What is moral injury?

moral-injury-in-the-context-of-war

Moral injury (also known as soul injury), is a serious mental condition similar to PTSD that many Americans are suffering from right now under Trump’s increasingly threatening and authoritarian administration.   This condition is also very common among soldiers who are forced to commit acts that go against their conscience or violate their understanding of right from wrong.

According to Wikipedia, moral injury

refers to an injury to an individual’s moral conscience resulting from an act of perceived moral transgression which produces profound emotional shame. The concept of moral injury emphasizes the psychological, social, cultural, and spiritual aspects of trauma. Distinct from pathology, moral injury is a normal human response to an abnormal traumatic event.  The concept is currently used in literature about the mental health of military veterans who have witnessed or perpetrated an act in combat that transgressed their deeply held moral beliefs. Moral injury can also be experienced by those who have been transgressed against. For example, when one goes to war thinking that the purpose of the war is to eradicate weapons of mass destruction, but finds that not to be the case, the warrior can experience moral injury. Those who have seen and experienced death, mayhem, destruction, and violence have had their worldviews shattered – the sanctity of life, safety, love, health, peace, etc. – can suffer moral injury as well. This injury can also occur in the medical space – among physicians and other emergency or first responder care providers who engage in traumatic high impact work environments which can affect their mental health and well-being.

Moral injury or soul injury is quite common, and can affect entire populations.   It tends to separate people with a conscience and empathy from sociopaths, the latter of which are likely to be drawn to the very person or situation that is causing moral injury and PTSD to the normal population.

Since moral injury is closely related to PTSD, the symptoms are very similar.    Depression, sadness, and even suicidal ideation is common, especially if the victim sees no escape from the threatening situation or tyrannical leader/ government.

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It is under the spiritual perspective of moral injury that Lindsay Carey (Australia), John Swinton (UK) and Daniel Grossoehme (USA), provided a comprehensive holistic defintion of moral injury based on the systematic reviews of Jinkerson plus Hodgson and Carey. [30]

Moral injury is a trauma related syndrome caused by the lasting physical, psychological, social and spiritual impact of grievous moral transgressions or violations of an individual’s deeply held moral beliefs and/or ethical standards due to (i) the betrayal of what is right by trusted individuals who hold legitimate authority and/or (ii) by an individual perpetrating, failing to prevent, bearing witness to, or learning about inhumane acts which result in the pain, suffering or death of others and which fundamentally challenges the moral integrity of an individual, organisation or community.

The violation of deeply-held moral beliefs and ethical standards—irrespective of the actual context of trauma—can lead to considerable moral dissonance, which if unresolved, leads to the development of core and secondary symptoms that often occur concurrently.  The core symptoms commonly identifiable are: (a) shame, (b) guilt, (c) a loss of trust in self, others, and/or transcendental/ultimate beings, and (d) spiritual/existential conflict including an ontological loss of meaning in life.  These core symptomatic features, influence the development of secondary indicators such as (a) depression, (b) anxiety, (c) anger, (d) re-experiencing the moral conflict, (e) social problems (e.g., social alienation) and (f) relationship issues (e.g., collegial, spousal, family), and ultimately (g) self-harm (i.e., self-sabotage, substance abuse, suicidal ideation and death).

Moral injury can be treated with CBT and other psychotherapies, but not everyone has access to professional help.  Self care is of vital importance.  If the news is disturbing or upsetting to you, and is causing you PTSD-like symptoms, take breaks from it, or even ban it from your life altogether.   While it’s important to stay informed, if there’s a real emergency, you will find out about it.  Your mental health is more important than knowing every detail of what’s going on in the world or in the country.

Try to break the hypervigilance habit.  Many people feel more “in control” if they stay on top of current events, even following the slightest detail, but the reality is, outside of practical activities like voting, signing petitions, writing letters, or protesting, there isn’t much you can do to change things.   SItting around being depressed or worrying about what might happen in a week, or a few months, or a year can drive you crazy and make you miserable.   It will drain all the joy our of your life.  Keep in mind that even in the most undemocratic regimes, most people can still find moments of joy and love in the people and the world around them.  Anne Frank was such a person who remained hopeful even while interned in a concentration camp.   Obviously not everyone has the emotional makeup to remain that upbeat and brave, but her story has brought hope to millions.

