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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 21 to 45 of 45. Go back in thread:
Posted by Zo on August 1, 2001, at 17:56:14
In reply to Re: BPD/antisocial/bipolar/Jamison/stimulants...., posted by margaretmarburg on July 28, 2001, at 5:10:08
BPD dx, in my understanding, requires a real "Splitting" be going on. The inability to hold the grey area, but to *truly* be capable of seeing things ONLY in black and white.
Borderline traits are pretty sexist-ly (?) (!) the way women get upset. Forget all that horses**t. Borderlines suffer in their Object Relations, they do not have Object Constancy, and that's a real early developmental stage. . .one which, whether through trauma or chemistry, didn't take place. So that growing up never really happens. They're stuck there.
That means, as is true in all Personality Disorders, the person is wired up wrong, hard wired, and that's very difficult to change.
Zo
Posted by MM on August 2, 2001, at 1:37:18
In reply to Re: Borderline Personality Disorder, posted by Zo on August 1, 2001, at 17:56:14
Zo, could you possibly explain Object Relations/Constancy to me?
I read one book on BPD (kind of an old one, by melissa someone? I think it was called borderline and beyond?) a while ago, but it didn't explain much to me.
Posted by MM on August 3, 2001, at 1:41:44
In reply to Re: Borderline Personality Disorder » Zo, posted by MM on August 2, 2001, at 1:37:18
Don't know if anyone's still reading this thread, but I also was wondering about the symptom of chronic emptiness in BPD. Isn't that a symptom of just regular depression too?
Posted by Mitch on August 3, 2001, at 11:36:11
In reply to Re: Borderline Personality Disorder, posted by MM on August 3, 2001, at 1:41:44
> Don't know if anyone's still reading this thread, but I also was wondering about the symptom of chronic emptiness in BPD. Isn't that a symptom of just regular depression too?
MM,
Yes, I would think so. I mean can someone more clearly define what "chronic emptiness" is? Sure sounds like depression to me. I think Elizabeth is right about this being a fad diagnosis and it being "overcalled" especially with women. I wouldn't be surprised that in the future it gets eliminated from the DSM. Nearly any person with clear-cut uncomplicated bipolar disorder already will have some of the "traits". And if you have one or more of the anxiety disorders you will have some of those "traits" as well. I think it is just a "catch-all" for something that pdocs have trouble treating. In my opinion, it is either/both a subset of ADHD patients, or a subset of bipolar patients with "mixed" symptoms.
Mitch
Posted by Elizabeth on August 3, 2001, at 18:19:40
In reply to Re: Borderline Personality Disorder » MM, posted by Mitch on August 3, 2001, at 11:36:11
[MM:]
> > Don't know if anyone's still reading this thread, but I also was wondering about the symptom of chronic emptiness in BPD. Isn't that a symptom of just regular depression too?I was never clear on what "emptiness" is supposed to mean anyway. I guess that it might be something like boredom or inability to feel okay/comfortable/at ease/fulfilled. This might contribute to the impulsive sensation-seeking that is commonly seen in BPD -- an attempt to fill the void.
[Mitch:]
> Yes, I would think so. I mean can someone more clearly define what "chronic emptiness" is? Sure sounds like depression to me.The overlap is substantial. I think that BPD probably does exist as a distinct entity (one that's prevalent, in particular, in women who were abused as children), but it's way overdiagnosed in people (especially women) who might really have ADHD, PTSD, bipolar disorder, atypical depression, substance dependence, etc., without first ruling out these disorders. And a primary diagnosis of personality disorder often prevents people from getting adequate medical treatment, since there's a general feeling that "personality disorders" don't respond to medication.
In fact, a variety of medications have been employed successfully in BPD: antidepressants (but not tricyclics), antipsychotics (mainly in low doses), anticonvulsants, lithium, psychostimulants, etc. This doesn't prove that these patients "really" have an axis I (or III) disorder and not BPD (for example, response to Depakote doesn't mean that a person is really suffering from bipolar disorder or temporal lobe epilepsy), but it does mean that pharmacotherapy should at least be considered. People with this disorder suffer a great deal, and their treaters often make it worse by getting irritated with them and labelling them with derogatory adjectives such as "manipulative," "attention-seeking," "immature," "demanding," etc., and by assuming that medication will not help.
Marsha Linehan (a psychologist who designed a modified form of cognitive-behavioural therapy specifically for BPD) thinks that one causative factor can be invalidation of a person's feelings and experiences in childhood. Reexperiencing that invalidation in the treatment setting can hardly be expected to help.
> I wouldn't be surprised that in the future it gets eliminated from the DSM.
I think it might be assimilated into the mood disorders category, perhaps as "affective reactivity disorder" or something like that. IMO, the primary feature of BPD is excessive sensitivity or mood reactivity.
> Nearly any person with clear-cut uncomplicated bipolar disorder already will have some of the "traits".
