#i know a lot of people don’t like the pd subtypes

[avpdpossum]

i might try to do a deep dive into the conflicted avoidant subtype at some point, and maybe the self-deserting subtype after that. every time i read the descriptions of them, i’m struck by how accurately they describe me, and i wish there was more info about the subtypes out there

[thatnarcissisticfeel]

hi! so i don’t rlly know how to even phrase this but lately i’ve had a lot of stuff getting worse, none of the “basic” diagnoses i have (like depression and anxiety and stuff) describes it at all. so i’ve started questioning if i maybe have a personality disorder bc it’d all make sense, both the behaviors and how i see the world and why its only getting worse and more noticeable now etc.

i keep finding myself in cluster B PD traits and lately ive been reading more on NPD and i genuinely completely see myself in the description of the covert subtype. i always blame others for everything and am completely unable of accepting or feeling guilt. nothing is ever my fault, its always someone else doing something or provoking me or it’s the way i was raised or it’s because of the system etc. i’m deeply insecure but hate showing any kind of vulnerability. when i’m in a vulnerable position i get ashamed and angry bc i cant stand feeling weak. i often get so angry i do shit that could easily destroy all the relationships i have. i never apologize (unless it’s a situation where i have to in order to save the relationship but still never actually feel sorry) bc that’s showing vulnerability and admitting i’m wrong. i always compare myself with others, i used to think this doesnt apply to me bc i generally don’t care about typical things such as popularity and status as i’ve always been an outcast - and it’s kind of a major part of my identity that i feel different than everyone else (even though its most likely just how i was forced to learn to cope with being excluded), but i’ve come to realize i absolutely do always see myself as “the worst one” in terms of mental health. i can’t stand others talking about their issues bc no you don’t even have it that bad at all, i’m worse. i feel like no one will ever be able to truly understand me bc the majority of people are npcs anyway. no one thinks for themselves, they dont have any self awareness and just do what they’re told. i treat others like shit but still expect them to be nice to me because i deserve it because i’m sick. i deserve more attention from doctors because of how unwell i feel. i should be the one that gets treated first. i obviously never voice these feelings but it makes me so pissed off when i have to wait like i’m never important enough for anyone. like there was this one case when i had to wait longer for my appointment bc some girl came in due to an emergency and all i felt was angry and annoyed and like when is it my turn to get taken seriously?? i completely lack affective empathy and very rarely genuinely care about others. others being sad annoys me and others being happy makes me angry, sometimes even to the point of having homicidal thoughts. i’m envious of pretty much everyone who i consider better off than me. and again i dont mean shit like money or clothes but more like just the ability to be normal, having close friends, being in a relationship, all that stuff i know i’ll never be able to have bc of my mental illnesses. i’ve never been able to form genuine relationships, i do have a few friends but they all mean nothing to me and are just there so i’m not lonely. i’ve never been able to feel love or affection for anyone. and when i think abt it i dont even really want to be like them, i just want to make them suffer. i lie to everyone and only reveal my “true” self when im having a breakdown and basically cant control myself anymore as i have so much suppressed anger inside i sometimes feel like i have to genuinely put effort into stopping myself from physically attacking others; who cares abt words when im that far gone. and even then i later turn it around and make it seem like im just depressed and stuff (which is true, but theres also so much more no one knows about). everyone around me considers me a shy meek polite nice caring person and it just feels so ironic.

idk what to do at this point, genuinely. writing it all down like this makes me sound so fucked up even though i act relatively normal when i’m stable enough. but in reality i feel like on the inside i’m just breaking, i’ve had to turn to drug abuse as its literally the only thing that helps me cope with everything & prevent me from being even more destructive (towards both others and myself) and its making me even more short tempered when im sober and even more paranoid someone’s going to find out and get me in trouble. my therapist knows about it but doesnt do shit. ive been on so many psych meds before but its as if literally nothing ever works on me. like i would never normally seek advice on tumblr out of all places but i thought just maybe i would get understood here as i keep getting just either ignored or insulted on places like reddit (sure jan calling me a psycho is definitely going to help my issues when all i did was fucking ask how to cope with my issues).

sorry abt the wall of text. do you have any advice? ive been going to therapy for years but its all useless. i cant be honest with anyone for pretty obvious reasons. i just really dont feel like living for much longer. but even just acknowledging this ask and not judging me would mean a lot.

