LTR'ing a rape victim

RedPillN00B · 2016-09-09T18:18:04+00:00

I know this is frowned upon, but hear me out. If a girl has all the qualities an alpha would look for in an LTR, but that girl is a victim of rape, what would...

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It certainly is underdiagnosed in men. You know what's interesting about what you say? The recovery rate for borderline is very high after a ten year period. People generally get borderline (as with most personality disorders) in their mid-20s. With lots of professional help (DBT is the treatment of choice) many of us reach recovery. 9 years later I did. That doesn't mean BPD isn't real - it means many people get better.

If you're on lamictal I'm guessing you're BP? I wonder if you were diagnosed with BPD if you'd believe in it then? I was in and out of the hospital 11 times.

If you still don't believe in BPD you might want to check out Marsha Linehan, the world's expert on BPD and the founder of DBT. Coincidentally, she had a very severe form of BPD when she was younger and very courageously came "out of the closet" about it a few years ago.

One of the world's experts on bipolar disorder, Dr. Kay Jamison, not surprisingly has the disorder herself as well! Once you've LIVED with it and been seen by many many psychiatrists and have had to change each of your symptoms (with help) one by one, then you know it's real.

There is no question that people are often diagnosed and that diagnoses can vary from one doctor to another. Yet the symptoms of BPD are so clear and markedly different from the other disorders that I've never heard anyone say they didn't "believe" in it. My life was hell for five years until I finally started to get better.

[–]SoRedSuchAlpha0 points1 point2 points 9 years ago* (3 children) | Copy Link

I have great respect for Linehan. Developing DBT was an incredibly important achievement. It's a little too twee for me to try it myself but the evidence in favor of it is quite compelling. In fact, her work substantially contributed to my BPD skepticism.

To be clear, though -- BPD skepticism is not a position I came up with on my own. Later today I can dig up my own expert opinions, or at least professional opinions (as in, I know I can cite the opinion of practitioners, not sure if I can cite a study). I personally am not a professional, just an educated layman. I may be confused about the details or making an error of reasoning, so let me lay out the facts as I understand them.

A "disorder" is a conceptual way of grouping together patients who are somehow "similar" to each other so that they can be studied and treated more easily. A disorder is "real" if it's useful and justifiable to group those patients in that way. There are 3 senses in which a disorder can be "real". Beginning with the most objective, you have organic or neurological disorders. These are the ones where you can locate the source of the disorder on a brain scan and/or the ones for which there's a proposed biological mechanism in play. Mood disorders don't have a known biological cause but they do have biological signs. Major depression is characterized by reduced levels of serotonin, norepinephrine, and/or dopamine. As far as I know there has been no proposed neurological mechanism for BPD.

The second way a disorder can be real is if it has a consistent social etiology. The concept of "PTSD" groups together patients with similar life experiences. It turns out that those life experiences are reliably linked to a set of symptoms, so we can say that PTSD is a "real" effect of trauma. BPD patients frequently have a history of family abuse, but there are no required events or experiences in the formation of BPD. The final and most subjective way a disorder can be "real" is that it might group patients whose symptoms have diverse causes but respond to the same treatment. "Narcolepsy," for example, has recently turned out to come in 2 variants with different biological causes, but both versions respond to the same medications. Whether BPD is a useful clinical category is necessarily subjective.

The DSM-V lists BPD with the "Cluster B" personality disorders, implying that it's similar to the Antisocial, Histrionic, or Narcisstic personalities. Although it's broadly true that all 4 types of patients tend to behave in more extreme and destructive ways than patients who present with Cluster C disorders, Borderline is actually very different from the other three. Perhaps the most important difference is that BPD does respond well to treatment, while the other 3 are famously untreatable. For a narcissist or psychopath, their "disorder" is just the way they are. It's fundamental to their, well, personality, and it can't be treated because those people don't see anything wrong with being who they are. Narcissists like being narcissists, but BPD folks hate being BPD. They would love to stop behaving that way, and with treatment many of them do. '

Most BPD patients were sexually abused as minors, and most of the rest were emotionally abused.

Finally, although PTSD as described in the DSM is a short-term disorder with very specific symptoms, therapists are starting to recognize that trauma can have effects that are more subtle, but also long-lasing and pervasive.

I'll post my actual argument as a reply to this comment, but please do let me know if you need to challenge any of my premises.

EDIT: I forgot to list one more premise: Women are vastly more likely to be diagnosed with BPD than men are. This might mean that Men are underdiagnosed, that women are overdiagnosed, or that women really are more likely to have it. Men are much more likely to be diangosed with ASPD than women are. This could mean that men are overdiagnosed, women are underdiagnosed, or that men really are more likely to have it.

[–]gattofila 0 points1 point2 points 9 years ago (2 children) | Copy Link

DBT didn't work for me at all. Btw I acknowledge how well you've informed yourself about the disorders, especially without a professional degree. My having BPD and also having majored in psych and then mastered in it really helped me understand the difference.

Many of the things you say make sense. I'd be very interested to see sources for how you came across a lot of this information. It's true that there is often a huge overlap across symptoms of the various disorders - that's why comorbidity is so high amongst psych patients. In fact, if you've got one diagnosis I'm betting you probably have another. I certainly do.

One of the things that's interesting about BPD is the stigma within the mental health field about the treating people with the disorder. These patients are often very difficult to work with. I've had to struggle against that misperception (since it doesn't apply to me) throughout my entire treatment process.

The symptoms of BPD are so very markedly different than any of the other psych disorders that it's not one of the personality disorders that I think doesn't need to be in the DSM. Actually, considering it has the second highest mortality rate of ALL the mental health disorder I would argue it needs to be studied much more to prevent future fatalities.

