CPTSD or Borderline PD? (or Covert Narcissist, or Psychopath, or…)?

Summary

The current evidence suggests that Complex PTSD, Borderline Personality Disorder, and related personality disorders exist on a trauma spectrum with overlapping features. Instead of viewing them as separate entities, it may be more accurate to see them as various manifestations of complex trauma. Ongoing research, including sophisticated methodologies like Latent Class Analysis, continues to refine our understanding, promising better diagnostic clarity and more effective, trauma-informed treatments for survivors. CPTSD or Borderline PD? (or Covert Narcissist, or Psychopath, or...)?

Abuse, Borderline, Covert Narcissist, narcissism, narcissist, Personality, Psychology, Reality, Sam Vaknin, Trauma, Vaknin Summaries

July 3, 2020

Tip: click a paragraph to jump to the exact moment in the video. CPTSD or Borderline PD? (or Covert Narcissist, or Psychopath, or…)?

00:02 my name is Sam back 9 I am a professor of psychology and the author of malignant self now narcissism revisited and several other books about personality disorders I’m cheerful and there’s nothing you can do about it sue me knowing myself I am probably cheerful because I’m about to discuss trauma and traumatized people always cheers me up and today’s topic is are you the listener the viewer the self-styled victim the real victim the so-called empath a covert narcissist probably are my name is Sam back 9 I am a professor of psychology and the author of malignant self now narcissism revisited and several other books about personality disorders I’m cheerful and there’s nothing you can do about it sue me knowing myself I am probably cheerful because I’m about to discuss trauma and traumatized people always cheers me up and today’s topic is are you the listener the viewer the self-styled victim the real victim the so-called empath a covert narcissist probably are
00:48 you a victim of post trauma are you a victim of complex post-traumatic stress disorder I oh are you a garden-variety run-of-the-mill borderline personality disorder patient your borderline or either CBT st in today’s online cyber environment where everyone and his dog is a life coach everyone is an expert on narcissistic abuse everyone knows everything about everything then of course to have suffered from complex post-traumatic stress disorder lends you an air of self-importance aggrandize is you a victim of post trauma are you a victim of complex post-traumatic stress disorder I oh are you a garden-variety run-of-the-mill borderline personality disorder patient your borderline or either CBT st in today’s online cyber environment where everyone and his dog is a life coach everyone is an expert on narcissistic abuse everyone knows everything about everything then of course to have suffered from complex post-traumatic stress disorder lends you an air of self-importance aggrandize is
01:37 you makes your experience special but complex post-traumatic stress disorder is much more rare than we are led to believe generally trauma is an extremely rare reaction through stressors to stressful life events PTSD is so rare that we have been able to observe it only in veterans of war for example Vietnam vets and most of the writings on trauma have been offered and published by psychiatrist who have spent most of their professional lives working with war veterans so you need to endure a war a war you know exploding shells flying you makes your experience special but complex post-traumatic stress disorder is much more rare than we are led to believe generally trauma is an extremely rare reaction through stressors to stressful life events PTSD is so rare that we have been able to observe it only in veterans of war for example Vietnam vets and most of the writings on trauma have been offered and published by psychiatrist who have spent most of their professional lives working with war veterans so you need to endure a war a war you know exploding shells flying
02:33 body parts you need to endure this in order to be truly traumatized no one is disputing that in very extreme situations of domestic violence sexual abuse mental abuse psychological abuse that is you know well-constructed repetitive over decades there’s no question that some people might experience complex post-traumatic stress disorder but there is good reason to believe that the majority of people who style themselves impulse sufferers of victims of C PTSD majority of people who advertise their abusers in order to body parts you need to endure this in order to be truly traumatized no one is disputing that in very extreme situations of domestic violence sexual abuse mental abuse psychological abuse that is you know well-constructed repetitive over decades there’s no question that some people might experience complex post-traumatic stress disorder but there is good reason to believe that the majority of people who style themselves impulse sufferers of victims of C PTSD majority of people who advertise their abusers in order to
03:18 aggrandize themselves actually you know if your abuser is special you’re special if there’s no one as demonic as Europe used abuser then for you for you is you know a badge of pride I I can envision the parades of for your victims in the future and it pays many of them write books many of them sell all kinds of products and so on it’s a cottage industry being a victim victim would face crime is to pay now victim would be I am NOT invalidating or minimizing what abusers do to their victims or praying I aggrandize themselves actually you know if your abuser is special you’re special if there’s no one as demonic as Europe used abuser then for you for you is you know a badge of pride I I can envision the parades of for your victims in the future and it pays many of them write books many of them sell all kinds of products and so on it’s a cottage industry being a victim victim would face crime is to pay now victim would be I am NOT invalidating or minimizing what abusers do to their victims or praying I
03:59 just am challenging and trying to undermine the proliferation the explosion of miss applied clinical and diagnostic labels it stand to reason that the majority of people who claim to have suffered complex post-traumatic stress disorder are actually nothing more than borderlines collapse narcissus covert narcissus or suffer from some other form of dysregulation we’ll come to it in a minute but perhaps before we go there let us start with a bit of history I teach the topic of post trauma borderline personality disorder other just am challenging and trying to undermine the proliferation the explosion of miss applied clinical and diagnostic labels it stand to reason that the majority of people who claim to have suffered complex post-traumatic stress disorder are actually nothing more than borderlines collapse narcissus covert narcissus or suffer from some other form of dysregulation we’ll come to it in a minute but perhaps before we go there let us start with a bit of history I teach the topic of post trauma borderline personality disorder other
04:47 PTSD related inci PTSD related conditions I teach this a whole semester so the whole semester dedicated to this in the Universities were I’m a professor and so I I’m very hard pressed to encompass all this information in a single video or even perhaps in a series of videos if you express if there is demand if you express a wish so please bear with me and forgive me for neglecting some aspects and some dimensions in the in the doomed attempt for brevity I will also state my my view of the issue to get it out of the way so PTSD related inci PTSD related conditions I teach this a whole semester so the whole semester dedicated to this in the Universities were I’m a professor and so I I’m very hard pressed to encompass all this information in a single video or even perhaps in a series of videos if you express if there is demand if you express a wish so please bear with me and forgive me for neglecting some aspects and some dimensions in the in the doomed attempt for brevity I will also state my my view of the issue to get it out of the way so
05:34 that we can discuss other experts and what they think some of these experts know a lot more than me about trauma very few if any know more than me about narcissistic personality disorder and some of them do not more than me about borderline personality disorder so I defer it to them and I respect their views I’m going to mention some of them but I would like all the same to present my team I’ve spent the last six or seven years trying to reconceive of borderline personality disorder and narcissistic that we can discuss other experts and what they think some of these experts know a lot more than me about trauma very few if any know more than me about narcissistic personality disorder and some of them do not more than me about borderline personality disorder so I defer it to them and I respect their views I’m going to mention some of them but I would like all the same to present my team I’ve spent the last six or seven years trying to reconceive of borderline personality disorder and narcissistic
06:09 personality disorder is post traumatic conditions I’ve been saying that these personality disorders are actually not personality disorders they are post-traumatic disorders they are reactions to see PTSD reactions to complex post-traumatic stress in childhood so in this sense of course narcissus and borderlines there are as much victims of abuse as the people they victimize and this is this affinity between abuser and abused is what generates the trauma bonding your narcissistic abuser is every bit as personality disorder is post traumatic conditions I’ve been saying that these personality disorders are actually not personality disorders they are post-traumatic disorders they are reactions to see PTSD reactions to complex post-traumatic stress in childhood so in this sense of course narcissus and borderlines there are as much victims of abuse as the people they victimize and this is this affinity between abuser and abused is what generates the trauma bonding your narcissistic abuser is every bit as
06:54 much and as like as like you he’s like you the narcissist is also the outcome of narcissistic abuse he is a link in a chain in the chain of narcissistic abuse his parents abused him is abusing you human both abused you to your children who will go on to abuse your brain kids and so on so forth abuse is transmissible exactly like a virus is contagious exactly like a virus it’s a pandemic exactly like a virus so borderline in narcissistic personality disorders are reactions to complex post-traumatic stress disorder in much and as like as like you he’s like you the narcissist is also the outcome of narcissistic abuse he is a link in a chain in the chain of narcissistic abuse his parents abused him is abusing you human both abused you to your children who will go on to abuse your brain kids and so on so forth abuse is transmissible exactly like a virus is contagious exactly like a virus it’s a pandemic exactly like a virus so borderline in narcissistic personality disorders are reactions to complex post-traumatic stress disorder in