Spend time with friends and family that you trust, obviously those who feel the same way as you do (things have become so polarized that you might have to avoid friends and family on the opposite side of the political spectrum, at least temporarily).   Be sure to spend time doing fun, nonpolitical things with your friends and family members, not just talking about politics and the news.   Of course there’s a place for that too.  If you want to feel like you’re making a difference, you can plan to attend protests as a group or have letter writing or phone call “parties.”

One way you can follow the news in a more lighthearted way is to watch the late night TV comedy shows, such as Saturday Night Live or Jimmy Kimmel, instead of cable or network news.     You will still get your news (in fact, these shows are often more accurate in reporting than actual news programs) but in a way that can make you laugh and see the lighter side of a very serious situation.    Gallows humor has its place, and can make an unpleasant or unbearable situation seem more tolerable.

Remember that if you are suffering from moral injury, there is nothing wrong with you.  In fact, it means you are functioning human being with a conscience, and you are merely reacting in a normal way to an abnormal situation.  Still, if the suffering becomes intolerable or you find it hard to function, it can’t hurt to seek counseling to learn coping skills.

Almost Sunrise is a documentary film about moral injury.  It focuses on returning soldiers, but should also be of interest to anyone suffering from this form of PTSD.    You can watch a short video and read an article about the film here:

Almost Sunrise / Moral Injury

According to their site, these are the most common symptoms of moral injury:

  • Overwhelming depression
  • Guilt or shame
  • Loss of meaning in life
  • Feelings of worthlessness, despair and remorse
  • Feeling like “I’ve lost a part of myself”
  • Feeling like “I do not know who I am anymore”
  • Feeling intense distrust
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Why doesn’t Trump ever talk about his mother?

Mary_Anne_Trump

Mary Anne MacLeod Trump

This is a very interesting article from Politico about Donald Trump’s relationship with his mother and what role she might have played in his personality development.   It’s interesting that he always praises his father but almost never talks about his mother, Mary.

The Mystery of Mary Trump

Most people who recognize Trump’s narcissism and sociopathy tend to think it was primarily his father who was to blame.   Fred Trump was very much like Donald, an emotionally distant and unsupportive taskmaster who instilled his own values of greed and materialism in his sons, and served as a role model for unscrupulous and dishonest behavior.   Donald Trump, the second youngest of five children and the middle son of three, felt unnoticed in his large family.  Desperate to gain the approval of his demanding father, who ruled his home with an iron fist, Donald essentially became a carbon copy of him.

Donald Trump Family

From left to right: Donald Trump, Fred C. Trump, Jr, Robert Trump, Elizabeth Trump, Maryanne Trump Barry.

 

While Fred Trump may have contributed to Trump’s character disorders,  it was his mother Mary who might have been unwittingly responsible for the development of his NPD (I know he has no official psychiatric diagnosis, but since he fits all 9 traits of NPD, I think it’s pretty safe to assume he has it, in addition to Antisocial Personality Disorder or sociopathy).

When Trump was two years old, Mary gave birth to his younger brother Robert.  While the birth of a younger sibling usually doesn’t pose a huge problem for toddlers other than the normal sibling rivalry,  the birth almost killed his mother and she was basically unable to care for Donald for two years due to her medical issues.

For a two year old, this is devastating.  Two year olds are too young to realize this may not be their mother’s fault and has nothing to do with a sudden withdrawal of love.  The child’s sense of self is still forming and the sudden emotional or physical absence of a parent (especially the mother) creates a void in the developing personality.    Attachment trauma before the age of 6 or so very often leads to personality disorders.  The toddler years, when the child is just learning they are a separate individual from the mother, are especially critical.

For Trump, “middle child syndrome,” combined with a father who was both unempathetic and a questionable role model, and a mother who was suddenly absent when Trump was a toddler, was a perfect storm of events that eventually led to Trump’s dangerous personality.   I also think the event that cemented his burgeoning personality disorder into place was his parents sending him away to military academy at the age of 13 — another critical age in psychological and moral development.  Being sent away to military academy both confirmed in Trump’s mind that he was too unloveable to be allowed to stay home, and further instilled hyper-masculine values that, combined with his narcissism and sociopathy, would lead to toxic masculinity and the worship of “strongmen” and dictators later on.   Almost sixty years later, he’s still trying to please his father and has taken America hostage in doing so.

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Donald Trump and his parents in the 1980s.