The difference is that in a personality disorder, they're enduring traits, not symptoms of a manic, depressive, or mixed episode. When you get into mixed mania, rapid cycling, and "soft" bipolar disorders (cyclothymia and bipolar II), though, the waters become muddy.
> And if you have one or more of the anxiety disorders you will have some of those "traits" as well.
Yes. I think the criteria should be more restrictive. Clinicians are often hasty to diagnose an Axis II condition based on a person's behaviour during a brief hospital stay. I think this is a serious problem. They seem to forget the general rule that personality disorders have to be enduring -- trait, not state -- and that the signs and symptoms must present in a variety of contexts (not just, for example, in the hospital). I also suspect that a lot of adolescent girls are diagnosed with BPD when in fact they're just going through the usual stuff that teenagers have to deal with.
> I think it is just a "catch-all" for something that pdocs have trouble treating.
Well, it's a way of blaming the patient for failing to get better, rather than blaming the doctor for failing to cure the patient. I don't think it's especially helpful in most cases, and it's quite stigmatising.
> In my opinion, it is either/both a subset of ADHD patients, or a subset of bipolar patients with "mixed" symptoms.
I think that is probably true in many cases.
-elizabeth
Posted by Else on August 3, 2001, at 18:48:13
In reply to Re: Borderline Personality Disorder, posted by Elizabeth on August 3, 2001, at 18:19:40
Elizabeth, you rule! Keep up the good work. I am so very impressed by how calm and knowledgeable you are. It's wonderful.
> [MM:]
> > > Don't know if anyone's still reading this thread, but I also was wondering about the symptom of chronic emptiness in BPD. Isn't that a symptom of just regular depression too?
>
> I was never clear on what "emptiness" is supposed to mean anyway. I guess that it might be something like boredom or inability to feel okay/comfortable/at ease/fulfilled. This might contribute to the impulsive sensation-seeking that is commonly seen in BPD -- an attempt to fill the void.
>
> [Mitch:]
> > Yes, I would think so. I mean can someone more clearly define what "chronic emptiness" is? Sure sounds like depression to me.
>
> The overlap is substantial. I think that BPD probably does exist as a distinct entity (one that's prevalent, in particular, in women who were abused as children), but it's way overdiagnosed in people (especially women) who might really have ADHD, PTSD, bipolar disorder, atypical depression, substance dependence, etc., without first ruling out these disorders. And a primary diagnosis of personality disorder often prevents people from getting adequate medical treatment, since there's a general feeling that "personality disorders" don't respond to medication.
>
> In fact, a variety of medications have been employed successfully in BPD: antidepressants (but not tricyclics), antipsychotics (mainly in low doses), anticonvulsants, lithium, psychostimulants, etc. This doesn't prove that these patients "really" have an axis I (or III) disorder and not BPD (for example, response to Depakote doesn't mean that a person is really suffering from bipolar disorder or temporal lobe epilepsy), but it does mean that pharmacotherapy should at least be considered. People with this disorder suffer a great deal, and their treaters often make it worse by getting irritated with them and labelling them with derogatory adjectives such as "manipulative," "attention-seeking," "immature," "demanding," etc., and by assuming that medication will not help.
>
> Marsha Linehan (a psychologist who designed a modified form of cognitive-behavioural therapy specifically for BPD) thinks that one causative factor can be invalidation of a person's feelings and experiences in childhood. Reexperiencing that invalidation in the treatment setting can hardly be expected to help.
>
> > I wouldn't be surprised that in the future it gets eliminated from the DSM.
>
> I think it might be assimilated into the mood disorders category, perhaps as "affective reactivity disorder" or something like that. IMO, the primary feature of BPD is excessive sensitivity or mood reactivity.
>
> > Nearly any person with clear-cut uncomplicated bipolar disorder already will have some of the "traits".
>
> The difference is that in a personality disorder, they're enduring traits, not symptoms of a manic, depressive, or mixed episode. When you get into mixed mania, rapid cycling, and "soft" bipolar disorders (cyclothymia and bipolar II), though, the waters become muddy.
>
> > And if you have one or more of the anxiety disorders you will have some of those "traits" as well.
>
> Yes. I think the criteria should be more restrictive. Clinicians are often hasty to diagnose an Axis II condition based on a person's behaviour during a brief hospital stay. I think this is a serious problem. They seem to forget the general rule that personality disorders have to be enduring -- trait, not state -- and that the signs and symptoms must present in a variety of contexts (not just, for example, in the hospital). I also suspect that a lot of adolescent girls are diagnosed with BPD when in fact they're just going through the usual stuff that teenagers have to deal with.
>
> > I think it is just a "catch-all" for something that pdocs have trouble treating.
>
> Well, it's a way of blaming the patient for failing to get better, rather than blaming the doctor for failing to cure the patient. I don't think it's especially helpful in most cases, and it's quite stigmatising.
>
> > In my opinion, it is either/both a subset of ADHD patients, or a subset of bipolar patients with "mixed" symptoms.