07:32 childhood but the reaction has very special features it involves dysfunctional attachment dissociative sense self states Arrested Development infantilism regression to infantile states cognitive deficits an emotional and affective dysregulation being overwhelmed by emotions or suppressing them altogether in order to not be overwhelmed back I have dealt with all these issues at length in previous videos and before you post comments wasting my time please don’t be lazy don’t be indolent don’t be spoiled these childhood but the reaction has very special features it involves dysfunctional attachment dissociative sense self states Arrested Development infantilism regression to infantile states cognitive deficits an emotional and affective dysregulation being overwhelmed by emotions or suppressing them altogether in order to not be overwhelmed back I have dealt with all these issues at length in previous videos and before you post comments wasting my time please don’t be lazy don’t be indolent don’t be spoiled these
08:16 are narcissistic traits search the channel for answers I promise I give you my word to respond to any question the answer to which does not exist in one of my videos now let’s go to complex post-traumatic stress disorder Jonathan Judith Herman was the first to suggest this diagnosis in 1992 but it has since taken wings and evolved and its most important iteration was in 2006 by rope immediately after Herman proposed complex post-traumatic stress disorder and by the way she she proposed this diagnosis in conjunction with war are narcissistic traits search the channel for answers I promise I give you my word to respond to any question the answer to which does not exist in one of my videos now let’s go to complex post-traumatic stress disorder Jonathan Judith Herman was the first to suggest this diagnosis in 1992 but it has since taken wings and evolved and its most important iteration was in 2006 by rope immediately after Herman proposed complex post-traumatic stress disorder and by the way she she proposed this diagnosis in conjunction with war
09:03 wounds war the effects of war she studied War veterans she had Inklings Inklings that see PTSD could be applied in other settings of repeated trauma repeated stressful trauma and so she in some of her writings she hinted that CBDs name maybe one day applied to domestic violence situations and others saw the merit in this new diagnostic category and the reason there was a need for this category is that the classic PTSD classic post-traumatic stress disorder as it had been defined in the Diagnostic wounds war the effects of war she studied War veterans she had Inklings Inklings that see PTSD could be applied in other settings of repeated trauma repeated stressful trauma and so she in some of her writings she hinted that CBDs name maybe one day applied to domestic violence situations and others saw the merit in this new diagnostic category and the reason there was a need for this category is that the classic PTSD classic post-traumatic stress disorder as it had been defined in the Diagnostic
09:48 and Statistical Manual edition for text revision PTSD there in this Bible of the profession was a reaction to a single stressful event natural disaster an accident a pandemic a death in the family a divorce but I mean like an event so PTSD was a pinpointed reaction to a single catastrophic traumatizing event and Herman said justly so what if a person is exposed repeatedly to numerous smaller events but all of them catastrophic all of them traumatising all of them disorienting and dislocating all of them enough to induce repression and Statistical Manual edition for text revision PTSD there in this Bible of the profession was a reaction to a single stressful event natural disaster an accident a pandemic a death in the family a divorce but I mean like an event so PTSD was a pinpointed reaction to a single catastrophic traumatizing event and Herman said justly so what if a person is exposed repeatedly to numerous smaller events but all of them catastrophic all of them traumatising all of them disorienting and dislocating all of them enough to induce repression
10:39 and dissociation what then she said we need something that leads ultimately to post-traumatic stress disorder but it is much more complex in the way it leads there hence complex PTSD as early as 1994 two years after Herman came up with her suggestion is Vander Kolk who is probably by far the leading trauma expert expert on trauma and traumatic disorders Vander Kolk and Fischler wrote an article in 1994 in psychiatric clinics on North America it’s an academic journal December 1994 and this is what they had and dissociation what then she said we need something that leads ultimately to post-traumatic stress disorder but it is much more complex in the way it leads there hence complex PTSD as early as 1994 two years after Herman came up with her suggestion is Vander Kolk who is probably by far the leading trauma expert expert on trauma and traumatic disorders Vander Kolk and Fischler wrote an article in 1994 in psychiatric clinics on North America it’s an academic journal December 1994 and this is what they had
11:22 to say linking trauma to borderline personality so this is what they had to say I’m quoting from long in severe trauma particularly trauma that occurs early in the life cycle tends to result in a chronic inability to modulate emotions when this occurs people can mobilize a range of behaviors that are best understood is a tempest it’s self soothing the task of therapists and researchers alike is to understand which memories are related to which affect effects to know when to explore feelings to say linking trauma to borderline personality so this is what they had to say I’m quoting from long in severe trauma particularly trauma that occurs early in the life cycle tends to result in a chronic inability to modulate emotions when this occurs people can mobilize a range of behaviors that are best understood is a tempest it’s self soothing the task of therapists and researchers alike is to understand which memories are related to which affect effects to know when to explore feelings
12:02 to allow conscious remembrance of past orders and to decide when to focus on mastery in the here and now that’s 1994 van der Kolk and Vizsla but contra to misinformation online and I’m so tired of saying this because I think I’m going to shorten it because if it’s online it’s misinformation I discovered to my horror and sadness most of the so-called information online is utter rubbish so contra to a lot of information on the Diagnostic and Statistical Manual does contain reference to see PTSD it’s not to allow conscious remembrance of past orders and to decide when to focus on mastery in the here and now that’s 1994 van der Kolk and Vizsla but contra to misinformation online and I’m so tired of saying this because I think I’m going to shorten it because if it’s online it’s misinformation I discovered to my horror and sadness most of the so-called information online is utter rubbish so contra to a lot of information on the Diagnostic and Statistical Manual does contain reference to see PTSD it’s not
12:45 true that the text revision published in the year 2000 eight years after hermann proposed a PTSD it’s not true that the dsm committee ignored germans work they actually incorporated it in the DSM so if you go to the DSM Diagnostic and Statistical Manual Edition for text revision year 2000 on page 425 it says the following in associate constellation of symptoms that may occur and are more commonly seen in association with an interpersonal stress or such as childhood sexual or physical abuse domestic violence torture or being true that the text revision published in the year 2000 eight years after hermann proposed a PTSD it’s not true that the dsm committee ignored germans work they actually incorporated it in the DSM so if you go to the DSM Diagnostic and Statistical Manual Edition for text revision year 2000 on page 425 it says the following in associate constellation of symptoms that may occur and are more commonly seen in association with an interpersonal stress or such as childhood sexual or physical abuse domestic violence torture or being
13:31 hostage or a prisoner of war so it seems that the committee even at that early stage because eight years in terms of science or nothing even at that early stage they saw marriage in the possible diagnosis of C PTSD indeed there’s a new addition about to be published of the global equivalent of the DSM the DSM is mostly used in North America and within North America mostly in the United States of America there’s another book another diagnostic manual is called the International classification of disorders it’s in its hostage or a prisoner of war so it seems that the committee even at that early stage because eight years in terms of science or nothing even at that early stage they saw marriage in the possible diagnosis of C PTSD indeed there’s a new addition about to be published of the global equivalent of the DSM the DSM is mostly used in North America and within North America mostly in the United States of America there’s another book another diagnostic manual is called the International classification of disorders it’s in its
14:11 tenth edition and the 11th edition is about to be published segments have already been published but the total edition is about to be published and within the ICD International classification of disorders icd-11 the 11th edition there is a diagnosis a clear-cut diagnostic entity clinical entity complex post-traumatic stress disorder say media sleep has arrived it has made it ICD the ICD is used by many more countries than the DSM it is the global the global part of Psychiatry the Chinese have their own dsm-5 and so we tenth edition and the 11th edition is about to be published segments have already been published but the total edition is about to be published and within the ICD International classification of disorders icd-11 the 11th edition there is a diagnosis a clear-cut diagnostic entity clinical entity complex post-traumatic stress disorder say media sleep has arrived it has made it ICD the ICD is used by many more countries than the DSM it is the global the global part of Psychiatry the Chinese have their own dsm-5 and so we
