It's confirmed: I must get undiagnosed: how?

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That's interesting too. It makes sense why I have always liked girls with aspie traits, maybe for the same reasons. But, then, they are not empathetic enough to understand PTSD/BPD, so I think it does not work long-term for those reasons.

As for alexithymia, ahogday, I think C-PTSD can look quite similarly. I am not sure if they are the same thing or not. But as far as not having emotions but feeling them as bodily sensations, that is one of the characteristics of PTSD. What do you think of the relationship between C-PTSD and alexithymia?



Then, there are aspies like Kjas who have high cognitive AND affective empathy. Some autistics have low affective and cognitive empathy. So I think it's theoretically possible for an autistic to have high cognitive and low affective empathy. You know, in an abusive situation with someone who builds trust and then exploits it, and then growing up with a psychotic father the rest of the time, cognitive empathy could develop as a survival mechanism in someone to avoid setting off the unstable, psychotic father. For the same reasons, experiencing other people negatively seems like it could lead to low affective empathy. When I am mad at people all the time, it's hard to have affective empathy. But that does not stop me from having cognitive empathy when I know someone is trying to cheat or manipulate or is upset.

Yes it's possible. The people with BPD I met I came along with pretty well, but there is a point where they realize that I'm not just shy but my social understanding is bad and somehow than it doesn't work out anymore.



Peolpe with PTSD have more often alexithymia, because they repress negative emotions, but it's not the only reason for alexithymia. Most autistics have high levels of alexithymia.

Last edited by Raziel on 09 May 2013, 1:54 am, edited 1 time in total.

Hi. I cannot really remember exactly what I wrote and am too tired to reread it just now--- will do so later, but no, I did not mean to suggest this but rather at a certain early stage of development the child is unable to completely individuate from the parent and so move on to the next stage of development. What stops him is probably not over nurturing but that the mother sees the child as an extension of herself, as an object rather than a person and so unconsciously does not want him to individuate himself from her as this kind of individuation would indicate a 'loss' of her own (false) sense of self which is represented to her as 'him.' This is my own verbalization of my perhaps limited understanding of what is called in psychoanalysis "object relations theory." So, yes, this would indicate that she herself has not formed this degree of individuation. This coupled with anger toward the child whose natural attempt to individuate would unconsciously represent to her that he is taking her 'self' away would presumably lead to a fixation at this stage of development for the child. If he tries to get away psychologically not only does he lose the possibility of receiving the genuine affection he is so craving, but if he stays at that immature level of development and tries to get it, which he never will, then he gives up the possibility of being himself.

So, a classic double bind, much like being put into a cage, and this would be enough to make anyone angry.

Is there a way out? Of course. There is a possibility to become free, but the way is not easy. It is not enough to take a seed and just toss it anywhere, on any kind of ground. This is why I say to Tyrion not to worry if he has exactly this or that diagnosis or gets this or that particular therapy. If he sincerely means to find the way out, and if his intention does not waver, if he is able to make a conscious dedication, prepare the right inner ground and has faith in his own inherent capacity and birthright to be free, and if he wishes the same for his brother and sister, then all the forces of the entire universe will come together to help the seed he plants grow into a flowering tree.

Except, in my case, getting an accurate diagnosis (whether it ends up ultimately just being C-PTSD or BPD + C-PTSD) was very important. I was not aware of the level of trauma, so I would only have focused on surface things like social dysfunction and "acting lessons" to learn voice projection had I not been made aware that severe trauma, disassociation, and fear of abandonment were behind nearly all my negative symptoms. I knew I had some abuse, but I did not realize how pervasively it affected me.

I think I am a CLASSIC example of why identifying the cause of a condition is important. Just from an external point of view, I had mild Asperger's and needed to learn to express emotion. However, such treatment is not only ineffective for someone in my circumstances, it can be highly DANGEROUS. I worked with an acting coach for 4 months to try to learn how to express emotion more in social situations in order to make connections with people, and it immediately caused me to go back to self-harming and getting into multiple fights. So yes, it was harmful.

Being in a social skills class with others who had Asperger's was also harmful because it encouraged me to project things negatively onto others, use others as a narcissistic supply, and subtly press buttons to cause one individual to go into meltdowns. It actually took almost two months for the supervisor/counselor to figure out that I was actually manipulating another member into having meltdowns; I wasn't even fully aware of what I was doing. That's when he talked to me about BPD rather than Asperger's, like "your social skills are fine, but you are a bad person" hahahaha. Then, my ex girlfriends confirmed it.