>
> I think that is probably true in many cases.
>
> -elizabeth
Posted by Elizabeth on August 4, 2001, at 21:52:58
In reply to Re: Borderline Personality Disorder » Elizabeth, posted by Else on August 3, 2001, at 18:48:13
> Elizabeth, you rule! Keep up the good work. I am so very impressed by how calm and knowledgeable you are. It's wonderful.
< blush > Thanks. (What prompted this outpouring of compliments? Not that I mind....)
-elizabeth
Posted by Survivor on August 5, 2001, at 3:50:51
In reply to Re: questions-borderline personality disorder, posted by Else on July 27, 2001, at 6:26:38
> > > If stimulant medications make me feel better, does that suggest ADD?
> >
> > Not necessarily. Stimulants have antidepressant effects in some people, for example; see early research on what is now known as atypical depression. The lines between these categories can be quite blurred, of course.
> >
> > I think that euphoria is seldom a side effect when people start taking them for ADD, for example: the doses used are simply too low. And anyway, not everyone finds stimulants euphoric or even pleasant.
> >
>
> Maybe not everyone, but a lot of people do, that's why they are controlled substances. They do directly stimulate the "pleasure" center in the brain. Even at low doses, they would help almost anyone concentrate, not just people with ADD. < <I was initially diagnosed at age 9 as "hyperactive" and extensively retested at age 40 and given a diagnosis of extreme ADHD. Stimulants were prescribed for me this time and there was *no high*, no elation or euphoria when I began taking them, even at very high doses. More appropriately, they calmed me down, put me to sleep, made me able to sit still and shut up, sometimes for minutes on end < g >.
This reaction is the goal in stimulant use. A true ADD or ADHD person will find stimulants sedating, an inverse response to the one a non-ADD/ADHD person will experience. Non-ADD people ought to be able to *fly* on the level of stimulants it takes to give me improved cognitive performance and greater (any) impulse control. Sleep problems, appetite suppression, feeling high, and other "standard" stimulant responses just never happen to me. Instead, they produce a measure of calm and quiet in my over-amped brain that no other medication can.
FWIW, I also take an antidepressant medication considered highly sedating. Before getting the right treatment for my ADHD, that highly sedating drug had me operating like a manic in overdrive, even as it helped my depression.
Comorbid conditions make the garden we grow in an unmangeable tangle; just keep hacking away at each new
weed that springs up and hope that some sunshine will eventually break through. It probably won't, but what else do you have to do that's more important than trying to get some light and warmth into your life?
Posted by Else on August 5, 2001, at 18:15:11
In reply to Re: Borderline Personality Disorder » Else, posted by Elizabeth on August 4, 2001, at 21:52:58
Just the way you replied to that post and every post you reply to in general, that's all. No reason to blush.
> > Elizabeth, you rule! Keep up the good work. I am so very impressed by how calm and knowledgeable you are. It's wonderful.
>
> < blush > Thanks. (What prompted this outpouring of compliments? Not that I mind....)
>
> -elizabeth
Posted by sillygrrl on August 7, 2001, at 2:36:33
In reply to questions-borderline personality disorder, posted by MM on July 23, 2001, at 1:15:29
someone might have already posted this, but i think it's an excellent comparison:
http://www.psycheducation.org/depression/borderline.htm
I think BipolarII often gets misdiagnosed as ADD or BPD - I got dianosed with ADD by shrinks who liked me and BPD by shrinks who didn't. They missed my euphoric mania (because i never went to see them then) and my dysphoric mania got pegged as depression.
I don't think BPD is the female version for ADD. BPD individuals tend to be manipulative and desperate and even cruel. I've heard it more than once be referred to as the female version of Antisocial Personality Disorder. My personal theory is that BPD is simply Bipolar or Cyclothymia coupled with severely impaired interpersonal and emotional coping skills.
sincerely,
silly> Does anyone have experience with BPD? What about the connection with bipolar? I've read some stuff, but it's kind of unclear what it is. Is it borderline schizophrenia? Is it a valid dx? If I identify with some of the traits, does that mean I have it, or should I just stick with the BPII dx? Just kinda want thoughts on BPD. I'm still amazed at how MUCH you guys know (being that it seems like most of you are not psychiatrists, but patients).
Posted by sillygrrl on August 7, 2001, at 2:56:16
In reply to Re: questions-borderline personality disorder, posted by sillygrrl on August 7, 2001, at 2:36:33
hey folks,
that wasn't very nice of me to refer to borderline folks as manipulative and desperate. Sorry about that. I think I have a very sour attitude towards the diagnosis because it was thrown at me and others I know who very clearly had other issues, and my mother, who was quite cruel and unstable, most likely has the disorder.
sillygrrl
Posted by Mitch on August 7, 2001, at 9:21:16
In reply to let me restate..., posted by sillygrrl on August 7, 2001, at 2:56:16
> hey folks,
>
> that wasn't very nice of me to refer to borderline folks as manipulative and desperate. Sorry about that. I think I have a very sour attitude towards the diagnosis because it was thrown at me and others I know who very clearly had other issues, and my mother, who was quite cruel and unstable, most likely has the disorder.
