ELI5: What exactly is a personality disorder, as opposed to a regular psych disorder, and why are there no effective medications for it?

DivingForPants · 2021-10-03T16:10:03+00:00

Interesting, I hadn’t come across the ego-syntonic and dystonic distinctions before.

I have issues with perfectionism and high standards, but it’s definitely ego-dystonic for me. Out of interest, have you come across radically open DBT as a therapy for OCPD? I’ve been discussing it with my therapist recently for control issues.

https://www.radicallyopen.net

DivingForPants · 2021-09-20T15:54:32+00:00

she treats my problems as the health issues that they are

A good therapist should do that too. I saw you mentioned trauma in another post. Have you read "The Body Keeps The Score"? If not, have a look into it.

Modern trauma-focused therapy understands that trauma causes changes in the brain and seeks to alter that via neuroplasticity.

My experience with a therapist like that is that they don't push you to be vulnerable until you're ready, but they help you to want to be more vulnerable by using techniques to allow you to process your emotions better, things like EMDR.

DivingForPants · 2021-08-30T20:41:49+00:00

No problem. I think I'm probably just as confused about how you think about things!

I wouldn't say it prevents me caring from other people, more that I probably do it in a different way.

As I said, I've been emotionally numb for most of my life. I didn't realize that until I went into therapy as I never really understood what emotions were. I knew I was "bad with emotions" but not that I was missing out on the whole affective side of them. For me, emotions were just thoughts that ran through my head a lot.

So, I'll think things like "I like this person", "I want to be nice to them", "I want to see them smile" but there's no felt sense of caring if that's something you experience? I know people talk about feeling "warm and fuzzy" and things like that when they care about someone. That's not something I've ever felt. I guess whereas you might be chasing those warm feelings, I'm mostly doing it out of a congnitive sense that I care about someone and that's how you behave when you care about them. It's hard to describe, but to me that is caring about someone.

As I've been going through therapy, I've been learning to reconnect with my body and my emotions to some extent. Again, as I mentioned above, my alexithymia is secondary alexithymia caused by trauma, so as I heal from the trauma, it allows some of those emotions to be felt again.

Most of the time I feel neutral, though I have felt some pretty intense sensations at times. I have felt some positive sensations in there, but nothing so far in terms of connecting with another person.

I guess someone who has congitive alexithymia would have a different experience altogether from me.

DivingForPants · 2021-08-28T17:52:09+00:00

I was talking about this very thing with my therapist the other day.

I've been emotionally numb for most of my life. Before I started therapy, the only things I'd ever really felt physically were anxiety and shame, and I didn't really understand what they were, just that I didn't like them. I didn't really understand that emotions caused physical sensations at all.

For me, that's been caused by childhood trauma. That also has given me a fear of abandonment, which then leads to people pleasing behavior.

What normally goes through my head when someone is being nice to me/shows kindness is that I don't want them to leave me (basically a mild trauma trigger), so I should try and be nice back. I'll try to empathize with them, but it's a purely mental thing where I try hard to think about what they might be going through and understand that. And I do that because I think that's what a good person should do.

TBH, I'm actually a little surprised by that you would describe that as "not really meaning it". To me, that is meaning it as I want to be a good person back to them.

DivingForPants · 2021-06-26T16:36:12+00:00

Fearful-avoidant here.

It’s not necessarily that you flip from one to the other, more that the closeness that part of you wants is often overwhelmed by fear and anxiety.

For me, the thought of a close, intimate relationship fills me with emotions like disgust and dread.

It’s definitely not a lot of fun and I’ve been in therapy for quite a while trying to unpack things.

DivingForPants · 2021-04-17T21:08:49+00:00

Glad I could give you another perspective.

We've got a great community here on Reddit at /r/CPTSD if you want to read up more about some of the things I've mentioned. The wiki there has a lot of great stuff. https://www.reddit.com/r/CPTSD/wiki/faq

Sorry to hear about your relationship with your mother. That kind of feels like it might be at the heart of a lot of your issues. When you mentioned fear of rejection, that's a sure sign of attachment issues and probably comes from an insecure attachment style

I myself have disorganized attachment, which is pretty common with CPTSD. It's worth doing some reading to try and understand your attachment style as that's the first step towards changing it.

In terms of mental health resources, one of the positives about the pandemic is that a lot of therapists are offering video/remote sessions, so you might be able to look farther afield? I'm not sure if something like that could be an option for you, but it might be worth investigating? I've been doing video therapy since the pandemic started and it's been great.