14:55 have all converged within the profession on the realization that there are traumatic processes which are gradual incremental traineeships surreptitious invisible subterranean and yet at some point volcanic Li erupt and generate the equivalent of PTSD post-traumatic stress disorder at some point all the defenses crumble there’s massive decompensation and there is acting out as we will discuss a bit late my only beef with these diagnostic manuals is the narrow definition of abuse because they stick have all converged within the profession on the realization that there are traumatic processes which are gradual incremental traineeships surreptitious invisible subterranean and yet at some point volcanic Li erupt and generate the equivalent of PTSD post-traumatic stress disorder at some point all the defenses crumble there’s massive decompensation and there is acting out as we will discuss a bit late my only beef with these diagnostic manuals is the narrow definition of abuse because they stick
15:39 to the 1950s the 1940s definition of abuse were abuse his only incest sexual abuse of children or beating up your life or shouting at someone I mean these are these are all abusive behaviors of course and they entail the leveraging and misuse of aggression and so there are music but today we know that abuse is any situation where boundaries are breached simple it’s a simple definition and it encompasses all the non forms of abuse if I have sex with you against your will I’m breaching your physical corporeal to the 1950s the 1940s definition of abuse were abuse his only incest sexual abuse of children or beating up your life or shouting at someone I mean these are these are all abusive behaviors of course and they entail the leveraging and misuse of aggression and so there are music but today we know that abuse is any situation where boundaries are breached simple it’s a simple definition and it encompasses all the non forms of abuse if I have sex with you against your will I’m breaching your physical corporeal
16:27 body boundaries if I if I camilli ate you in public and breaching your boundaries if I force you to do something and pretty no boundaries of course if I beat you up and bridge preaching about all these boundary boundary breaching boundary violation conditions when it happens in childhood there are many ways to breach the boundaries of the child sexual abuse physical abuse verbal and psychological abuse all these are of course boundaries violating a boundary victimization conditions but there are many others for body boundaries if I if I camilli ate you in public and breaching your boundaries if I force you to do something and pretty no boundaries of course if I beat you up and bridge preaching about all these boundary boundary breaching boundary violation conditions when it happens in childhood there are many ways to breach the boundaries of the child sexual abuse physical abuse verbal and psychological abuse all these are of course boundaries violating a boundary victimization conditions but there are many others for
17:04 example if you idolize the child you convert him into an idol you convert him into an object if instrumentalize the child if you use the child for example to realize your unfulfilled dreams to to see your wishes come true by instrumentalizing the child you have converted him into an instrument again an object this is a forms of object objectification if you parent if I the child if you force the child to believe as your parent and you act as your child’s child parent if occation if you provide conditional love love example if you idolize the child you convert him into an idol you convert him into an object if instrumentalize the child if you use the child for example to realize your unfulfilled dreams to to see your wishes come true by instrumentalizing the child you have converted him into an instrument again an object this is a forms of object objectification if you parent if I the child if you force the child to believe as your parent and you act as your child’s child parent if occation if you provide conditional love love
17:42 depends crucially on performance and on fulfillment of expectations I see all these spoiling pampering all these don’t allow the child to separate from you and to become an individual the process that is known as separation individuation in any bridge and violation boundaries during the separation individuation phase is abuse regrettably all these official texts don’t recognize these behaviors is abusive and of course they don’t recognize these behaviors abusing precisely because of the reason they depends crucially on performance and on fulfillment of expectations I see all these spoiling pampering all these don’t allow the child to separate from you and to become an individual the process that is known as separation individuation in any bridge and violation boundaries during the separation individuation phase is abuse regrettably all these official texts don’t recognize these behaviors is abusive and of course they don’t recognize these behaviors abusing precisely because of the reason they
18:22 don’t accept sadism as a mental health disorder I’m kidding you’re not sadism is not included in the dsm-5 and why is that politics political correctness or trying not to infringe on law enforcement try not to mix boundaries not to try to keep boundaries between the profession and law enforcement so like if you spoil your child and I’m telling you that you’re abusing your child you will say what get out of here if you idolize your child isn’t it normal and if you’re sadistic shouldn’t don’t accept sadism as a mental health disorder I’m kidding you’re not sadism is not included in the dsm-5 and why is that politics political correctness or trying not to infringe on law enforcement try not to mix boundaries not to try to keep boundaries between the profession and law enforcement so like if you spoil your child and I’m telling you that you’re abusing your child you will say what get out of here if you idolize your child isn’t it normal and if you’re sadistic shouldn’t
19:03 you be put in jail rather than treated so there’s a lot of politics that go into the determination of what is what is mental illness and what is socially unacceptable behavior many conditions are culture bound they reflect values and morals not clinical entities and many clinical entities actually should be included and are not many behaviors should be pathologize and are not so we said wine brain we said that the icd-11 name the world equivalent of the DSM published by the way among others by the you be put in jail rather than treated so there’s a lot of politics that go into the determination of what is what is mental illness and what is socially unacceptable behavior many conditions are culture bound they reflect values and morals not clinical entities and many clinical entities actually should be included and are not many behaviors should be pathologize and are not so we said wine brain we said that the icd-11 name the world equivalent of the DSM published by the way among others by the
19:47 wh oak proposed this pandemic we say that the icd-11 recognizes CBT any describes see PTSD in the new text as combination PTSD plus emotional dysregulation plus negative self cognition plus interpersonal hardship let’s focus on each of these briefly emotional dysregulation is when your emotions overwhelm you you feel that you’re about to drown you feel that a faucet has been turned on in you’re drowning you can’t help it there’s nothing you can do you must escape you must run away it must do something crazy wh oak proposed this pandemic we say that the icd-11 recognizes CBT any describes see PTSD in the new text as combination PTSD plus emotional dysregulation plus negative self cognition plus interpersonal hardship let’s focus on each of these briefly emotional dysregulation is when your emotions overwhelm you you feel that you’re about to drown you feel that a faucet has been turned on in you’re drowning you can’t help it there’s nothing you can do you must escape you must run away it must do something crazy
20:30 you must drink you must do drugs this is emotional dysregulation negative self cognitions unknown in cognitive behavioral therapy as automatic negative thoughts these are beliefs that you bought about yourself which are negative and also untrue counterfactual unreal so failure of reality testing with regards to yourself and interpersonal hardship ask any spouse of a borderline he will explain this part in details I’m sure but if you put all of this together the piteously the motion of this regulation you must drink you must do drugs this is emotional dysregulation negative self cognitions unknown in cognitive behavioral therapy as automatic negative thoughts these are beliefs that you bought about yourself which are negative and also untrue counterfactual unreal so failure of reality testing with regards to yourself and interpersonal hardship ask any spouse of a borderline he will explain this part in details I’m sure but if you put all of this together the piteously the motion of this regulation
21:08 the negative self cognitions and the interpersonal are cheap what you get yes you get borderline personality disorder if you take the ICD 11th definition of see PTSD it is suspiciously identical to the DSM s definition of borderline personality disorder fourth plus borderline plus an active trauma a condition called complex trauma complex trauma usually involves a feeling of threat imminent and Beyond threat or direct threat a feeling that you are trapped that there’s no way out that you’re ended at a dead end there’s the negative self cognitions and the interpersonal are cheap what you get yes you get borderline personality disorder if you take the ICD 11th definition of see PTSD it is suspiciously identical to the DSM s definition of borderline personality disorder fourth plus borderline plus an active trauma a condition called complex trauma complex trauma usually involves a feeling of threat imminent and Beyond threat or direct threat a feeling that you are trapped that there’s no way out that you’re ended at a dead end there’s
21:53 no outlet enough solution and a feeling of it’ll interpersonal friction and hardship so see PTSD in the icd-11 is borderline plus borderline plus and the plus is active complex strong but aren’t all borderless aren’t all involved in active complex trauma isn’t the borderline condition reflective over an active underlying trauma I will go even further isn’t borderline personality disorder all its manifestations lack of impulse control objecting constancies splitting acting out self-harm and self-mutilation up to no outlet enough solution and a feeling of it’ll interpersonal friction and hardship so see PTSD in the icd-11 is borderline plus borderline plus and the plus is active complex strong but aren’t all borderless aren’t all involved in active complex trauma isn’t the borderline condition reflective over an active underlying trauma I will go even further isn’t borderline personality disorder all its manifestations lack of impulse control objecting constancies splitting acting out self-harm and self-mutilation up to