>
> sillygrrlsg,
Well those are some of the current *traits* of having that disorder. I thought that it was some form of subset of bipolar or subset of ADHD. Given that sexual abuse occurs more often to women than men in their childhood and that a high number of BPD people were abused makes me wonder if it is a combination of bipolar genetics combined with the psycho-social trauma of abuse as a child (sexual and physical PTSD if you will). That might account for a lot of the traits commonly associated with it even *cruelty* that you mentioned.
Mitch
Posted by Survivor on August 9, 2001, at 1:46:19
In reply to Re: let me restate... » sillygrrl, posted by Mitch on August 7, 2001, at 9:21:16
I think BPD is one of those variable labels like the Multiple Personality Disorder/Dissociative Disorder/Grand Hysteria sequence that get revised regularly. These revisions aren't necessarily based on any new understanding of the conditions, but seem to be more related to changes in the jargon of the treatment community.
I've never heard of BPD referred to as a subset of ADHD, although that doesn't surprise me. It does seem to share ADHD's impulse control problems and inappropriate disinhibition - I'm speaking as an off-the-scale ADHD adult who takes *massive* doses of medication to control my symptoms here - but is far more complex with its aggressive, hostile, and sometimes paranoid aspects. I've heard it diagnosed as a temporal lobe dysfunction rather than a psychiatric disorder, but aren't a lot of these problems based in the temporal lobe?
It isn't unusual to find an angry, defensive, somewhat dissociative adult grow out of an abusive childhood spent trying to survive mentally ill parents. Toss in some sexual and/or physical abuse, and I wonder if the behavior that results is actually a new disorder of some kind or simply the understandable outcome of a highly dangerous, uncontrollable childhood.
Sometimes I think the experts are too quick to diagnose or discover a new pathology in situations where the behavior makes a lot of sense when you look at the background of the people who are suffering from it. Raised by wolves, we learn to respond with equally vicious attitudes and behaviors in attempts to defend ourselves from unpredictable and unjustified attacks. Unfortunately, these behaviors that are self-defensive in our formative years don't translate well into outside social situations. Isn't that a problem with adjusting to perceived threats in the outside world that can be helped through learning new social patterns more than an organic brain dysfunction or other pathology?
Learning to ease up on ourselves is probably the first step toward letting go of the expectation that everyone and everything else in the world poses an immediate threat to you, long after you've left the circumstances where, in fact, almost everything did. Maybe BPD is much closer to PTSD than any other recognized disorder when it grows out of such disordered surroundings, if a psychiatric diagnosis is desired. Maybe it is closer to the truth to classify it instead as a residual socially maladaptive behavior problem.
> Well those are some of the current *traits* of having that disorder. I thought that it was some form of subset of bipolar or subset of ADHD. Given that sexual abuse occurs more often to women than men in their childhood and that a high number of BPD people were abused makes me wonder if it is a combination of bipolar genetics combined with the psycho-social trauma of abuse as a child (sexual and physical PTSD if you will). That might account for a lot of the traits commonly associated with it even *cruelty* that you mentioned.
>
> Mitch
Posted by Mitch on August 9, 2001, at 9:34:01
In reply to Re: let me restate..., posted by Survivor on August 9, 2001, at 1:46:19
> I think BPD is one of those variable labels like the Multiple Personality Disorder/Dissociative Disorder/Grand Hysteria sequence that get revised regularly. These revisions aren't necessarily based on any new understanding of the conditions, but seem to be more related to changes in the jargon of the treatment community.
Sure, that makes sense. You still see similar "phenomena"-the *label* just gets tweaked with time. My grandmother was diagnosed as schizophrenic in the 50's and given ECT, when in fact she only had one episode of psychotic depression, and didn't have any other episodes.
>
> I've never heard of BPD referred to as a subset of ADHD, although that doesn't surprise me. It does seem to share ADHD's impulse control problems and inappropriate disinhibition - I'm speaking as an off-the-scale ADHD adult who takes *massive* doses of medication to control my symptoms here - but is far more complex with its aggressive, hostile, and sometimes paranoid aspects. I've heard it diagnosed as a temporal lobe dysfunction rather than a psychiatric disorder, but aren't a lot of these problems based in the temporal lobe?BPD probably is something a lot of pdocs and researchers would like to find an organic basis for given their relative lack of success with conventional treatments (thinking that a medication could be created/discovered for that condition).
>
> It isn't unusual to find an angry, defensive, somewhat dissociative adult grow out of an abusive childhood spent trying to survive mentally ill parents. Toss in some sexual and/or physical abuse, and I wonder if the behavior that results is actually a new disorder of some kind or simply the understandable outcome of a highly dangerous, uncontrollable childhood.I didnt' suffer any abuse but my parents definitely had their problems. My Mom epilepsy-OCD/GAD and my Dad probably bipolar (explosive temper). I have known others that have suffered from abuse and it DID effect them very deleteriously.
