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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 19 of 19. This is the beginning of the thread.
Posted by terrics on March 19, 2004, at 17:12:32
First of all I have an unfair question which of course no one has to answer. Do you have a personality disorder and which one?
Do you believe that it is an accurate diagnosis?
Do you think it is fair to label a person personality disordered?
I have had many diagnoses, but one T labled me borderline. After alot of agony over it I think she was wrong. It does leave a little scar on my heart though. terrics
Posted by Dinah on March 19, 2004, at 18:32:43
In reply to personality disorders/fair?, posted by terrics on March 19, 2004, at 17:12:32
> First of all I have an unfair question which of course no one has to answer. Do you have a personality disorder and which one?
>
Almost definitely, though which one is up for grabs. My therapist thinks I have schizotypal traits on the outside with borderline traits on the inside. Probably leading to a package of personality disorder - not otherwise specified.> Do you believe that it is an accurate diagnosis?
I don't think I'm schizotypal or borderline. I do think I have significant traits from both, plus schizoid traits.
> Do you think it is fair to label a person personality disordered?
No. I think what are called personality disorders are actually just a cluster of manifestations of and coping mechanisms used to deal with either a) an underlying biological vulnerability or b) a history of trauma or neglect or c) both.
> I have had many diagnoses, but one T labled me borderline. After alot of agony over it I think she was wrong. It does leave a little scar on my heart though. terricsIf you self injure, a certain percent of therapists are going to label you borderline without much further ado. If the majority of the mental health professionals you've seen disagree with the diagnosis, and you disagree with the diagnosis, I would just assume it was a synonym for self injury for this therapist.
Posted by Racer on March 20, 2004, at 1:08:24
In reply to Re: personality disorders/fair? » terrics, posted by Dinah on March 19, 2004, at 18:32:43
You know that I've been struggling with this damned therapist about which personality disorder I have -- since she's convinced I must have one -- and we had a bit of a run in over it the other day. She kept saying, "we all have personality traits, dear, and we have to face up to it when we have diagnoses in order to get better." I told her that, being a middle aged woman, NOT having a personality would be pathological, but having personality traits was a sign of HEALTH. I went on to say that she was welcome to explore any diagnosis she wanted, but if she wanted to help me it might be nice to talk a little bit about -- maybe? -- my emotions, perceptions, etc?
Needless to say, that did not go over very well.
Anyway, as you know from above, I printed out the stuff that Jane linked to, and I've been going over it all piece by piece. I can see things that do apply to me -- but I can also see things that might LOOK as though they apply to me if you didn't look closely. Here's an example of what I mean:
From the Borderline criteria:
"(1) Frantic efforts to avoid real or imagined abandonment."
OK, now let's examine this. Frantic efforts to avoid abandonment may not be pathological. Let's try this scenerio to show what I mean:
We're in a car, you're driving, I'm in the passenger seat. You pull up in front of my house, and tell me to get out. If I then throw a fit to try to keep you, that's weird and fits into a disordered world. Especially if I'll see you again tomorrow.
Now let's get back into that car. You drive this time way out into the boonies, on a little road in the middle of nowhere, someplace I've never been before. Suddenly, you pull over to the side of the road and tell me to get out. If I thow that same fit again now, that really doesn't seem so strange to me.
Does that make sense? Some of the criteria are so context sensitive that it makes me wonder about the usefulness of using diagnoses at all. Then again, I know from statistical studies that you do need to have a way to catagorize patients for larger studies, and I can see how it would be great when you have to be able to communicate with a collegue about referring a patient, and I also know that insurance companies really don't react well to notes saying, "I gotta see this chick three times a week, on accounta she's Froot Loops." Aside from those aspects, though, I cannot see a unique funtional benefit to a patient in using the diagnostic criteria as the be all and end all.
And I'm very suspicious of any stigmatized mental disorder that is more often diagnosed in one gender or the other. Yes, for every female borderline, there's a male antisocial, but that makes me nervous. I tend to think that the underlying pathology may be the same, while the outward manifestation is sexually dimorphic. And the fact that borderline is so heavily stigmatized, while antisocial is considered more a behavioral constellation, really makes me question its validity.
That said, I also agree with Dinah: a lot of therapists and doctors may not know what else to say. It's kinda like multiple personality disorder: the greatest indicator of your likelihood of being diagnosed with MPD was going to a doctor who had diagnosed someone else with it. So, some doctors come back to the same handy dandy vaguery of one disorder or another, rather than dealing with the amorphous whole.