I find it both ironic and tragic that Trump is allowing Border Patrol and ICE agents to deliberately separate immigrant Hispanic children from their mothers and families.   Such egregious cruelty can only be carried out by someone who is lacking both a conscience and empathy.   Even if these children are eventually reunited with their parents (which is unlikely), they will almost certainly suffer serious psychological trauma, leading to attachment disorders such as RAD (reactive attachment disorder).  RAD very often leads to antisocial, borderline, and narcissistic personalities when these children reach adulthood if there is no psychological intervention.  At the very least they will struggle with lifelong C-PTSD and other trauma based disorders, especially if they are being farmed out to human traffickers.

It’s almost as if Trump is taking unconscious revenge on his mother for suddenly “abandoning” him by forcibly causing toddlers at the border to be separated from their mothers.

PTSD & the Blindness of the Just Man

A friend wrote this thought provoking post (closely related to the one I posted earlier today). Comments are disabled; please leave comments on the original post.

Unraveled and the Birth of Joy

blog image YodaLove will find a way where wolves fear to thread.
– Lord Byron

Recently I took part in a research study regarding OIF and OEF veterans with post-traumatic stress disorder, that was designed to examine how a vet’s PTSD affects present and past relationship partners.  Psychiatrists are discovering that the failure by our government to provide effective deprogramming to combat vets, and their resulting emotional suppression, disregulation, and too often infantile personality syndrome, is now resulting in widespread PTSD in “dependents” (wives, husbands, and children) and their romantic partners as well.

Seems incorrectly treated (or untreated) PTSD in combat vets is contagious.

The shameful truth is, this country keeps its soldiers ready for deployment – by medical suppression of symptoms and emotions (utilizing anti-depressants, anti-anxieties, and stigma propaganda) but largely does not make us of trigger normalization and cognitive therapy, known world-wide to help heal PTSD, and necessary for a…

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Part One: “Heart-Sync”– a psycho-spiritual therapy for trauma and attachment disorders.

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This article will be in two parts.

This part is a brief overview of HeartSync and how it works. The second part will be about my personal experience in Chapel Hill over the past four days.   I just returned today from a four day intensive spiritual/psychological retreat that addresses childhood trauma and helps you release that trauma to re-connect the various parts of your heart that were separated or dissociated due to trauma.   HeartSync attempts to re-synchronize the various parts of your “heart” (really different parts of the brain), to make you whole again, recognizing that God himself (Jesus) is the only one who can bring a person back together again and rebuild the neural pathways that were broken by a lack of early attachment to the mother.  The therapist is just a facilitator.

The goal is to release “trapped pain,” through emotional catharsis facilitated by “God as primary therapist.” Once the trapped pain is released, the person usually begins to see improvements. Sometimes this can be pretty dramatic (as I will describe later — we got to see four “live demonstrations”).

I can’t give you a exhaustive description of everything I learned, because there was so much information. In a nutshell, HeartSync is a type of trauma and attachment-therapy that merges psychoanalytic and traditional psychological modalities (including brain science) of healing with Christianity and spirituality.

It’s believed that anything can be healed with God/Jesus present in the therapy room guiding the session, but there are certain protocols that must be followed by the therapist, as with any other modality of psychotherapeutic healing.  The patient or client must also be willing and have at least some belief in God or Christianity for it to be effective.

An Overview of HeartSync

HeartSync was developed by Father Andrew Miller, an Anglican minister and licensed therapist (LCSW), using an intriguing combination of his knowledge of brain science, traditional psychology, psychoanalytic techniques, and Christ-centered spirituality used to heal trauma and “mend the brokenhearted.”

It is believed that there is no one with any disorder who cannot be healed–and not only that, healed much faster than using traditional, secular therapy–just by using HeartSync techniques.   Some people whose trauma doesn’t run too deep can be healed in a single session.   Others take longer, but it normally doesn’t take as long as traditional therapy, due to the presence of inviting God/Jesus into the sessions to direct the course of therapy.

Here is their website. 

Unfortunately, it’s under construction right now, so the information on the site right now is minimal and a bit hard to navigate.   I’ve been assured this is being worked on.

The human brain and its “core parts.”

All humans are made up of “core parts,” which make up the “heart” of a person.  These core parts correspond to various areas of the brain.   These “core parts” are:

Emotion (feelings, intuition, creativity, visual — overseen by Right Pre-frontal cortex).

Function (thinking, learning, language, beliefs, verbal — overseen by Left Pre-frontal cortex).