I obviously can’t diagnose you, but I will say a LOT of what you said is behaviors that and I other NPDs do, which makes me think that even if you don’t have it, advice and such that is geared towards pwNPD could help you. Unfortunately there isn’t much self-help geared towards pwNPD (I say self-help bc clearly your therapist is not a good therapist for you and I know it would probably be difficult to get a new one), but DBT workbooks are a good place to start. I think they’re technically geared more towards BPD, but they can definitely still help narcissists. Stuff like this is why I hate how much NPD is stigmatized, because we all DO deserve help and we all DON’T deserve to feel like this.

It sounds pretty basic, but are you a part of anything like online NPD/cluster B support groups, ie discord servers? Obviously they’re not a cure-all, but even just being around people who have the same thing and who you don’t have to mask around can help. If you don’t have any I could happily provide some if I can find a public one. Of course, communities like that can be a hit or miss, but it’s definitely at least worth a shot to try to find a group of people who are struggling with the same thing.

Another piece of advice, which might sound completely neurotypical on the surface, is to start journaling or writing down feelings. It might seem like just a small thing but having a place that only you can access where you can talk about things like vulnerability could be a good starting point, because at least you’re admitting it to yourself and getting it out there in some way. Lying to everyone and not being able to show your true self is really exhausting, so having one space that’s yours and yours only where you can learn to be comfortable with being vulnerable — even if it’s just to yourself — is a tiny thing that can work wonders. It doesn’t have to be some super dramatic “dear diary, woe is me” type thing, it can be something as simple as “Today I fucked up, and I know I fucked up, but I still blame xyz, I hate xyz.” That way you’re getting the vulnerable thoughts AND the angry thoughts out there without 1.) hurting others with the angry thoughts or 2.) having to show vulnerabity which would hurt you.

Of course the end goal might be to “unlearn” the behaviors, so to speak, but that can’t be done overnight, and until it is done, it’s better to have a few places to be open, even if it’s just amongst yourself or other pwNPD.

I hope this helped, lmk if you need more advice — and definitely know that you’re not alone, as cheesy as it sounds.

[modernidolater]

TW: Violence, dark humor, all that jazz. Go no further, angry shit, yadda.

So, yanno...i'm just gonna yell into the void about something.

When i was very young, I read a lot of encyclopedias. Most of my knowledge of the world was attributable to the Encyclopedia Britannica, which my mother kept because well, a home should have a nice, impressive looking set of books. Along with a bunch of other old books that just...really weren't the best choice for a regressive anti-technology apocalyptic fundamentalist cult, but then, as we used to joke, my mother doesn't have to make sense, she just has to make decisions.

So, I eventually started plumbing the depths to try and figure out "what the hell is wrong with my family."

While i didn't get an answer about my family in general, I did note that i seemed to be oddly suited to the definition of "psychopath," minus the whole "being a problem for society at large" thing. Asocial, low empathy, lack of guilt, inability to plan cohesively, difficulty conceptualizing consequences, near total lack of emotions except curiosity and rage, both of which are carefully stifled, aggressive tendencies...frankly, I look at my younger siblings and i can definitely assure anyone that asks that had I not been raised quite far away from society, or if I'd stayed in the cult, I would most definitely have been a problem for society.

But psychopaths are *monsters,* you see. They're so, so bad, you see. Everyone assured me, at great length, that I couldn't be that, no, no sirree. I was too nice. Too kind. I didn't punch people nearly often enough (largely because I don't like being punched outside of sex, and I like to be in charge of where I'm being punched, and even that mostly cause I'm kinda badly out together physically, but that's aside the point.)

I wasn't *hate-able.* My empathy was too high.

On that last note, I have spoken elsewhere and i believe here regarding my empathy. My empathy is specifically a learned skill picked up by reading Edgar Allen Poe's Auguste Dupin stories. Dupin explains his near preternatural ability to get inside people's heads by his learned skill of micro-mimicking body and facial language and then analyzing what he feels when he copies someone else. Works absolute wonders, particularly as up to that point (i was 8-9), I was using the classical technique of provoking and hurting people around me to experimentally figure out how other people worked. Admittedly, it's somewhat like recording a speech and listening to it at the lwvel of a whisper in a crowded room, but then mimicry is far less likely to get you punched, and see previous for my feelings on getting punched.