Thus, it was very important for me to get a proper diagnosis. From here, getting the exact one is not important, but knowing at least what the root of my social dysfunction is was important.

Thanks for the details. The extent of testing you went through is also very interesting.

This has been an interesting thread for me because even the term borderline, makes it very difficult for me to approach the condition to understand it as it is an inherently vague term associated with emotion.

From the details I have learned now, It seems interesting to me that in my life, there have been quite a few of my relationships where the other individual had some of these characteristics, one in particular of a cold and/or neglecting parent. I had the opposite as the cold parent left and the warm parent stayed resulting in very trusting view of the world, even when I was not accepting by people in it.

That nurture gave me an incredible resilience to the effect of any negative intention of others.

I personally see that inclination of nurture and environment as more likely to seek people it can trust, and part of Autism at it's core seems to be communicating intention without hidden meaning.

I have to work very hard to create metaphor in my writing that makes it tolerable for others to read other than an entry out of a dictionary.

Overall, per human nature, it appears that in patriarchal culture where there is a "strong" element of sexual dimorphism there is often an "opposites" attract feature per nurture and the protector.

Our society in metaphorical terms has become the protector, so egalitarianism is more likely to thrive. One sees this the most I think in homogenous societies particularly some Scandinavian one's where social welfare is the prize instead of the enemy among most.

Sorry, I often digress.

Thanks for the clarification that sounds like the "sometimes" "vicious" cycle of nature and nurture, where it is "somewhat" of a "Catch Twenty Two" situation that can be averted if one can find a way to adapt. Where borderline otherwise can lead to additional borderline.

I have my own theory that is based on evolution. I think there are primal emotions that involve only pleasure-centers and those associated with the fight-or-flight response. Things like basic happiness, fear, and anger. These are emotions even animals have. They imply consciousness but don't require self-awareness. Then there are more complex emotions that involve the self-conscious ego. Things like pride, shame, guilt, embarrassment, etc... They are tied to relationships to others. These are (I'm guessing) only highly developed in humans and don't even become fully developed until one becomes an adult.

However, the higher self-conscious emotions involve ingredients of the more primal emotions because they branch from the same root. In the very early stages of development there isn't much differentiation. The different branches and distinctions develop as one grows and develops. This would be similar to how cells in organisms begin with a generic blueprint and then differentiate into distinct specialized functions. Emotions differentiate and become more specialized the more mature a person becomes.

I think alexithymia and BPD are both related to emotions not differentiating properly. With alexithymia the person isn't aware of the subtle distinctions. With BPD the problem is more like the various branches are tangled together in knots. There are too many tightly wound knots and connections so one thing sets another off. BPD involves the self-conscious relational emotions and this ties in with the whole object relations theory. Trauma can be like a scar that causes the branches to tangle rather than grow straight.

So IMO the goal of therapy is to untangle the branches. Hope this makes sense to someone besides me.

Raziel answered the question about Alexithymia, as with PTSD, it is often emotions that are thought to be repressed rather than an underlying biological mechanism that is suggested as associated with Autism. If I remember correctly while there is a studied 85% association of Alexithymia and Autism there is a 40% association in PTSD. There is a great deal of research that suggests connectivity differences in Autism that could explain the disconnect between emotion and language in some forms of Autism.

Part of the problem so eloquently described by Tom Insel, the director of the National Institute of Mental health, is that the current model of classification by the DSM does not adequately address the neurological factors of causation in what is currently described as Mental Disorders, rather than his future direction in research as Brain Disorders.

As a result of the currently "Observable Behavioral Impairment" Model of Autism, causation is not usually addressed further, than a record of history in development or observable behavioral impairment.

The ultimate result is literally hundreds of causal factors that underlie those behavioral impairments.

In your case there is an identified neurodevelopmental issue of language delay you report that is more likely to account for your differences in social communication with others rather than environment alone. It is interesting that you have a non-verbal learning disorder and a language delay, as that is a particularly difficult combination to adapt to, as NLD often means navigating the world in words and language delay often means navigating the world in pictures, but nature doesn't play by a rule book of diagnostic criteria.

I think this is probably one of the reasons your analyst may have been hesitant to diagnose you with BPD, if the analyst was aware of that neurodevelopmental issue associated with language. The analyst is likely also well versed in Gillberg Criteria in overlooking the language delay and suggesting a potential of Asperger's syndrome, if aware of the delay.