Original Self (The Identity Center; “who am I”? — this is overseen by the Orbital Prefrontal Cortex and regulates Dopamine (the “feel good” chemical.)     In a healthy person , the Original Self can move around freely and is not obscured or buried by Hidden Guardians, or renegade Function or Emotion parts that have overtaken the Original Self in reaction to traumatic events.   A person without access to or who is dissociated from their O.S. will feel an inner emptiness or a “void” they cannot fill.  This “emptiness”  is common in C-PTSD, BPD, NPD, and other personality disorders.  It is also present in DID.

Guardians (precortical — amygdala).  Guardians stand between Function and Emotion but under normal circumstances do not block the interface between them in pathological ways.  These guardians allow the person to have healthy boundaries, not only between themselves and others, but between their various “core parts.”   In a healthy person, there is free communication between all the core parts, but only as needed.     The Original Self (soul–prefrontal cortex), Emotion (right brain–cortical), and Function (left brain–cortical) work together beautifully when they are synchronized and allow God in to guide the person along in their life choices.

The “Attachment Center” is ruled by the thalamus and basal ganglia — these are the most primitive pre-cortical (primitive) brain structures.  Attachment is our most basic need.  If attachment and bonding was not sufficiently formed during infancy, the person will experience problems with all the higher brain function listed above.   A trauma occurring at a lower level/more primitive level of brain function will be much harder to heal than one occurring during later childhood or adolescence, when the cortex was fully formed and cognitive memory and language had kicked in.

But “remembering” an event is not necessary for healing.  Even if a trauma occurred during early infancy or even in the womb,  before myelinization occurred, thus making  cognitive memory possible,  a person can still release emotional or physical trauma, even if they can’t remember what the trauma actually was.

Every human possesses all these core parts.   They should all work together like a symphony.

Unfortunately, with trauma, the core parts get so separated they can no longer communicate with each other, and in severe cases, become so dissociated or blocked the entire personality splits up into alters (Dissociative Identity Disorder).

Severe trauma, especially Type A trauma, can lead to a physical altering of the actual brain itself, which cannot normally be healed without the intervention of God through prayer and the willingness of the individual who is to be treated to change.

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The lower the level of the brain structure (1 – 4 in the diagram ), the earlier the trauma occurred and the more difficult the treatment will be.

*****

Type A and Type B Trauma

There are two types of trauma:

Type A trauma:  not getting what you need from a caregiver (outside of physical needs like food, shelter, warmth, and fluids): the lack of love, acceptance, positive mirroring, acknowledgement, nurturing, communication.   The Still Face experiment,  which I’ve talked about in previous posts, shows very graphically the changes that come over an infant denied those important attachment signals from the mom, even if only for a few minutes in a controlled setting like a therapist’s office.     We are wired for attachment, and the lack of it has devastating effects on the personality.

Type B trauma:  any bad thing that happens to you, either in childhood or later on.   This could be physical or overt emotional abuse, sexual abuse, ritual abuse (many DID patients were ritually abused in satanic or other cults),  PTSD caused by trauma in war combat, natural disasters, serious illness, being battered by an abusive spouse, being abandoned, the death of a loved one, the sudden loss of a job, or even loss of a dream.

Type A trauma can be worse than Type B, because it tends to happen during infancy, is pre-verbal, and unlike later trauma (which is stored in Emotion or Function, which are both part of the cerebral cortex of the brain) is stored in the very primitive, subcortical, “reptilian” regions of the brain (the amygdala, basal ganglia, and thalamus).  The victim can’t name or describe the trauma because they have no language for it and it may have happened so early the brain wasn’t myelinized yet and so there is no corresponding cognitive memory of the trauma.

It’s harder for a patient to describe Type A trauma– a “lack” of attachment–or convince others that this is abuse, because most people are more likely to show sympathy when you can “name” the abuse or traumatic event and it was overt (Type B trauma).   People may not be sympathetic when you received all your physical requirements, were physically well cared for, and were not physically abused.  But if there was a failure of maternal/infant bonding, the person will never know learn how to connect meaningfully with others and build a healthy relational capacity until and if they can address the Type A trauma they endured.

Type A trauma is why children who were orphaned or abandoned as infants so often develop severe attachment disorders, which can and do lead to Complex PTSD and the personality disorders (the partial fracturing of the Original Self — in the case of NPD the person sets up an “alter”-like “personality” called the False Self) or even DID (the complete fracturing of a personality into separate “alters”) later in life.

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The roles of the Guardians.