But now i had, for all intent, a system to demonstrate empathy. Thanks to my mother's abuse, I had a complete paranoid delusion aping guilt. I could check plans past others, and once I got my hands on Google at 14, I had the capacity to directly look up what the general, societal consequences of most actions were and model behaviors that achieved my ends. I further had 18 years of direct training in mind control and manipulation, thanks to my cult.

You may notice that what you just read sounds like the origin story of a serial killer. Ape people around them to avoid detection, paranoia making them scrupulous enough to not get caught, and careful study of laws to find the lines, plus a hyper manipulative persona.

Roll with me here. This continues forward.

So, i'm out and about, 2, 5, 6 years free of my cult. I have married a self avowed psychopath who actually HAS been diagnosed with antisocial disorder thanks to a teenage habit of theft and punching people. He is fairly sure I am not one, since I perform guilt and empathy fantastically, by rote at this point. I literally have days that my face hurts from faking emotions for too long, i am slowly developing agoraphobia because there are far too many people to mimic in a retail job, and my guilt subroutine is just a voice chanting in my head, "they're coming to get you, don't fuck up" 24/7 to the point that i am developing hallucinations, but yeah. It's definitely not psychopathy. At this point, that's just ASPD, and i'm just too darn social. Never that. I'm no monster, you see. I'm "nice."

About this point, I have learned to use mind control techniques to help people, carefully applying them with direct permission to help people open up and discuss problems. My near preternatural ability to get into people's heads, my ability to find information, and my absolute lack of fucks about morals (thus making me wildly nonjudgemental), makes me the go-to confidant for many of my friends. This neatly surrounds me with people that can smooth my life out, but you can't tell people you're friends with them cause the world is made of grey paste and you're deathly bored 24/7 and being allowed to pick through people's minds and help them optimize is the closest you get to not wanting to shoot yourself or others. Or that you carefully maintain contact with people so you can check and make sure you're not doing anything jail worthy. Or that a large group to mimic lets you blend in easier, and finding one that also is transgressive, but socially permissable (thanks, kink) blows off some steam.

Of course, people that don't know me find me deeply off-putting, as I am at this point rapidly learning to turn off the mimicry when not immediately interacting with people. This results in me appearing utterly emotionless, but as soon as people talk to me, bing, back on. I had also joined the kink subculture, giving my hedonistic and transgressive sides an outlet.

I'd also gone to the trouble of getting a multifaceted degree. Ostensibly, my degree is "multimedia journalism." If you aren't aware, this means I have a degree in research, interpersonal communication, public speaking, written communication, mass communication, some psychology, critical thinking, media creation and analysis. In short, I have the literal perfect degree for figuring out, communicating with, and functionally understanding people, as well as a vastly enhanced ability to locate obscure information.

Fast forward again. Three mental breakdowns, four years of therapy, poking at my gender, figuring out a lot of mental health problems, and a rotating series of diagnoses, life is...slowly improving. I've left a toxic marriage (toxic on both sides), moved to a completely new place, started over. I have sort of resigned myself to focusing on my (admittedly annoyingly complex and wide ranging) physical disabilities.

And it comes up, in talking to my partner, that his adoptive mother displayed (she's dead) quite a few signs of ASPD. And he asks curiously if there's any connection between ADHD, autism, and ASPD, mainly cause the "personality disorder" part. PD's can, with long or early exposure, sometimes be passed on, you see.

Guess what's being studied, right now? Not a connection between ASPD and ADHD. A connection between psychopathy and ADHD. Wait, but I thought psychopathy wasn't a thing, says I? I thought there was only ASPD, now?

Ah, but for you see, the DSM is a load of horseshit. And i have heard that from multiple communities with different relations to it, and from multiple therapists, psychiatrists, professors...as a general rule, when the people who use it, the people it's used on, and the people who teach it all agree that a document is manure, I get a touch distrustful. I get more so when current studies use umbrella terms disavowed by a document known for being reductivist and that has been noted as having a great number of entries that were manipulated deliberately to make them as narrow and unusable as possible.

So anyway.

Turns out that while no, ADHD and Autism don't make you a psychopath, there's a distinct overlap. Empathy issues are a possiblity in all three, though both ADHD and autism can create *hyper*empathy. Inability to navigate social constructs is another point of overlap.

