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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 7 to 31 of 31. Go back in thread:
Posted by sigismund on January 21, 2011, at 0:26:53
In reply to Re: GOOD reading for borderline type disorder » floatingbridge, posted by Phillipa on January 20, 2011, at 21:40:52
I had thought (uninformed and sceptical) that borderline was psychiatry's cowardly way of saying you were a bad person.
Posted by sigismund on January 21, 2011, at 0:32:30
In reply to Re: GOOD reading for borderline type disorder, posted by sigismund on January 21, 2011, at 0:26:53
>I had thought (uninformed and sceptical) that borderline was psychiatry's cowardly way of saying you were a bad person.
You might call that a rush to blame.
Three times in the one sentence.
Important to feel you can touch bottom, and maybe if it feels bad it seems more real?
Posted by softheprairie on January 21, 2011, at 2:50:29
In reply to GOOD reading for borderline type disorder, posted by floatingbridge on January 20, 2011, at 16:48:09
I haven't read this yet, but I read good reviews of "The Buddha and the Borderline." It is a memoir of a person who leads a wild life, goes through DBT, and turns to Buddhism.
P.S. I would like to say that I _do not_ approve of referring to a person by their diagnosis as the title of this book does.
Posted by pegasus on January 21, 2011, at 11:19:29
In reply to GOOD reading for borderline type disorder, posted by floatingbridge on January 20, 2011, at 16:48:09
There is a school of thought that is emerging, suggesting that often what gets diagnosed as Borderline Personality Disorder, is a response to repeated trauma, especially during early development. The idea is that many people who are diagnosed with BPD have a history of childhood abuse or neglect of one sort or another. And the symptoms that get them diagnosed with BPD may perhaps be more helpfully understood as a complex reponse to those traumas. So, there is a new diagnosis that is being discussed for inclusion in the upcoming revision of the DSM (the big book of diagnoses for mental disorders) that is called "Complex Post Traumatic Stress Disorder". I'm thinking that it looks like it won't be included in this round, but it makes a heck of a lot of sense to me.
So, if that seems to be a helpful way to look at your BPD diagnosis, then some trauma books, like "Waking the Tiger" by Peter Levine, or "I Can't Get Over It" by Aphrodite Matsakis might be helpful. If you're into a pretty thick and clinical but wonderfully informative book, you might try "Trauma and Recovery" by Judith Herman.
- P
Posted by floatingbridge on January 21, 2011, at 11:36:43
In reply to Re: GOOD reading for borderline type disorder, posted by pegasus on January 21, 2011, at 11:19:29
Pegasus,
I feel that my experience is c-ptsd. However, It's walking around in a self that is either always being triggered, or not knowing I'm triggered. No sense of self or so fleeting. Or if there is a sense of self, it's like too much to face.
I've looked at Waking the Tiger. I feel
guilty and weird because the really awful stuff didn't happen to me.I used to be afraid of BPD. And I don't think BDP people are all 'nasty' are they?
Is that a way of saying they habitually and maladaptively project hurt outward? (I do the opposite; hence niceness. I told my therapist not to use that word with me. And Violette, no worries--you are
very supportive.)I've got to go for now. Thanks everyone.
fb
Posted by emmanuel98 on January 22, 2011, at 19:22:59
In reply to Re: GOOD reading for borderline type disorder » pegasus, posted by floatingbridge on January 21, 2011, at 11:36:43
My p-doc thinks the hall mark of borderline personality disorder is the inability to regulate emotions. This is why DBT is so helpful -- the focus is on distres tolerance and emotional regulation. I also recommend Glen Gabbard's Psychodynamic Therapy in Clinical Practice. There's a long chapter on treating BPD and Gabbard specialized in this. The book is a text for psychiatry students but it's very accessible.
Posted by sigismund on January 22, 2011, at 20:20:23
In reply to Re: GOOD reading for borderline type disorder, posted by emmanuel98 on January 22, 2011, at 19:22:59
>My p-doc thinks the hall mark of borderline personality disorder is the inability to regulate emotions.
So if you had an inability to regulate mood, that might be called bipolar?
And mood and emotions are different?
Is one the climate and the other the weather?
Posted by emmanuel98 on January 23, 2011, at 2:11:38
In reply to Re: GOOD reading for borderline type disorder » emmanuel98, posted by sigismund on January 22, 2011, at 20:20:23
So if you had an inability to regulate mood, that might be called bipolar?
not bipolar, but borderline personality disorder.