We all have Guardians.   Guardians are universal core parts situated between Function and Emotion; they are responsible for all our defense mechanisms and decide what Emotions can be felt by the person at a given time and which ones can’t.  They help us maintain good boundaries. Everyone has at least one Guardian (the Primary Guardian).  A person with trauma-or attachment-based disorders such as Complex PTSD, DID or the personality disorders, probably has several or many Guardians (Hidden Guardians), which may appear to the person as different “people.”  Hidden Guardians are all split off from the Primary Guardian at the time of the trauma that created them, so some guardians are still very young children and their particular “job” (defense mechanism) is the only thing they ever knew how to do. There are at least 15 kinds of Hidden Guardians. Most of these are merely dysfunctional; a few are aggressive and hostile.

All Guardians (including Hidden Guardians) have one primary purpose: to protect the inner child (Original Self) from having to feel or experience further trauma or painful emotion by keeping it locked up in the Emotion part of the brain, not letting it through to Function (or only letting it through when it’s appropriate to do so, if the Guardian is healthy). Guardians are the mind’s Gatekeepers.

In a person with DID, the guardians (as well as the split Emotion/Function core parts) are so disconnected from each other that the person has amnesia for some or most of their alters and there is little to no communication between the various core parts, or hostility/animosity between the core parts, including the Guardians.

When healthy, Guardians enable the person to create healthy boundaries and allow just enough information as the person needs to filter from Emotion to Function, and back again.  When a person begins to heal, Guardians don’t disappear, but they may “flip their role” from a pathological defense mechanism to a healthy defense.

For example, a Guardian, when healed, does not go away. Instead, it can learn to switch from negative judgment of people and situations (that keeps a person trapped in unhealthy and self sabotaging life habits) to a role of wise discernment, or making the best choices (this is where God comes in, who helps the person make those healthier choices).

Levels of trauma.

Here is the continuum from normal brain functioning to the most pathological due to severe abandonment/abuse trauma:

  1. Daydreaming: partial, temporary “dissociation” when uncomfortable feelings (including “boredom”) begin to arise.   Everyone does this.   Type A or B trauma is not necessary at this stage.
  2. Painful Memory: No dissociation, but could comprise traumatic memory and possibly the use of defense mechanisms (this is part of what Guardians are for).    Painful Memory can be experienced by a mentally normal person who has experienced Type B trauma (a bad thing happened to them).  Most humans have experienced Type B trauma and the painful memory may be a trigger for them.
  3. Ego-States:  Includes partial dissociation.  “Ego-states” (more circumscribed than painful memories that may include some separation but not to the degree of DID “alters”)  include the Personality Disorders, Complex PTSD, severe PTSD, and possibly Bipolar Disorder, Schizophrenia, and other serious mental conditions outside the common “neurotic” anxiety states and mild depression that most people experience from time to time.   For people stuck in the ego-states, Type A (and possibly Type B) trauma were present.    As an aside, my own theory about NPD in regards to this theory is that it is probably the closest of the personality disorders to DID — due to the development of a distinctive “false self” (a sort of “alter”) that differs from and almost completely obscures the true self (Original Self), which the person may not be consciously aware of. In other PD’s the true/original self is not as well hidden. My feeling is NPD is a takeover by a strong, hostile Guardian or group of hostile Guardians who will not allow any vulnerable Emotion through to Function unless it serves their immediate purpose.
  4. DID and DID caused by Ritual Abuse:  Complete dissociation resulting in a fracturing into separate “alters” who may have amnesia for other alters or the core personality.   Usually both Type A and Type B trauma were present, especially in Ritual Abuse, an especially traumatic type of abuse that may involve the deliberate “programming” of a person to carry out certain actions, even suicide, if a certain “trigger” is activated.     The effects are even worse if this type of abuse has been going on since infancy or early childhood, and the prognosis more grim.

Because there is SO much more information and my goal here isn’t to be a HeartSync instructor (at least not now), I am going to stop this post here.  You can check their website above if you’d like to learn more.

My next post (Part Two) will be about my personal experience  over the past few days.  That will be up tonight. I need to get it here while it’s still fresh in my mind. In some ways, I feel like a completely different person and feel a lot “lighter” mentally and emotionally.

You can read about my first day in this post (that resulted in am intense release in a very large pocket of trapped pain).
https://luckyottershaven.com/2016/11/16/checking-in/

Empty words.

love_quote

“I love you.”