22:38 suicide and all these don’t they reflect what one khalq called attempts at self soothing aren’t all these mere reactions to very active troll I suggested yes they are in other words I say that all VP DS all people with borderline are in a permanent state permanent post traumatic State never ending never ceasing not for a second they are embedded in their trauma entangled with a trauma inseparable from their trauma they are their trauma I refer you to a March 2018 article in the world Journal suicide and all these don’t they reflect what one khalq called attempts at self soothing aren’t all these mere reactions to very active troll I suggested yes they are in other words I say that all VP DS all people with borderline are in a permanent state permanent post traumatic State never ending never ceasing not for a second they are embedded in their trauma entangled with a trauma inseparable from their trauma they are their trauma I refer you to a March 2018 article in the world Journal
23:23 of Psychiatry by Jill Scott COO and jealous topple an Estella is an aside with these names I would also end up in psychiatry so this article deals exactly with these issues so what’s it what’s the differential how do we differentiate see PTSD from BPD if someone comes to us and we see you know emotional dysregulation these they’re acting out negative self cognitions all dismiss do we see an active trauma should we just because it’s an active trauma rule out borderline personality of Psychiatry by Jill Scott COO and jealous topple an Estella is an aside with these names I would also end up in psychiatry so this article deals exactly with these issues so what’s it what’s the differential how do we differentiate see PTSD from BPD if someone comes to us and we see you know emotional dysregulation these they’re acting out negative self cognitions all dismiss do we see an active trauma should we just because it’s an active trauma rule out borderline personality
24:03 disorder or should we say the hell with it it’s a borderline person with an active trauma in other words what’s the primary diagnosis is the primary diagnosis borderline and the C PTSD is a kind of symptom like temperature in covered 19 fever in covered 19 is the precipitous D the fever the fever aspect the symptomatic aspect of borderline personality disorder and when the trauma is not active the borderline is asymptomatic to use pandemic vocabulary or should we make a clear distinction disorder or should we say the hell with it it’s a borderline person with an active trauma in other words what’s the primary diagnosis is the primary diagnosis borderline and the C PTSD is a kind of symptom like temperature in covered 19 fever in covered 19 is the precipitous D the fever the fever aspect the symptomatic aspect of borderline personality disorder and when the trauma is not active the borderline is asymptomatic to use pandemic vocabulary or should we make a clear distinction
24:42 between these two and that’s exactly the big debate today in psychiatry a debate to which I will induct you I will introduce you the rudiments of this debate some there’s a group of scholars who say there is a clear demarcation a clear distinction between C PTSD and borderline personality disorder in death the way it should be because borderlines these scholars see borderlines are frantically trying to avoid abandonment the efforts to avoid abandonment this distinguished borderline from someone between these two and that’s exactly the big debate today in psychiatry a debate to which I will induct you I will introduce you the rudiments of this debate some there’s a group of scholars who say there is a clear demarcation a clear distinction between C PTSD and borderline personality disorder in death the way it should be because borderlines these scholars see borderlines are frantically trying to avoid abandonment the efforts to avoid abandonment this distinguished borderline from someone
25:25 with PTSD simplicity borderlines of identity disturbance identity diffusion we discussed it in many of the videos they have an unstable sense of self they don’t know who they are to use a colloquial sentence that’s not typical of civility waterlines have unstable and intense interpersonal relationships borderlines are impulsive and so say these experts this elements alone are enough to distinguish borderline from CPD see someone comes to you with CP DS DS is not likely to be afraid of abandonment terrified terrified of with PTSD simplicity borderlines of identity disturbance identity diffusion we discussed it in many of the videos they have an unstable sense of self they don’t know who they are to use a colloquial sentence that’s not typical of civility waterlines have unstable and intense interpersonal relationships borderlines are impulsive and so say these experts this elements alone are enough to distinguish borderline from CPD see someone comes to you with CP DS DS is not likely to be afraid of abandonment terrified terrified of
26:03 abandonment is not likely to engage for example in pre-emptive abandonment which are described in several of my videos he is likely to have a very stable kernel or core what young watch him called constellated self what Freud called the trial a trilateral more ego in heed so it’s likely someone comes to you with C PTSD is not likely to have problematic interpersonal relationships anything is these are the results of his C PTSD not the cause in other words because he had acquired si PTSD that affected abandonment is not likely to engage for example in pre-emptive abandonment which are described in several of my videos he is likely to have a very stable kernel or core what young watch him called constellated self what Freud called the trial a trilateral more ego in heed so it’s likely someone comes to you with C PTSD is not likely to have problematic interpersonal relationships anything is these are the results of his C PTSD not the cause in other words because he had acquired si PTSD that affected
26:40 relationships which otherwise used to be stable and not intense and finally people with civilians they are not impulsive they don’t have a problem to delay gratification they foresee the consequences of their actions and they allow these consequences to affect the decision-making process they’re also much more empathic consequently so in the European Journal of psychopharmacology 2014 you can read an article by Croatoan gar vert in Bryant which presents this point of view other scholars disagree Julianne Ford in relationships which otherwise used to be stable and not intense and finally people with civilians they are not impulsive they don’t have a problem to delay gratification they foresee the consequences of their actions and they allow these consequences to affect the decision-making process they’re also much more empathic consequently so in the European Journal of psychopharmacology 2014 you can read an article by Croatoan gar vert in Bryant which presents this point of view other scholars disagree Julianne Ford in
27:20 court wah for example disagree they say that complex post-traumatic stress disorder includes dysregulation in emotions process processing they say people with CP T is d the first thing you see is that they cannot regulate their emotions they come to the they come to the session to the therapy session they start to cry or they fall apart in front of your very eyes and sometimes the falling apart is so abrupt that we can you might as well call it switching between self states very similar to multiple personality disorder court wah for example disagree they say that complex post-traumatic stress disorder includes dysregulation in emotions process processing they say people with CP T is d the first thing you see is that they cannot regulate their emotions they come to the they come to the session to the therapy session they start to cry or they fall apart in front of your very eyes and sometimes the falling apart is so abrupt that we can you might as well call it switching between self states very similar to multiple personality disorder
27:53 so emotional dysregulation is critical part of C PTSD se call to inform self organization relational security are also affected by this regulation the level of organization of the personality under perpetuated stress and repeated trauma the level of organization goes down the personality becomes much less organized much more chaotic the self organization is disregulated relational security is affected in other words these people gradually come to distrust their partners they come to expect their partners to harm them and so emotional dysregulation is critical part of C PTSD se call to inform self organization relational security are also affected by this regulation the level of organization of the personality under perpetuated stress and repeated trauma the level of organization goes down the personality becomes much less organized much more chaotic the self organization is disregulated relational security is affected in other words these people gradually come to distrust their partners they come to expect their partners to harm them and
28:31 hurt them thus paranoid the secretary ideation they create the secretary object they expect abandonment and rejection and they act in advance to forestall or to regain control of perceived abandon and projected or anticipated abandonment very similar to BPD and so they said the only difference between CPT Sdn and borderline is that we know more what is borderline there’s a reason for the arguments they say borderline is a kind of basket clinical entity diagnosis category whatever it’s like we throw hurt them thus paranoid the secretary ideation they create the secretary object they expect abandonment and rejection and they act in advance to forestall or to regain control of perceived abandon and projected or anticipated abandonment very similar to BPD and so they said the only difference between CPT Sdn and borderline is that we know more what is borderline there’s a reason for the arguments they say borderline is a kind of basket clinical entity diagnosis category whatever it’s like we throw