>
> Sometimes I think the experts are too quick to diagnose or discover a new pathology in situations where the behavior makes a lot of sense when you look at the background of the people who are suffering from it. Raised by wolves, we learn to respond with equally vicious attitudes and behaviors in attempts to defend ourselves from unpredictable and unjustified attacks. Unfortunately, these behaviors that are self-defensive in our formative years don't translate well into outside social situations. Isn't that a problem with adjusting to perceived threats in the outside world that can be helped through learning new social patterns more than an organic brain dysfunction or other pathology?I have brought this up before, but what about the impact of accelerating technology on communities and our sense of empathy for others-effects of increased depersonalization?
>
> Learning to ease up on ourselves is probably the first step toward letting go of the expectation that everyone and everything else in the world poses an immediate threat to you, long after you've left the circumstances where, in fact, almost everything did. Maybe BPD is much closer to PTSD than any other recognized disorder when it grows out of such disordered surroundings, if a psychiatric diagnosis is desired. Maybe it is closer to the truth to classify it instead as a residual socially maladaptive behavior problem.Most anxiety disorders are based in irrational fears and catastrophic prejudice about others and situations.
Mitch
Posted by Elizabeth on August 9, 2001, at 10:11:30
In reply to Re: let me restate..., posted by Survivor on August 9, 2001, at 1:46:19
> I've never heard of BPD referred to as a subset of ADHD, although that doesn't surprise me.
Some people labelled "borderline" have been found to respond to stimulants. To conclude that BPD is therefore the same thing as ADHD would be faulty logic, but some people do so anyway. As you point out, there are similarities.
> I've heard it diagnosed as a temporal lobe dysfunction rather than a psychiatric disorder, but aren't a lot of these problems based in the temporal lobe?
Yes. The idea of BPD = epilepsy is probably flawed, although interictal emotional problems related to temporal lobe epilepsy can resemble "borderline" symptoms.
> ... I wonder if the behavior that results is actually a new disorder of some kind or simply the understandable outcome of a highly dangerous, uncontrollable childhood.
I don't think that the two are mututally exclusive. Posttraumatic stress disorder, for example, has sometimes been described as a normal response to an abnormal or unusual event.
> Maybe BPD is much closer to PTSD than any other recognized disorder when it grows out of such disordered surroundings, if a psychiatric diagnosis is desired.
Have you ever heard of the concept of "complex PTSD?"
-elizabeth
Posted by Survivor on August 10, 2001, at 3:50:14
In reply to Re: let me restate... » Survivor, posted by Mitch on August 9, 2001, at 9:34:01
Mitch,
> > I didnt' suffer any abuse but my parents definitely had their problems. My Mom epilepsy-OCD/GAD and my Dad probably bipolar (explosive temper). I have known others that have suffered from abuse and it DID effect them very deleteriously.< <I grew up with a severely bipolar father with a hair trigger rage and my mother was sunk in her own depressions, too. It may not have been physical, but I think that is a *very* abusive background you're describing. For one thing, you could never be sure of anything around a rage-expressive manic-depressive - my father changed the rules faster than I could learn them, resulting in total insecurity about my perceptions and the safety of life in general which fed my organic depression and anxiety. Another is that you watch those behaviors and learn them from a very tender age, or at least learn to let others direct the effects of their illnesses upon you. Since we are blends of nature and nurture, such an unstable home life is, in my mind, the worst incubator for the organic aspects of our currents disorders. How can you grow healthy flowers in poisoned soil? You deserve credit for having survived that kind of upbringing.
> > I have brought this up before, but what about the impact of accelerating technology on communities and our sense of empathy for others-effects of increased depersonalization?< <
Being new here, I haven't been in on your previous posts on this topic, but I feel that technology gave me a way to communicate with the world when my ability to interact with it on a personal or "real" level didn't even exist yet. Your point is valid for many people, but for me, my first computer was my first contact point with the outside world after 5 agoraphobic years of solitude. Its anonymous nature let me learn to socialize and todesensitize my knee-jerk panic toward everyone and everything until I could eventually risk meeting someone in the flesh. So there can be an upside for some people to the rapid evolution and increasingly dominant role technology has today. Just another perspective.
>
> > Most anxiety disorders are based in irrational fears and catastrophic prejudice about others and situations.< <Again, here I'm going to reference your growing up with a bipolar parent. Maybe your fears were entirely rational at the time, given your circumstances. Maybe they weren't prejudices, but recognition that something was very wrong with the dynamics in your household. There is also an organic basis for anxiety disorders, in my opinion at least. Left unattended to multiply and build on themselves, anxieties and prejudices like you mention look very much to me like vestigal self-defense survival reactions that no longer play a useful role in one's life. Again, just my point of view.