But really, it's the serotonin deficiency that hurls it across the line for me. And the genetic factors. Can psychopathy result from environment? Yeah, seems so. But there does seem to be a genetic and neurochemical component. Which is...curious for a disorder presented as purely a traumatic abreaction that creates dangerous amorals.

I then looked it up. And wouldn't you know, psychopathy is only pathologized as ASPD/APD, and DPD? The former is the sort of psychopathy that is characterized by violent amd criminal antisocial behavior, and the other an inability to understand and perform social mores at all. But this is the DSM, so these are of course diagnosed by problems caused for others as a first line.

Violation of societal norms, lack of emotions other than rage, aggression...it's almost like the same people that named a serotonin and function deficiency Attention Deficit Hyperactivity Disorder to enshrine the disorder only by those aspects that make neurotypical people uncomfortable rather than seeking to help the neurodivergent person, the same people that invented torturous behavioral correction therapies to "fix" the neurodivergent person? Those strike me as people that might possibly have looked a serotonin deficiency that causes rage, limited emotions, impulsivity, difficulty conceptualizing consequence, and potentially a hell of a lot of other fun side shit and decided to call that "Doesn't get along with others well" disorder.

What really kicks it in the teeth for me, however, is that psychopathy used to mean more than "a social pariah." You see, Theodore Millon, the guy that wrote the book on personality disorders, noted between 5 and 10 subtypes. Do you know what they are?

Nomadic

(including schizoid and avoidant features)

Drifters; roamers, vagrants; adventurer, itinerant vagabonds, tramps, wanderers; they typically adapt easily in difficult situations, shrewd and impulsive. Mood centers in doom and invincibility

Malevolent

(including sadistic and paranoid features)

Belligerent, mordant, rancorous, vicious, sadistic, malignant, brutal, resentful; anticipates betrayal and punishment; desires revenge; truculent, callous, fearless; guiltless; many dangerous criminals, including serial killers.

Covetous

(including negativistic features) Rapacious, begrudging, discontentedly yearning; hostile and domineering; envious, avaricious; pleasures more in taking than in having.

Risk-taking

(including histrionic features) Dauntless, venturesome, intrepid, bold, audacious, daring; reckless, foolhardy, heedless; unfazed by hazard; pursues perilous ventures.

Reputation-defending 

(including narcissistic features) Needs to be thought of as infallible, unbreakable, indomitable, formidable, inviolable; intransigent when status is questioned; overreactive to slights.

(It should be noted: the features listed above are simply what each presentation is most likely to display if disordered. A reputation-defender may not display narcissm, a risk taker may not be histrionic. A malevolent [what a terribly judgy name...] could be negativistic, or avoidant, or histrionic. And so on.)

Now, ya may be going, "wait, hold up, narcissism is on there! We still have that! Schizoid is on there, we have that! Sadism, paranoia, we got all those things!"

Flash quiz: do you know what a personality disorder is? It's a series of learned behaviors that require moderation and unlearning.

Why yes, they did spin multiple neurotypes off into diagnoses that require behavioral therapy to "fix." Why on earth would you think they wouldn't? They're still trying to use reparative therapy on auties. Hell, near as I can figure, histrionic got spun into Borderline Personality disorder. You know what the therapy for that is? DBT, aka, "it IS your fault and you SHOULD feel bad."

Beyond knowing there used to be different flavors, did you know that there is about a millionty scare articles about how psychopaths are everywhere? Guess why.

What do you get when someone has an absolute need to see what's on the other side of the hill and no real fucks to give about how you get there? You get scientists, explorers, people utterly driven to find out. Think about how many of our science and exploration heros are noted as deeply weird and off-kilter. We have whole stereotypes about this. There are books and articles devoted to the transgressive personas and behaviors of famous scientists and explorers.

What do you get when someone is belligerent, paranoid, truculent, violent, fearless? Snipers. Literally. The army has openly stated they like psychopaths quite a lot. Someone that can look at a map of human lives and commit calculus with the phrase "acceptable losses" makes a damn fine general, wouldn't you say? Hunters, too. Make a good king? Or bounty hunter. Or, if we're going to be honest, a martial artist. Hell, think of all the ways our society accepts violence in real terms and symbolically. Management. Video gamer. Espionage. Actuary. Pest control. There are THOUSANDS of of societal uses for people like this.

