Voicelessness and Emotional Survival Message Board
Voicelessness and Emotional Survival => Voicelessness and Emotional Survival Message Board => Topic started by: jordanspeeps on August 05, 2007, 08:32:21 PM
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In my Psychiatric-Mental Health Nursing class, we learned, in no great detail, may I say, a bit about personality disorders and what nursing interventions we should employ when dealing with patients with personality disorders in the hospital setting. In fact, most PDs are lumped together and treated similarly. There is not necessarily a huge difference in the way you would communicate, educate, limit-set, etc., between Ns, Borderlines, Anti-socials, Histrionics, Schizotypals, or Compulsives. Interesting take, nursing has, on the best ways to deal with PDs, but I can go into that later. But it got me to thinking and what I found upon deeper research into PDs was fascinating and I wonder if anyone here can vouch for this:
Does NPD seem to encompass or summarize many of the characteristics of other PDs? When you look at the other PDs, do you find that your N exhibits many of the other disordered traits, (manipulation, suspicion, self-focus, negativism, lack of accountability, lack of introspection and empathy etc.)? I recently realized that according to the DSM-IV TR my mother is also a classic Borderline PD and quite the little Histrionic as well. She has recently admitted to believing at one time (this was a ploy I believe to get me to admit that I thought she was crazy), that she may have been Schizophrenic. She most certainly has bouts of Depression and Anxiety. Honestly, I look at the characterizations of the various personality disorders and see it all in her. Maybe she’s a class A nut case of the highest order; unique and isolated in her pyschological mosaic. Or maybe Narcissism is a catch-all disorder that both trumps and includes all the other PDs. Just a theory. I’m curious to know if anyone else can relate. Here’s a succinct description of the various PDs:
http://www.mayoclinic.com/health/personality-disorders/DS00562/DSECTION=2
Googling “personality disorders” will give you more detail and the best definitions are in the DSM IV-TR, there is an online version, I believe.
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This is just my experience. I looked for my whole life to find out what was wrong with my mother. When I found this board and Vaknin's book, I knew with all certainty that she was an NPD. It explained it all. It was a huge ,profound relief.
She did not really fit in to any others.IME, I think that NPD defines a certain type of person. When it fits--- it fits. That ,for me, was the total and complete answer and my search was over.
Other people ,might have a different experience . I really like your posts, Friend Love Ami
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Jordanspeep, I was interested in your post and also interested to see that you are a full member. I've been around for one year and didn't remember you name. Out of curiousity I looked up your recent posts and read part of your story posted last August and found that very interesting.
I am fascinated by the similarities you identify in the various PD. Your list in and of itself is fascinating to me: (manipulation, suspicion, self-focus, negativism, lack of accountability, lack of introspection and empathy etc.)
I have NEVER seen negativsim listed among the characteristics of Ns but it is one of the most frustrating of both my parents personalities and until recently my own. I have only recently become aware of the lack of introspection of both my parents. I really never thought about that in regards to my father but one of the psychiatrists mentioned it in one of his competency hearings and my brother picked up on it. It makes sense to me that a person who has no insight into their own lives could not possibly have empathy for anyone else. My NPD father also has paranoia - I never would have recognized that until his psychiatrists did. His expression of paranoia does not sound like fear but more like an annoying irrational thought. For example (try not to laugh too hard) when my father renewed his liscense this spring he listed as his address, his former wife, who does not forward his mail, because he didn't want the government to know his address. Consequently he has no liscense. Why didn't I see this a paranoia? Because he will tell anyone the story as a matter of fact - as though it is reasonable. He doesn't hide the fact, he's not whispering and looking over his shoulders, so I didn't recognize it as one of a million small examples. He and my mother could simply be named Manipulation R Us. And slow though I am - after 24 - count them 24 years of counseling I finally, that is, FINALLY recognize that they are MANIPULATIVE. (It frightens me to think what it is going to take me 25 more years to figure out!!)
All of this is to say - your perceptions are very interesting to me and your story is very interesting to me. I really applaud you for making such enormous strides at such a young age. I applaud you and I'm envious. Would that I were anywhere as far along by your age.
I'm so glad you are posting again and hope you will stick around for a while. Thank you - Gaining Strength
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Hey Jordan,
I have pretty much worked with PD's of one form or another since I qualified as a psych nurse in 87. If it's any help I worked for a year in a therapeutic community for PD's. The ethos behind this programme was basically that The PD's managed themselves as whatever PD they had , they all had the same basics... i.e. manipulation, self focus, lack of accountability, and lack of insight. Therefore they couldn't pull the wool over each others eyes. They stayed there for a year. It was fascinating work. They did all have the basics but thenthey had different extras on top of those.