Posted by Survivor on August 10, 2001, at 3:53:34
In reply to Re: let me restate... » Survivor, posted by Elizabeth on August 9, 2001, at 10:11:30
> > Have you ever heard of the concept of "complex PTSD?"
>
> -elizabeth< <Elizabeth,
No I haven't. Can you tell me more or point me toward some information about it?
Posted by Elizabeth on August 10, 2001, at 17:10:25
In reply to Re: let me restate... » Elizabeth, posted by Survivor on August 10, 2001, at 3:53:34
> > > Have you ever heard of the concept of "complex PTSD?"
>
> No I haven't. Can you tell me more or point me toward some information about it?It's basically the same as BPD. It's supposed to result from repeated, long-term trauma in childhood, as opposed to the currently recognised form of PTSD, which can result from a single traumatic incident in adulthood.
A cursory web search turned up a couple of sites that might be helpful:
http://www.ncptsd.org/facts/specific/fs_complex_ptsd.html
http://www.palace.net/~llama/psych/cptsd.html
-e
Posted by Mitch on August 10, 2001, at 23:45:52
In reply to Re: let me restate... » Survivor, posted by Elizabeth on August 10, 2001, at 17:10:25
> > > > Have you ever heard of the concept of "complex PTSD?"
> >
> > No I haven't. Can you tell me more or point me toward some information about it?
>
> It's basically the same as BPD. It's supposed to result from repeated, long-term trauma in childhood, as opposed to the currently recognised form of PTSD, which can result from a single traumatic incident in adulthood.
>
> A cursory web search turned up a couple of sites that might be helpful:
>
> http://www.ncptsd.org/facts/specific/fs_complex_ptsd.html
>
> http://www.palace.net/~llama/psych/cptsd.html
>
> -eElizabeth,
I checked the website and it was very informative, thanks. I am (with many others) currently in a workplace situation with a boss who is a total control freak (and diagnosed with borderline and OCD) and we are getting more and more miserable. Half of our area is now taking antidepressants or suffering from psychosomatic illnesses. Could this workplace stress over months/years be actually a complex PTSD symptomology brought on by an abusive boss?
Mitch
Posted by Elizabeth on August 11, 2001, at 13:10:38
In reply to Re: workplace stress and complex PTSD? » Elizabeth, posted by Mitch on August 10, 2001, at 23:45:52
> I checked the website and it was very informative, thanks.
Cool. Which one?
> I am (with many others) currently in a workplace situation with a boss who is a total control freak (and diagnosed with borderline and OCD) and we are getting more and more miserable.
I can't imagine that situation being easy.
> Half of our area is now taking antidepressants or suffering from psychosomatic illnesses. Could this workplace stress over months/years be actually a complex PTSD symptomology brought on by an abusive boss?
I don't know that it would be posttraumatic stress so much as the type of anxiety that often arises from difficult interpersonal situations. What particular kinds of things does your boss do that upset people at work, if you're comfortable talking about it?
-elizabeth
Posted by Mitch on August 11, 2001, at 13:41:10
In reply to Re: workplace stress and complex PTSD? » Mitch, posted by Elizabeth on August 11, 2001, at 13:10:38
> > I checked the website and it was very informative, thanks.
>
> Cool. Which one?The PTSD.org "complex PTSD" webpage.
>
> > I am (with many others) currently in a workplace situation with a boss who is a total control freak (and diagnosed with borderline and OCD) and we are getting more and more miserable.
>
> I can't imagine that situation being easy.
>
> > Half of our area is now taking antidepressants or suffering from psychosomatic illnesses. Could this workplace stress over months/years be actually a complex PTSD symptomology brought on by an abusive boss?
>
> I don't know that it would be posttraumatic stress so much as the type of anxiety that often arises from difficult interpersonal situations. What particular kinds of things does your boss do that upset people at work, if you're comfortable talking about it?
>
> -elizabethSure, we are in a high-tech business and the work we do is very detailed and mistakes can be very costly. Someone I work with made a mistake (transposed ONE number) and it cost $750,000. I liken it to air-traffic control stress. The problems with the boss is a little uncomfortable and difficult to describe. Well, she is a perfectionist (borderline-OCD personality) (and unfortunately so are many of us) and has had "breakdowns" several times over the past few years. It just feels like there is nothing you can do to *please* her. There is always something not quite right. The "rules" seem to change on a weekly basis, and what is worse it seems like she gets a perverse pleasure "changing the rules" and jumping us for it. She likes to play little games with everyone's head that lead you to think that you are going to get fired/disciplined, etc. There is also a big information "shell game" that gets played where she is privy to something important to a project you are working on that she withholds, and then you look stupid later and she looks superior. It's not just me, EVERYONE says the same stuff. But she knows her boundaries and how to keep from getting in trouble for it. I am just sick of it. It reminds me of the Twilight Zone-the movie's, episode where the kid has all the adults in the house captive watching cartoons and eating bad food all day. And if you rebel you lost your ability to speak-you know that girl that didn't have a mouth? I am ready to quit, but it pays well, I just don't know what to do.
