Tag Archive: Journal of Threat Assessment and Management

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

The charts of my own DID personality

 

The schema’s of my way of thinking
read also the summary that goes with them:
LINK

The biggest misunderstanding within talking about DID comes with the ANP parts

Some call them a hosts, some call them alters, some call them my other personality’s and some call them all ANP’s. To me-us that is pretty confusing. So we had a very long talk about the ANP’s with our clinical teacher and therapist. Sometimes I’m asking his head of he says, but each time he has the patience to work through my questions in order to make understandable for me how and why I created parts to function, why they are there, what there function is in the whole system and why they refuse or didn’t learn how to work together.

The Neuro typical clinical nerd and a traumatized autistic (Asperger) woman can bring some pretty hilarious situations, but also creative findings in way’s to understand each other. I started to make visible to my therapist the schema’s which I created in my head and which are very helpful to understand things. This made also possible that my therapist could guide me to a therapeutically process.
You could think ‘wow that is a bunch of work’ but to me it isn’t.
It’s how I think, picturing things in my brain, it’s how I function and understand the outside world.

A clinical glimpse into my own DID personality

my own three ANP/EP daily life emotion & tasks handling systems

 

life_systems_chart2011big

 

the 3 DID houses

 

Copyrighted Nique

Complex Trauma Community

 

 

 

 

 

Journal of Threat Assessment and Management

Journal JTAM
Call for Papers

Journal of Threat Assessment and Management (JTAM) is a scholarly journal publishing peer-reviewed papers representing the science and practice of risk for violence and fear-inducing behavior. JTAM is published by the American Psychological Association and is a forum for scholarly dialogue regarding the most important emerging issues in the field. The first issue of the journal will appear in Spring 2013.

The Journal of Threat Assessment and Management will be an international periodical for professionals and scholars whose work focuses on operational aspects of threat assessment and management. The journal will be unique in three ways. First, it will be devoted exclusively to the subject of violence risk. Second, it will be applied in nature, dealing with the development, implementation, and evaluation of procedures for assessing and managing violence risk. Third, it will both reflect and promote the values of interdisciplinarity and internationalism, based on the view that preventing violence requires collaborations that cross professional and, in many cases, geopolitical boundaries.

Being published by APA connects Journal of Threat Assessment and Management to a large body of authoritative and high-quality research available through PsycARTICLES®, the most used full-text database in psychology and one of the most popular databases in all scholarly disciplines and fields. PsycARTICLES® is available to a global audience of nearly 3,200 institutions and 60 million potential users.

Journal Board Members. Stephen D. Hart, PhD is the incoming Editor of Journal of Threat Assessment and Management. He is professor of psychology at Simon Fraser University. Dr. Hart’s primary area of expertise is forensic psychology. His work focuses on clinical-forensic assessment in criminal and civil settings, particularly of violence risk and psychopathic personality disorder. As Editor, Dr. Hart is joined by international senior editorial advisory board members Jens Hoffman, PhD, J. Reid Meloy, PhD, and Lisa Warren, PhD.

By Journal of Threat Assessment and Management – EAPL Student Society – Everything you want to know about Forensic Psychology.