Tag Archive: dissociative amnesia

Trauma disorders, Borderline- and Dissociative Disorders

(c) Nique(c) Nique TRTCenter NLI did receive the question:

Could you try to explain in your own words and average understandable language; the different types of Trauma disorders (diagnoses), versus a Borderline Personality Disorder and the relation of both with Dissociative Disorders – without the interference of the understanding of a Structural dissociation of the personality.

And my answer to it is: Yes I feel very honored to give it a try in my own words.

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I. TRAUMA and Posttraumatic Stress Disorders – PTSD & CPTSD

Very simplified we know 3 main groups of diagnoses to a mental disturbance caused by Trauma:childabuse

1 an acute short term mentally disturbance (ASD)
2 a middle long term mentally disturbance (PTSD)
3 a long term e.g. chronically disturbance (CPTSD)

a bit more defined:

  1. Acute Stress Disorder
    an acute short term mentally disturbance / reaction to a one time experienced Traumatic event
    for example: witnessing a very heavy train accident
  2. PTSD
    Post-Traumatic Stress disorder – middle long term mentally disturbance caused by experiencing a dead scary Traumatic event
    for example: a kidnapping or a onetime rape experience, or other dead scary experiences
  3. C-PTSD
    Complex Post-Traumatic Stress disorder – a long term e.g. chronically mentally disturbance caused by experiencing more than one Traumatic event
    a. Childhood trauma like sexually and or physically abuse
    for example: incest or other repeated child molestation e.g. child abuse
    b. War experiences (veteran care), etc.

To simplify: above we have mentioned the different types of Trauma disorders (diagnoses).

And keep in mind that those diagnoses can be given to everyone who experienced a Traumatic event. So also to people with Borderline, with Autism, with no mental disorder, etc.. From the policeman to the house wife – they can all experience a dead scary traumatic event which can lead to a post traumatic stress disorder.

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II. DISSOCIATIVE DISORDERS – DD

The Second mental disorders I want you all to get acquainted with is the category
Dissociative Disorder – abbreviation = DD (watch out, it’s no DID)

  1. Dissociative identity disorder – DID a trauma related polysymptomatic condition which is characterized by a hidden presentation
  2. Other Specified Dissociative Disorder – OSDD
  3. Dissociative Amnesia
  4. Depersonalization/Derealization Disorder
    sub group:
  5. Unspecified Dissociative Disorder (DDnos)

Are dissociative disorders with switching behavior to different personality states always related to a Dissociative Identity Disorder (DID)………   :  NO

Switching between personality parts is not a phenomenon that only belongs to a Dissociative Identity Disorder (trauma related).There are other disorders that have symptoms of identity problems and switching behavior between personality states such as a theatrical personality disorder, a Borderline Personality disorder, a bipolar disorder or schizophrenia.
A Dissociative Disorder (DD) has a wider range of being a co-morbidity disorder.

PTSD and it’s relation to Dissociative Disorders (OSDD and DID):
Within the category Dissociative Disorders, we know two types of diagnoses which are related to Psychologically-Trauma:

1. Otherwise Subscribed Dissociative Disorders (OSDD) and
2. the Dissociative identity Disorder (DID) – caused by Psycholotically-Trauma

Those two Dissociative disorders are both categorized by Trauma specialists as Complex Psychologically-Trauma disorders.
Sometimes also knows as a Trauma type – II and type – III

And both disorders are known with a wide range of dissociative problems. From Amnesia, Depersonalization to Derealization to somatic dissociation, etc.. The difference between a trauma related OSDD and DID is the comorbidity of disorders and the presentation of the Switching behavior. Both disorders are likewise severe and don’t tell a thing about more or more severe Trauma experiences – because both disorders are categorized as likewise very severe disorders ! they cause severe clinically distress and agony in life.

A Trauma related diagnose tells you only something about the complexity of the disorder(s).