Mitch
Posted by anita on August 11, 2001, at 14:28:17
In reply to Re: workplace stress and complex PTSD? » Elizabeth, posted by Mitch on August 11, 2001, at 13:41:10
Mitch,
I think chronic work stress, if it is similar to a kind of chronic stress you've had in the past, can trigger a complex PTSD syndrome. For example, I have complex PTSD from my childhood, and when I had a job where my boss was like my mother (borderline), I exhibited an exacerbation of all my PTSD symptoms. This job was the precipitating factor in a major depression and led to me going on disability. Perhaps your experience with your boss triggers a kind of stress reaction you've had in your past?
I strongly urge you to switch jobs for the sake of your mental health. Not all bosses are crazy. It's become my number one priority in a job to find a boss who is generally sane. I have a sane one now, and the difference is amazing -- I don't hate work, I worry less, and I'm less hyper about everything. Even just looking for another job will help you feel better.
Good luck,
anita
Posted by Mitch on August 11, 2001, at 15:05:53
In reply to Re: workplace stress and complex PTSD? Mitch, posted by anita on August 11, 2001, at 14:28:17
> Mitch,
>
> I think chronic work stress, if it is similar to a kind of chronic stress you've had in the past, can trigger a complex PTSD syndrome. For example, I have complex PTSD from my childhood, and when I had a job where my boss was like my mother (borderline), I exhibited an exacerbation of all my PTSD symptoms. This job was the precipitating factor in a major depression and led to me going on disability. Perhaps your experience with your boss triggers a kind of stress reaction you've had in your past?
>
> I strongly urge you to switch jobs for the sake of your mental health. Not all bosses are crazy. It's become my number one priority in a job to find a boss who is generally sane. I have a sane one now, and the difference is amazing -- I don't hate work, I worry less, and I'm less hyper about everything. Even just looking for another job will help you feel better.
>
> Good luck,
> anitaAnita, thanks for the response. I also have social anxiety and I work in a place that can't tolerate mistakes! duh, bright choice of jobs to get yourself painted in to, eh? Yes, it is true that any chronic stressors that crop up that I can't *control* worsens all of my symptoms. And come to think of it I have become more isolated and depressed and agoraphobic over the last two or three years. I came across someone I knew back when I was in college and they were just amazed at how devastated I looked and felt and told me- "what has happened to you, you used to be such a people person and so optimistic,". My pdoc wants me to keep the job despite everything and work on my "problems". I think your advice is better.
Mitch
Posted by Elizabeth on August 11, 2001, at 23:06:35
In reply to Re: workplace stress and complex PTSD? » Elizabeth, posted by Mitch on August 11, 2001, at 13:41:10
> The PTSD.org "complex PTSD" webpage.
OK, I'll bookmark it for future reference.
> Sure, we are in a high-tech business and the work we do is very detailed and mistakes can be very costly. Someone I work with made a mistake (transposed ONE number) and it cost $750,000. I liken it to air-traffic control stress. The problems with the boss is a little uncomfortable and difficult to describe. Well, she is a perfectionist (borderline-OCD personality) (and unfortunately so are many of us) and has had "breakdowns" several times over the past few years.
I'm not sure that perfectionism is a "borderline" or OCD trait. There is something called obsessive-compulsive *personality* disorder (OCPD) that is very much associated with perfectionism and extreme criticalness (if that's a word < g >).
> It just feels like there is nothing you can do to *please* her. There is always something not quite right. The "rules" seem to change on a weekly basis, and what is worse it seems like she gets a perverse pleasure "changing the rules" and jumping us for it.
That sounds more "borderline-like" -- rapidly and dramatically shifting moods with corresponding shifts in world-view. (This is what the "alternating between idealisation and devaluation" criterion is getting at.)
Is she the big boss, or does she have a superior?
> She likes to play little games with everyone's head that lead you to think that you are going to get fired/disciplined, etc.
You think she's really intentionally trying to f*** with people? Or could it be a result of her extreme moodiness? I ask because a lot of people who are described as "borderline" appear to be "manipulative," although they don't intend to be -- they've just learned, in the implicit sense, that certain behaviours get certain results. This lies on the interface between "borderline" and "histrionic" character traits; it's related to a view of the world that is very black-and-white, where everything is seen in extremes and the person forms global impressions of the "big picture" or "general idea" at the cost of attention to details and specifics.
> But she knows her boundaries and how to keep from getting in trouble for it.
I'd argue that she's crossing some pretty important boundaries, just based on the amount of information you have about her personal history.