29:07 them everything doesn’t fit anywhere else we throw into borderline this heterogeneity of the diagnosis is so gigantic so enormous that the diagnosis is actually prophetic in other words it’s not malevolent it’s not clear-cut give me any ten patients and if I tweak a little tweak a little their parameters I can claim that all of them are have borderline personalities because what is not included in borderline narcissism in borderline psychopath a borderline impulse control borderline defines borderline them everything doesn’t fit anywhere else we throw into borderline this heterogeneity of the diagnosis is so gigantic so enormous that the diagnosis is actually prophetic in other words it’s not malevolent it’s not clear-cut give me any ten patients and if I tweak a little tweak a little their parameters I can claim that all of them are have borderline personalities because what is not included in borderline narcissism in borderline psychopath a borderline impulse control borderline defines borderline
29:43 abandonment borderline dysregulation negative automatic thoughts and you name it it’s in borderline has never been under egg gnosis so open-ended that everyone and his therapist fit into it heterogeneity is a problem in the heterogeneity is to do with the fact that each and every one of us reacts very differently to psychological trauma so if we have comorbidity if we have a mental health condition that goes together with trauma with post-traumatic stress disorder if we with dissociated big parts of our childhood and childhood abandonment borderline dysregulation negative automatic thoughts and you name it it’s in borderline has never been under egg gnosis so open-ended that everyone and his therapist fit into it heterogeneity is a problem in the heterogeneity is to do with the fact that each and every one of us reacts very differently to psychological trauma so if we have comorbidity if we have a mental health condition that goes together with trauma with post-traumatic stress disorder if we with dissociated big parts of our childhood and childhood
30:26 abuse if our effect is dysregulated so if we have always of course we will present differently each one of us would present totally differently but still as you see it wants to do all of this is to do we trauma and how we react to trauma so in other words the author’s asking and I’m asking as well how on earth can you dissociate can you disconnect can you detach poor the line from trauma borderline personality disorder is meaningless if we take away the traumatic etiology meaningless at least that’s what I teach abuse if our effect is dysregulated so if we have always of course we will present differently each one of us would present totally differently but still as you see it wants to do all of this is to do we trauma and how we react to trauma so in other words the author’s asking and I’m asking as well how on earth can you dissociate can you disconnect can you detach poor the line from trauma borderline personality disorder is meaningless if we take away the traumatic etiology meaningless at least that’s what I teach
31:07 my students borderline personality disorder is actually an elaborate form of complex PTSD a form of complex PTSD with emphasis on some behavioral and trait dimensions there are those who go as far like kulkarni the go as far as suggesting to strap to delete borderline personality disorder altogether and to replace it with a much wider category called emotional dysregulation or emotional regulation disorder within which there will be secret eesti I refer you to Kulkarni’s article March 2017 in my students borderline personality disorder is actually an elaborate form of complex PTSD a form of complex PTSD with emphasis on some behavioral and trait dimensions there are those who go as far like kulkarni the go as far as suggesting to strap to delete borderline personality disorder altogether and to replace it with a much wider category called emotional dysregulation or emotional regulation disorder within which there will be secret eesti I refer you to Kulkarni’s article March 2017 in
31:53 Australasian psychiatry some academic journal another discovery over the years was it our reaction to trauma or the very fact that we experience trauma is crucially dependent not only on internal factors but on social support and are on our attachment style and attachment figures if we have very high level of social support if we are loved if we are surrounded by our loved ones nearest and dearest if we have relatively healthy attachment style we are very unlikely to experience strong mind that’s what I told you that the Australasian psychiatry some academic journal another discovery over the years was it our reaction to trauma or the very fact that we experience trauma is crucially dependent not only on internal factors but on social support and are on our attachment style and attachment figures if we have very high level of social support if we are loved if we are surrounded by our loved ones nearest and dearest if we have relatively healthy attachment style we are very unlikely to experience strong mind that’s what I told you that the
32:38 incidence of trauma is much less than people make out to make it out to be online people safe diagnose or rely on anecdotes or my my neighbor’s aunt told me that I’m traumatized not trauma is rare because most people have some some form of social support in the vast majority of people believe it or not have a healthy attachment style frustrated by others mainly abuses but still vast majority are healthy attached I can prove it by the way musketry do people have children hospital review of people had very good incidence of trauma is much less than people make out to make it out to be online people safe diagnose or rely on anecdotes or my my neighbor’s aunt told me that I’m traumatized not trauma is rare because most people have some some form of social support in the vast majority of people believe it or not have a healthy attachment style frustrated by others mainly abuses but still vast majority are healthy attached I can prove it by the way musketry do people have children hospital review of people had very good
33:11 relations with their children so attachment healthy attachment is much more common the dysfunctional attachment like for example avoidant attachment and so when we give social support and healthy attachment we don’t have trauma and there’s been a study in academic journal advances in psychiatric treatment volume 15 issue 3 where this has been conclusively demonstrated in the same article they made a comparison between complex PTSD and borderline personalities and here are the differences they found in my view relations with their children so attachment healthy attachment is much more common the dysfunctional attachment like for example avoidant attachment and so when we give social support and healthy attachment we don’t have trauma and there’s been a study in academic journal advances in psychiatric treatment volume 15 issue 3 where this has been conclusively demonstrated in the same article they made a comparison between complex PTSD and borderline personalities and here are the differences they found in my view
33:53 differences in degree quantitative differences not qualitative but you be judge the judges in complex PTSD does impaired affect modulation effect is how we express our emotions so we have an impaired effect modulation we express our emotions wrongly it could be wrong effect fled effect bed effect whatever we kind of there’s a disconnect between how we feel and what other people see from the outside that we are feeling they it’s easy to misunderstand how we are feeling because we don’t express our differences in degree quantitative differences not qualitative but you be judge the judges in complex PTSD does impaired affect modulation effect is how we express our emotions so we have an impaired effect modulation we express our emotions wrongly it could be wrong effect fled effect bed effect whatever we kind of there’s a disconnect between how we feel and what other people see from the outside that we are feeling they it’s easy to misunderstand how we are feeling because we don’t express our
34:35 emotions properly so in complex PTSD there’s impaired effect modulation in borderline this impulsivity in at least two potentially self damaging areas recurrent suicidal thoughts instability inappropriate intense anger or difficulty in controlling and so they’re comparing impaired affect modulation with impulsivity and of course impulsivity is usually the outcome of a disconnect with your emotions it’s compensatory it’s soothing but it also reflects the fact that you’re not in emotions properly so in complex PTSD there’s impaired effect modulation in borderline this impulsivity in at least two potentially self damaging areas recurrent suicidal thoughts instability inappropriate intense anger or difficulty in controlling and so they’re comparing impaired affect modulation with impulsivity and of course impulsivity is usually the outcome of a disconnect with your emotions it’s compensatory it’s soothing but it also reflects the fact that you’re not in
35:13 touch with yourself in complex PTSD according to the authors there’s dissociative symptoms in borderline personality disorder stress-related paranoid ideation or severe dissociation right this right said before I think if these are better semadar of quantity lot of quality while in complex PTSD there would be dissociative symptoms he will lose minutes though in borderline you could lose hours or days so severe dissociation or you could have D realization with depersonalization identity is persistently unstable this touch with yourself in complex PTSD according to the authors there’s dissociative symptoms in borderline personality disorder stress-related paranoid ideation or severe dissociation right this right said before I think if these are better semadar of quantity lot of quality while in complex PTSD there would be dissociative symptoms he will lose minutes though in borderline you could lose hours or days so severe dissociation or you could have D realization with depersonalization identity is persistently unstable this
35:51 unstable self-image or even sense of self and there’s a chronic feeling of emptiness in borderline but of course again it’s a question of quantity because if dissociation is all pervasive if it’s strong enough how will you form an identity if you keep forgetting things if you don’t have continuous memory how can you have a continuous identity I have a lecture that I gave in a university in Russia it’s available online it’s called identity in memory can have a deeper look there and finally the authors unstable self-image or even sense of self and there’s a chronic feeling of emptiness in borderline but of course again it’s a question of quantity because if dissociation is all pervasive if it’s strong enough how will you form an identity if you keep forgetting things if you don’t have continuous memory how can you have a continuous identity I have a lecture that I gave in a university in Russia it’s available online it’s called identity in memory can have a deeper look there and finally the authors