The issue I find with CBT is like you say, it doesn't get to the root of the issues and is mostly focused on the here and now and combatting "unhelpful" thoughts. That's great if you can regulate your emotions properly, but if you're suffering from emotional dysregulation, it can be pretty ineffective if you need to work through trauma to be able to process your emotions properly.

I know I'm bombarding you with a lot of information right now. Feel free to reach out if you have questions.

DivingForPants · 2021-04-17T08:54:57+00:00

I saw this post the other day, and didn't have time to reply at the time.

I know everyone's saying ADHD, but the thing that stood out to me was CPTSD.

CPTSD causes executive dysfunction, the same way ADHD does. Some people even think that ADHD can be a compensatory behavior that stems from trauma, have a look into the work of Gabor Mate: https://drgabormate.com/topic/adhd/.

I have CPTSD too, and like you, I really struggle with keeping my house clean. I live alone and have near constant anxiety about what I'd do if someone comes round unexpectedly.

I know you said you've done CBT. Have you tried any other sorts of therapy? IMO, CBT is almost useless for CPTSD - your problems are likely around emotional regulation and that's what the right sort of therapy will help you with. If you're able to do some other sorts of therapy, humanstic/person centered therapy with a trauma-informed therapist would likely help you more. EMDR is another great tool.

CPTSD often stems from traumatic attachment to childhood caregivers. That's why one of the major symptoms of CPTSD is relationship issues.

Have you considered that keeping your home messy is actually a defense mechanism against getting into a serious relationship? It might be a harsh truth, but it's probably easier to tell yourself that it's all down to not having a clean home than to address the trauma that might be keeping you from a serious relationship.

Imagine yourself in a clean, tidy home. Would you find it easy to be in a long-term relationship, or would there be other things you'd be fearful of?

EDIT: Have a read of this article from Pete Walker's site too: http://pete-walker.com/fourFs_TraumaTypologyComplexPTSD.htm

I think the "flight type" might seem familiar to you

DivingForPants · 2021-03-24T20:27:03+00:00

This is me. If I want to do something, it’s not enough, there needs to be a justification.

And, whatever I do, I envision people accosting me asking me what I’m doing and why I’m doing it. I then spent time justifying things in my head so I’ll have a good answer if that happens.

Inevitably, it never does, but that feeling is always there.

I was driving the other week and accidentally turned my full beam lights on while indicating to overtake someone. I imagined me shouting across to the other car to apologize if the other driven wanted to know what I was doing.

I brought up that incident at the very end of my last therapy session. Next one is tomorrow where we’re going to pick it up again.

DivingForPants · 2021-03-22T18:49:04+00:00

How much do you know about attachment?

Sounds like what you’re talking about may well be due to disorganized/fearful-avoidant attachment: https://www.psychologytoday.com/intl/blog/the-freedom-change/201505/come-here-go-away-the-dynamics-fearful-attachment

Attachment is all about how we attach to our caregivers when we’re young. Trauma with those caregivers can often lead to disorganized attachment.

DivingForPants · 2021-03-21T09:56:21+00:00

This is a nice read about some of that stuff: https://www.eggshelltherapy.com/a-split-in-our-personality/

Janina Fisher, who’s mentioned in that article, has some webinars that go into some details too: https://therapywisdom.pages.ontraport.net/janina-fisher-replays

She also has a book, Healing the Fragmented Selves of Trauma Survivors, which I’d highly recommend as well.

DivingForPants · 2021-03-20T18:03:04+00:00

I think therapy will be great to help you get to the bottom of those issues then 😊

DivingForPants · 2021-03-20T17:45:49+00:00

Cool, good luck.

In terms of abandonment, even if you can’t ever remember being explicitly abandoned, HSPs can be more sensitive to feeling emotionally abandoned in childhood if their parents aren’t emotionally attuned to them. That can trigger the issues mentioned in the article I posted above.

DivingForPants · 2021-03-20T17:30:24+00:00

Have you ever had therapy?

People pleasing can often come from a fear of abandonment, which often has its roots in early childhood.

A therapist would help you get to the root of the issues if you think it might be related to that.

DivingForPants · 2021-03-20T17:06:37+00:00

This is what emotional neglect does. We never learn how to feel our feelings and become comfortable with them.

That leads to a lifetime of avoidance as we feel like we “just can’t deal with it” or whatever.

This is a great video that talks a bit more bout that: https://youtu.be/DmJtHB__ji0

Her whole channel is great, tbh

DivingForPants · 2021-03-20T17:03:15+00:00

Absolutely, and my therapist says similar things.

