guess I would like to see a stronger differentiation between cptsd and pd.

But seriously, love the new place!!!!

[emotion overload]

Thank you for the new forum!! I have a suggestion for an improvement though...I understand that many symptoms of mental health struggles are co morbid,  I read the what is cptsd and thought yep, that's me. And then I read symptoms of cptsd and thought is was similar enough to OOTF that it was more descriptive of a PD. those symptoms didnt really fit me but I could definitely identify with the other description of CPTSD. I guess I would like to see a stronger differentiation between cptsd and pd.

But seriously, love the new place!!!!

Survivor, I think that is a tough distinction to make.  I've been OOTF and reading non-stop for about 9 months.  Every once in a while, I still worry that I have PD.  For about the first 6 months that I saw my T, I asked her every session if I had a PD.  Yes, I agree there are many overlapping symptoms.  And it's hard to put into words that tell you the difference. Generally, if you are on this forum, it's assumed you are not PD, because they don't see to recognize themselves in the definitions.  And if you are in doubt, consult a therapist.

[Kizzie]

Hi Survivor and my apologies, in the flurry of getting the site up and going I missed answering your post.  Thanks EO for responding and bumping Survivor's post 

I think EO has hit the nail on the head "Generally, if you are on this forum, it's assumed you are not PD, because they don't see to recognize themselves in the definitions."  The biggest difference for me is that those of us with CPTSD are self-reflective; that is, we know there is a problem, we often seek treatment, and our disorder is treatable. 

Those who have a PD on the other hand, do not typically recognize they have a problem, do not often seek out treatment, and tend to be treatment resistant when they do.  Now how that all filters down into clinical differences I cannot say, but PDs are identified as different diagnoses in both the American Psychological Association's Diagnostic and Statistical Manual and the World Health Organization's International Statistical Classification of Diseases and Related Health Problems. That is, CPTSD is a trauma/stress disorder while PDS are disorders of the personality.  One final difference that I see as someone who suffers from CPTSD but grew up with PD FOO is that my disorder is mainly turned inward, whereas my FOO's PDs were turned outward. 

Great discussion Survivor, thanks for bringing it up and it does help top understand what we are dealing with.  If anyone has anything to add please feel free to weigh in!

[pam]

I'm not up to date with everything in the world of psychology, but I do wonder:

What if personality disorders are also caused by trauma?
I've read in the past that Borderline Personality is, and I believe it's possible that even Narcissists can be created rather than born.

I doubt we'll ever have an answer to this nature-nurture thing. I feel bad for people with PDs (in theory anyway, lol). I mean just because they lack in things like self-awareness and empathy--maybe that wasn't their fault? I admit I personally feel like certain people on my FOO are "evil" or malicious on purpose when I'm their victim, but what if they aren't? What if they are just worse off than us and it got to be so ingrained that they are almost impossible to help? What if their trauma was so complete that it wiped out any shred of health and they are left completely dysfunctional (and not very nice)?

[coda]

There's a quote in the site "Understanding Complex Trauma, Complex Reactions, and Treatment Approaches" listed in articles (http://giftfromwithin.org/html/cptsd-understanding-treatment.html) that absolutely shook me:

Of note, many of the major characteristics resemble the symptom picture of emotional lability, relational instability, impulsivity, unstable self-structuresense of self, and self-harm tendencies most associated with borderline personality disorder (BPD; American Psychiatric Association, 1994). The BPD diagnosis has carried enormous stigma in the treatment community where it continues to be applied predominantly to women clients in a pejorative way, usually signifying that they are irrational and beyond help.

In many years of treatment, no doctor or T ever diagnosed me with a PD, though I often worried and asked. I'd been depressed since 10, but then major depression, panic attacks and self-harming overtook me and ended my career and I entered the world of MDs as opposed to therapists. Even then, it was about how dysfunctional and far-reaching my early life had been. How old survival techniques had mutated into what they called maladaptive behavior.

My mother and sister displayed (and still do) extreme, consistent and pervasive PD behaviors...but never wanted, "needed" or sought help. There was never any acknowledgement of irrationality or cruelty, everything was masked or absolved. Everything could be blamed on others. They are dishonest to their core, which I don't think they can help. But I was & am considered the over-sensitive, problematic one. Because agoraphobia played a huge role throughout my life, some symptoms of Avoidant PD were discussed, but given the social threats I grew up with, CPTSD has always provided the clearest explanation.

Then I got involved in a civil lawsuit, and was forced to endure an evaluation. Guess what? Borderline. Born that way. Irresponsible, manipulative and guilty. Also: incurable. This is the "N"-word of psychiatry.  It has been a nightmare of indescribable proportions and is still ongoing.

[Badmemories]

Ty for the link.. It is a good one!

[Butterfly]

Then I got involved in a civil lawsuit, and was forced to endure an evaluation. Guess what? Borderline. Born that way. Irresponsible, manipulative and guilty. Also: incurable. This is the "N"-word of psychiatry.  It has been a nightmare of indescribable proportions and is still ongoing.

How awful.

