Complex PTSD vs BPD | KAREN JACOB

Dr. Karen Jacob discusses some of the similarities and differences between Borderline Personality Disorder and Complex Post-Traumatic Stress Disorder. Topics include blame and guilt, environment and personal responsibility, validation, trauma and self-diagnosis.

Dr. Jacob is at the forefront of treatment for people with BPD, including those who experience co-occurring psychiatric conditions such as substance use, eating disorders, depression, or anxiety. Her short bio:

"Karen L. Jacob, PhD, is an expert treater of those with BPD, a Program Director for a Borderline Personality Disorder Treatment Program, and an Instructor of Psychology. She received her PhD in clinical psychology from Clark University and completed her post-doctoral training at Cambridge Health Alliance at Harvard Medical School. Her clinical training has been primarily in cognitive behavior therapy (CBT) for patients struggling with mood, anxiety, and personality disorders, as well as in mindfulness, mentalization, dialectical behavior, and biofeedback therapies.

Dr. Jacob has an extensive research training background, having studied topics including diabetes, adoption, attachment, panic disorder, and psychotherapy outcomes. She has authored numerous papers and presentations and was honored with the Hiatt Scholarship. Her current research interests include understanding the effectiveness of empirically-supported treatments in clinical contexts and in elucidating mechanisms of change in treatment. Dr. Jacob has a particular interest in understanding the relative impact of different components of treatment on outcome, as measured by both symptom and functional improvement."

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Disclaimer: "Please be advised this video may contain sensitive information. All content found within this publication (VIDEO) is provided for informational purposes only. All cases may differ, and the information provided is a general guide. The content is not intended to be used as a substitute for medical advice, diagnosis, or treatment. If you have specific questions about a medical condition, you should consult your doctor or other qualified medical professional for assistance or questions you have regarding a medical condition. Studio Comma The, LLC and BorderlinerNotes does not recommend any specific course of medical remedy, physicians, products,opinion, or other information.

[mcparks]

My wife has Celiac Disease, and I have BPD. She has REALLY struggled for years understanding my disorder. Just recently, we had a great talk that really turned on the lightbulb for her.

BPD is Celiac Disease of the Psyche.

When a Celiac gets even a tiny bit of gluten into their gut, even accidentally, their protective system, their body's defenses go into MAJOR overdrive and attack itself and cause even greater damage to the gut, the rest of the digestive system, the nervous system, the immune system, and the rest of the body.

When a Borderline gets even a tiny bit of abandonment or rejection into their psyche, even accidentally, their protective system, their body's defenses go into MAJOR overdrive and attack itself and cause even greater damage to the mind and spirit, the rest of the psychological systems, the nervous system, and the rest of the body.

[sacksoh]

And as I watched this, I had to tell myself, "you were definitely abused with a capital T. This video does not speak to your experience, nor does it speak to the experience of most folks diagnosed with BPD." My BPD diagnosis came first, then years later came the PTSD diagnosis. Why? Because for many years even I didn't know how to talk about the abuse I suffered as a child. "The Body Keeps the Score" by van der Kolk does an excellent job of explaining why that is. Abuse isn't always obvious to a child -- some of the most heinous abuse is done by the most charismatic, manipulative parent or parents (my words -- not van der Kolk's.) Child development in the wrong hands can really screw a kid up. Doesn't mean we stop trying. Just means we need to honor our experience before we can heal.

[nicholasbogosian]

It was during an 8 year chronic trauma situation where I had BPD traits arise (but leaning more towards CPTSD traits). Resolving dissociation has been the biggest thing in returning to neutral. If you really research dissociation, it can be argued that it is at the root of most BPD and CPTSD symptoms. Not existing fully in your body alters the way you think and process information.

[sacksoh]

I've been clinically diagnosed with both. IMO, I think the BPD was a maladaptation to the chronic trauma that didn't end until I was kicked out of the home -- & that same trauma, to this day, has never been acknowledged. I don't think my experience is uncommon. That's why BPD & CPTSD overlap so much. How many kids from abusive homes grow up & go on to hear from the abusive parent, "I was horrible to you, I am sorry, & now I'm going to shout from the mountaintops so everyone will know what I put you through." Confiding in others often yields mixed results that are sometimes trauma-reinforcing. Trauma is an isolating conspiracy of silence a person often has to learn to live with from a very young age. Of course it's going to affect personality development.