Covetous? Well, banks are openly quite loving towards psychopaths. CEOs are indicated here. Businessmen. Fandoms with collection as a function have any number of anecdotes of individuals who have an intense drive to get more. "Focused on the chase, rather than the victory, to the exclusion of all else" is considered a positive, laudable personality trait. To put it in other terms, "can't stop, won't stop, never done." Sports players, yes? Football, rugby, hockey...

Risk takers are the real standouts, in terms of societal love. Doctors. Firemen. EMT's. Skydivers. Extreme sports players. Equipment testers. The list goes on. Society loves risk taking psychopaths. Hell, look at the diagnostic criterion up there: it's mostly traits with high positive connotations.

Reputation defending? Politics. Law. Advertising. Acting. Writing. Religion. Leadership of any kind.

I'm not talking out my ass here. All those fields have been noted as friendly towards, attractive to, and having a high representation of people who fit the behavioral model of psychopath.

But only if they're useful. Like literally every other non-normative neurotype.

Society loves ADHD and autistic people when they're displaying savant abilities or when they can mask well enough to use their sensory and cognitive differences to societal ends.

And if they're a problem for people around them, that's treated. The underlying difficulties? The societal structures that punish and harm them? The pain of adapting their entire neurobiome to do all the work of interfacing with different neurotypes while being driven to harness anything useful and discard the rest of their brain? No, we don't treat that. That's just the price of doing business. "Pull yourself up and don't be a problem."

And here's the problem, in plain terms: psychopaths who learn to cope, to mask, to adapt like I did are never diagnosed. I have spent most of my life fairly concerned about the fact that I seem not to have emotions or compunction, that i am always consciously working to figure out and connect to people around me on the most basic level, that I am constantly working to keep an active model of social norms going at all times. And I don't mean "shake hands, eye contact." I mean I have the same mental conversation regarding "don't shoot that person" and "use a turn signal." All prosocial behaviors, all social behaviors period, are a struggle to understand.

The funny thing is, it also makes antisocial behaviors difficult. Shooting someone seems remarkably inconvenient in many cases. Regardless of whether I care about getting caught or not, shooting somone will interrupt my day.

Not shooting them also seems remarkably inconvenient in many cases. Yes, it'd be a pain in the ass to shoot them, but then again, if I do it correctly, I only have to do it once.

But again, "correctly" is a wildly unfixed variable, and the whole question won't come up if I always ensure I fail the "do i currently have a firearm" step. And I don't. Ever.

That's how my brain works. Y'all go on about moral and ethical and legal reasons. That's an exhausting conscious mental conversation to have every other day, so my shortcut is:

"Should I shoot them? Oh, right, I don't have a gun. Guess not. Should I get one? No, cause I might shoot someone, and that'd be a pain in the ass. Welp, no shooting people."

And so it goes. I don't understand any social norms. Good or bad. I have all the problematic issues still, mind you. Environmental factors. I mimic and I was raised in an apocalypse cult in Oklahoma. I spend a lot of brain space sorting between prosocial behaviors and the violent antisocial behaviors I was taught were prosocial.

Because, you see, I can't really understand the prosocial behaviors, but I can see they work. And antisocial behaviors don't, really. Have i impulsively pocketed something? Couple times. Even got away with. Can't steal a house, though. And theft gets boring, for me.

Ok, except piracy. I may quite enjoy piracy.

Cooperation with a larger whole can and does yield benefits. Forcing myself to sit through mind numbing gratification delays does seem to yield results that are beneficial, though I really try to keep that one to a minimum. I refuse to be bored if I can help it. Making nice talky sounds gets me shit faster than making angry talky sounds.

Possibly this is a result if being raised manipulative. No idea. Kinda don't care.

Point is, I'm one of the psychopaths that, while not immediately useful, is also not actively a problem. So no-one will listen when i talk about everything being gray and cold and exhaustingly complicated because people make no sense and almost all my emotions are dialed so far down it's a joke i lack the ability to laugh about.

