Should BPD be removed from the DSM?

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Meadow
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24 Dec 2009, 11:34 pm

I do think people who manipulate, act out and cry wolf fall into this category and for that reason it should stay. Sorry if that sounds blunt or offensive to anyone. Hopefully clinicians can get it right more times than not though in making their diagnoses.



TheHaywire
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25 Dec 2009, 12:41 am

makuranososhi wrote:
TheHaywire wrote:
Here is what I am curious about.

25% of people with BPD are not victims of trauma while the other 75% are. Why the similar symptoms? It can't be a coincidence that the majority of people with BPD are trauma survivors. This is why I feel like it should be changed to CPTSD. At least for the 75%.


There are a lot of conditions that share symptoms, whether dealing with physical, mental, social or emotional conditions. I can agree that those whose histories include trauma should be evaluated for C-PTSD first; that does not preclude that there is an overlap, either.


M.


How would we go about getting people whose histories include trauma evaluated for C-PTSD before the borderline label is slapped on them?



TheHaywire
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25 Dec 2009, 12:43 am

Meadow wrote:
I do think people who manipulate, act out and cry wolf fall into this category and for that reason it should stay. Sorry if that sounds blunt or offensive to anyone. Hopefully clinicians can get it right more times than not though in making their diagnoses.


Those people are just sociopaths. This is considered very controversial but I feel that the 25% of people with BPD who have not been through trauma are actually just sociopaths. This offends a lot of people but it's simply how I feel.



Meadow
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25 Dec 2009, 12:57 am

TheHaywire wrote:
Meadow wrote:
I do think people who manipulate, act out and cry wolf fall into this category and for that reason it should stay. Sorry if that sounds blunt or offensive to anyone. Hopefully clinicians can get it right more times than not though in making their diagnoses.


Those people are just sociopaths. This is considered very controversial but I feel that the 25% of people with BPD who have not been through trauma are actually just sociopaths. This offends a lot of people but it's simply how I feel.


I think of a sociopath as someone who is almost inhuman in many ways and think it is biologically based whereas those folks who are merely attention seeking and acting out wouldn't likely fall into such a serious sort of scary category. I don't think I can agree with that but I appreciate your concern with the issue.



makuranososhi
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25 Dec 2009, 1:12 am

I don't know that "we" can do anything about it, other than lobby and provide a statistical basis for the argument. I disagree that the remaining 25% are sociopaths, or psychopaths for that matter. The polarization - in this case, of emotional manipulation instead of emotional state as is found in bipolar disorders - is a defining characteristic... the push/pull, love/hate sorts of relationships they have with people and activities is remarkable.


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Meadow
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25 Dec 2009, 1:29 am

makuranososhi wrote:
I don't know that "we" can do anything about it, other than lobby and provide a statistical basis for the argument. I disagree that the remaining 25% are sociopaths, or psychopaths for that matter. The polarization - in this case, of emotional manipulation instead of emotional state as is found in bipolar disorders - is a defining characteristic... the push/pull, love/hate sorts of relationships they have with people and activities is remarkable.


M.


Pretty serious and yes, remarkable indeed.



TheHaywire
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25 Dec 2009, 10:05 am

I've never met a push/pull, love/hate borderline that hadn't experienced trauma. I started a group on facebook to get the diagnosis removed from the DSM (and replaced with CPTSD) which is, if nothing else, a start. I'm actually thinking of switching my minor to Psychology so I can fight for this. This is going to sound psychotic and off-the-wall but I feel that the 25% of borderlines who haven't experienced trauma aren't actually borderline. I think that they pretend to have emotions to manipulate people which seems like sociopathic behavior to me. I don't see how anyone can truly be borderline without having experienced trauma.

These are sociopathic traits that are also borderline traits:

4. Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). Note: Do not include suicidal or self-injuring behavior covered in Criterion 5
7. Chronic feelings of emptiness

These may not appear to be trauma related at first but it becomes quite obvious that what's happening is displacement:

8. Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms

If someone gets violently attacked by their father on a consistent basis.... when they finally move out of the house and grow to realize how wrong this was they end up getting extremely angry and lashing out at innocent people. (these innocent people subconsciously allow them to get their anger out at their father) They think that everyone is out to get them because they have been abused their whole lives.

Since other people don't know what the borderline has been through they see the borderline as manipulative and cruel without reason. If one is manipulative and cruel without reason I can only conclude that they are some type of sociopath that likes to play around with emotions as chess pieces. The borderline has reason to be manipulative and cruel. Dissociation. It's not logical reasoning but it's a human reaction.

The same diagnosis should not be applied to people who have experienced trauma and people who haven't. I feel that the 25% who haven't experienced trauma need to be studied more because their behavior makes absolutely no sense outside of genetics. I don't believe that genetics cause personality disorders.



Meadow
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25 Dec 2009, 1:49 pm

I don't really agree with this when I think more about it. I was violently abused in every way on a daily basis when I was a child but I didn't grow up to act out any of those behaviors you've listed upon others. I was actually more sensitive to how fragile we are as human beings and much more careful around others than my counterparts. Yet I was abused in exactly those ways by someone who had been through only a very minor degree of emotional abuse but who was otherwise very sheltered, someone who likewise had no apparent understanding of our human frailties and no respect or regard for them either and acted out in the most horrible, manipulative ways imagineable. And I have been seriously psychologically traumatized by it as well because of their cunning nature and my rather gullible nature in kind despite all that I had been through. I think too many of the people who claim to be abuse victims to the extent you've mentioned for the most part are malingerers. Case in point, it's highly suspicious when someone says they have an abuse/trauma history but can't recollect a single account to support the notion while under the guise of a DID. It's a very convenient scenario for the Borderline client to utilize a disorder like this to manipulate those around them and all they have to say is they "don't remember".



Last edited by Meadow on 25 Dec 2009, 2:10 pm, edited 1 time in total.

makuranososhi
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25 Dec 2009, 2:01 pm

You are entitled to your opinion; I just have to restate that I do not agree with it beyond the fact that I can see where those who have C-PTSD would exhibit in a manner consistent with the way that BPD expresses itself. It seems that you are dismissing those who, on a diagnostic basis, do have BPD and are not considered to be sociopathic, and attempting to push them into the same sort of negative labeling that you seem to be seeking freedom from as someone who feels that C-PTSD is a more accurate diagnosis of their condition than BPD. To do the very thing that upsets you toward another person does not make sense to me. As for personal experience, I have met the BPD diagnosed individual who did not have traumatic history; he lied, manipulated, would tell his girlfriend (a friend of mine) in front of my face how he loved her one moment, then within seconds how she had sabotaged his life, making plans only to cancel them at the last minute. I see a distinction, however, between this sort of behavior and being a sociopath. Lastly, if there were to be an unthinkable experiment, where 100 people were exposed to severe traumas over a period of time... not all of them would react in the manner you describe. So there has to be a fundamental difference in the individual that leads to those behaviors and the belief set that supports them. Therefore, both conditions are a little shaky as to where I believe our understanding of the actual underlying causes and triggers are concerned.


M.


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