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III. BORDERLINE PERSONALITY DISORDER – BPD

not C-PTSD related – Abbreviation BPD

A Borderline personality disorder is a personality disorder which causes severe agony to life. It’s also a disorder which very often is misunderstood and stigmatized. People with a BPD suffer a lot, so please don’t judge them by the disorder but try to understand them.

BPD is a diagnose of a mental disorder which points out a list of ongoing disturbed, unstable and or harmful symptomatically behavior caused by a broad range of influences during childhood and a biologically given mental weakness. Examples of causes:

  • too less love and attention (negative child neglect)
  • too much negative love and attention (positive child neglect)
  • broth up by parents with harmful addictions
  • broth up by parents with social problems
  • broth up in a harmful e.g. stressful living environment
  • etc.
  • and the most upper handed cause to develop BPD:
    is most likely a mental weakness given by biologically genes (Borderline structure).
    A by nature given, not being able to handle or coupe well with stressful situations. A biological basis to develop a BPD.
    Note: Not everyone born with the biologically genes will develop a Borderline Personality Disorder during life –  A Borderline structure (is not a BPD) only tells something about the mental straight to coupe or handle with stressful situations.

Some psychologist e.g. mental clinicians like to call the causes to the development of a BPD – ‘childhood trauma’. But if you understand the clinical definition of Trauma you can’t place those causes in a direct line of Traumatic experiences. So I fully disagree with people who think and or declare that a Borderline Personality disorder is per definition caused by Trauma, and or is always trauma related, because it isn’t.

A Borderline Structure or a Borderline Personality Disorder by itself isn’t caused by Trauma !

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And now we end up to the most spoken CLINICAL DISPUTE * * *

BPD and It’s relation with Dissociative Disorders  (OSDD and or DDnos):

attentionOf course it all needs research and a global acceptance to define the difference and or relation of causes and the influences of different comorbidity disorders, but I will give you a bit of an explanation in the line of both clinical streams which are still arguing about the cause and understanding of a BPD in combination with Dissociative Disorders and or dissociation caused by Trauma:

A bit Freudiaans and a bit Janetiaans – I think; both theoretically streams do have a point

                      1. BPD + DDnos not Trauma related
                        BPD + Dissociative symptoms and switching behavior to different emotional personality states NOT Trauma related
                        (BPD + comorbidity DDnos)

People who suffer a Borderline Personality Disorder very often can’t coupe (independently) with stressful situation. They clamp on to addictive behavior to escape the inner stress and daily life stress, and or they clamp on to other people which can guide them through a stressful situation of life. If stress comes in to (such) a relation someone who suffers a BPD wants also to escape this relation (again) by clamping on to another person. They don’t attach on a healthy way and it’s not uncommon that someone with a BPD has a storrmy history of different relationships or switches back and forward towards and between more than one relationship. They easily panic if they are left alone. And they show very often impulsive and or addictive behavior.  It’s also not uncommon that someone who suffers a BPD seeks attention, I prefer to call it   they seek HELP because they are scared – they do this to escape the inner stress and the fear of being left alone. Life itself is sometimes even too much to handle and the fear of loneliness then also gets enormous, almost unbearable.
Graphed by this fear they sometimes develop different somatic problems with no physical cause, or they even start to develop their own internal family and play mates to escape the fear of being left alone. They start to Dissociate by the development of emotional personality parts.

                      1. BPD + (CPTSD) OSDD Trauma related
                        BPD + Dissociative symptoms and switching behavior under the influence of emotional personality parts:Trauma Related
                        (BPD + CPTSD + OSDD)

Like every human being also someone who suffers a BPD can experience a dead scary traumatic events or have suffered also Childhood sexual and or physical abuse which leads to the symptoms of a PTSD or a CPTSD with dissociative symptoms.
It’s also not oncoming that you see also severe Dissociative symptoms and dissociative Switching behavior in this category of a double mental disturbance and category of diagnosis.