[Kizzie]

Coda - I'm not a professional but I absolutely agree with Pete Walker when he suggests that CPTSD if often misdiagnosed:

I have witnessed many clients with CPTSD misdiagnosed with various anxiety and depressive disorders.  Moreover, many are also unfairly and inaccurately labeled with bipolar, narcissistic, codependent, autism spectrum and borderlines disorders ....

Most of the diagnoses mentioned above are typically treated as innate characterological defects rather than as learned maladaptations to stress -- adaptations that survivors were forced to learn as traumatized children.  And, most importantly, because these adaptions were learned, they can often be extinguished or significantly diminished and replaced with more functional adaptations to stress (p. 9, CPTSD, From Surviving to Thriving, 2013).

You do NOT have to accept that evaluation!

[Butterfly]

What if personality disorders are also caused by trauma? I've read in the past that Borderline Personality is, and I believe it's possible that even Narcissists can be created rather than born.

Personally I do believe that to be the case, at least it was in my family history. Childhood trauma may have caused uPD mum to be how she is complicated by the fact that she learned her behavior from her own mother but she doesn't believe there's anything at all wrong with her behavior.

And while I exhibited some similar traits from my own childhood abuse at her hand and learned her behavior, the difference is I realized this is not normal adult behavior and learned to grow into an adult long before OOTF when I left home and observed the adult working world around me.

Perhaps the difference is she stays stuck as BPD because she refuses to look outward at the world around her to even see something is not right with her behavior combined with the fact that she refuses to look inward and recognize her damage. Perhaps I would have simply continued the cycle had I not look outward and inward.

The reason I find myself on OOTF and OOTS is that I was hoovered into moving back to the area under the guise of her nearing her death (lies) and was pulled into a quagmire until I realized I was right back where I started - frozen in fear and completely under her control. Even living far away there was some measure of fear obligation and guilt, so it hasn't been a completely bad thing. I am finally truly free.

[Kizzie]

My H and I have talked a lot about how we escaped developed a PD and I think for us it was being the Scapegoat and Lost Child - our PD parents did not focus on us as much as out siblings AND we got out of the house early on which help ground us in real world behaviours.  My H joined Cadets Canada program when he was 13 and stayed with them until 18 then went on to the military so as a teen he was away a lot of evenings during the week and on weekends and went away on course every summer.  As for me, I stayed behind in Ontario to finish high school when my F was posted to Quebec (military) and then went on to university so I didn't get as much exposure as my NPDB.

As Butterfly suggests, we come out of the trauma because something grounds us in some way such as getting away from PD FOO and having a significant adult or organization to provide us with healthy boundaries/guidelines to balance what is happening at home.  As a Lost Child I escaped to my room and read a lot which helped me to realize there was a bigger, saner world than what I lived in at home, and as a Scapegoat I knew on some level that I was being treated unfairly because I was targeted while my B was not.  So my H came away injured, but not broken whereas our parents did not fare as well.
My H's and my parents had a inordinate amount of trauma in their childhoods, the kind that you don't come back from (depression, war time, death of both M's, both alcoholic F's), and that in their generation you did not talk about or seek help for. 

I suppose what I'm getting at here is that while PDs may be created by trauma, there are factors which mitigate how severe and what form a person's reaction is to that trauma. Those of us with CPTSD still have the ability to be self-reflective, to have insight into ourselves and others, something that is missing or very deeply buried in those with PDs. 

[Rrecovery]

I agree that the hallmark of PDs is a profound defensiveness; a pattern of blaming their pain on external factors rather than looking within for sources of pain and dysfunction. BDP is becoming a treatable condition as long as the sufferer is willing to take responsibility and be open to treatment. Even NPD can be treated if the sufferer can somehow see that they have a problem. But some narcissists biologically lack the capacity for empathy - like sociopaths - and are not treatable.
Those of us here see/admit we have problems that are inside us and we are willing to work on our recovery. We may struggle with some PD traits - our early learning taught us to think and behave along those lines - but we do not have PDs.

Sound reasonable?

[selfcompassion]

I often think that the difference between those of us who respond to trauma by flight, and those who develop narcissistic survival strategies, may lie in what we naturally dissociate from best. Maybe the scapegoated child is better at dissociating from pain, and the narcissist child finds escape in mirroring its tormentors, and dissociating from shame/blame and guilt.

A physically or sexually violated child has great capacity for dissociation and denial. Because a full  realization of the extent of the trauma -- at the moment it is taking place -- could be too overpowering for the child to thrive. It seems to me that the child that turns toward narcissism as a survival strategy, does so as a result of closing himself off to the shame of the abuse that is taking place. The denial and complete blocking of shame, happens at the same time they are trying to forget the overpowering memories of what has taken place in the home. The memories are overpoweringly shameful, so the child simply throws the whole mess out of his mind, and banishes shame along with the bad memories -- forever, if he can. There is a wellspring of shame in these families; the scapegoats wear their shame on their sleeve, and the narcissist makes believe that shame simply does not exist.

