Formal Diagnosis HPD and NPD

I've noticed in both the HPD and NPD forums all you nons (and perhaps others who say you are Dx) keep relating to your HPD or NPD gf and bf. How do you know? I mean sincerely have they been Dx by a professional? I dont care how close of traits you read about on the internet only a professional can diagnose. I know this from personal experience. Not everything I thought about me was correct and things I said no to were actually part of what I "deal" with. So much complaining and wishing harm and saying how people are evil. What if this is just the way the person is and you think it's a disorder?

Hi questioning -

My thoughts are this:

So I've been watching some of the Jodi Arias trial (big trail in the USA) and along the way we've heard both speculative and tested diagnosis form psychiatrists and psychologists including PTSD/not-PTSD, BPD/not-BPD, sociopath or psychopath, battered woman syndrome/not-battered, abused by parents/parents-deny-abuse*, and more...

The "experts" often don't agree.

When I worked in a related field it was common enough that the psychiatrists would have their preferred diagnosis, and even change a patients diagnosis when covering each other. For better or worse, psychology is not an exact science, and unlike viewing an x-ray and diagnosing an illness, nobody can yet scan our brains well enough to be sure. Even then, mis-diagnosis happens when treating other bodily illness.

*But I wanted to say more about the abuse/not-abuse question. See a big problem is that for the most part a therapist or psych is only going to hear from the patient. The input from parents, friends, ex's, current partners may be completely missing, or if provided, like the parents of Jodi, of course they are going to say 'we never abused her, it was all in her head'

On top of that I once calculated how many combinations of criteria there are for HPD alone in the DSM-IV. If I recall there are nearly 93 combinations of those criteria that ( unique combinations 5 of 8 criteria ) that would mean the person qualifies for HPD. If that all wasn't enough, HPD as a diagnosis may be tossed/re-classified in the DSM V. Then add in that even the criteria are often very subjective, like who gets to define "interaction with others is often characterized by inappropriate sexually seductive or provocative behavior"

So in a very real way, the diagnosis only matters so much. A diagnosis seems to have two useful purposes -

1.) A short-hand way for psychs to talk to each other about what is going on with a patient without having to spell it all out.

2.) Hopefully, it may be true too that for people that exhibit certain patterns of thinking/feeling, that can help in selecting a treatment based on research that shows that other people with similar thinking/feeling patterns have responded.

Put another way, so suppose someone you know is repeatedly physically abusive, or steals from you, lies, etc. It only matters so much whether or not the person ends up with an official diagnosis of AsPD. From the point of view of those affected, it's maybe nice to know "oh, now that I know that I can do some research into how others with similar thinking/feeling patterns behave, and see it's not me!", but in terms of protecting oneself? It's just enough to know that it hurts, and steer clear.

My opinion is that Cluster B folks all have various dimensions in common

empathy/lack of empathy/narcissim
dissociation/unreality
grandiosity
hostility/aggression
etc.,
and instead of neat little boxes the woof and weave of the above traits creates a multi-dimensional cloud-like structure; and HPD or NPD are just concentrated areas and therefore locations within the Cluster B cloud.
So, for example even though Ted Bundy had the concentrated locations of lack of empathy and hostility that characterize an AsPD psychopath, he also displayed secondary exhibitionist / grandiose qualities of HPD when he dramatically defended himself and got married while on trial for murder in FLA.

Also, I think it wise to remind myself that I am not 100% sure of what I believe to be true, but since I do believe I am in the 90th percentile I refer to any people suspected of HPD as probable, or likely.

Psychiatric diagnoses should be like medical diagnoses in the way that those traits are symptoms of a disorder not confirmation of it.

A rash could be a washing powder allergy, or it could be meningitis... the rash isn't diagnostic, its a warning sign. The actual disorder traits should only be ascertained from reaching the issues underneath the symptoms. In many cases psychiatric professionals completely misinterpret the cause of symptoms based on their own perceptions, simply because those symptoms can be made to fit a certain category in the DSM. Its a question of bad diagnostic practice.