No one has believed me that the one emotion I have in spades is rage and that i have to literally consciously work out from first principles why violence is a bad option as my sole method of controlling that, my ONLY EMOTION OF ANY STRENGTH, which I cannot allow myself to feel for any length of time because I start losing sight of that consequence model and I worry i'll make a mistake I can't unmake. Or that it took me two decades to learn not to smash things I need when someone looks at me funny. Or just smash them.

Or that i have to keep my hands in my pockets and chant "don't steal" in my head some days. That I wear tight clothing with shallow pockets to make stealing harder so that, like guns, I simply can't do it easily and therefore short circuit my behaviors.

People are more than happy to hurl me at any problem that requires a lack of emotion, but if I dare to be less than appropriately emotional on a date? At a wedding? Funeral? If I make an error and don't diagnose it myself and perform contrition appropriately, regardless of if I knew there was a social or personal rule there? Well, I'm fired/broken up with/punished/evicted.

But I am not actively a problem for society. So none of those things are worth diagnosing. Or helping in any way.

And those that are useful? Are often fed utter horseshit and encouraged to break society. Bankers creating recessions. Generals commanding useless wars. Cops. Doctors that uphold a broken system. Politicians that pursue a broken society.

I know, I can see, that ASPD people catch a shit ton of shit cause they get blamed for "useful" psychopaths mistakes, and none of the benefits when said same psychopaths are lionized. Looking back at what it was, and what it is now, pathologically speaking, it makes perfect fucking sense for the asshats that designed a diagnosis to only include the people they don't like as the "sick" ones, and label the "good" ones as "heroes." Makes a nice distinction there between people we want to demonize and people we want to lionize for having the exact same chemical imbalance, and neatly creates a fall group when any of the "heroes" trip up. Silence those who can't cope, elevate those that can, treat neither effectively, and if an elevated one stops coping, we can just "realize" they were "sick" all along, and oh, yeah, those sick people are so bad, you guys, nothing like those heroes at allllllll.

I am...so tired of this society bullshit.

So anyway, I'm a psychopath. Paranoid, some schizoid. So whatever grains of salt you feel like taking, grab 'em, I guess. I'd mostly like for people like me to stop being weaponized, lionized, or punished for having a different neurotype. I'd like to be able to talk to a doctor about that and for there to be some options beyond "stop that," "get locked up," "have you considered the army" (yes, a doctor actually asked me that as a teenager) or "you seem fine, tho."

And if you resonate with this, well...I'm 32, never been arrested, mostly managed to avoid terrible shit, and I've got a life, couple partners, and I'm surviving, so like. You can do this. Lotta people wanna tell you you can't have this or that cause "you're not bad, tho." They're stupid. Y'ain't evil, just different. Don't let them get to you.

And (this is a joke) if you decide to shoot someone, do it once, correctly. Saves time.

[textsfromtheborderline]

We’ve had a couple questions about ASPD vs BPD sitting in our inbox for a couple days now, so I wanted to take the time to answer them and sort of combine them into this post. To be honest, I only know the basics of ASPD, but I’m by no means an expert. 

I did some digging around, and for more informed answers, you may want to head over to your-aspd-dad as they’re certainly more knowledgable, and seem very willing to answer questions!

Questions/Answers under the cut :)

Q: Hi. I’m pretty sure I have aspd and was unofficially diagnosed with it. It fits perfectly, except for some things: I have mostly rage outbursts, but sometimes RANDOM general emotional breakdowns. I have excoriation disorder, and daily persecutory delusions. I have in my mind someone that sounds very much like what you called FP, but I still haven’t met someone like that. Also, really often, when the boredom/void strikes, i happen to dissociate. These made me think of bpd; wyt?

A: By “in your mind,” do you mean you have the idea of an FP? Or do you mean that as part of your delusions/psychotic symptoms you feel you have an FP though it isn’t necessarily another person? My answer would change depending on that. I think we’ve gone pretty in depth about FPs this past week, so check out our FP tag if you haven’t already!

There’s a lot of overlap when it comes to any cluster B disorder, and if you look at Millon’s Subtypes you can read a lot more about different ways that PDs may present (though no one is going to completely cut and dry fit into any one subtype, it’s a good place to start). On page 15 here you can read much more in depth descriptions of how different traits may present in ASPD. That same text, you can read about BPD on page 20 (though pp. 17-19 may also be helpful because Millon’s language sucked sometimes).