But it’s also very difficult for diagnosticians to diagnose BPD + Dissociative Symptoms and the Switching behavior to other personality states of this category, because they need to determine if the Dissociative symptoms are caused by the BPD or by trauma related Dissociation (OSDD). And that is not an easy thing to do.

 

Fact or Factious:
ptsd vrijSomeone who suffers a BPD + Dissociative symptoms (DDnos and or OSDD) suffers severe agony in life. We know that this group is also the most difficult group to treat because of the underlying BPD and wide range of dissociative symptoms. Prognosis of treatment aren’t much positive because of the severity of the combinations of disorders. And although researches are doing their best to develop better diagnostically instruments (differential instruments) and treatment possibility’s, it’s still a group which gets to less global attention and understanding.

For the difference between a OSDD and DID dissociative disorder
I refer to the following link: The difference between OSDD and DID

(c) Nique

Complex Trauma PTSD

Structural Dissociation and amnesia

attention
But first a note of attention:


To all the professional mental caretakers and psychotherapists out there

please inform yourself on a professional way about the trauma related structural dissociation of the personality such as given by Kathy Steele, Onno van der Hart and Ellert Nijenhuis.

And to all readers pleas note
In order to correctly understand the explanation of my own personality systems, you need some knowledge of the summary of a SD. Be ware: Switching between personality parts is not a phenomenon that only belongs to a trauma related Structural Dissociation (SD) – such as a very complex PTSD the dissociative identity disorder (DID) – or a complex PTSD Secondary SD (OSDD) – or a less complex Post traumatic stress disorder PTSD.

There are other disorders that have symptoms of identity problems and switching behavior between personality states such as a theatrical personality disorder, a Borderline Personality disorder, a bipolar disorder or schizophrenia. A Dissociative Disorder (DD) has a wider range of being a co-morbidity disorder. And also the tertiary SD, DID, the trauma related Dissociative Identity disorder is a polysymptomatic condition which is characterized by a hidden presentation (S.Boon & N. Draijer).
So keep in mind: Diagnoses of a ‘trauma related’ structural dissociation of the personality can only be done by an experienced clinical trauma psychologist/psychotherapist which is specially taint to do so. 

*  *  *  *  *

Structural Dissociation and amnesia

ptsd vrijFirst notice:

The memory loss is not caused by a physical neurological or a somatic problem.
If caused by psychological Trauma;
The memory loss is often not permanently.

 

How to explain memory loss to a Trauma related Structural Dissociation

  1. PTSD – DD – primary
    partial or full dissociation of the traumatic experience (the ANP is phobic to remember the traumatizing experience)
  2. Complex PTSD – OSDD or DDnos – secondary
    partial or full dissociation of more than one traumatic childhood experience. The ANP suffers big stress under the influence of more than one EP which holds traumatizing experiences of the past or which go in contact with memories of the past (EP’s).
  3. Very Complex PTSD – DID – tertiary 
    partial or full dissociation of more than one traumatic childhood experience
    but also amnesia during and for daily life tasks (not traumatic experiences)

I start again with a very small summary of the three levels of a Trauma related Structural Dissociation of the personality, and the understanding of an Apparently Normal Personality part and an Emotional Personality part which holds a traumatic experience or a part of a traumatic experience.

 

scaredParagraph 1)
Dissociation between ANP & EP (PTSD dd – CPTSD osdd ddnos)

Traumatized experience – a memory (EP) – can be:
partially dissociated
ANP can remember a part of the traumatizing experience
fully dissociated
ANP can’t remember a thing of the traumatizing experience

this can occur within
1. primary SD
2. secondary SD
3. tertiary SD

Note: partially or fully dissociating of an EP, a traumatized memory of the past

 

A note to paragraph 1

Not remembering the past or a traumatizing experience we call ‘dissociating a traumatic event’. The ANP is Phobic for remembering the traumatizing experience. If the EP is triggered and starts to influence the behavior of the ANP, or even takes control of the ANP’s behavior by switching to an emotional personality state, then the ANP loses the ability to comprehend the implementation of a daily requirement or task. The influence of the EP (or more EP’s) on the ANP can cause severe agony in daily life.