Spyralle x
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The general rule of thumb is that all psychopaths are Narcissistic.
What you have is an N who commits crimes.
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Spyralle,
PDs living together....... cannot imagine it. Tell more I am really interested in how you can stay sane in the middle of all of that
axa
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Hey Izzy,!!
Welcome back!! how was your visit?
Waves!!!
OVER HERE!!!! I got the N WHO COMMITTED CRIMES!!!
Deb
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Hey Jordan
Welcome.
Yes I agree that my X probably fit all those descriptions.
I would classify mine as a CLASS A NUT.
I would like to hear more about your thoughts. Very interesting.
Nice to meet you.
Deb
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Hello all,
To Ami: thanks!! I like your posts as well. I, too, knew exactly what I was dealing with once I visited Vankin's site and then came here. Honestly, with the exception of God's grace, this place, this forum has probably been the single, most healing factor in my walk with my Nfamily. When I came here back in June of 2005, I was so excited to have deciphered the lifelong mystery of why my life was the way it was. When I started to read of other's experiences I knew I was home, so to speak. A fall-out with a board member caused me to retreat and not be so open and vulnerable but I never lost my love for what goes on here. God bless Dr. Grossman for developing this place!!
To G.S.: I hope I can stay around a little longer this time, however, I'm in this breakneck accelerated nursing program that won't relent in it's demands on my time and energy. I expect to graduate in Dec. of this year, but sheesh, it has truly taken it's toll on my family life/personal time/social life. With regard to negativism, G.S. I see it in my mother in subtle, mostly manipulative ways. But I recognize it as pessimism all the same. She doesn't believe in people. She believes that people have to be constantly cajoled into doing what she needs them to do and that it is such a cross for her to bear to have to be such a source of strength and knowledge all the time. She's getting weaker, more dependent, and this makes for a much unhappier N. She feels used and she's constantly complaining about how people take advantage of her. I'm not sure if she's like this with everyone and she does consider me her "doctor/therapist" now that I'm in nursing. Sometimes I feel like Dr. Melfi giving therapeutic communication with a socio/psychopath who just doesn't get it. I don't know who here watched "the Sopranos" but, I could really relate to her when she said that she wanted to stop seeing Tony because providing him therapy was actually doing more harm than good as he would just use their sessions to justify his off-thinking and to process his evil deeds without ever really taking responsibility for the role he played in creating them. Sorry for the tangent, but being one of the only people my mother truly confides in, it can be harrowing to endure her N-logic, based in her own low self-esteem and envy of other's genuine happiness. So I would agree with you there any negativism is probably more an offshoot of their own desire to manipulate you into buying into their "poor me" plight.
The paranoia is also astounding. It could be born in the fact that, in my mother's case, she really has done a considerable number of BAD acts. And it's catching up with her. Cheating, lying, neglecting, bearing false witness have been staples of N-arsenal for years and years. I believe all the souls she's hurt and all the innocents she's damaged as a nurse, business leader, and clergymember are plaguing her somewhere in there and she's quite paranoid of who and/or what will come to exact their vengeance. This could be from any of her own children, whom she Munchausened-by Proxy from birth, to the IRS whom she's slighted and ducked for the past several years. Whatever the case, it's all catching with her and I can sense the paranoia in her. She can't sleep at night. She has to have someone there in the house with her. Her blood pressure sky-rockets and she gets palpitations. Again, these could be manifestations of anxiety or even manipulation as she does have a way of preceding her episodes with consumption of known offenders like McDonald's fries and mega-large sweet teas, but she does this, I believe in a ploy to maintain contact with her children and to keep them from leaving her alone. She's taken to Munchausening, if my create a word, herself.
The Borderline part, is brought on when her children, mind you the youngest of said "children" are 31, attempt to get space from her. She freaks. She starts in with the ER visits and the protracted hypertensive and heart failure episodes and although they are real clinical manifestations, they most certainly are brought on by her own fear of being left alone. She's a Nurse Practitioner for goodness sakes. She knows how to take care of herself. She has one of these wrist watch type blood pressure monitors that she's wears constantly, needless to say, not as reliable as an arm cuff type, but of course when it reads wrong, nobody around there really knows why. She has everyone on full alert that either her blood pressure is going out of control or that her blood sugar is going nuts or that her shortness of breath is becoming more intense. She'll say, "I almost stroked out, last night!" Imagine my own dismay, to be a student nurse who knows how serious these problems are and how quickly something could go horribly wrong and take her life, not able to respond with full vigor, because I'm almost positive she is "crying wolf" or has done something to precipitate her own sickness. Her last MRI showed that she has, to quote the doc, "the brain of a twenty year old," (of course, she managed to squeeze in this braggardry while at the same time complaining that no one is taking her ill health seriously) Brilliant :?
