Tag Archive: c-ptss

DID and BPD in one? (Pag.2)

Part 2: DID and BPD in one?DD-BPD-DID

Before you read this page, you first need to read Part 1:  DID and BPD in one?

 So can BPD and DIS occur at the same time

BPD:
A Borderline personality disorder finds its origin in psychological neglect of the younger child. A child that has to fight over and over again to be seen, heard and loved. Or had to prove itself over and over again to feel worthily. Such a child develops an unbearable need to fill the gap of emptiness caused by the psychological and mental neglect in which it develops an ongoing hunger for love and attention that even more results in previous and repeatedly painful deceptions: I’m not worthy to be loved, I’m not worthy to been seen, love is not trustable, etc. The child loses the ability to trust and attach to other people although it suffers an ongoing, unbearable and insatiable hunger for love and attention.
Now the first question could be: Where do we draw the line of defining ‘trauma eo traumatized experiences to a (C)PTSD’. Not everyone with an BPD had to go through childhood traumatic experiences such as sexual or severe physical abuse. Although they are severe psychological and mentally wounded by neglect it doesn’t lead directly to a Complex PTSD in the order of a structural dissociation of the personality.

So perhaps we could define (C)PTSD as:
If there had been psychological and physical abuse, extreme anxiety sensations and or bodily injury, than you speak of severe trauma that can lead to the category ‘Dissociative Disorder’ in the order of a structural dissociation of the personality:
3 levels: PSD, SSD and TSD

And define the trauma related structural dissociation as:
A Structural dissociation of the personality in order of a PTSD and CPTSD is based on trauma with psychological- and physical abuse, severe anxiety sensations and or bodily injury.

the rock of live

PIII

Then we could point out the most striking difference between BPD and DID:

  1. BPD is caused by psychological neglect: too little positive attention
    The child no longer knows how to beat the ongoing hunger for love and attention, and how to deal with both. The child loses the ability to trust and attach although it suffers an ongoing, unbearable and insatiable hunger for love and attention to fill the gap of psychological emptiness. The personality (the inner self) stays intact but is suffering a personality disorder that dominates the whole person at all times.
  2. DID too much negative and abusive attention
    The very young child learnt by instinct to take care of the psychological en emotional self, and developed handling systems to bare the ongoing suffering from pain and anxiety that it couldn’t couple to a person, a moment or an explicit experience at that time, because it didn’t yet reached the age to do so. The child learns by instinct how not to be seen, because then it risked to be physically and or sexual abused (pain and anxiety suffering). The child loses the ability to listen to its own needs for love and caring. And did not learn how to ask for help or love, and it also didn’t learn how to trust in the safety of love and attention. It trusts only on his/her inner self.

* * *

Now we can declare:
Every person has only one personality!
That personality dominates at all times the behavior of the person, so also how a disorder express itself.

So can a child develop DID and later also a BPD?
I would say ‘No
Because a child develops DID in a premature and very early stage of life (I would almost say: a trauma related development disorder). Such a child doesn’t wants to get attention, because attention means suffering. It learnt only how to survive, how to bare, how to be safe by itself and how to trust on the own inner self by developing handling (act) systems (ANP’s and EP’s). It loses the ability to listen to the own needs for warmth, love and attention. The inner self has fallen apart (ANP’s and EP’s).

Can a child that developed a Borderline personality disorder also develop a Dissociative Disorder?
I would say without a doubt: ‘Yes’.

Also someone that suffers a BPD can be severe traumatized and develop all sorts of dissociative symptoms (DD) up to a level II of the structural dissociation of the personality, except DID because a child that develops a BPD has already past the age to develop a DID. The switching behavior of someone that is suffering a BPD will also behave under the influence of that personality disorder. And a Borderline Personality can’t handle stable act e.g. handling systems (more than one ANP’s) where is not a lot of room for emotional switching behavior (EP switching) such as you can see by a DID.

A mature symptom of BPD is ‘impulsive and acting out behavior’ the host (1 ANP) suffers under the high influence of emotional personality parts (EP’s). But that isn’t a recognizable symptom of a DID disorder, where the most recognizable symptom is: more than one very stable Act (handling) systems over time, place, thinking, feelings, memories and task that they are the best in to handle or to manage (in daily live), and which act like apparently normal personality’s (more than one ANP and EP’s systems).. This kind of handling systems are not manageable for impulsive and acting out personality’s such as a Borderline personality. 
There the Borderline personality can develop all sorts of symptoms (DD) as far as can go; a level 2, BPD+OSDD the secondary structural dissociation of the personality.

In order of text summary:
How to fit in the difference between BPD and DID in the theory of the structural dissociation of the personality level 2 and level 3: Stable act eo handling systems, more than one ANP and more than one EP with not a lot of space for EP switching behavior such as you can find within DID personalities are NOT manageable for Borderline personality’s (also a BPD dominates the host at all time). One significant disorder symptom of a Borderline personality is a lack of stable handling, this makes the EP influence very high – and also impulsive behavior that goes under the influence of EP’s.

 My own quest to understand continuous…

@Nique

Follow or take part of discussion: Google+ DID

* * * *

end of part II
can BPD and DID accur at the same time

Can a DID part have BPD? (Pag.3)

So can an ANP, an identifiable stable act system, DD-BPD-DID
an Apparently Normal Personality part of a personality that suffers a DID,
suffer a BPD in order of a double diagnose DID and BPD ?