>
> And mood and emotions are different?I think moods and emotions are the same. The problem is that, with BPD, the tendency is to let emotions overrun you to the point that they become moods or long-run feeling states. At least this is what my DBT therapist would say.
>
> Is one the climate and the other the weather?
Posted by floatingbridge on January 23, 2011, at 16:36:32
In reply to Re: GOOD reading for borderline type disorder » emmanuel98, posted by sigismund on January 22, 2011, at 20:20:23
I was dx'd with bipolar nos for almost a decade; stabilizers never helped.
My pdoc of 2.5 years agreed with the dx of c-ptsd. I brought in some articles. I also had asked him previously why he no longer tried mood stabilizers. "Because I don't believe your bipolar," he said.
I recently found an article by Pete Walker MA, MFT that discusses c-ptsd developing through totalitarian run families and emotional neglect. That was the validation I was looking for, in that I would (will?) constantly berate myself for
being 'this sick' when nothing 'that bad' had happened.
The article is very Googleable by his name. (I don't know how to attach one on my phone.)I wanted to thank everyone for responding and for the reading suggested. And mention that if I didn't care for something (like how I mentioned being triggered by Waking the Tiger), my comments were not criticism--I still appreciated the suggestion.
Out of all the books mentioned, I've read Herman's almost cover to cover. It is very good; however, everyone in it were victims of catastrophic events or such physical violence and abuse, again, I felt ashamed that I fit the description. My unendurables are very mild in comparison. I guess, however, they were enough for me.
fb
Posted by obsidian on January 23, 2011, at 17:01:42
In reply to Re: GOOD reading for borderline type disorder » sigismund, posted by floatingbridge on January 23, 2011, at 16:36:32
> I wanted to thank everyone for responding and for the reading suggested. And mention that if I didn't care for something (like how I mentioned being triggered by Waking the Tiger), my comments were not criticism--I still appreciated the suggestion.
>
> Out of all the books mentioned, I've read Herman's almost cover to cover. It is very good; however, everyone in it were victims of catastrophic events or such physical violence and abuse, again, I felt ashamed that I fit the description. My unendurables are very mild in comparison. I guess, however, they were enough for me.
>
> fbI wouldn't minimize it fb. Your pain is your own, not to be measured against another's.
I found "trapped in the mirror" (it's about adult children of narcissists) an interesting read
that's not specifically about borderline PD though. I don't know if you'd relate to it or not, but I figured I mention it.
I suppose it's about "relational trauma" as some call it.
Posted by sigismund on January 23, 2011, at 21:11:45
In reply to Re: GOOD reading for borderline type disorder » sigismund, posted by floatingbridge on January 23, 2011, at 16:36:32
>totalitarian run families and emotional neglect.
>I would (will?) constantly berate myself for
>being 'this sick' when nothing 'that bad' had happened.If babies are sufficiently neglected (I read once) they can enter into marasmic states (nice name!) and then die. You know yourself how critical your attention is to kids, and how they thrive on it. I had no advantages or skills as a parent but I have learned from seeing my kids grow just how important real attention is. To be deprived of real attention is to be deprived of the possibility of relationship. People back then didn't know what they were doing, thinking of my own case.
Posted by sigismund on January 23, 2011, at 21:20:30
In reply to Re: GOOD reading for borderline type disorder » floatingbridge, posted by obsidian on January 23, 2011, at 17:01:42
>Narcissists behave, Golomb says, as if they are the center of the universe, organizing their lives around denial of negative feelings about themselves.
Just like important people.
I don't know why some people even bother to have children. It's a lot of work. Would you do it just so you could fit the norm? I guess.
Posted by violette on January 23, 2011, at 21:46:41
In reply to Re: GOOD reading for borderline type disorder » pegasus, posted by floatingbridge on January 21, 2011, at 11:36:43
> used to be afraid of BPD. And I don't think BDP people are all 'nasty' are they?
> Is that a way of saying they habitually and maladaptively project hurt outward? (I do the opposite; hence niceness. I told my therapist not to use that word with me.
FB, hi, if you had a passive temperment as a child-you'd probably turn anger against yourself and thus would not sound like Borderline nor would you meet the criteria of a Borderline PD diagnosis as it currently is described in the DSM. I had a very passive temperment as a child, was quiet and was never given a Borderline diagnosis either. some people are just less aggressive than others.