Spyralle: Thanks for your observations. I'm curious to know if you are still in psyche nursing and if not, why?. Isn't it fascinating work? I do believe that someday, once I've begun to get my "feet wet" in the field, I'm going to gravitate towards that type of nursing. I've been doing my Management Practicum and Senior Synthesis in the Adult Psyche dept of the University hospital and that extra exposure to psych nursing has really had an effect on me. I'm sure my FOO makes me a little more interested in this field, as most of my fellow classmates won't touch it with ten-foot pole. I remembered my peers being petrified of going into our Psych clinicals. I rather enjoyed it and my clinical instructor said I understood the "art" not just the science of Psyche nursing. It's probably because my having a NPD grandma, NPD/Borderline/Munchausen mom, introverted NDad, Bipolar brother, Epileptic brother, and rising Nsister, I had more than enough experience getting through to the crazies. I myself struggle with anxiety and I have developed more than a few tools for combating that. Anyhoo, like axa, Spyralle, I wonder what your psyche-nurse experiences were like and if you would endorse that line of work.
Isitoolate: I so want to expound on the point you made, but I'm such a long winded writer that I don't want to overwhelm. I have a ton of readings on Ns and psychopaths, spurred on by my being convinced that my shy, non-descript father is in fact a psychopath. I've been having these flashbacks to my early childhood when I'd seen things that I've yet to be able to explain. I know that he is what they call an introverted N, but I think even worse than that is that he is hiding some dark, dark secrets. I totally agree with your statement there.
Thanks for the responses guys and until later,
tiffany
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Hi Tiff,
It's wonderful to hear your voice and your post was just amazing.
(As is your Nmother.)
I am so impressed with how accurately you see her; I know you'll get the same clarity on your father.
I'm really glad you had time to pop in, but sure understand an insane schedule.
Take very good care of yourself while racing, okay? And come back for more when you get a breather.
It's really good to hear from you.
love
Hops
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She starts in with the ER visits
LOL My mother started in on the ER yesterday. She called me mid morning feelings terrible with numbness in her legs and hungry. I was walking into the grocery store and asked her what I could bring. In a pitiful voice she said she would wait until lunch. By mid afternoon she said that she had called her dr's office and they said for her to go to the ER but she would wait until I got back from lunch. I called my brother who called her and told her that from now on she would have to have a sitter on the weekends because we could not continue to be available to take her to the hospital. (We have lived at the hospital off an on for both parents from May 13th until July 23rd. ) The trouble is - it is hard to tell if her request is genuine or not. When I called at 4pm and said I was ready to take her she said she felt much better. She didn't feel llike going today when she had a sitter.
It is very interesting to me to finally understand that all of this is about N ism.
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In my experience, narcissism seems to have traits of borderline personality disorder along with it.
Kay showed the typical N signs of "lack of empathy, grandiosity, projection" but she also was very able to "feel guilt, alternate between the come close/get away, codepent behaviors."
Mary was borderline all the way...not a stitch of real cruelty in her. She would hide behind her husband and let him be the "heavy" if she wanted to lash out at me or cut me off. She would say "Bill is right here next to me" as though that was sposed to scare me or make her feel protected.
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Hey Jordan,
I'd say you were spot on with your insight into why you are considering psyche nursing. A therapist once said exactly the same thing to me. I always work in the most chaotic and unsafe situations. He said that was familiar to me, so what most people would find abhorrent or just plain scary I'd be happily wandering in there without a care in the world. the good thing about that though is that I have an ability to connect with chaotic people and I have really enjoyed my work over the years. I chose to always stay where I was familiar. Basically with PD's of one type or another and now specialising in addiction. I have no regrets, not even one about the career path I chose even though N mum says it is only the 'lowest of the low' who would do psyche nursing. They were convinced for some reason that it would drive me insane and I would start hitting myself over the head with bottles.. Bizzarre but true.. Needless to say.. I'm not and I didn't...!!
Axa... You are right that was the closest I came to going insane, not so much because of the PD's even though they were bad but more so because of the staff. There was an awful lot of counter transference going on and minimal supervision. It was quite difficult to differentiate between staff and patients. In some respects though it worked... the PD's ran the place.. and if you didn't stick to the rules you were gone... Fascinating work.. Only stayed a year though.. else I might have just become one of them...
