Co-occurring personality disorder patterns and trauma, seeking advice

Your description is clear, concise, and accurate 👍. Basically, your psyche has "broken into pieces" in order to protect itself and you. Your systems can't tolerate the impact of the unity of all the traumas, so it disassembles itself to ease the shock. The result is what are called symptoms or illness.
According to the Jungians (Donald Kalsched), a major goal in life is to become "whole." That's hard to do when the pieces are broken and jagged. Good therapy over a long period of time could help in reconstructing the Self-patching the good pieces (James Hillman's daimon) together. Smooth out the potholes and speedbumps, and see if you can stay on the road to wholeness.

I also have complex PTSD/Trauma, Dissociative Identify Disorder, and Borderline Personality Disorder (I fall into Cluster B traits). First, I found it helpful to narrow down BPD. I have the “quiet” variety, but sounds like you might have the “noisy” type. There are plenty of sites with definitions of each.

As to the rest, I have also been through many therapies (CBT, DBT, NARM, ACT, etc. etc.) and none made sense to me. That is until my current therapist introduced me to Internal Family Systems (IFS). For example, in your case, you might find that you have a “part” who is self-destructive. Believe it or not, this part is actually a protector — being self-destructive is a part in your doing things to prevent you from facing more traumatic issues. The dissociation is a big part, again a protector, who has been called on so many times to prevent you from being faced with trauma.

I sit quietly each afternoon to talk to any part who wants to come forward. I’ve had a 24yo part whose husband just left her with a baby and parents who rejected her. She became ‘unburdened’ from this trauma by me telling her that she was not rejected or abandoned — she was liberated from toxic people. I also have children parts who just need love and protection from their abuser.

Do an experiment — sit down in a quiet place and when you’re calm and centered, ask (out loud) “would anyone like to talk to me.” If you get an answer, talk to the part, find out how old it is, what does it fear (assuming it’s been traumatized), and so on. You might then ask the part what you can do to help it feel better. You could ask the part if it would like to be somewhere else (I have parts living large in NYC, in cottages, in the mountains, and in bed asleep).

I’m NOT saying this will work for everyone, but I have a feeling you might be more receptive to it given the challenges you’ve been facing. I unburdened a holiday depression part recently and felt immediately lighter — you do feel this in your body. When you ask to talk to parts, you may start crying, you may feel fear, and will likely feel anxiety. That means a part is there and likely wants to be healed from their anxiety.

There are a lot of articles about IFS and even an app to help you keep track of your parts. Again, give it a try and if it works for you, you will likely say this is the craziest thing you’ve ever done and amazed at how well it works!

@suzleigh Hello, thank you for sharing. My most prominent diagnosis is borderline personality disorder. However, my paranoia has evolved into a behavioral pattern. My first visit to a mental health clinic was due to my delusions of persecution, feelings of being monitored, and self-harm. I also frequently experience fear for no apparent reason—without any triggering event. It might happen when I wake up in the middle of the night, or even while I'm doing something one moment. I don't know where or when my borderline disorder started, but it's the most visible aspect. No therapist has ever suggested CBT or DBT for me. I've tried these approaches on my own, but I couldn't master any of the skills in my own situation. The same goes for exposure therapy. The psychiatrists I've encountered only follow one rigid logic: [My hyperactivity = hypomania = Quetiapine + Valproic Acid, I don't know what I'm doing = I'm depressed = Bupropion, Trauma-related self-harm substances 🟰 Addiction]. Then they just tell me to consider physical therapy.

First of all, I think you’ve shown great courage and commitment to yourself to seek out answers to your struggles.

It sounds like you could really benefit from therapy, understanding that finding the right therapist can be a challenge. I found my current therapist on line and I have virtual sessions with her (she’s about 200 miles from me). With new insurance rules for virtual sessions, the therapist must be in the same state you live in. You can look for both in-person and virtual therapists at PsychologyToday.com.

I also find so many benefits from listening to podcasts — you might want to stick with the ones who are psychologists/psychiatrists.

Personally, I am also going to be starting ECT in January for lifelong severe depression and dissociation. Perhaps worth a try for you.

Thank you for sharing; I shall look into the website you mentioned. You are truly very brave. I haven't tried ECT myself, partly because I'm unsure whether it's due to the stigma attached to it or the fear of being labelled. I simply don't wish to try it. Moreover, I've heard there can be temporary memory effects. Some say that after treatment, one might recall the traumatic experience itself, but not the emotions felt during it. For me, that would feel rather incomplete, wouldn't it? I'm not yet ready to try it, as several therapists I've seen have recommended hospitalisation followed by transcranial magnetic stimulation and physical therapy. I'm unsure what exactly he means by 'physical therapy' here?

@xine You are very self aware and that can be a good thing. Therapy and getting sober helped me be able to just start to know the parts of myself that I apparently compartmentalized for so many years. I know that DBT and EMDR work for deep trauma, the research shows this. I have a hard time regulating my emotions and I have a part of me that will stop me from feeling deep emotional pain. I get glimpses in therapy, so that is a start. My therapist and I are doing parts work and a piece of that is talking to the different sides of me that show up. The goal is that "I" realize that "I" can take care of myself. I no longer need those old survival skills to jump in. This is a process, a journey. If I stay in the present, I do much better. It takes practice. I woke this morning in a panic and could feel my cortisol level jump. I laid in the bed and told myself that there is nothing at this moment for me to flip out about. I am in the bed. I felt my body in the bed and kept telling myself that I am okay at this moment.

I appreciate you sharing here.

@diverdown1 You have an amazing awareness of your parts. I still spiral some when faced with some issues — I have severe memory loss (due to complex PTSD and dissociation) and the part who is being overwhelmed doesn’t necessarily understand parts work. I’m getting a little better at it though.

Thank you for your story!

@xine I must admit I’m mystified at physical therapy for depression! I found the article below — maybe that might help.

Not wanting to do ECT is understandable. It took me a solid year to come to terms with it, mostly because nothing else was working and something had to change.
https://www.amnhealthcare.com/blog/allied/travel/role-of-physical-therapy-in-mental-health/

@suzleigh Thanks for sharing, you're so kind. I have no idea what they plan to treat with physical therapy. Actually, yesterday I did some assessments on Psytest following the GPT AI assistant's instructions, including the LSRS, ISI-5, AI-3, MAS, SCS30, and a few others. I actually asked it why it kept ignoring my requests for measurements related to my paranoia or tried to redirect my focus to my BPD. Yes, my BPD measurements are nearly maxed out, but even after I repeatedly clarified that paranoia was my primary concern, GPT kept trying to steer the conversation away and gave me links to irrelevant measurement sites multiple times—as if it were a switch or a forbidden zone. This is odd. Its explanation was that paranoia is often dispersed across multiple conditions and not treated as a standalone diagnosis.

I reiterate that you are showing remarkable courage by reaching out to this community. I looked up the paranoia (yes, it’s in the DSM) and found the information interesting in that I also share some traits. For me, knowing what the traits are then help me to recognize them and I want to understand where they might be coming from (I’ll be talking to my therapist about this).

After looking at this, do you have any thoughts?
https://www.theravive.com/therapedia/paranoid-personality-disorder-dsm--5-301.0-(f60.0)