There. Them's some of my opinions. You want more? I got plenty of 'em. Heck, I gots so many I gotta give 'em away!
Posted by lonelygirl on March 20, 2004, at 1:24:11
In reply to personality disorders/fair?, posted by terrics on March 19, 2004, at 17:12:32
I don't know if I have ever actually been diagnosed, but when I take those online tests, it always comes up with avoidant, and I personally think there is little question that it is true.
Posted by Camille Dumont on March 20, 2004, at 11:32:03
In reply to personality disorders/fair?, posted by terrics on March 19, 2004, at 17:12:32
I agree that we can all have traits of personality disorders but ... I don't know ... it seems to me that the step from just having some traits and it being a disorder is a bit too blurry.
Pdoc used to say that I was avoidant ... which I do agree with in that I do have many of those thoughts ... but hey, I do work, I talk on the phone, talk in public and such ... so it doesn't seem to me that its a huge disorder.
Also it seems to me that they change alot. Last time I saw the pdoc, I told her how I don't seem to miss people, that I can go years without talking to my parents and it doesn't bother me ... I just don't miss them ... that it made me feel as though I was somehow defective ... that I don't have that part of the brain that makes you want the companionship of people and taht I prefered being alon.
Well lo and behold ... now I'm Avoidant AND "possibly" schizoid ...
Plus I don't like the stigma around them ... the way it is said to be "maladaptive", "pervasive" and such ...
Posted by lonelygirl on March 20, 2004, at 12:02:04
In reply to personality disorders/fair?, posted by terrics on March 19, 2004, at 17:12:32
Now that I think about it, I think my current psychologist has really avoided labeling me (to my face, at least). I don't know if this is just his style or if he somehow sensed that I hate it, but I don't think he has ever once said the words "depression" or "low self-esteem" that seem to come so automatically from everybody else (nor has he labeled me with a personality disorder). I suppose he also might not have said it because that's not what he thinks, but I highly doubt that. So -- he must be either really brilliant or really stupid :)
Posted by EmmyS on March 20, 2004, at 12:02:09
In reply to Re: personality disorders/fair?, posted by Camille Dumont on March 20, 2004, at 11:32:03
Camille - I'm the same way. I think since I was basically raised by wolves, now I'd prefer to just live in a cave. Perhaps you and I could find a lovely cliff some where and locate a couple of distant caves?
Sure would make the holidays simpler.
Emmy
Posted by Dinah on March 20, 2004, at 14:38:42
In reply to I think I'm with Dinah, posted by Racer on March 20, 2004, at 1:08:24
I've read before the sex differences between antisocial and borderline personality disorder, and the idea that they are both manifestations of the same disorder, but I'm not really convinced of that. I think there may be some people with both disorders. But I always think of antisocial personality disorder as being linked to lack of empathy for others, though I might be confusing it with psychopathy. And I just don't see any linkage between lack of empathy and borderline personality disorder.
Here's a really good article about not only antisocial personality disorder and psychopathy, but also about the inherent weaknesses in the current Axis II categories, which are based more on easily quantifiable behavior characteristics rather than harder to quantify personality characteristics.
http://www.psychiatrictimes.com/p960239.html
I'm also not sure whether the fact that doctors who have previously diagnosed MPD patients are more likely to diagnose it again is in any way related to whether or not their patients are more likely to have multiple personality disorder (or DID in today's terminology). It may be totally unrelated. If you aren't willing to accept the existance of MPD and a patient who has it comes to you, you're not going to diagnose it. And if your treatment technique for dealing with emerging ego states is to ignore them, refuse to talk to them, etc. and then your patients no longer present with different ego states, does this mean that the ego states where a fiction to begin with? I don't really know that you can conclude that.
If I go to the doctor and tell him I have a pain in my stomach. And if that doctor checks everything out and tells me there isn't anything wrong with my stomach, and he doesn't want to hear any more about the pain in my stomach, I'm not likely to tell that doctor about the pain in my stomach again. Especially if he repeats it a few times or especially adamant. But that doesn't mean I don't really have a pain in my stomach.
So I don't think you can determine causality unless you examine both the doctors who do diagnose MPD and those who don't diagnose MPD. Because never having seen a case of MPD might say as much about a doctor as having seen a hundred cases does.
Posted by Camille Dumont on March 20, 2004, at 20:29:19
In reply to Re: personality disorders/fair? » Camille Dumont, posted by EmmyS on March 20, 2004, at 12:02:09
Oh yes! The dreaded holidays! UGH!