Spyralle xxx
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Spy,
In some respects though it worked...
How so? Did any of them actually improve?
mud
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jordanpeeps,
hey, i'm doing my prereqs to apply for a psych NP program, myself! psych stuff has always really fascinated me. especially the personality disorders.
from what i've read, a lot of people tend to lump the PDs together. they do tend to have a lot of the same characteristics, for sure. but they have been separated for a reason.
i've read stuff by Invicta, who apparently is an MA in counseling/psychology. she has some interesting stuff to say about this very topic.
for me personally, i can see how NPD and psychopaths have much in common. however, i always had this problem, after reading Vaknin's stuff so much, as he tends to equate the two as being the same thing....when in reality, if you dig deeper and read other people's stuff, NPD and psychopathy can be differentiated. my problem was that my N father has ALL the symptoms of an N per the DSM criteria, but to my knowledge, there is no real proof that he's ever done things a true psychopath would do....say like financial fraud, outright sexual abuse (although there were some things that were disturbing), violence, hard crime, nothing like that. so when reading how Ns supposedly do all of this stuff (in SVs works), i kept wondering why my father had never really done that kind of stuff.
anyway, here's some of Invicta's writings:
http://www.angelfire.com/zine2/narcissism/malignant_narcissism_vaknin_revisited.html
http://www.angelfire.com/zine2/narcissism/narcissism_checklist.html
There are a lot of links on those pages up there....interesting stuff.
But yeah, I can definitely see where they overlap. Like when someone with BPD rages at the first sign of being abandoned, I don't see how that's terribly different than the rage an N goes into when they perceive someone may have insulted them. Or when an N devalues and discards their entire family because they have a new one, I don't see how that's so different from someone with antisocial personality disorder doing the same thing. Or when someone with BPD creates chaos and drama all around them...how is that different from HPD? Maybe the differences lie within the motivation and thought processes, rather than the resulting behavior/action.
Also, I have read that people often will have more than one PD.
I think we don't really know enough yet about PDs, is what it comes down to.
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But yeah, I can definitely see where they overlap. Like when someone with BPD rages at the first sign of being abandoned, I don't see how that's terribly different than the rage an N goes into when they perceive someone may have insulted them. Or when an N devalues and discards their entire family because they have a new one, I don't see how that's so different from someone with antisocial personality disorder doing the same thing. Or when someone with BPD creates chaos and drama all around them...how is that different from HPD? Maybe the differences lie within the motivation and thought processes, rather than the resulting behavior/action.
It my limited nonprofessional experience it seems to help to go back to what the wounding is
when a BPD rages about being invalidated then if I acknowledge and validate their feelings (this is not agreeing with their reality, it is just seeing it and allowing them to have it instead of insisting that my version is right) then they will calm down because there is space for them, they can accept there are two separate people with different worlds and appreciate the allowing of both in the relationship
if a NPD rages because I don't share their version they will keep raging until they have won my mind and soul, I must agree, there is no room for two people, two worlds, they must conquer they have to be right, to have the last word
besee
yes, that totally makes sense to me. that's good choice of words, too "wounding", rather than "motivation" or "trigger". and you're right about the N and wanting to completely devour your "otherness", your very self.
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Hey Mud,
Yeah they did to some extent. They would start conforming and sticking to boundaries. They regularly elected a top 3 who were given certain responsibilities and they remarkably would stick to them.. You would see them making changes over the year.. opening up, forming realitonships... Don't get me wrong.. they were not cured (for want of a better word) just a bit different Trouble was that we didn't monitor outcomes... See I really don't know how they could have sustained it when they got outside. When they were able to get away with the same behaviours again..... Problem is you can't really change someone's personality.. It's integral to who they are, but I learned that you can in an environment like that see them react in a different way. Saying that, sooo many people left or were thrown out..
Spy x
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See I really don't know how they could have sustained it when they got outside.
Well that's the problem isn't it? Their keepers keep on leaving the cage open and letting them outside.
mud
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Hi all,
About the overlapping...
I think we have the tightest diagnoses that science has come up with...but that's still a limited language.
I think a diabetic can have arthritis and migraines and...umm...allergies.
So maybe personality systems can be likewise as interrelated as physical ones, or at least often coexist...so NPD +/- one or another, although it's got to make things much harder to sort out for the onlooker, doesn't seem unlikely...
eh?
Hops
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Hey Mud,
I reckon the best thing to do would be to put them all on an 'escape from new yorkesque' desert island and let them control each other.. If I ever get to be prime minister.........
Spy x