Adult children of narcissists hear those words a lot.  But they ring hollow and false to my ears, because words are just words–it’s the actions behind them that give them meaning.  And I haven’t been shown much (if any) love or support by my family or the other narcissists in my life who have have uttered those three words to me so many times.

Anyone can send a Hallmark card or say “I love you” but that’s as close to love as narcissists can get, because they never learned what love really is.

There’s a blogger I read who is a narcissist.   I like his posts because he writes about narcissistic abuse from a narcissist’s point of view (nope, not Sam Vaknin).  Oftentimes you learn more about something when it comes out of the proverbial horse’s mouth.    You get a whole new perspective on things that way.    Usually he writes about the tactics a narcissist uses to prey on others, but sometimes he’s more transparent and and shows some vulnerability–even writing about the abuse that was done to him and turned him into a narcissist.  From one especially gutwrenching post where the blogger, HG Tudor, describes what sort of “love” he was taught as a child:

Love is being told to never trust anybody.

Love is being made to re-write the entire essay because of one spelling mistake.

Love is being sent to stand outside on a cold winter’s day until all three verses of Ode to Autumn are recited correctly.

Love is knowing nothing is ever good enough.

Love is understanding that someone else knows better than you what is best for you.

Love is turning away from the reality.

Love is standing straight against a wall for several hours for speaking out of turn.

Love is for the weak.

Love is being told that when I am gone nobody else will look out for you.

Love is succeeding.

Love is building a wall as high as possible.

Love is trying until it hurts and gaining that final curt nod of approval.

Love is being seen and not heard.

Love is fulfilling your potential and securing that legacy.

Love is hurting you even though it hurts me, but someone in this household has to do it and it won’t be him will it?

Love is reading to yourself than being read to.

Love is living in the shadows and hoping not to be noticed.

Love is being the best.

Love is the preserve of the powerful.

Love is being denied a birthday party because the other children are too stupid.

Love is being undermined in order to prevent conceit.

Love is a begrudged recognition and the injunction to try harder, go further, climb higher, run faster, study longer.

Love is burning your hand but not crying.

Love is a righteous beating.

Love is being distant and pretending things never happened.

Love is being sent away.

Love is not being told.

Love is splendid isolation. 

 

He has it right.   He knows this is not what love is, even if he has no idea what real love is.    There’s a lot of anger in his post.  What he may not realize is this list could apply to ALL children of narcissistic families, not just people like him who have NPD.

There’s one difference though.   For those of us who didn’t become narcissists, we somehow learned what love is.   Real love is unconditional love: love that is unearned, love that is given just because you’re who you are, regardless of your flaws and shortcomings. You are not shamed for being who you are, at any point, ever.  You are cherished for your soul, not your appearance, income, intelligence, or achievements.   You are not judged for being in a bad mood or for not being happy all the time.  Someone who truly loves you will still love you even when you’re sad, mad or afraid.  They will offer support in some way, not turn their back on you or blame you or kick you while you’re on the ground.

Those of us with C-PTSD and other trauma based disorders didn’t get unconditional love from our immediate families.   But if we didn’t become narcissists we might have had a taste of enough of it to make a model of it for ourselves.  Maybe a loving relative outside of our immediate family–a  grandfather or aunt perhaps–showed us this kind of unconditional unearned love.  Maybe we were “adopted” by the loving parents of a friend (not literally adopted, just treated like a member of that family).   Perhaps we were fortunate enough not to marry an abuser (unfortunately, that’s not the case for most of us, since we were programmed to attract and be attracted to abusers) who showed us what real love is all about.   Maybe we had a compassionate teacher when we were young.  It’s even possible that one or both of our narcissist parents (if they weren’t malignant or sociopathic) had occasional moments of lucidity when their false self was temporarily down for whatever reason, and during those rare moments were able to see and love us for who we really were, not for what they wanted us to be or what we could give them.