36:28 suggested in complex PTSD this impaired insecure relationships with others while in borderline their frantic efforts to avoid real or imagined abandonment and a pattern of unstable relationships I want to quote something written by one of the foremost European experts there Bryant is by the Australian but he works with Europeans mostly not with Americans clever chap so Bryant wrote in American Journal of Psychiatry August 2010 an article and I found one of the paragraphs very pertinent to our to our suggested in complex PTSD this impaired insecure relationships with others while in borderline their frantic efforts to avoid real or imagined abandonment and a pattern of unstable relationships I want to quote something written by one of the foremost European experts there Bryant is by the Australian but he works with Europeans mostly not with Americans clever chap so Bryant wrote in American Journal of Psychiatry August 2010 an article and I found one of the paragraphs very pertinent to our to our
37:11 discourse I will quote him now see PTSD shares certain properties with borderline personality disorder imagine that it’s an Australian accent another very good at imitating borderline see PTSD share certain properties with borderline personality disorder but the latter borderline is distinguished by its emphasis on severe be Averill and emotional dysregulation in fear of abandonment rather than PTSD symptoms what are you saying in effect the two diagnoses are coterminous they are same but the emphasis is different discourse I will quote him now see PTSD shares certain properties with borderline personality disorder imagine that it’s an Australian accent another very good at imitating borderline see PTSD share certain properties with borderline personality disorder but the latter borderline is distinguished by its emphasis on severe be Averill and emotional dysregulation in fear of abandonment rather than PTSD symptoms what are you saying in effect the two diagnoses are coterminous they are same but the emphasis is different
37:50 the emphasis is different in Porter line the emphasis is on behavioral problems emotional dysregulation fear of abandonment chaotic personality structure insipid easily resolved obvious but the emphasis is on the trauma on PTSD he continues pranked 2010 whereas some studies of borderline personality report increased reactivity to stimuli as would be expected in patients with PTSD other studies are found that patients with borderline personality disorder are characterized by elevated Toni tonic levels of emotional intensity but not the emphasis is different in Porter line the emphasis is on behavioral problems emotional dysregulation fear of abandonment chaotic personality structure insipid easily resolved obvious but the emphasis is on the trauma on PTSD he continues pranked 2010 whereas some studies of borderline personality report increased reactivity to stimuli as would be expected in patients with PTSD other studies are found that patients with borderline personality disorder are characterized by elevated Toni tonic levels of emotional intensity but not
38:34 increased reactivity and this is the famous distinction between shine shine borderline quiet quiet borderlines and real motor lights a totally spurious unsubstantiated non clinical nonsensical distinction very very similar to impacts in other trash online there is no such thing as shy of white borderline all border lines are sometimes shy and quiet and then they are emotionally intense but they don’t show it they are not they don’t have increased reactivity and at other times they’re very same border increased reactivity and this is the famous distinction between shine shine borderline quiet quiet borderlines and real motor lights a totally spurious unsubstantiated non clinical nonsensical distinction very very similar to impacts in other trash online there is no such thing as shy of white borderline all border lines are sometimes shy and quiet and then they are emotionally intense but they don’t show it they are not they don’t have increased reactivity and at other times they’re very same border
39:19 lights suddenly erupt lose impulse control become defiant psychopathic and courageously misbehave they externalize their aggression in the form of secondary psychopathy all border lines are both it’s not true that a shy borderline would never ever aggress against someone again it’s a self aggrandizing self slapped label I am a borderline but I am NOT a bad person because I never hurt other people I I’m an empath I’m 100% victim I didn’t do anything wrong to deserve this don’t you see what’s going on these are lights suddenly erupt lose impulse control become defiant psychopathic and courageously misbehave they externalize their aggression in the form of secondary psychopathy all border lines are both it’s not true that a shy borderline would never ever aggress against someone again it’s a self aggrandizing self slapped label I am a borderline but I am NOT a bad person because I never hurt other people I I’m an empath I’m 100% victim I didn’t do anything wrong to deserve this don’t you see what’s going on these are
40:06 narcissistic grandiose defenses these people are probably covert narcissists and continuing with bright complex PTSD is also conceptually similar to disorder of extreme stress not otherwise specified that’s a diagnosis in the DSM so complex PTSD is also conceptually similar to disorder of extreme stress not otherwise specified which in addition to PTSD symptoms is often described as having alterations in self identity self directed harm and chaotic relationships in other words disorder of extreme narcissistic grandiose defenses these people are probably covert narcissists and continuing with bright complex PTSD is also conceptually similar to disorder of extreme stress not otherwise specified that’s a diagnosis in the DSM so complex PTSD is also conceptually similar to disorder of extreme stress not otherwise specified which in addition to PTSD symptoms is often described as having alterations in self identity self directed harm and chaotic relationships in other words disorder of extreme
40:46 stress not otherwise specified is a very long phrase to describe essentially bottom-line and PTSD as Bryant admits it’s very similar to this and so groups of groups of scholars decided enough is enough including Bryant by the way enough is enough let’s test let’s see who is who what is what and who is right so between 2010 Tara 14 I’m sorry in 2020 there are a series of studies very very big studies and with interesting results before I go into these studies I would like to introduce you to a methodology a stress not otherwise specified is a very long phrase to describe essentially bottom-line and PTSD as Bryant admits it’s very similar to this and so groups of groups of scholars decided enough is enough including Bryant by the way enough is enough let’s test let’s see who is who what is what and who is right so between 2010 Tara 14 I’m sorry in 2020 there are a series of studies very very big studies and with interesting results before I go into these studies I would like to introduce you to a methodology a
41:30 research methodology called LCA NCA is a is methodology that allows us to reveal differences between classes of people and so on LCA is is short for latent latent close analysis it’s a measurement model in which individuals can be classified in two mutually exclusive and exhaustive types so we have groups that have nothing to do with each other these are called the latent classes based on their pattern of answers on a set of categorical indicator variables in other words they are interviewed research methodology called LCA NCA is a is methodology that allows us to reveal differences between classes of people and so on LCA is is short for latent latent close analysis it’s a measurement model in which individuals can be classified in two mutually exclusive and exhaustive types so we have groups that have nothing to do with each other these are called the latent classes based on their pattern of answers on a set of categorical indicator variables in other words they are interviewed
42:09 there’s a series of structured interviews in question years very long they answer these and then they’re divided into groups that have nothing with each other nothing in common with each other these are called latent classes and it’s a bit similar to factor analysis it’s also a measurement model but now factor analysis has discrete indicators so factor analysis analyzes factors factor 1 2 3 this factor analysis for example for personality it has five factors but five no continuity there’s a series of structured interviews in question years very long they answer these and then they’re divided into groups that have nothing with each other nothing in common with each other these are called latent classes and it’s a bit similar to factor analysis it’s also a measurement model but now factor analysis has discrete indicators so factor analysis analyzes factors factor 1 2 3 this factor analysis for example for personality it has five factors but five no continuity
42:46 just one two three four five as though we were all fragmented into five portions which of course is not true so today most scholars most researchers prefer LC a latent class analysis latency gives you continuty gives you a spectrum of responses and so in 2004 the aforementioned Australian from Down Under Bryant gar vert and Claude clutter which we have mentioned before they set out to determine who is who now who is doing what to whom and why and allow me to quote their research rationale their just one two three four five as though we were all fragmented into five portions which of course is not true so today most scholars most researchers prefer LC a latent class analysis latency gives you continuty gives you a spectrum of responses and so in 2004 the aforementioned Australian from Down Under Bryant gar vert and Claude clutter which we have mentioned before they set out to determine who is who now who is doing what to whom and why and allow me to quote their research rationale their