[frannybkranny]

I was a full grown adult on the outside but not emotionally developed. I was still seeking my mother's love and approval as late as my 40's. It was in that decade of my life that things were becoming clearer to me as I learned more and more about BPD. It's hard to say that as an adult I was responsible for my actions. Having had so much trauma from the past and in the present that I was carrying...I was literally on autopilot...not ever really processing anything because life/the world doesn't stop for your trauma. As a mother you have to keep trudging forward because you have kids to care for. Dissociation and psychoses pull your mind out of the world and you're just a shell of yourself. My life was like a movie and I was on the outside looking in in a dream state. Always reactive. Hostile, angry, outbursts. Manic and depressed...all while trying to raise 3 babies. Hypervigilant. Making myself a barrier between them and their father who was a self-confessed child molester (which I learned later). More trauma, as I, myself, was sexually abused as a child. It was another layer of trauma added to the miles high list of traumas I still had not yet processed including exiting a cult. Please don't judge me. It took hitting rock bottom and losing them to him to understand what had happened to me. That I had a deeper mental illness than depression. I was misdiagnosed. I was not being treated for Bipolar and BPD. I was very hard on my eldest child repeating the same behaviors I experienced with my own mother with her. My life was on repeat like Groundhog Day. Today, I see clearly what I could not back then. Am I responsible? How could I have known to do better if I was not self aware? If I was undiagnosed...and carrying the weight of the world on my shoulders? I did not know anything about BPD (me)...nor Narcissism, or Anti-social disorder (my mother, my ex-husband). Perhaps if I'd had help...someone to talk to and help me process my life, I could've done better.
Thanks for listening.

[Birthdaycakesmom]

I have someone in my life with BPD. The most difficult thing is when they get upset with me because I often struggle to understand why something is upsetting them when just the day before it was fine, and was even desirable. As well, trying not to let what they say get too deep inside.

[a.a.]

One study cited (a large one) by Bessel Van Der Kolk giving a conference on BPD & CPTSD was that 84% of BPD sufferers had symptoms of PTSD as well. 84%.

I believe the reason the field struggles with all these overlapping syndromes & diagnoses (Is it X or is it Y?) is because we aren't asking the right questions to get at the crux of the issue: what happened to you in your upbringing ? My greatest contention with the newly shifted biological model paradigm that the medical field has taken to understanding mental health syndromes (because that's how the DSM began- recognizing these affective states, thoughts & behaviors as syndromes- an amalgam of the human experience) is how it discounts the psychosocial & emphasizes the biological when we can't even properly quantify the chemicals creating these 'imbalances'.

Apologies for the major rant, but it's frustrating that it's so heavily focused on determinism rather than acknowledging the psychosocial realities underlying the collection of syndromes these 'diagnoses' share.

[JMSsssssss]

Interesting. I've been in therapy on and off for over 30 years. I didn't get any kind of a diagnosis until last year, at the age of 53, and that was CPTSD, at a women's program at Macleans. However, I don't have flashbacks or nightmares, which leaves me wondering. I also have never self harmed or been suicidal, and I've never engaged in risk taking behaviour. I have however suffered in the past from severe social anxiety as well as not wanting to live, and I don't connect easily with others. And I have had plenty of anger over the years. I only fixate on a diagnosis as a way to further understand myself and "what happened to my personality". It seems like the logical approach either way is insight - understanding the root of our behaviour. I've done a crap ton of self examination over the years. I am not without defense mechanisms to this day, but I am far more functional than I used to be. I am able now to have empathy for my father, though I can't say that I have forgiven him. Thank you so much for making these conversations available, they are really helpful.

[stephanier]

Not "all" people are "doing the best they can" in any given moment....

Serial killers are NOT "doing the best they can" unless you mean needing to destroy women/children/men/animals.
Rapists are NOT "doing the best they can" unless you mean taking what they want when they want it.
Child predators are NOT "doing the best they can" unless you mean getting their sick need for sex with little ones satiated.
Sadists are NOT "doing the best they can" unless you mean deriving maximum pleasure from the suffering of others.
Psychopathic police officers are NOT "doing the best they can" unless you mean using their position of trust-authority to exploit the vulnerability of others.
Predatory teachers and coaches are NOT "doing the best they can" unless you mean using their position of trust-authority to prey on vulnerable kids who may not be getting their needs met at home.
Predators....in general...no matter who they are or what gender they may be/choose are NOT "doing the best they can" unless you mean doing the best they can to exploit weakness in others and NOT getting caught or held accountable while doing so.