In my case it excluded me from a diagnosis of "Gillberg" Asperger's and put me into the classification of PDDNOS. That is kind of ironic if one thinks about it. However, my psychiatrist had never heard of the term "Hyperlexia" until I brought it to his atttention, so I guess its not too surprising.

The human mind per genetics and environment is too complex to play strictly by any DSM diagnostic rules. The appropriate treatment is much more important than label, and part of the reason the "reason thinking" Tom Insel is moving toward causation and treatment rather than relying on labels for a road map to find that destination.

Interestingly, it is the genetics and commonalities found in individuals with Autism, Schizophrenia, Bi-Polar and other disorders that is leading him in that direction of reason.

In many cases it may be similar genetic underlying factors and different environmental conditions that lead to what is eventually described as differing diagnostic labels for some people with the same basic underlying genetic commonalities of difference. The relatively new pursuit of research in the direction of "Epigenetics" may provide many of those answers.

All that said, you mentioned insurance and what might be covered and not covered in the US. Even if you are covered under the diagnostic label of PTSD or Asperger's, I don't think as long as your therapist is properly trained and compassionate in the care of others, that you are going to have too much of a roadblock in receiving the therapy you need if it is reasonably going to help you.

It is definitely to your advantage that you have the knowledge to help the therapist consider what you think will help you the best, if it is DBT. I can't see where DBT could harm someone from what I understand of it, unless another more effective therapy was ignored. The most important factor may be seeking out a therapist that is certified and/or properly trained to provide the DBT therapy.

Tyrion, you seem to have not understood what I was trying to say. I am saying the diagnosis per se is not necessarily the way out. You already got one probably wrong diagnosis if not more than one. It is really obvious to me that you are BPD and I think it would be to most any therapist, so what happened there? How about when you tried to kill yourself by hanging out a window or whatever? You probably went to a mental hospital then I am guessing or into some kind of therapy, and there was another attempt you mentioned which involved cutting. You did not get a diagnosis then? BPD is very common and it seems to me the average therapist could spot it. And you didn't know you had serious trauma as a child? I have read some stuff you have written here and on other threads which indicates to me you must have in some way known..

One point is you went to a in some way lame therapist, but it is not all cut and dried. It is hard to sort things out. Anyway, they say DBT or whatever it is called works, but we do not know what "works" means, or at least I don't. It could just mean and probably does---minimally adjusted. Some of the people who are referred that kind of therapy are probably referred there because they are way unadjusted and basically unable to function, fresh out of mental hospitals and various episodes.. And just because it is the so-called 'right' therapy does not mean the therapist is any good. A lot of those folks are misguided or sick puppies. I'm not telling you to not get a diagnosis or not to go there, but saying something else.

All of this diagnosis stuff can be helpful but it can also be a pastime, a way to superficially communicate or even to avoid really communicating---or it can be a way to build a bridge, as has already been pointed out by myself and I think Marshall.

Personally I think finding a really good therapist would be more important than even the kind of therapy, but how would you know the therapist is good? And who even says that the therapy you participated in is even that good for aspies? Not I, that's for sure. They would possibly benefit more from this DBT, too.

After writing this I have done some brief internet research on this subject of DBT therapy and there seems to be some actual evidence for most, if not all of the points I have been speculating about regarding DBT.

1. The previous suicide attempt was explained away in terms of depression.

2. No one has ever known about the self-harm.

3. Gender bias.

4. Asperger's was a distraction from my real issues. I may really have a mild version of it also, but "oh, it's just a result of having Asperger's and having difficulty relating to the world" was starting to get so maddening, I could have punched someone. C-PTSD/BPD make a lot more sense. If anything, having Asperger's is a benefit to me because it gives me useful skills that have helped me to stay gainfully employed or in school.

5. I just did get a diagnosis I can accept: C-PTSD and also told I meet the criteria for BPD. My doctor and I actually have an appointment scheduled to discuss whether being diagnosed with BPD would be helpful to me given how it is stigmatizing and how C-PTSD might be able to get me all the same support.

I am done with diagnoses now. This is the right one. I just knew instinctively that the others were wrong; that's why I was so desperate to have my real issues and trauma recognized. They were impossible to spot because my personal presentation does not come across as someone who has BPD AND I can't talk about most of these things in person. I shut down, so it actually required projective tests to bring any of these things to a therapist's attention, which is why she ran a bunch of them. She suspected something was up, just like my ex girlfriends did, but knew I wasn't going to be open about it.