I think you and your coworkers should start keeping a log of incidents involving her. I also like Anita's advice that you keep an eye open for other job opportunities (Anita is generally smart about interpersonal situations, IMO). In general it would be good for you to work with other people who are adversely affected by your boss's behaviour, because such people often seem to polarise others into two groups, of people who support the individual and people who oppose her, respectively. Resisting the tendency to form factions like that keeps the situation from getting worse (if you and your coworkers can't agree to work together, nothing will ever get done about your boss's behaviour).
These situations are difficult, but not impossible, to resolve. The important thing, regardless of whether you're able to make things better in your current workplace or whether you end up taking another job, is that you feel you have some control over your situation.
I hope this has been of help. Be well.
-elizabeth
Posted by Mitch on August 12, 2001, at 11:37:21
In reply to Re: workplace stress and complex PTSD? » Mitch, posted by Elizabeth on August 11, 2001, at 23:06:35
> > Sure, we are in a high-tech business and the work we do is very detailed and mistakes can be very costly. Someone I work with made a mistake (transposed ONE number) and it cost $750,000. I liken it to air-traffic control stress. The problems with the boss is a little uncomfortable and difficult to describe. Well, she is a perfectionist (borderline-OCD personality) (and unfortunately so are many of us) and has had "breakdowns" several times over the past few years.
>
> I'm not sure that perfectionism is a "borderline" or OCD trait. There is something called obsessive-compulsive *personality* disorder (OCPD) that is very much associated with perfectionism and extreme criticalness (if that's a word < g >).
>
> > It just feels like there is nothing you can do to *please* her. There is always something not quite right. The "rules" seem to change on a weekly basis, and what is worse it seems like she gets a perverse pleasure "changing the rules" and jumping us for it.
>
> That sounds more "borderline-like" -- rapidly and dramatically shifting moods with corresponding shifts in world-view. (This is what the "alternating between idealisation and devaluation" criterion is getting at.)
>
> Is she the big boss, or does she have a superior?She has one immediate superior, but he is a narcissist big time and I and several other people in there have gotten into arguments with him. Basically he put her in charge of us because there was a lot of big problems and issues that needed to be dealt with that he either didn't have time to deal with(he got promoted, too) or was afraid he would fail at. Other co-workers theorize that he set her up with the job so she would either crackup from the stress and quit or get fired(there was another person that "cracked up" in the same position several years ago and bailed out of it). Interestingly, when I took the job (he hired me) he warned me about "her" and he was very upset with her and had gotten into a really nasty ongoing fight with her where she nearly was fired. But that is the thing-it is like she is in an "ongoing fight" with *everybody* that she has to deal with that NEVER has any closure to it. In other words differences NEVER seem to get settled. If you disagree (even very slight) about any decision that she is making she REMEMBERS and you GET IT later. Always these revenge tactics - "the ongoing fight with everybody"
>
> > She likes to play little games with everyone's head that lead you to think that you are going to get fired/disciplined, etc.
>
> You think she's really intentionally trying to f*** with people? Or could it be a result of her extreme moodiness? I ask because a lot of people who are described as "borderline" appear to be "manipulative," although they don't intend to be -- they've just learned, in the implicit sense, that certain behaviours get certain results. This lies on the interface between "borderline" and "histrionic" character traits; it's related to a view of the world that is very black-and-white, where everything is seen in extremes and the person forms global impressions of the "big picture" or "general idea" at the cost of attention to details and specifics.I would agree with that to some extent. But it still seems she holds grudges from YEARS ago that she never lets go of. It is true that when she is in a better mood she is almost likable, but when she is in a bad one it is not immediately obvious, and she can get very verbally abusive.
>
> > But she knows her boundaries and how to keep from getting in trouble for it.
>
> I'd argue that she's crossing some pretty important boundaries, just based on the amount of information you have about her personal history.Well, what I really meant is that she knows where "the line in the sand is" with respect to getting fired. She knows what her "reach" is and how much slack (tolerability) she has at any given time. Although it does seem that she gets very defensive and angry.
> I think you and your coworkers should start keeping a log of incidents involving her. I also like Anita's advice that you keep an eye open for other job opportunities (Anita is generally smart about interpersonal situations, IMO). In general it would be good for you to work with other people who are adversely affected by your boss's behaviour, because such people often seem to polarise others into two groups, of people who support the individual and people who oppose her, respectively. Resisting the tendency to form factions like that keeps the situation from getting worse (if you and your coworkers can't agree to work together, nothing will ever get done about your boss's behaviour).Oh, nearly everbody complains about it, but the thing is most of these people are nearing retirement and don't want to "rock the boat", they are seeing their "escape hatch" getting closer and they don't want to chance making things more miserable for themselves short term for a possible better atmosphere longterm.
>
> These situations are difficult, but not impossible, to resolve. The important thing, regardless of whether you're able to make things better in your current workplace or whether you end up taking another job, is that you feel you have some control over your situation.
>
> I hope this has been of help. Be well.
>
> -elizabethThanks a lot. You and Anita really have a lot of facts and good advice with regard to this problem. It is true that just looking at classifieds and working on my resume relieves a lot of stress.
Mitch
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