There’s a good chance you may have ASPD with borderline traits! It’s not unheard of! Personality disorders (and really just the human mind and the way it develops) are incredibly complex, and having one doesn’t disqualify you from having another. A friend of mine has AvPD and DPD! Both are cluster C disorders. Cluster overlap is way more common that you would think, even in cluster B disorders where some of them feel polar opposite sometimes. I’d talk more with your doctor about this, as they’ll know better than me, and if it’s something that’s weighing on your mind, a mental health professional is going to be your best resource.

Q: Thanks for the fp input. Honestly l know there’s something wrong with me, I can’t really say what. All the aspd symptoms match perfectly, I cannot find anything that makes me think “I don’t have this”, but I definitely feel in need of a fp just like you described, which contradicts aspd. But I don’t trust anyone to have an actual fp, and that’s more aspd. I don’t want to self diagnose but I’ve been manipulating my therapist ever since and I have this huge big mask that 1) would be stupid to drop 2) i was so good at creating basically another person they wouldn’t even take me seriously if I talked about aspd or bpd 3) it’s like i physically can’t stop manipulating and lying to them. I have both of my parents with mental disorders and a couple of diagnosed BPD people in my family, don’t know if there’s any genetic involved 

I thiiiink this is the same person? I’m not sure, though, which is why I made sure to distinguish the two asks. 

Personality disorders certainly have a genetic component, as with any mental illness. Having mentally ill family members affects you in both “nature and nurture” as it were. So, having family members with BPD certainly increases your likelihood of developing it as well.

As I said in the ask I answered above, cluster B PDs have a lot of overlap. Craving an FP doesn’t invalidate your having ASPD, nor does it mean that you therefore must also have BPD. Having traits of another disorder is not uncommon nor unheard of, and the desire for that level of comfort and reliance on another person doesn’t make your PD any less real.

If you say you’ve been manipulating your therapist and you don’t want to drop your “mask,” then I say you have two options. Suck it up, drop the mask, and talk to your therapist openly and honestly. Admit you lied about things and that you want to work on getting better and moving past the things you were hiding before. Your therapist might be surprised, but won’t be upset. Your other option is to just find a new therapist and start from scratch. Be honest from the get-go. I know myself, and I know I would much rather just come clean to my original therapist, but you and I are different people, so, hey, what do I know?

Your therapist is there to help you. They can’t help if they don’t know there’s a problem. And you don’t have to say, “Hey, remember when I said all this stuff? I was lying!” You can start the conversation instead by saying, “Hey, I said this stuff before, but I didn’t mean, I just wasn’t ready to talk about [x]. I think I’m ready now.” It’s your therapist’s job to understand and to work with you. They’re not there to make judgements. They can’t help you if you don’t talk. That’s what you’re there for. So talk!

I hope this helped in some way, and I’m sorry I couldn’t be more helpful. Like I said, I’m not the most informed about ASPD. I sincerely wish you luck, though, as you continue to work towards recovery and getting the help you need <3

-Sydney

[inanawesomewave]