My point here is that love was somehow modeled for us by somebody before the critical period for being able to accept–and give–love came to a close.   Probably not enough to heal our wounds; the damage done to us was severe and complete healing may not be possible.   The scars will always remain, no matter how much work we do on ourselves.   We may be compromised in our ability to give and receive love, but we can still learn.    Even if we’ve been shown very little love throughout our lives, by the grace of God, our souls, though damaged, somehow remained intact.    For a narcissist, there’s no inkling of what actual love might feel like, even if, as with the blogger quoted above, they want to know.

love_corinthians

I’m so starved for unconditional love that when it is given to me, I want to cry in gratitude and some emotion that feels very close to relief.   Occasionally I have.    I can tell you what that kind of love feels like:  a sincere hug when you’re depressed; concerned ears that listen without judgment even if they disagree with you;  someone who isn’t a fair weather friend and is still your friend even when you’re going through a rough time or aren’t at your best; a real family that always welcomes and supports you no matter how old you are or how many problems you’ve faced and doesn’t disown you, judge you, shun you, talk badly about you behind your back, or tell you everything’s your own fault.   Love is like a respite from pain after an excruciating illness; it’s reassurance that the thing you dreaded the most did not come to pass, that in fact, the outcome was wonderful instead.    That’s what love feels like, and it’s everyone’s birthright.  That some of us received so little of it–or none at all–is appalling to me.     The injustice of it makes feel rage.

I received just enough of this kind of love, and at an early enough age, that it was modeled for me.  I received just enough that my soul escaped relatively intact, even if my mind did not.    I can feel unconditional love for others, but I’m still afraid to reach out to them, because I learned that people can’t be trusted.  So many people in my life have shown me their “love” has no real meaning and is just three pretty words with nothing inside but betrayal and hurt.    The terrible irony of having received enough of a “taste” to know what real love is  like is that you constantly crave more of it, like a drowning person gasping for air.  You haven’t received enough to feel confident that it will last or that anyone in the world really cares about you, so you either clutch onto it for dear life or avoid relationships altogether.

NPD “alter” in a DID patient.

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I have to admit I know next to nothing about this, but I found this fascinating and wonder if anyone else ever heard of anything like it or knows anything about it. Someone who comments on this blog described a woman they know who has Dissociative Identity Disorder (DID). Like C-PTSD and the personality disorders, DID is caused by abuse during childhood. If you’re not familiar with DID, it’s one of the Dissociative disorders. It used to be known as Multiple Personality Disorder (MPD). DID is when a person has one or more “alters” in addition to their base personality, and switches from one alter to another, usually in response to a trigger. The core self usually has amnesia for the the time spent as an alter (many people with DID present because of frequent “blackouts”–gaps in memory where the person can’t remember anything they did as an alter), but there may be some awareness among the various alters of each other’s existence.  Each alter may have their own name, set of interests, likes and dislikes, etc.  They may even have opinions about the other alters as if they were actual people. Adopting different alters is how the DID person copes with trauma-related stress. DID usually first presents during childhood.  It’s a fascinating disorder in its own right.

Like almost everyone with DID, the woman this commenter described had been horrifically abused. One of her alters had Narcissistic Personality Disorder, maybe more than one. I don’t know how many alters the woman had, and I don’t know whether or not she was NPD at her core (usually the core personality is a rather passive and victimized character, and I would think that adopting NPD as a dominant coping mechanism would negate the “need” to develop DID). I found it fascinating that one of her alters had NPD and she was able to switch it off whenever she left that alter. The human mind is an amazing and mysterious thing.

Borderlines: incurable demons or trauma victims?

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The symptoms of Complex PTSD are almost identical to those of BPD.

Something has come to my attention during the time I’ve been blogging, which I think is important enough to merit another post about it.

Borderline Personality Disorder (BPD, DSM code 301.83) is classified by the Diagnostic and Statistical Manual of Mental Disorders as a Cluster B (emotional/dramatic/erratic) personality disorder having many similarities to character disorders like Narcissistic Personality Disorder (NPD) and Antisocial Personality Disorder (ASPD). Both NPD and ASPD are characterized by a lack of empathy, entitled behavior, and disregard for the rights or feelings of others. It’s also true that some Borderlines act out in ways harmful to themselves and others. Hence, “Cluster B” has become a pejorative category and some ACONs (adult children of narcissists) and others have demonized people with BPD as being amoral, immoral, and almost inhuman, nearly or as bad as as people with NPD or ASPD. Some even go so far as to lump all borderlines in with the “narcs” and barely make a distinction between them. In their minds, if you’re a Borderline, you’re no better than a “narc” and that’s all there is to it. You’re a bad person and to be avoided.

To make matters even worse, many mental health professionals refuse to treat people with BPD, believing them to be troublemakers, incurable, or both. I remember one therapist I saw years ago for an intake session and seemed to connect well with, called me a few days later after he received my psychiatric records, and told me he couldn’t take me on as a patient. “I don’t work with borderlines,” he said.