6. I knew about the trauma. I posted about it here earlier, sexual as well as physical abuse. I even made a thread about 5 months ago asking if sexual abuse could cause Asperger's (yes, it can). I just didn't think it had affected me that much at the time I wrote that I didn't feel like it was a big deal. Well, apparently it has. How bad I think it was depends on my mood at the moment. But it always affects me.

I did not talk about it before because I was afraid of not being believed; that's another reason my BPD was missed. Only when it was confirmed by the MMPI and several projective tests was I willing to even acknowledge it to a professional.

You see: lots of things can cause suicide. I was thought of as more of a Schizoid type because I don't express emotions very well and am reluctant to share personal information when I talk (anon over the internet is different). This contributed to my issues being hidden and hard to identify. So yeah...suicidal ideation = Ass Burgers + depression. BPD was never considered because it was highly camouflaged.

So, still, how was it missed? I am a male, and society is sexist. Men don't get BPD according to some people. What matters is that it's been professionally recognized now as real. I officially meet 8/9 of the criteria for BPD. Whether I actually get the diagnosis or not, I don't care. I just know that I have identified the source of the problem, which is what my goal was all along.

I can now access many support resources for people with BPD whether I officially have C-PTSD or BPD; they are basically the same thing.

A lot of people are identified as BPD when they break the law and go to prison. I have broken the law several times but was lucky enough to either (1) not get caught or (2) get simply a slap on the wrist, such as with my aborted Court Martial.

Many, many people in my life interpreted my interpersonal problems as "missing social cues" rather than for what it is: "hating people" and deliberately ignoring social cues.

All these things, especially my being uncomfortable with therapy and inability to express myself, caused my C-PTSD/BPD to be missed for many years.

Tyrion. I think littlebee is on your side, don't take the frustration personally. I think she thinks it's time to move past the diagnosis stuff (since pretty much everyone agrees on the problem) and instead work on making sure you get a good therapist. I know, not exactly easy.

I'm also pretty concerned that you're taking an exam soon. I had a major mental breakdown in graduate school where I almost got kicked out. I was on a full fellowship but suddenly my issues got out of control and I couldn't focus and the department chair must have decided I was "slacking off". He set up a meeting with my adviser (not my adviser's decision) where I walked into the room and he basically cornered me out of the blue that I was suddenly on thin ice. I was so upset and enraged I went into a complete daze. Was basically having all kinds of suicidal and homicidal thoughts. A family member was able to come and bail me out by dealing with University bureaucracy because there was no way I could even talk to anyone. It turned out he couldn't threaten to "fire" me on his own due to the union agreements and he was reprimanded by the dean. Though I was set back such that my fellowship ran out and I had to pay my own way the final year, I did manage to get my MS degree two years after the incident.

I don't know how high the stakes are for you right now. You're obviously very intelligent, like was the case with me, but unfortunately some academic people seem short on empathy when it comes to mental health problems. For me it was a science degree program and all the people in the department basically had some kind of aspergers or something because they were absolutely clueless as to what was going on with me and neither I nor the counselor I was working with had any way of dealing with them.

Well I really don't know what your situation is but this whole thing is triggering some fears of this kind of thing. I wonder if it would be better to just take a break from all this and try to focus on work/school for the moment.

Yeah, I know. I kind of felt attacked for a moment. Not sure why.

It's like I had formerly been blocked at every step in terms of figuring out the problem, not least of all people who say "labels don't matter; focus on your issues." And constantly being attacked, dismissed, or misread my entire life. My therapist herself said it was likely that I had been attacked, dismissed, and misread my entire life because of the way everything is camouflaged. I did not even mention this previously and was even scared to mention some things or bring up labels out of fear of being attacked and dismissed.

Problem is, when you have alexithymia/major disassociation from PTSD, it's hard to even know what your issues are, and it's even harder to express yourself. So, for me, getting the correct "label" was very important. That type of advice actually is offensive to me based on what I've been through with constantly being attacked, dismissed, misread, or told not to focus on labels because I'm already supposed to know what my issues are, like normal people. "Oh, you just lack confidence. Oh, you need to learn how to express emotion more and develop more self-esteem. Oh, you are too hard on yourself."