I think your perspective is interesting, but trying to explain to any specialist in the field why you don't think BPD is real, specifically a professional who actually has the disorder and has studied it for years, is a bit like me trying to tell you're you're not bipolar (without having studied it academically or having it myself).

I appreciate the fact that you've educated yourself to the extent that you have and correct people who very dangerously throw the terms around (other red pillers in particular) who have no idea what they mean. That leads to further ignorance and stigma about the disorders.

I think dialogues like this are very important. I may learn something from your POV and vice versa. I doubt we'll agree on everything but for me, BPD, has been an incredibly challenging and empowering part of my life.

[–]SoRedSuchAlpha0 points1 point2 points 9 years ago (1 child) | Copy Link

Here's a recent article from my university outlining the feminist critique of BPD. As for sourcing my factual claims, you might actually want to start with Wikipedia. Their page on Borderline Personality Disorder has 180 footnotes! Some highlights:

As is the case with other mental disorders, the causes of BPD are complex and not fully agreed upon.[33] Evidence suggests that BPD and post-traumatic stress disorder (PTSD) may be related in some way.[34] Most researchers agree that a history of childhood trauma can be a contributing factor,[35]

34 and 35 refer to studies by Sabo and Kluft respectively.

There is a strong correlation between child abuse, especially child sexual abuse, and development of BPD.[55][56][57] Many individuals with BPD report a history of abuse and neglect as young children, but causation is still debated.[58] Patients with BPD have been found to be significantly more likely to report having been verbally, emotionally, physically, or sexually abused by caregivers of either gender. They also report a high incidence of incest and loss of caregivers in early childhood.[59]

Sources are Cohen, Herman, Quadrio, Ball and Links, and Zanarini et al.

Alternative suggestions for names include . . . . Another term suggested by psychiatrist Carolyn Quadrio is post traumatic personality disorganization (PTPD), reflecting the condition's status as (often) both a form of chronic post traumatic stress disorder (PTSD) as well as a personality disorder.[57] However, although many with BPD do have traumatic histories, some do not report any kind of traumatic event, which suggests that BPD is not necessarily a trauma spectrum disorder.[64] The Treatment and Research Advancements National Association for Personality Disorders (TARA-APD) campaigned unsuccessfully to change the name and designation of BPD in DSM-5 . . .

Is there anything else you wanted sources for? The other factual claim I remember making is my assertion that NPD and ASPD can't be treated, which I think is common knowledge or at least conventional wisdom.

EDIT: by the way your mention of "other red pillers" made me realize you've assumed (quite reasonably) that I'm a red piller. I'm not, I'm a liberal feminist.

[–]gattofila 0 points1 point2 points 9 years ago (0 children) | Copy Link

I apologize for the assumption! I think the idea of changing the name of the disorder is ridiculous. I note that the "many individuals" certainly isn't the 75% I saw you claim yesterday. I'm not one of those individuals - though I was emotionally and physically abused.

I noticed in a lot of your posts you don't include links to actual resources but you toss percentages and statements around a lot and that's not a good idea because some people reading what you write might believe it's true.

I think THIS is the most telling however, "as is the case with other mental disorders." There we go! People are always arguing over these disorders - are they over-diagnosed or under? Are women overdiagnosed with some and men underdiagnosed (absolutely in terms of BPD).

The DSM 5 is just a tool. As a practitioner it's SO so important to be aware of our clients' other behaviors, including tone of voice, gestures, eye contact, current or past use of drugs, self-harm, any previous admissions to the hospital, etc.

Many people seem to still trying to take psychology (and psychiatry) into the realm of the "hard sciences." We're getting a lot more information about how most of these drugs work and how some people's brains who have the are different than others.

That will never change the actual experience of having the disorder itself. Millions of people have BPD and thousands are dying - why would we remove it from the DSM? How about reducing the stigma and actually studying it more and researching other ways of helping people who have it?

The thing I most wanted to know is this and tell me if it's too personal. Whatever your diagnosis is or was, how would you feel if an "educated layman" without the disorder told you he/she didn't think it existed? That's what I'm the most curious about.

[–]SoRedSuchAlpha0 points1 point2 points 9 years ago (1 child) | Copy Link

I'm pretty sure you're making a Bayesian error here.

TLDR: There's only a 5% chance she has borderline.

Most women diagnosed with Borderline have been sexually abused. However, it doesn't follow that most people who have been sexually abused will develop borderline. Most CEOs are male, but most men are not CEOs. Most people with cancer will test positive for cancer, but most people who test positive for cancer don't have cancer.

According to some website with sources I can't be bothered to check, 2% of american women have Borderline and 3/4 of them have been raped. That means 1.5% of american women are rape victims with borderline. To figure out what % of rape victims have borderline, you need to know what % of women have been raped. This is disputed, political, and dependent on age, but I think we can agree that at least 15% of women in their 20s have been raped or molested. If 15% of women are victims, and 1.5% of women are victims with BPD, then only 10% of rape victims have BPD. Many of those will be unstable in ways that are immediately obvious, so if she seems stable, the chance is reduced.

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Title	LTR'ing a rape victim
Author	RedPillN00B
Upvotes	0
Comments	24
Date	September 9, 2016 6:18 PM UTC (9 years ago)
Subreddit	Posted in /r/askTRP
Original Link	https://old.reddit.com/r/asktrp/comments/51yu8t/ltring_a_rape_victim/
Archive Link	https://theredarchive.com/r/askTRP/ltring-a-rape-victim.111061 https://theredarchive.com/post/111061

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