43:27 research goals they said we set out to determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse these patterns of symptoms whether they form classes classes that are consistent with diagnostic criteria for PTSD complex PTSD in borderline personality disorder in other words they went from the tail to the head so certainly women come to us they complain of childhood abuse usually sexual women come to us the complain of childhood abuse and they display symptoms and these symptoms research goals they said we set out to determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse these patterns of symptoms whether they form classes classes that are consistent with diagnostic criteria for PTSD complex PTSD in borderline personality disorder in other words they went from the tail to the head so certainly women come to us they complain of childhood abuse usually sexual women come to us the complain of childhood abuse and they display symptoms and these symptoms
44:01 coalesce into clusters into patterns now let us see if these symptoms form latent clauses in other words let’s see if this seemed too congregate or coalesce around the core that is different for each disorder to put it much more simply let’s see if PTSD see PTSD a borderline have different classes of symptoms the latent class analysis revealed I’m continuing to quote from the study the latent class analysis revealed 44 distinct classes of individuals a low symptom class characterized by no endorsements of all coalesce into clusters into patterns now let us see if these symptoms form latent clauses in other words let’s see if this seemed too congregate or coalesce around the core that is different for each disorder to put it much more simply let’s see if PTSD see PTSD a borderline have different classes of symptoms the latent class analysis revealed I’m continuing to quote from the study the latent class analysis revealed 44 distinct classes of individuals a low symptom class characterized by no endorsements of all
44:45 symptoms kind of simmering simmering post-traumatic condition a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define complex PTSD and borderline diagnosis in other words people with PTSD had symptoms that were in a class of their own and had very little to do with the symptoms of C PTSD and BPD the third group was a complex PTSD Klotz characterized by elevated symptoms of PTSD and self-organization symptoms that defined the complex PTSD cap diagnosis symptoms kind of simmering simmering post-traumatic condition a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define complex PTSD and borderline diagnosis in other words people with PTSD had symptoms that were in a class of their own and had very little to do with the symptoms of C PTSD and BPD the third group was a complex PTSD Klotz characterized by elevated symptoms of PTSD and self-organization symptoms that defined the complex PTSD cap diagnosis
45:25 but were low on the symptoms of BPD borderline now that’s the best interesting part the class of symptoms of C PTSD had a lot to do with a class of symptoms of PTSD but very little to do with the class of symptoms of borderline and there was a fourth the borderline class online personality disorder class characterized by symptoms of borderline personality so and that’s all they continued for borderline personality disorder symptoms were found to greatly increase the odds of being in the borderline class compared to the but were low on the symptoms of BPD borderline now that’s the best interesting part the class of symptoms of C PTSD had a lot to do with a class of symptoms of PTSD but very little to do with the class of symptoms of borderline and there was a fourth the borderline class online personality disorder class characterized by symptoms of borderline personality so and that’s all they continued for borderline personality disorder symptoms were found to greatly increase the odds of being in the borderline class compared to the
46:06 complex PTSD class so there were four symptoms that were much more likely to be found in the borderline class than in the cpt C PTSD clause for symptoms is a lot so if we really have a situation where BPD has four symptoms that see PTSD doesn’t they’re not the same and these are the symptoms they found one frantic efforts to avoid abandonment two unstable sense of self three unstable and intense interpersonal relationships for impulsiveness these were typical of borderline but not typical of see PTSD complex PTSD class so there were four symptoms that were much more likely to be found in the borderline class than in the cpt C PTSD clause for symptoms is a lot so if we really have a situation where BPD has four symptoms that see PTSD doesn’t they’re not the same and these are the symptoms they found one frantic efforts to avoid abandonment two unstable sense of self three unstable and intense interpersonal relationships for impulsiveness these were typical of borderline but not typical of see PTSD
46:50 according to the author’s six years of past our techniques improved our understanding of the borderline has changed dramatically today’s to today’s knowledge of borderline is absolutely I would even say nothing to do with our knowledge of borderline twenty years ago for example today we conceive of female borderline personality disorder is a manifestation expression of secondary psychopathy in females secondary reactives recover in females totally new today we understand that BPD has such pronounced according to the author’s six years of past our techniques improved our understanding of the borderline has changed dramatically today’s to today’s knowledge of borderline is absolutely I would even say nothing to do with our knowledge of borderline twenty years ago for example today we conceive of female borderline personality disorder is a manifestation expression of secondary psychopathy in females secondary reactives recover in females totally new today we understand that BPD has such pronounced
47:32 dissociative features that possibly it’s in the class of dissociative disorders rather than personality disorders and so on so today we are we are beginning to see a different picture on the line and consequently this year karate Asst in Chadron two scholars publish a new study in in academic journal called personality disorders theory research and treatment vol 11 issue one 2020 and what they have done they have essentially replicated the 2014 experiment or a study of Bryant and others they replicated it and they came dissociative features that possibly it’s in the class of dissociative disorders rather than personality disorders and so on so today we are we are beginning to see a different picture on the line and consequently this year karate Asst in Chadron two scholars publish a new study in in academic journal called personality disorders theory research and treatment vol 11 issue one 2020 and what they have done they have essentially replicated the 2014 experiment or a study of Bryant and others they replicated it and they came
48:23 to dramatically different conclusions so you can say before episode you can say so so who should we believe of course it’s easy for me to say I believe the latest I tend to believe that see PTSD borderline personality psychopathy narcissism they are only indistinguishable they’re single clinical entity with different emphases so it’s I like this I love the result in 2020 and I dislike the result in 2014 but science is not about liking or disliking even psychology which is not a science is not about liking it to dramatically different conclusions so you can say before episode you can say so so who should we believe of course it’s easy for me to say I believe the latest I tend to believe that see PTSD borderline personality psychopathy narcissism they are only indistinguishable they’re single clinical entity with different emphases so it’s I like this I love the result in 2020 and I dislike the result in 2014 but science is not about liking or disliking even psychology which is not a science is not about liking it
49:00 dislike you must look at the facts but I still vote for the 2020 study for several methodological reasons which I don’t want to go into right now one of which is our developing understanding of borderline personality but I think another is that I believe that in the original study of 2014 the definitions the parameters diagnostic parameters for each of these categories in my view could have been improved and I’m trying to be charitably understated while in the karate arson Shevlin study I found dislike you must look at the facts but I still vote for the 2020 study for several methodological reasons which I don’t want to go into right now one of which is our developing understanding of borderline personality but I think another is that I believe that in the original study of 2014 the definitions the parameters diagnostic parameters for each of these categories in my view could have been improved and I’m trying to be charitably understated while in the karate arson Shevlin study I found
49:45 some good work as far as differential diagnosis so let’s see what they have to say I am quoting complex post-traumatic stress disorder see PTSD has been included as a diagnostic category in the International classification of diseases 11th edition consisting of six symptom clusters the three PTSD criteria for layoffs re-experiencing avoidance and hyper vigilance in addition to three disturbances of self-organization symptoms defined as emotional dysregulation interpersonal difficulties and negative self-concept a spotter line some good work as far as differential diagnosis so let’s see what they have to say I am quoting complex post-traumatic stress disorder see PTSD has been included as a diagnostic category in the International classification of diseases 11th edition consisting of six symptom clusters the three PTSD criteria for layoffs re-experiencing avoidance and hyper vigilance in addition to three disturbances of self-organization symptoms defined as emotional dysregulation interpersonal difficulties and negative self-concept a spotter line
50:27 personality disorder shares similar features to disturbances of self organization presentations and as borderline personality disorder is commonly associated with PTSD there is a debate as to whether and how CP C PTSD is distinct from PTSD comorbid with BPD in other words what they are saying is if we have someone with borderline who has PTSD maybe this is say PTSD maybe the patients who come to us with CP SD are borderlines who have just been traumatized this article the authors continue this article aimed to identify personality disorder shares similar features to disturbances of self organization presentations and as borderline personality disorder is commonly associated with PTSD there is a debate as to whether and how CP C PTSD is distinct from PTSD comorbid with BPD in other words what they are saying is if we have someone with borderline who has PTSD maybe this is say PTSD maybe the patients who come to us with CP SD are borderlines who have just been traumatized this article the authors continue this article aimed to identify