So anyone who denounces being obsessed with "labels" is going to set off triggers because I have personally had bad experiences with misdiagnoses whose treatments actually were harmful. From here, now that at least the correct symptoms have been identified, I agree; I don't think labels are that important, and I am not focusing on them anymore except as far as figuring out which one is better for insurance and support.

Last edited by Tyri0n on 08 May 2013, 11:57 pm, edited 2 times in total.

I think that does make sense.

Alexithymia is also highly associated with Border Line Personality Disorder although research suggests that it is more directly associated with co-morbids of anxiety and depression often associated with BPD.

http://www.ncbi.nlm.nih.gov/pubmed/22281457

Some animals though do seem to experience "higher order" emotions, particularly elephants that will go as far as burying people they kill in aggressive action.

Serious references from an evolutionary biologist published in Psychology Today:

http://www.psychologytoday.com/blog/animal-emotions

Serious but amusing reference from Cracked dot com:

http://www.cracked.com/article_20141_5- ... tions.html

In my most difficult period of Alexithymia after chronic severe stress losing almost complete connection with my emotions, I could recognize my cat as more human than I as far as the ability to connect with other cats and humans.

Emotions are extremely important to the memory process and making decisions in life. Repression of emotion at times is a defense mechanism for survival, but is not a long term solution to thrive in life.

The type of Alexithymia that comes from environment can be reversed through therapy, with time.

Considering the impact of emotion on memory and the decision making process, I do not believe that many people that make good grades in school could be absent of the ability to experience "healthy" levels of complex emotion, even if they could not adequately describe them in words or demonstrate the emotion to others.

The research from Rogers in the article I presented earlier on cognitive vs. affective empathy was reflective of IQ close to an average of 120 in the group of people described with Asperger's syndrome, who on average were college educated at the 4 year level.

That study was highly biased and not at all reflective of the actual norm in society who are actually diagnosed with Asperger's assessed at slightly lower than the 100 middle of the bell curve of IQ, at somewhere close to 98, in the general population.

That research by Roger's is not very meaningful as representative of the entire spectrum. Nor is the participation on this website, where the bell curve of IQ in assessed in large informal polls close to the 125 area of IQ.

Per the association of memory and the decision making process, it is not likely that individuals, overall with that level of IQ, would not be able to experience "normal" if not intense emotion, whether it was adequately expressed in reciprocal social communication, or not.

Recent research also shows that when a person is engaged in activities of mechanical task of mechanical cognition nature as opposed to social tasks of social cognition nature, the opposing pathway in the Brain is repressed.

People who engage in mechanical tasks in their life as opposed to social tasks through the process of neuroplasticity are more likely to strengthen that pathway as opposed to those who engage in social tasks related to social cognition.

I spent close two decades in the social tasks and social cognition of dealing with people in the general public as opposed to the previous two decades in an almost entirely academic endeavor and then moved back in the other direction when computers came along and there was another avenue for academic pursuit.

My AQ score over my life looks like an upside down bell curve moving from mid 40's to somewhere close to 30 back to mid 40's.

It is the environment and social vs. mechanical cognition tasks that made the neuroplastic difference in my life. And most certainly the biggest difference was having a nurturing parent rather than a parent that was not nurturing, as it was an environment of social task and social cognition when I was a very young child above and beyond an environment of mechanical task and mechanical cognition. That nurturing connection likely helped me with emotion and at least in part spelled a greater potential of academic success in school and whatever social interaction I was able to succeed in.

Okay it sounds like a misunderstanding. It seems like she has strong opinions on therapy but maybe we should just back off and let you decide.

I don't know that much about DBT but from personal experience there are definitely things that won't work if you're too intelligent. I personally can't deal with therapists who try to tell me I'm "thinking wrong". For one, what I really think and what comes out of my mouth when frustrated are two different things so criticizing something that comes out of my mouth in frustration is pointless. Second, a lot of the "thinking" stuff is subjective opinion anyways so trying to convince me that one way of thinking is more rational over another comes off as a pointless game that's not going to work on me. The bottom line is I don't think I really am capable of changing my thoughts or trying to self-talk myself into believing something different. That's the root of why that kind of "therapy" just leads a lot of arguments and intellectual games without really touching any real issues. Another kind of bad therapist is one that just makes small talk and tries to listen to you all the time because they don't really want to put any pressure at all on you. That's fine for getting things off your chest but you don't really make progress. You do need someone that challenges you in some way but also doesn't do it in a way that insults your intelligence or triggers you to be defensive.