Abusive parents are NOT doing the best they can because they sure as hell do not walk around abusing their children in front of people who can hold them accountable....and ESPECIALLY not when they BRAG to their friends, decades after they abused you, about just what they did, all so they can take pleasure in their sadistic satisfaction one more time...

Some abusive parents are NOT sorry for what they did....they GLOAT decades later to their friends/associates about just how abusive they were to you....sometimes while those "friends" look on in shock at what they are hearing/seeing transpire before them.

I don't have BPD (a disorder I would not wish on my worse enemy), but I cannot imagine how telling someone with BPD that their sadistic parent "did the best they could".

Sadistic people are completely capable of behaving appropriately in front of law enforcement.

....and even when psychiatric professionals tell sadistic parents that THEY are the problem and 100% the cause of a child's issues (as a psychiatrist told my mother about the problems my older brother was having) the sadistic parent plays the victim of an unfair system who 'blames everything on the mother" [a predictable and expected response from a narcissist].

You can CLAIM that people are "doing the best they can" in the moment....but when they are ENJOYING the retelling of the abuse they inflicted on their children to their friends, 20-30-40 years after the physical abuse stopped, but when the adult-children have returned home to revisit the abusive-parent, that is...in my opinion...the ANTITHESIS of an adult "doing the best they can".

[phd-c]

Starting to love this very bright lady, bet she drops some real truth bombs 💣

[LuxMeow]

I haven't really done 'not good stuff' to others more likely to myself. If anything I've been told by ex's and others that I've lifted them up in life and added value to their life in a good way. Sometimes to the point where they can't/don't want to let go. So I think a lot of the idea all of us borderlines wreak havoc on the life's of others is part of the stigma or stereotype. For people who experience BPD as I do, we turn inwards with a lot of our turmoil and don't want to bother others with our depression and so tend to avoid and isolate more than involve others. On good days we want to be around people and they only really see our best, calm self even if our inner state is chaotic. Some people will never even know or suspect I'm anything other then well balanced with a good head on my shoulders. They really have no idea how much torment I am living in on a day to day basis. If anything many people come to me with their issues and that also makes it hard because sometimes it can become too much trying to balance my own pain while also being supportive to other people's.

[zzendawgie]

I so appreciate this channel and the maker of these videos! This one in particular with Dr. Karen Jacob is great. I’m a therapist and learn so much from this content. Thank you

[chrissilver]

People call me selfish when I am triggered and want to self-protect. I know I can be selfish, but calling someone with BPD selfish, seems like a disparaging, invalidating, oversimplification of what is going on in me. Does anyone else feel this?

[lynnbarr]

Please do more interviews with Dr. Jacob, she’s on it!

[pavlinar]

Another video with dr. Jacob... and it could not cover a better topic, that I wanted. Thank you for another one with this clinician! Big thank you 🙂.

[tinabod]

I was labeled bpd for years, and yes I can see I had traits... but I noticed here, hospitals and some therapists are so quick to diagnose bpd... But I found the stigma prevented me from reaching out... I did once and told myself never again.... I've been with my therapist for 3 years she worked with bpd clients before opening her private practice.... She hates labels and never labelled me, but recently I needed a report for something and so we talked about diagnosis... She said cptsd, but because it isnt in the dsm she had to write bpd traits.... I was weirdly happy after hearing her thoughts... I think because I was away from that bpd stigma....

[sophial]

You guys are interpreting this the wrong way. She is simply saying, you can have a BPD diagnosis without trauma, trauma is not necessary to be diagnosed with BPD. She also says that, that doesn’t mean that you can’t have experienced trauma. And she even says that you can have both a PTSD diagnosis and a BPD diagnosis.

[smokerscough]

BPD is used to discredit women. Doctors are quick to slap that personality disorder onto a woman who has a history of childhood trauma. CPTSD is the way forward as it is a less stigmatizing label and allows breathing room to patients. All this video does is try to discredit the lived reality of so many people who do not feel BPD is descriptive of them

[LurkingLinnet]

This was so good! Just spot on! Thank you, it was very comforting as well. Really means a lot, Thank You❤

[daisydeg]

Hi please could you make a video explaining the differences of DID, CPTSD and BPD. Regarding Dissociation symptoms, PTSD symptoms, emotional regulation. As these diagnosis have great amounts of over lap between the 3 while also being completely separate diagnosis in how the brain with each separate dissorder will be connected.