The diagnostic criteria of BPD-is only a list of symptoms for those with severe cases (and is also laregly responsible for the misunderstandings and stigma). Currently there is no diagnosis of mild-moderate Borderline, but it is a concept that has been recognized in psychodynamic literature for decades. The symptoms of C-PTSD are written more vaugely-so the description may sound like it better fits those who might be mild to moderately Borderline. These are the types of things I've been trying to tell people on this forum for over a year now.
Complex PTSD describes the same traits of those who have Borderline type personalities. Identity, emotional dysregulation, cognitive problems etc. I wouldn't worry that you didn't have the traumas that are part of C-PTSD..the symptoms are the same, just described in a 'nicer' way and might be more helpful for those uncomfortable with the term Borderline.
I've also read Peter Walker's site; what he writes about are the same concepts contained in a huge body of psychodynamic literature about Borderline. So if you didn't have trauma, that doesn't mean you don't have the symptoms described by the concept of C-PTSD. Hope that helps.
Posted by floatingbridge on January 24, 2011, at 0:04:37
In reply to Re: GOOD reading for borderline type disorder, posted by violette on January 23, 2011, at 21:46:41
Hi Violette,
Thanks for your input. I always like hearing from you :)
I'm not sure. Aren't we both kinda saying the same thing in different ways? I think, esp after reading Pete Walker, that I do have c-ptsd. My condition is specifically abuse /neglect related. My
family was 'quite' dysfunctional (though no family ever truly wins that prize...).I understand BPD as a spectrum disorder. And that, however
much my therapist(s) dissuade me, the
level of my distress (subjective) tells me something, as does the absence of a
sense of a reliable self or source of comfort. I think I disassociate (as
Solstice described to B2Chica in a thread), by spacing out, getting lost in
pain states. If it walks like a duck, quacks like a duck.... I feel that my case of c-ptsd has borderline features, placing it on a continuum.You see, I did have trauma. It sounds
like a tiny-weeny, endless, water torture trauma of being alone for years and
years. Walker's article, just as Sigi mentioned, includes simple neglect--a relational vacuum as trauma to a
developing child. (Then there were later traumas, for an isolated, naive adolescent who leaves home usually runs into trouble.)fb
Posted by violette on February 1, 2011, at 16:23:51
In reply to Re: GOOD reading for borderline type disorder » violette, posted by floatingbridge on January 24, 2011, at 0:04:37
> I'm not sure. Aren't we both kinda saying the same thing in different ways?
Yes, it is the same thing said in different ways-that is what is helpful to know.
> You see, I did have trauma. It sounds like a tiny-weeny, endless, water torture trauma of being alone for years and years. Walker's article, just as Sigi mentioned, includes simple neglect--a relational vacuum as trauma to a developing child. (Then there were later traumas, for an isolated, naive adolescent who leaves home usually runs into trouble.)
I sse-i thought you had said you didn't suffer traumas...it doesn't sound teeny-weeny to me. I understand though, people minimize all the time.
But-please don't underestimate neglect.i would never know for sure but i feel that its affected me more than all the other types of abuse combined. Lots of attachment related stuff i read confirms how much neglect can affect children as they develop.
Especially when you are an infant. People might not even be aware of being neglected while so small. 'Good' parents can have temporary dysfunction too-post partum depression or other issues. Maybe even the parents whose best intentions match their actions, but don't know any better. Then there are those who are severely ill themselves, with personality disorders but who don't have enough axis i traits to bring them to treatment, or who are too ill to see they need treatment.
Posted by floatingbridge on February 1, 2011, at 17:03:35
In reply to Re: GOOD reading for borderline type disorder, posted by violette on February 1, 2011, at 16:23:51
Violette,
Since you're here today, what is the difference between axis 1 & 2? And this only applies to psychiatric conditions?
(I mean 'physical' diseases have no such breakdown.)
And where did the axis 'metaphor' come from?
That's alot to answer. Point me to reading, or Just answer one?
And anyone else know?