I usually end up playing with the dogs or someone's baby ... they tend to be less judgemental and annoying.
I even think I know why I'm like this. My parents divorced when I was 4 so I had to learn to live without one of them at all times ... so I guess you lose the missing people feeling.
Somehow its kind of even sick. I have norwegian rats as pets and I had to help one to die last week. She had barely passed and I missed her already. I've been missing her ever since so I guess I DO have feelings ... but I reserve them for those who's affection is trully genuine and unconditionnal.
I would LOVE to go live somewhere far away from everybody ... and NO PHONE! I hate phonecalls from people I know. I let friendships die because I just don't seem to know how to go about them ... its just better to be by myself with pets.
Who needs humans?
Posted by Camille Dumont on March 20, 2004, at 20:33:43
In reply to Re: Personality disorders » Racer, posted by Dinah on March 20, 2004, at 14:38:42
.
Posted by pegasus on March 21, 2004, at 1:13:05
In reply to I think I'm with Dinah, posted by Racer on March 20, 2004, at 1:08:24
LOL! I love the way you stand up to your T. Also, I thought her statement sounded pretty condescending (dear?) and unhelpful. You don't need to face up to diagnoses, for heaven's sake. You don't even need to know about them. My Ts have always avoided diagnosing me, and they've been very helpful. So nyah to her!
- p
Posted by Racer on March 21, 2004, at 9:42:21
In reply to Re: I think I'm with Dinah » Racer, posted by pegasus on March 21, 2004, at 1:13:05
See, I'm feeling as if I'm so profoundly disturbed that I can't even face up to how sick I really am. You know what I mean, right? "Gee, I think I need to work on getting internal validation of my perceptions, but I guess I'm totally wrong. Maybe I really do need to work through this denial..." Having you restate the picture really helps. You're right -- I can feel in my bones that you're right -- I don't need to know my diagnosis in order to work at getting better.
Pfinstegg's comment, that some doctors are rethinking the whole Axis II thing is also so helpful. It's like gay marriage: the rest of the world is looking towards binding civil union for gay and straight, and we're here arguing for gay marriage. That's all or nothing thinking, which is one of those traits that's associated with borderline, right? Maybe taking a deep breath and looking with more neutral eyes would help with both issues? I agree that the whole Axis II is probably better understood as an artifact of experience, which also makes it a lot easier to treat, right?
Thank you both. I really needed that.
Posted by terrics on March 21, 2004, at 10:34:05
In reply to I think I'm with Dinah, posted by Racer on March 20, 2004, at 1:08:24
Pegasus is right . You are good at standing up to your T. You could teach us all a lesson. Maybe you should be the T. terrics
Posted by terrics on March 21, 2004, at 10:37:17
In reply to personality disorders/fair?, posted by terrics on March 19, 2004, at 17:12:32
Thank you all for your thoughts and perceptions. terrics
Posted by terrics on March 21, 2004, at 15:25:10
In reply to Re: personality disorders/fair? » terrics, posted by Dinah on March 19, 2004, at 18:32:43
thanks Dinah, The last part of your post made me feel better. My whole life my dx.has been depression and anxiety. These sound accurate to me. terrics [except the cutting]
Posted by unlucky1 on March 21, 2004, at 18:53:58
In reply to Re: personality disorders/fair? » Dinah, posted by terrics on March 21, 2004, at 15:25:10
I feel better "knowing" that I am BP-at least my actions make a little more sense now and I can think I am a little less of a bad person.
P.S. I am brand new-Hi everyone...
Posted by Dinah on March 21, 2004, at 18:57:54
In reply to Re: personality disorders/fair?, posted by unlucky1 on March 21, 2004, at 18:53:58
Posted by terrics on March 22, 2004, at 8:11:24
In reply to Re: personality disorders/fair?, posted by unlucky1 on March 21, 2004, at 18:53:58
Hi and welcome. Hope you like it here. It is a great place for giving and getting support. terrics
Posted by corafree on October 12, 2004, at 19:30:45
In reply to Re: personality disorders/fair? » unlucky1, posted by terrics on March 22, 2004, at 8:11:24
T - Let me know if you get this post today, because being away from home, maybe I am entering my name wrong...don't have my little book. Is there anyway for you to go to your response to my earlier abandonment post and send it to me? hangin' on, cf
> Hi and welcome. Hope you like it here. It is a great place for giving and getting support. terrics
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