There I also want to answer with a ‘No’.
And I will explain why I think so.

Concised view of defined terms:
An ANP is a Host, an identifiable part of the personality, an act system, an Apparently Normal Personality
An EP is an Emotional Personality part of the main Personality. Each ANP can have stored all sorts of traumatized EP’s.
DID is a dissociative Identity Disorder with more than one identifiable Host act system (ANP’s)
DID is not a personality disorder
BPD is a Borderline Personality Disorder

Edit: 18-4-2014
An additional reaction from my therapist

after reading all my own writings on my Blogsite in order to explain a ‘structural dissociation of the personality’, the PTSD levels and the difference between DID and OSDD (complex PTSD level II and III). Probably a more compact clinical clarification and additional to the difference between ANP-EP and DID-OSDD by my therapist.
ANP’s don’t do to personification. They focus purely on tasks of everyday life and leave aside the EP’s of their consciousness mind. The influence of EP’s that they do experience, they experience not as a part of their own lives (they think it’s not a part of me)
EP’s don’t do to presentification (don’t live in the present time). They only think from out the past and don’t take notice of the fact that it’s already 2014.

In case of a OSDD there is one ANP and a lot more EP’s. Those EP’s don’t completely take over the consciousness mind of the ANP. So the ANP stays more a less in contact with the EP’s.

In case of a DID there are more than one ANP, and the EP’s can take over the consciousness mind of that or that particular ANP on that moment (that cause losing time in the daily functioning of the ANP’s). Amnesia is therefore also a typical symptom that goes with a tertiary dissociation of the personality.

No Pain

So each person has only one personality !

Lets look closer to a personality that suffers a DID:
You can identify different DID-ANP’s of a personality that suffers a DID (stable act systems).
BPD is a personality disorder and not a partial identity disorder.
There you only could ask yourself the next question:
‘can a DID-ANP part suffer symptoms of a Borderline structure?’
Yes that is possible, but than a less that isn’t a BPD.

If the main host suffers a BPD, then the personality can’t handle or develop stable DID act systems (DID ANP’s EP’s). The total personality will always go under the influence of that personality disorder. One of the main symptoms of BPD is impulsive and acting out behavior, and they suffer also a very high influence of EP’s (emotional PERSONALITY parts). That isn’t a DID symptom, where one of the main symptoms is: More than one ANP and more than one EP = Together they form very stable act systems, identifiable DID-ANP’s, which don’t leave a lot of room to the EP’s to take control over the personality. The ANP’s are protecting each other, and the personality, against the influence of those painful EP’s (a survival system that didn’t learn how to synthesize)

A often heard explanation in answering the main question ‘can a part (ANP) of a DID personality suffer a Borderline personality disorder?’, is:
Most given answer: Yes, it is possible because there are people with both diagnosed disorders.
My first reaction there is: ‘Could it be that such a double diagnose is wrong?’
And ‘that’ is possible. Because diagnosing a trauma related dissociative disorder can only be done by experienced specialists which are trained to do so

Than de difference from a therapy need and point of view:

Identities of a personality which suffers a DID (ANP’s – apparently normal personality) protect each other against the influence of painful emotional personality parts. They don’t leave a lot of room to the EP’s to interfere (take control of the personality).
DID: In therapy and only within therapy, we learn the ANP’s to give room to the EP’s so they can make a start to integrate within the ANP (they need to give more room to the EP’s to work with)
OSDD: In therapy the Host (1 ANP) has to learn to take more control over the influence of EP’s, because there they have too much room to take over the behavior of the main APN (the EP’s have to much room and influence, in taking control of the personality).

Love to you all
Nique

ps:
A little language barrier

Sometimes a laugh is also very important to survive…

goodmorning

After 28 years no writing or speaking English, I have to learn English again to make myself understandable to you all.
But now I will learn you all a little bit Dutch.

So I’ll give you a Dutch sentence:
Mijn buurvrouw heeft koolmeesjes maar wat doet uw haan op mijn ezel.

Means:
My neighbor has great little birds, but what does your rooster on my donkey

And now go to google translator, see link:
http://translate.google.nl/?hl=nl#nl/en/mijn%20buurvrouw%20heeft%20koolmeesjes%20maar%20wat%20doet%20uw%20haan%20op%20mijn%20ezel

Coping with Trauma

A patient-oriented manual for complex trauma survivors

And the clinical theory behind this treatment

This training manual for patients who have a trauma-related dissociative disorder includes short educational pieces, homework sheets, and exercises that address ways in which dissociation interferes with essential emotional and life skills, and support inner communication and collaboration with dissociative parts of the personality. Topics include understanding dissociation and PTSD, using inner reflection, emotion regulation, coping with dissociative problems related to triggers and traumatic memories, resolving sleep problems related to dissociation, coping with relational difficulties, and help with many other difficulties with daily life. The manual can be used in individual therapy or structured groups.

 treatment trauma

Link to: the Book ‘Coping with Trauma-related Dissociation
Link to: table of contents
This book will give you a guideline to learn
How to Cope with Trauma-Related Dissociation:
Skills Training for Patients and Their Therapists

 

The Haunted Self

 

The use of imagery in phase 1
treatment of clients with complex dissociative disorders
written by Ph.D. O. vd Hart

 

And if you really want to give this book a try and your therapist is also in for it, you could also consider to read the clinical theory behind this treatment such as given in the book
The Hanted Self’.

It’s a clinical learning book.