This can happen within all three the levels of a trauma related structural dissociation,
primary, secondary and tertiary SD
Because all three levels have an ANP and EP part.

silence


Paragraph 2)

 

Amnesia ANP & ANP   ( tertiary SD – DID)

amnesia of daily life activities which are taken care of by more than one ANP.

example:
On a daily life base losing track of time, or not remembering doing things (tasks) in the present time. Like not knowing what you did this morning or not knowing that you did already take care of the groceries or not remembering that you did go to work this morning etc. the present time tasks (amnesia)
Amnesia caused by switching between more than one ANP.


A note to paragraph 2

This we call a Tertiary SD which is related to a Dissociative identity disorder

Amnesia for daily life tasks or daily life events, caused by more than one ANP which goes in control of taking care of daily life tasks. This only can happen by the tertiary SD, because this is the only Trauma related SD level which has more than one ANP (DID)

An example of amnesia caused by more than one ANP
Let’s take an example of 2 ANP’s

Trauma Fog

One of the tasks of ANP 1 system is:
going to work on a daily base and she/he doesn’t like physical contact

One of the tasks of ANP 2 system is:
taking care of the kids, husband/wife, and she/he has no problems with handling psychical contact.

Both ANP’s leaves aside the EP’s (memories of the past) and together they don’t leave a lot of room to the EP’s to take control of their consciousness mind. On this way they minimize and avoid the influence of EP’s on their daily life. The ANP’s focus purely on surviving daily life tasks and emotions.

If someone, without a warning, touches ANP1 on a physical way, an EP could get triggered. Then a nasty memory comes to close to the consciousness mind of ANP1 and by instinct this ANP will redraw to avoid the EP. Forcing ANP2 to take over the moment of daily life. Normally the ANP’s switch during the day by doing the tasks they each are best in and trainet to take care of, but they also provide protection against the influence of nasty EP’s

The switching moments between the ANP’s can be experienced as coming out of a very thick Fog realizing by an instant of being in the kitchen without remembering how he or she did get there. ANP2 gets confused for a moment and needs to adjust to the situation. But ANP2 can’t remember the nasty feeling which hit ANP1 before the switching moment. And ANP2 also can’t remember what took place on the moment that ANP1 was in control. Now ANP 2 suffers amnesia for the time being of ANP1 was in control, and ignores or avoids thinking about it. Likewise the other way around.
Both ANP’s are focust on thinking, there is only me and I don’t suffer a Trauma or trauma related disorder.
numb

And although the memory is not really gone….

ANP2 suffers amnesia for the time being that ANP1 was in control. They never learnt to communicate and work together and they are dead-scared for their own – but also for each others – memories. They only learnt ‘how to survive pain and nasty traumatizing events and memories’.

So here the EP’s couldn’t take over the consciousness mind of the ANP. Because if the EP’s had succeeded  ANP1 would have experienced the same agony and suffering such as described under paragraph 1 – a switching behavior to an emotional personality state – a personality state that goes under the influence of an EP –  caused by a trigger moment such as a physical touch.