51:07 groups with distinct profiles of self-reported see PTSD and BPD symptoms and associated trauma history characteristics a latent class analysis using C PTSD and BP t symptom variables was conducted on a sample of 195 treatment seeking adults at especially strong a service the classes were then compared on demographic and clinical characteristics using a series of analysis of variance in he to this kind of statistical test the latent class analysis determined three distinct classes before I proceed you remember groups with distinct profiles of self-reported see PTSD and BPD symptoms and associated trauma history characteristics a latent class analysis using C PTSD and BP t symptom variables was conducted on a sample of 195 treatment seeking adults at especially strong a service the classes were then compared on demographic and clinical characteristics using a series of analysis of variance in he to this kind of statistical test the latent class analysis determined three distinct classes before I proceed you remember
51:50 that a 2014 study found four classes and they had nothing to do with each other with one exception the C PTSD class had some elements of the PTSD class but according to two drew south on 2014 study there was no overlap between the diagnoses they were clearly demarcated and the differential diagnosis were very strict and boundary this study came up with three no four three classes a CBT is the high BPD class characterized by high symptom endorsement across both conditions so the first class of people that a 2014 study found four classes and they had nothing to do with each other with one exception the C PTSD class had some elements of the PTSD class but according to two drew south on 2014 study there was no overlap between the diagnoses they were clearly demarcated and the differential diagnosis were very strict and boundary this study came up with three no four three classes a CBT is the high BPD class characterized by high symptom endorsement across both conditions so the first class of people
52:29 had C PTSD and very high borderline borderline personalities or extreme borderline personalities and they had high symptoms very greater symptoms of both conditions comorbid second group of people second class a CPT is the moderate BPD class characterized by IC PTSD and high disturbance of self-organization symptom endorsements and moderate borderline moderate BPD and and so this was the second group the second group is like the PTSD were high the sort of post trauma post Rama symptoms of rare hi had C PTSD and very high borderline borderline personalities or extreme borderline personalities and they had high symptoms very greater symptoms of both conditions comorbid second group of people second class a CPT is the moderate BPD class characterized by IC PTSD and high disturbance of self-organization symptom endorsements and moderate borderline moderate BPD and and so this was the second group the second group is like the PTSD were high the sort of post trauma post Rama symptoms of rare hi
53:17 there was a disturbance in self perception self-organization the personality was ko ko Thais like some explosive device imploded or likely exploded or like sting personality imploded so that was very high but the BPD itself was moderate still pay attention in this second group we still have comorbidity we still have PTSD going hand-in-hand with with borderline in the third group similarly involves both PTSD and borderline they did not find a single class single group which had only produced or only borderline there was a disturbance in self perception self-organization the personality was ko ko Thais like some explosive device imploded or likely exploded or like sting personality imploded so that was very high but the BPD itself was moderate still pay attention in this second group we still have comorbidity we still have PTSD going hand-in-hand with with borderline in the third group similarly involves both PTSD and borderline they did not find a single class single group which had only produced or only borderline
54:03 they all people all hundred and ninety five participants had both so the third group was PTSD low borderline personality disorder class characterized by post-traumatic stress disorder symptoms and low disturbance of self organization and low borderline personality disorders symptom endorsement so here the trauma was the most expressed I suspect that had they interviewed narcissist immediately after modification they would have found this very high in PTSD and very low narcissism of grandiosity and very low disturbance of self they all people all hundred and ninety five participants had both so the third group was PTSD low borderline personality disorder class characterized by post-traumatic stress disorder symptoms and low disturbance of self organization and low borderline personality disorders symptom endorsement so here the trauma was the most expressed I suspect that had they interviewed narcissist immediately after modification they would have found this very high in PTSD and very low narcissism of grandiosity and very low disturbance of self
54:48 organization on the contrary I think modification enhances self organization which is a very new experience for the narcissist very shocking very traumatic in its in its way the to the offers continue the to see PTSD classes were associated with a greater exposure to multiple interpersonal traumas earlier in life both of them exhibited higher functional impairment findings they summarize the author’s summarized finding support the construct finding support the concern over see PTSD diagnosis as a separate organization on the contrary I think modification enhances self organization which is a very new experience for the narcissist very shocking very traumatic in its in its way the to the offers continue the to see PTSD classes were associated with a greater exposure to multiple interpersonal traumas earlier in life both of them exhibited higher functional impairment findings they summarize the author’s summarized finding support the construct finding support the concern over see PTSD diagnosis as a separate
55:27 entity although borderline personality disorder features seem to overlap greatly with Si PTSD symptoms in this highly traumatized clinical sample which of course begs the question if there’s such giant overlap why do we need to diagnosis that was precisely the problem with the DSM 4 there was such a huge overlap between cluster B personality disorder then every patient ended up with three diagnoses or four diagnosis it’s very common to find someone who’s been diagnosed with narcissistic entity although borderline personality disorder features seem to overlap greatly with Si PTSD symptoms in this highly traumatized clinical sample which of course begs the question if there’s such giant overlap why do we need to diagnosis that was precisely the problem with the DSM 4 there was such a huge overlap between cluster B personality disorder then every patient ended up with three diagnoses or four diagnosis it’s very common to find someone who’s been diagnosed with narcissistic
55:59 antisocial borderline and histrionic Personality Disorder plus mood disorder plus Erin what it’s ridiculous it’s ridiculous because clinical entities should be clearly demarcate the next leap that these authors should have done is to say with great courage let’s eliminate borderline it’s wrong there’s no such thing there is only a post from that single post traumatic state it may lead to expressed grandiosity and hyper vigilance related to that grandiosity then we have a narcissist it may lead to severe antisocial borderline and histrionic Personality Disorder plus mood disorder plus Erin what it’s ridiculous it’s ridiculous because clinical entities should be clearly demarcate the next leap that these authors should have done is to say with great courage let’s eliminate borderline it’s wrong there’s no such thing there is only a post from that single post traumatic state it may lead to expressed grandiosity and hyper vigilance related to that grandiosity then we have a narcissist it may lead to severe
56:39 abandonment anxiety hyper vigilance related to abandonment at rejection anticipation of Austin a hostile world and its reactions and so on and then we have borderline and then we also have secondary psychopathy as a reactive behavior or it may lead to desperate attempts to control the world impulsively aggressively violently at all cost dis empathically then we have an antisocial cluster B personality disorder are like the famous story of the elephant and the three scholars one scholar hugged the legs of the elephant abandonment anxiety hyper vigilance related to abandonment at rejection anticipation of Austin a hostile world and its reactions and so on and then we have borderline and then we also have secondary psychopathy as a reactive behavior or it may lead to desperate attempts to control the world impulsively aggressively violently at all cost dis empathically then we have an antisocial cluster B personality disorder are like the famous story of the elephant and the three scholars one scholar hugged the legs of the elephant
57:18 another touched the trunk of the elephant yet another touch his ears of course they had three totally different descriptions of the same animal we’re dealing with the same animal in the name of this animal is trauma another touched the trunk of the elephant yet another touch his ears of course they had three totally different descriptions of the same animal we’re dealing with the same animal in the name of this animal is trauma

Summary Link:

https://vakninsummaries.com/cptsd-or-borderline-pd-or-covert-narcissist-or-psychopath-or/

https://vakninsummaries.com/ (Full summaries of Sam Vaknin’s videos)

http://www.narcissistic-abuse.com/mediakit.html (My work in psychology: Media Kit and Press Room)

Bonus Consultations with Sam Vaknin or Lidija Rangelovska (or both) http://www.narcissistic-abuse.com/ctcounsel.html

http://www.youtube.com/samvaknin (Narcissists, Psychopaths, Abuse)

http://www.youtube.com/vakninmusings (World in Conflict and Transition)

http://www.narcissistic-abuse.com (Malignant Self-love: Narcissism Revisited)

http://www.narcissistic-abuse.com/cv.html (Biography and Resume)

Summary

Abuse, Borderline, Covert Narcissist, narcissism, narcissist, Personality, Psychology, Reality, Sam Vaknin, Trauma, Vaknin Summaries

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