Hope you are doing well, Violette.
fb
Posted by Phillipa on February 1, 2011, at 21:47:43
In reply to axis l and axis ll? » violette, posted by floatingbridge on February 1, 2011, at 17:03:35
FB Axis 1 primary psychiatric disorder Axix 11 personality disorder if one is present. Not all have an Axis 11. Phillipa
Posted by violette on February 1, 2011, at 23:10:43
In reply to axis l and axis ll? » violette, posted by floatingbridge on February 1, 2011, at 17:03:35
Hi FB,
The difference is, imo, the APA chose to divide mental illness that way...anyway, though this doesn't relate to the background of divisions delineated by the APA-I generally think axis II are more permanent illnesses, while many of the axis i are temporary or just symptoms of axis II traits or disorders.Also thinking defense mechanisms used have considerable influence, which seems to be underrated, which probably will remain so until unconscious cognitive processes can be quantitatively measured or mapped (i don't mean tests like the MMPI) with use of technology. Maybe 20 years??
I recently found out the APA is strongly considering combining axis I and II, using the spectrum spectrum idea. This article might answer some of your questions:
http://www.dsm5.org/Research/Documents/Krueger%20et%20al_Dimensions%20and%20PDs.pdf
Ironically, this major change seems to be more in line with psychoanalytic thinking. Which is odd. Because now we have more information about genetic influences and physiology, Etc. The other oddity is that it was the psychodynamic people, i believe, that wanted the axis II in the first place.This new structure, while not ideal, makes a lot more sense to me that the current approach.
Wouldn't it be fun if those on this forum created our own version of the DSM? ha-THAT likely wouldn't happen (too many disagreements-different perspectives).
Have fun with this stuff. :)
Other articles/good information here:
http://www.dsm5.org/Research/Pages/Publications.aspx
Posted by floatingbridge on February 2, 2011, at 1:45:53
In reply to Re: axis l and axis ll?, posted by violette on February 1, 2011, at 23:10:43
Posted by Phillipa on February 2, 2011, at 19:28:37
In reply to violette + phillipa, thank you both (nm) » violette, posted by floatingbridge on February 2, 2011, at 1:45:53
FB good old Wiki current Axis's And meaning But must scroll down past history. Phillipa
http://en.wikipedia.org/wiki/Diagnostic_and_Statistical_Manual_of_Mental_Disorders
Posted by Phillipa on February 2, 2011, at 19:38:19
In reply to Re: violette + phillipa, thank you both » floatingbridge, posted by Phillipa on February 2, 2011, at 19:28:37
In the Wiki article the Gaf score is included which is intereting. Level of functioning. Phillipa
Posted by floatingbridge on February 3, 2011, at 10:39:14
In reply to Re: violette + phillipa, thank you both » floatingbridge, posted by Phillipa on February 2, 2011, at 19:28:37
Oh yeah. That was talked about once at Stanford. Mine was not very high :(
Will read when fever breaks. Thanks.
Posted by violette on February 3, 2011, at 18:32:20
In reply to Re: violette + phillipa, thank you both » Phillipa, posted by floatingbridge on February 3, 2011, at 10:39:14
FB, did the physicians at Stanford diagnose you as MDD and PTSD, or is that the dx from your regular doctor? Curious, but if too personal, I understand... Didn't know if Stanford helped or not.was it worth the trip do you think?
Posted by floatingbridge on February 3, 2011, at 21:37:02
In reply to Re: violette + phillipa, thank you both, posted by violette on February 3, 2011, at 18:32:20
Stanford dx'd double depression, made no mention of ptsd or c-ptsd. For me it was not worth the effort, really, except that he recommended rTMS and perhaps a maoi for existential depression.
For someone else, they might get more out of it, like you, fast on your feet.
There is another doctor in the department, and I have thought of seeing him. The Stanford guy spoke so fast w/ little pause.
I do better w/ a more contemplative type.
The dx from my pdoc is c-ptsd. Before that, I was dx'd bipolar nos.
Be well Violette. I'm always glad to see your name on board.
Posted by violette on February 5, 2011, at 10:41:31
In reply to Re: violette + phillipa, thank you both » violette, posted by floatingbridge on February 3, 2011, at 21:37:02
Oh-no-I would not get more out of a trip to Stanford at all as i don't believe the solution lies in biology so much as they would. Not that biology doesnt cause a lot of the distress you experience as i know it does.
I'm sorry Stanford wasn't so great. I think you might have better luck with a psychoanalyst-psychiatrist. if you haven't already tried that approach and decide to do so-just make sure you mention up front you were diagnosed with PTSD and bipolar.
Sometimes I think you distance yourself from your emotions which is why you have so many somatic symptoms and think you might also have a lot of inner conflicts. Thats only a perception, maybe some of it is my projections, can't reassure you there. but that's the impression i always get considering the posts you've written in the past.
Best of luck to you my dear.
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