ANP living
Being traumatized is also very often explained as living in a Fog
The ANP does the job that has to be done – as being on an automatic pilot.
A foggy mental state, not fully mentally sharp and or touched by daily life emotions.
Sometimes a very deep fog is needed to keep a distance of traumatized memories (EP’s)

 

 

Complex Trauma PTSD

How about the chemical brain balance

How about the chemical brain balance 

(the magic of our brain complexity)

Hypnotic Thoughts

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Broadcasted by:  HypnoticThoughts


Hypnotist Paul Ramsay

 

Paul Ramsay

Paul Ramsay is a board certified hypnotist in private practice, hypnotizes over 1500 people per year, and tours as a stage hypnotist. For over 10 years, Paul Ramsay has been entertaining college and high school students as a stage hypnotist. In 2011, Paul introduced his exclusive interactive show called Mind Games. Paul’s video series Hypnotic shows a day in the life of a traveling stage hypnotist. Paul’s private practice is dedicated to helping individuals stop negative habits such as smoking, fingernail biting, and overeating. Ramsay’s private practice also offers customized, individual personal coaching programs to help his clients achieve their goals and maximize their potential. www.PaulRamsay.com

and
mani-saint-victor

Cognitive Neuroscientist Manuel Saint-Victor

M.D. Dr. Saint-Victor is Chief Neuroscientist at Mindful360, which he co-founded. Dr. Saint-Victor is focused on using a non-pathological approach to helping people get better by becoming more self-aware of their strengths and resources. Dr. Saint-Victor trained under Dr. Eva Ritvo, M.D. and Dr. Ray Ownby, M.D., MBA, Ph.D. as a Psychiatry Resident at Jackson Memorial Hospital; attended Medical School at UNC Chapel Hill School of Medicine; and conducted cognitive neuroscience research under the supervision of Stephen M. Kosslyn, Ph.D. as an undergraduate at Harvard University. Dr. Saint-Victor’s white paper about Core Value Alignment will be released in July 2014.

 

dopamine

What is Dopamine? Reward, Learning, and Flexibility

Dopamine is the neurotransmitter responsible for reward-based learning. It’s involved in compulsive behaviors and wanting (anticipation, craving) but not liking (pleasure).  Dopamine is made in the Substantia Nigra. dopamine pathway problems include addiction, Alzheimer’s disease, and schizophrenia.

Go to see the interview broadcast

 

 

 

Serotonin

What is Serotonin? Resource Availability Central

Serotonin is about creating a subjective sense of resource availability.  In lower organisms, this could mean food.  In higher organisms, especially social organisms, this translates into availabilities for mating opportunities, socioeconomic position/dominance, and mood.  It also plays a role in appetite and sleep.   It is derived from tryptophan.  In addition to its role in your central nervous system serotonin is also active in your gut canal and in your platelets.  In fact, 95% of your serotonin is found in your bowels. This explains, in part, the bowel irritation associated with nervousness and stress.

Go to see the interview broadcast

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stress_cortisol
What is Cortisol?

Cortisol is your stress hormone.  It increases in your body to organize fight, flight, faint behavior.  This includes shutting down any systems not immediately needed for escape or combat, shutting down your immune system, and switching your brain to acting based on habits.

On a molecular level, a cortisol cascade shut down the connection that allows your prefrontal cortex to modulate your amygdala.  This sets the amygdala free to fire, signaling intense arousal.  At Mindful360, we discuss this effect in our Amygdala hijack series.

Go to see the interview broadcast

Oxytocin-reflexjpg

 

What is Oxytocin? Trust Me, It’s a good one.

Oxytocin, often called the snuggle hormone, is better thought of as the neuromodulator of the attachment system.  It is associated with group bonding, empathy through narrative, breast-feeding, and that warm-fuzzy feeling after orgasm.  The dark side of oxytocin, sometimes called the mother-bear effect, is outgroup intolerance, and exclusivity.  The divider between the two effects us trust.

Go to see the interview broadcast

orexinjpg

 


What is Orexin? Aroused yet?

Orexin, also known as hypocretin is all about energy, metabolism, and arousal.  Without it you may suffer from narcolepsy or drop fits when you laugh.  Some label it as being at the intersection of consciousness.  The best way to think of this is that your heart rate and breathing rate affect how you feel emotionally about everything else and orexin controls that.

Go to see the interview broadcast

 

 

Complex Trauma PTSD