It’s true that there are some similarities between the Cluster B disorders, and both BPD and NPD/ASPD have roots in childhood abuse or neglect. But the similarities don’t run very deep. What I mean by that is while both a borderline and a narcissist cn be manipulative or abusive to others, the reasons are very different. There’s also the matter of intention. Borderlines, if they act out against others, aren’t usually aware they’re being abusive and/or manipulative. If their bad behavior is brought to their attention, they normally become very upset and feel terrible about it (unless they have a comorbid NPD or ASPD diagnosis). They act out because of overpowering emotions that they haven’t learned how to control. In contrast, a narcissist or person with ASPD acts out because they can. If their behavior is brought to their attention, they’re likely to become angry and rage against the accusation, make excuses, blame-shift it onto someone else, or deny it.  Unlike most borderlines, they don’t feel remorse, guilt or shame for hurting others.

In addition, many borderlines are much more harmful to themselves than to other people. If they do act out against others, most are as frightened by their own outbursts as others are and sometimes more so. In a nutshell, people with BPD know they have a problem and wish they could be different. Untreated BPD makes a Borderline’s life miserable, while people with NPD or ASPD are usually not bothered by their disorder. That’s why, even though Borderlines can act “crazier” than narcissists, they can get better and are much more responsive to therapy or behavioral treatments such as DBT or CBT.

But we’re still caught in a gray zone, neither here or there.   The stigma against borderlines (in my observation) has grown worse, and most narcissistic abuse sites pretty much regard people with BPD  as the “female or over-emotional version of NPD.”  (actually, Covert/Fragile NPD or Histrionic Personality Disorder would come closer).   If we’re narcissistic abuse victims suffering from complex PTSD, it takes a great deal of courage to admit you also have a BPD diagnosis.  It took me a few months to come out about it on this blog. Fortunately,  I haven’t received too much (or really, any) flack about it.

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Click to enlarge graph.

The good news is, a number of BPD bloggers are helping to reduce the negative stigma that we’re “bad seeds” with an untreatable disorder just because we’re OMG “Cluster B.” Think about this: have you ever noticed that there aren’t too many people with NPD (or ASPD) blogging about their challenges and insecurities, or fighting to reduce the stigma against their disorder? If they blog about their narcissism or psychopathy, it’s usually to brag about how NPD/psychopathy makes them superior or allows them to have control over others and be successful in the world. That’s because they don’t think they have a problem (They just cause others to have problems). Most Borderlines know they have a problem and struggle with it constantly, since it makes them feel so crazy and lowers their quality of life. I can only think of ONE blogger with NPD who was unhappy with his disorder and successfully treated for it (or so he says). That man probably had low-spectrum and probably covert NPD; a person with malignant or high spectrum grandiose-type NPD will never have enough insight or willingness to admit that THEY are the ones with a problem. In contrast, I can think of about 20 bloggers with BPD who are in treatment or therapy or have even been healed! I’m sure there’s many more that I don’t even know about.

BPD also seems to co-occur a lot with complex PTSD or PTSD. Most BPD bloggers I can think of also have complex PTSD or are in treatment for it. The symptoms of BPD and Complex PTSD are almost the same. The DSM does not recognize Complex PTSD as a diagnosis; it only recognizes PTSD, which is not caused by chronic trauma over a long period of time (such as having been abused as a child), but by one traumatic incident (such as fighting in a war or being raped). Therapeutic treatments for complex PTSD and BPD are also almost the same (for that matter, NPD and other personality disorders are treated almost the same way). Both BPD and Complex PTSD have a higher cure rate than NPD. Since Complex PTSD isn’t recognized as a valid diagnosis, I think a lot of people (especially women) who might have been diagnosed with complex PTSD if it was recognized get slapped with the “Borderline” label instead. Although I accept my BPD diagnosis (and have even become a little attached to it), I wonder if I might never have been diagnosed with it at all had Complex PTSD been recognized by the psychiatric profession. I think in some cases, BPD may not really be accurate, or could even be the same thing as C-PTSD due to their many similarities. At least one blogger (BPD Transformation, who used to comment here but stopped for some reason), doesn’t even think BPD is a valid diagnosis and shouldn’t exist at all.

Further reading:

Are BPD and Complex PTSD the Same Disorder?

Is BPD a Real Disorder or Should it Be Eliminated as a Diagnosis?