^ excellent criticism -"correlation does not prove causation." However the reality is observations always precede analysis. For example, paranoia and aggressiveness can occur from drinking too much saltwater, contraction of the rabies virus, or certain types of schizophrenia. But it has been far easier to analyze the concentration of salt in body fluids, or to find Negri bodies in brain tissue or other evidence of rabies, and it is only recently with the advent of neurotransmitter chemistry and brain imagery that direct evidence of schizophrenia has become available. Since the genetics, biochemistry of Personality Disorders are little known, and the enviromental development processes somewhat variable, for now what must be relied on to suggest the existence of HPD are many independent observations which have the same description, after eliminating other possible syndromes due to medical conditions or drugs, alcohol, etc.
No doubt angry jilted people on this forum have simply and incorrectly trashed an ex with a diagnosis (especially more so a few years back,) but if you carefully went through all the posts and threw the obvious ones out, you should end up with a lot of independently arrived at similar obsevations, and if subjected to statistical analysis, it should be indicative of what is described as HPD, or at least closely related (BPD), to related (NPD) to somewhat related (AsPD) other Cluster B concentrations.
But if the variation of characteristics described in the posts is the same as in the general population, then HPD, at least within this forum, has no meaning.

So my mom was seen by a new physician who saw here maybe 15 mins every week or so. The physician of course didn't know her on a regular basis but from what little the physician observed, thought maybe she was bi-polar. That was on the basis of her being up or down during the visits.

What the physician was not aware of is that the mood cycles happened multiple times per day around those of us who lived with her, or many of the other behaviors/thinking/feeling she suppressed around strangers.

Add in to that my mom felt nothing was wrong with her (no matter how many suggested she get help), and it is a reminder that many never seek help, that from the point of view of the person with the disorder they may believe they are fine, that even a professional doesn't necessarily get to observe the person like everyone else does, that the professional may never get input from family/loved-ones/friends, and that the person may suppress their disorder or mask some of the symptoms around strangers or those they are trying to impress (my mom definitely could be a different person around strangers and "doctors" because she idolized doctors, especially male doctors). Then even if you get past all of that, you have to work with a professional that has sufficient understanding of a disorder to diagnose it.

I guess I'm not entirely surprised then that the odds of a person with a disorder getting past all the hurdles and impediments of reaching the point of receiving a viable diagnosis are slim.

p.s. As my mom became increasingly ill and spent more time around the physician the physician learned more. I heard from the physician a year later. Sorry and apologies. Wondering how it is that neither my sister or I didn't end up worse off. I'm good with diagnostic tools, and many are designed to probe through the facade a person can put on, but a key issue with many disorders is that who the person is around strangers, and who they are around those close them can be so different. It's why you read so many stories here from nons who essentially say "nobody believes what I've been through"

questioning_life wrote:I've noticed in both the HPD and NPD forums all you nons (and perhaps others who say you are Dx) keep relating to your HPD or NPD gf and bf. How do you know?

During my custody battle with her, I paid a little over 2k for a PhD shrink to analyze both of us. She marched right in there thinking there was nothing wrong with her. The PhD thought otherwise and hit the nail on the head. I read the wiki post about HPD and couldn't believe how accurately it described my now ex-wife.

Really few of us if any loves hearing there is something fundamentally wrong with our personality, even if we know things in our lives are not working.

xdude wrote:Really few of us if any loves hearing there is something fundamentally wrong with our personality, even if we know things in our lives are not working.

How true is this!!

xdude wrote:Really few of us if any loves hearing there is something fundamentally wrong with our personality, even if we know things in our lives are not working.

I'm sure my HPD ex has read the report and lots of other HPD info by now, but she still wants to have nothing to do with me even though my kids still do. It's sad but unfortunately for them she can't "undrop" the nuke. I want the truth to be accepted by her side so they will stop using me as a scapegoat. I pray that someday she will stop blaming me for her problems, and I can only hope it happens before our children are completely raised. Until then I just have to move on and be strong for them.