Differences between treatment for CPTSD and BPD

[GlassBox]

Hi guys.  First post.

A little about me: I've struggled with CPTSD all my life, but I didn't know what to call it.  As of today, I have yet to be formally diagnosed, but when I read about CPTSD it was like reading a description of my personality that was written by someone who had access to my internal thoughts.  (I'm a "freeze" type, incidentally).  For the first time I'm able to see my maladaptive behaviors as responses to trauma rather than as character flaws.  Understanding what's going on with me has given me some immediate relief, as well as some much needed hope.  The description of CPTSD doesn't fit me like a glove, it fits me like my own skin. 

My experience with therapists in my neck of the woods is that they don't like to make formal diagnoses.  My therapist right now sees my constellation of symptoms and wants to treat them with CBT and DBT, which are the generally recommended treatments for CPTSD.  However, I'm worried that he doesn't really get it.  He tells me that it's not really important what to call a condition, and he's fearful that putting a label on it might make me "live up to the label".  He seems to think that whatever I'm struggling with is in a certain ballpark of BPD, which is frustrating to me, and from perusing the forums it seems like that's a common frustration.   I feel like there's a lot of miscommunication especially regarding treatments and getting healthier.  Therapists often want to set up a system of rewards.  They don't understand it when i tell them I don't respond to rewards because there's simply no self (ego) to receive a reward.  It makes things difficult, and I sometimes get the impression that they think I'm just being stubborn.

I've been through a lot of intensive therapy already, and though it helped me around the edges, it didn't address my core issues.  (Toxic shame, and that awful critic).  Most of the therapy just fell in the "hole", as it were.  Even though the therapies are the same and many of the symptoms are the same as BPD, I'm worried that the fundamental problems of CPTSD won't be addressed.

I live in Canada, which means that mental health is covered under our healthcare, but it's a kind of "take what you can get" proposition.  I'm grateful for it, since without it I'd have nothing, but I can't pick the exact therapists and course of treatment that I want.  I'm going to get some CBT and probably DBT in a group setting, and I can take it or leave it.  I'm taking it.

In short, I'm asking what the differences are between treatment for BPD and CPTSD, and how important those differences are.  What do I need to be aware of regarding CBT and DBT with respect to CPTSD?

[89abc123]

I don't know if there is a difference between treatment.

Dbt followed by schema therapy has been amazingly helpful to me and I don't know why more therapists aren't recommending it.

[Danaus plexippus]

Kati Morton explains it like this: https://youtu.be/g7B3n9jobus & https://youtu.be/hDJi86n9-Rk plus she has videos about PTSD and cPTSD

[GlassBox]

Thanks guys

[woodsgnome]

Thanks,  GlassBox---excellent observations on the tricky field of therapy.

Something that I noticed was that your therapist seemed to invalidate your own take by suggesting labels just push you towards 'living to the label'. In fact, it appears you have done lots of work on your own and he's implying that he knows better than you, that maybe his own labels are better. I presume you've laid out your reasons to him as to your assessment, so it's a tad inconsiderate, it seems, for him to not take that into consideration, labeled or not.

I found this disconnect in understanding common with several therapists, and most seemed stuck in their training regimens, most of it pre-cptsd. Sometimes labels truly don't matter--I resist them myself in most areas of life. Except this one--my reaction to the cptsd materials (especially Walker's book) was the same as you've described, GlassBox--I knew the descriptions were spot-on (freeze type as well, but at one time probably shades of flight/freeze hybrid).

I recently started with a new therapist; living in a very isolated area there's also not many t's around, anyway.  But then I 'lucked out', I guess. Found one more possibility; a bit further away than I wanted, but it clicked. What helped immediately is that she was clear that she doesn't DO therapy to anyone, she works with one's process. The amazing part--she wanted to read Walker's book, did, and now we use it together in reference to my core issues--I also have shame/inner critic probs at the top of the list. This approach of accepting the client's take but also contributing from her own background is refreshing and unlike any other t I've ever encountered. Both of us know the labels and how they can go awry; what we do know is that what's called cptsd fits my situation exactly.

I'm not sure this helps much, though. I just wanted to share that there are decent t's around, if elusive. They can guide, suggest, etc., ad infinitum; my present t does a lot of it, but from a level of understanding and openness, not just preconceived notions.

I don't know; therapy often seems, to me, more of an intuitive process than a prescriptive remedy. More of an art form, maybe? More questions than answers, it seems; my own biggest question was why I didn't give up years ago on finding any help from the therapy route. And now I'm glad I stayed with it. No panacea, but finding another voice in this swamp has increased my hope from total darkness to a glimmer.

Here's a take on the therapeutic relationship I found insightful:

http://www.lifewithoutacentre.com/writings/therapy-without-a-therapist/

[resurgent]

Hi, Glassbox-

What you describe rings a bell with me, too--despite years upon years in therapy, nothing seemed to make a dent in the deep and abiding shame I've felt for most of my life, nor could I ever discover the source of/get control over that nasty inner critic. Continued with therapy anyway, but had internally lost hope that it could effect any change---UNTIL----drum roll-----I heard about CPTSD and read Pete Walker's book.

One thing I've done recently and has had a HUGE impact on how I've felt lately, and my sense that's there's been movement, actual forward motion, in my recovery, is EMDR. Is that available where you are? My previous therapist, when I expressed interest in trying it said "people tend to oversell that," and seemed to discourage me from doing it. But I can vouch for its effectiveness, where I'm concerned, at least.