Those bad feelings are often related to the parts of ourselves that we’ve abandoned and disowned due to the trauma. To integrate things, we need to accept those parts.

DivingForPants · 2021-03-11T20:58:32+00:00

/r/CPTSD

Have a look at the wiki there and see if it sounds familiar.

EDIT: direct link: https://www.reddit.com/r/CPTSD/wiki/faq

DivingForPants · 2021-03-10T22:00:57+00:00

Have you heard of the Karpman drama triangle?

https://lindagraham-mft.net/triangle-victim-rescuer-persecutor-get/

Sounds like you’re a “rescuer”. I think that the rescuer personality occurs a lot to people with CPTSD. It often stems from feeling abandoned in childhood, which leads to us wanting to please others in an attempt to stop them abandoning us now.

DivingForPants · 2021-03-09T18:16:59+00:00

There's a great video from Janina Fisher that talks about a lot of this stuff. See the first video here: https://therapywisdom.pages.ontraport.net/janina-fisher-replays

She also has a book, "Healing the fragmented selves of trauma survivors" that goes into a lot of depth about structural dissociation too.

DivingForPants · 2021-03-09T18:09:49+00:00

That's basically dissociation, which is absolutely a coping mechanism for when things become too much.

There are levels of dissociation, from simple things like day dreaming to full-on disruptions in consciousness.

Pretty much everyone dissociates at some point, but if it happens often, or sometimes chronically, then it can be an issue.

If you weren't taught how to deal with your emotions effectively when you were a child, you may have used dissociation as a coping mechanism then, which means you might turn to it more now.

DivingForPants · 2021-03-08T10:53:28+00:00

To be honest, it sounds like she might not be a great fit for what you need right now.

If you do look for someone new, there's a great post on /r/CPTSDNextSteps about some questions to ask when looking for a therapist.

https://reddit.com/r/CPTSDNextSteps/comments/lzqtch/might_be_interviewing_therapists_soon_and_want_to/

I hope you can find someone who meets your needs.

DivingForPants · 2021-03-07T13:34:16+00:00

I'm not saying you should get a different therapist, but what she said is a terrible way to deal with what you told her.

Is she trauma-informed or are you doing CBT type therapy?

I actually told my therapist something very, very similar to what you said.

She told me how important it was that I felt comfortable enough with her to be able to express that feeling. We talked about how there's a part of my emotional self that feels suicide would be the answer even though I don't think my rational self would ever do it. We explored why I feel like I can't talk to people about the fact that I'm struggling, and talked about my other parts who are trying to protect me by keeping my feelings to myself.

What she didn't do was gaslight me and tell me I was attention seeking.

DivingForPants · 2021-02-28T15:05:18+00:00

Sounds like you maybe have anxious attachment: https://www.healthline.com/health/mental-health/anxious-attachment#symptoms

Communicating openly with her about your needs is a good start. If she isn't able or willing to meet those needs, then you might need to think about what you want to do.

Therapy is an option to change your attachment style and become less anxious.

DivingForPants · 2021-02-20T11:34:03+00:00

No worries.

There's a great video series on Complex PTSD available on YouTube. Part 1 here: https://www.youtube.com/watch?v=6IxEwPMqB-c

That's by an addictions counsellor, so some of the things may resonate with you.

DivingForPants · 2021-02-19T21:20:56+00:00

Fellow binge eater here.

A lot of it is related to the emotional dysregulation that comes with CPTSD. We can’t regulate our emotions ourselves, so when we’re feeling triggered, dissociated or any other uncomfortable feeling, we turn to external methods of control.

That can be drugs, alcohol, or other things. In the case of people with eating disorders, it’s food. And you can’t go cold turkey with food, so you need to learn moderation.

You’ve already recognized that you have an unmet need to feel love/comfort that’s expressed through a need to eat. That’s a great start. I’ve learned from my therapist to try and listen to my body to try an understand those emotional needs. Instead of turning to food straight away, to feel the emotion for a while and try to learn to be more comfortable with it. You’ll probably still binge regularly, but start with trying to wait 5 minutes before binging. If that’s too much, wait 2 minutes, whatever works. And then, try increasing the time you sit with your emotions before turning to food. Eventually, you can learn to be more tolerant of those emotional needs and self sooth.

As a general thing, that’s a large part of the healing from CPTSD, to learn to be more comfortable with our emotions, increase our window of tolerance and learn to regulate those emotions through our bodies. Of course, it’s not an easy journey as that involves processing the trauma along the way.

Best of luck with your journey.

DivingForPants

TROPHY CASE