I have listened to narcissists whom I have known for years, sit in front of me and exclaim that they don't feel guilty for anything they have done in their lives. They have no regrets. Everything they have done was necessary for them to come out well. These same people have victims spread out behind them on both sides of the road. But they feel no shame, blame or guilt. When shame is disabled -- removed from the conscience construct -- as a maladaptive, but indelible survival mechanism, anti-social character traits seem to develop in the void. They seem to call this development a personality disorder.

The narcissists of my recollection all seemed to have that wonderful ability to keep shame banished from their ego-tunnel. And if you don't have shame, you don't take the blame. If there is no acceptance of blame, guilt does not develop. While I have rubbed shoulders with some sociopaths in my life, I don't think any of them have fully severed ties with shame. By denying it, it remains trapped inside them forever, and it drives them into a life of delusions. The denial of shame traps them in their anger and rage over the injustice of it all.  Of all the damaged people in the dysfunctional family system, they are the most self-abandoned, and damaged of us all; with very little -- if any -- chance of getting to know their authentic selves.

Trauma makes victims of all who go through it.

[MaryGrace]

I had a weird revelation last night. There is a common belief that children often grow up to marry a partner that resembles (not physically but in nature) one of our parents. I did get pretty early on our marriage that I am a "nicer" version of DH's pdDad (ack). I did have huge problem with being controlling when were first married (his father is a control freak) but I couldn't quite figure out how that worked for me as far as choosing DH -until yesterday when I was re-reading what I wrote in my introduction on this site. My dh-because of his exacting abusive dad -deflects responsibility, avoids responsibility and will when he's in panic mode blame everything but himself, when in truth he feels enormous guilt and shame underneath it all -is having an emotional flashback and just doesn't want to feel. My PDmom absolutely can not accept responsibility for anything -ever, ever, ever. And I do believe it is also caused by deep guilt and shame in her case but she has stuffed that guilt and shame so far into her psyche that she doesn't feel it any more. Her response is rage, and cruelty. Dh avoids conflict at all cost and he is not malevolent.  And while I was (and to some degree still have issues) with control -I recognized pretty early on that I had a problem and have worked very hard to correct this short coming where as DH's dad doesn't want to change, doesn't care. In a rare moment of honesty (rather shocking actually) his father said he knows he's an *. Those were his exact words (right after a death in the family -which is usually when he gets somewhat remotely human for a very brief period).

I, at least don't believe I have C-PTSD only because I don't think my trauma was as severe as DH's, but I definitely still had/have issues. I think the difference is PD's are malevolent and they do not want to change. C-PTSD survivors are reacting to trauma, they know something is wrong and even when their reactions can be hurtful to others that is never their intent.

Back to DH's active alcoholic days long before I even knew about C-PTSD I used to always say dh often made choices that caused me a lot of pain but that was never his intent. He was never ever actively trying to hurt me. The PD's in our lives most certainly intended to hurt us, they intended suffering and they saw/see nothing wrong with their actions or they just don't care.

So those are just my thoughts and ramblings as an interloper on the board trying to be supportive of my DH's recovery.

[Kizzie]

I know when I first went to OOTF MaryGrace I wondered if I had a PD but I realized in short order that there really is a difference between me and my PD M and B - they do not feel shame (consciously anyway), whereas in my case I feel toxic amounts of shame, and I would hazard a guess that your H is the same way.  CPTSD gives us that in truckloads unfortunately and it kicks in whenever we encounter a situation that is similar to what we went through in childhood.  So when he was caught out at the grocery store, I'm sure he went right into an emotional flashback.  I don't know if you've read about those yet but it's an overwhelming melange of feelings - shame, fear   ...... from childhood which wells up and overtakes us  Perhaps that is why he is willing to go back to his T?  It may have been a catalyst event so even though it didn't sit well with you (and shouldn't), perhaps something good will come from it.

It's really good to read about your feelings for your H as they come through loud and clear (loving, caring, concerned), and best of all you get that he is not trying to hurt you deliberately.  I was thinking as I was reading that perhaps you chose one another because you saw the opportunity to do things better even with the fleas, because you are both able to.  Our PD FOO really just couldn't - that was hard to accept but I believe it completely now.  As Self-Compassion suggests, PDs seem to have a well-honed ability to banish their shame from the conscious ego and without healthy shame you are rudderless in life.   

[Butterfly]

What an amazing topic, so insightful. Disassociation and shame - interesting.

Some comments lean toward a PD being unable somehow to look internally but I'm still on the fence and feel it's a choice. They don't *have* to behave this way to survive, there are other ways to survive. Perhaps because of the trauma they're unable to look inward because it's such a dreadfully dark and terrible place. But honestly as uPDm behavior becomes more insane with passing time, how can she not see? She is more than willing to see her mother wasnt right yet is a mirror replica and more. Is that the definition of insane? Wait, let me check. Ah yes "in a state of mind that prevents normal perception, behavior, or social interaction; seriously mentally ill" that helps me.

uPDm is definitely fight response whereas I'm freeze and was Lost GC if that's a possible combination. DH was a Lost SG and we both came to marriage damaged but helped one another see fleas. We did that without even knowing we were doing that and it was horribly rocky but helpful.

Injured but not broken, kizzie I like that and may have to take that as a tag line. It soothed my soul to read that today.