Millon’s Subtypes of ASPD: Tag Yourself

A problem I think I’ve encountered with ASPD and the public perception is that people have very fixed ideas in their heads about what a psychopath should or shouldn’t look like. Is he the slimy politician having affairs with his interns and screwing over minorities without so much as a wince? Is she the career bitch who seems to enjoy having many underpaid staff devoted to her every sadistic whim just a little bit too much? Is he the unbearably handsome compulsive liar your best mate used to fuck? You know, that guy in the suit for no reason?  And I mean, yeah. Maybe. But it’s not all as broad as that. American Psychologist Theodore Millon, in his life, did extensive work on personality disorders, specifically to do with dividing individuals diagnosed with such disorders into subtypes and fuck me if I don’t just love a good set of categories.  Technically he divided psychopathy into two separate personality disorders, one being Sadistic Personality Disorder (psychopathy) which was distinct from Antisocial Personality Disorder (sociopathy). Some say there’s a difference and some don’t - I tend to think if I fell at that far end, or even if psychopath/sociopath was/were synonymous with ASPD as some people claim, I’d be the sociopath. However, when Millon proposed that this be recognised as a PD, his proposal was rejected. Sadism is part of the dark tetrad to which most of us ASPD friends can relate here and there (a friend once called me “unnecessarily sadistic” but really, it’s a fleeting kind of trait at best), but is not its own disorder. With that said, here’s the subtypes of ASPD, as proposed by Millon: Nomadic (including schizoid and avoidant features) Think Charles Manson. Crazy bastard has spent his entire life in and out of institutions, living on the margins of society, here we have antisociality that works due to slipping between the cracks on a constant level, hard to pin down, hard to understand. Nomadic psychopaths don’t give a fuck about the Armani suit or the Rolex. They wanna grow a beard and smoke discarded cigarette butts and sure, maybe sometimes they’ll start a cult and send for the murders of high-profile celebrities, get a swastika tattooed to their forehead, just basic shit like that.  Malevolent (including sadistic and paranoid features) This is where you start to see psychopaths really behave like psychopaths. They’re belligerent, sadistic, quarrelsome, they anticipate betrayal so preemptively explode it in as loud and visually striking way they can. Where some antisocial people are the most charming and sociable creatures you’ve ever met (and so you don’t know you’ve met them), malevolent psychopaths are antisocial and asocial all at once. They don’t like you, or your friends, or your family, or your fucking dead pet dog or cat or whatever it is you keep bleating on about. Malevolent types of antisocial people want to set fire not just to your home, but to your whole street just in case you were friendly with your neighbours. Covetous (including primarily negativistic features) Incessant and directionless yearning for what they don’t have, envy, jealousy, bitterness, ruled by greed and a desire for oneupmanship, seeks pleasure in taking without giving back, and enjoys taking more than having.  Now we’re getting into Patrick Bateman territory. This kind of psychopath IS the psychopath you’ve been imagining. If he’s managed to be rich in some way, then he’s got a beautifully stylish and sickeningly expensive apartment that he fucking hates because someone else got a slightly more expensive one. If he’s not managed to become rich then he’s the used car salesman who spends his lunch break steadily poisoning his colleague Dan’s instant coffee because Dan got a better company car and that’s just fucking bullshit. Dan’s got to go.  Risk-taking (including histrionic features) Dauntless, venturesome, adrenaline junkie, heedless, fearless. This is the psychopath I’ve heard least about. She’s jumping out of planes for charity and keeping the money herself, she’s ruthless and seems to get her satisfaction not so much from slowly and insidiously working on a victim over the course of months or even years, she’s much more likely to act on a whim and take the big risk that might not pay off. She’s going to be into gambling and might be in a lot of debt but whatever, it doesn’t matter. She can always fake her own death and fuck off to St Lucia with her mysteriously disappeared ex-husband’s life-savings.  Reputation-defending (including narcissistic features) This is the WHY DON’T YOU LOVE ME psychopath, the psychopath that nobody ever wants to admit to being, but hey, someone’s got to be it, and it might as well be you. This is the psychopath who is going to get caught, the clumsy psychopath. The psychopath who thinks they’re infallible but hasn’t got anything to back it up with, because they didn’t see why they should have to try or do any legwork - people should just fear them even though they’re not frightening. This I feel is the most vulnerable psychopath at all, the one simultaneously the closest to an empath and the farthest away one can possibly get, because they have human distress that comes -- not from the covetousness or enviousness from before -- but a self-imposed greatness that is so fragile and precarious that anything at any second can threaten it to fall. And you don’t want to be there when it does. This psychopath is terrified of being thought of in any way that undermines their inherent greatness. Tell that psychopath they’re a fucking no-hoper with no friends, and they will likely brush you off and assume your rage comes from a greater envy at their formidable and indomitable power and strength. But tell that psychopath you preferred their hair before it got cut? Looks like it’s you who’s getting cut now. Interestingly enough, this is the subtype of psychopath who is least likely to know that their behaviour is psychopathic. After all. It’s not their fault. It’s yours.  So now we’ve all had fun working out which we are, take a minute to work out which one you are. Of course the examples I gave were hyped up to illustrate the point - a malevolent psychopath might just stand in line at a shop having a rapid slideshow of violent imagery of the death of the man in front of them in the queue, because the man at the shop is taking too long and eating into their time, thinking, “the selfish cunt, why should HE get to take up all that space? What makes HIM all of a sudden need all that time? Fucking state of him, you know, this is exactly what is wrong with ABSOLUTELY FUCKING EVERYTHING god I’m going to burn this place to the fucking ground, none of the families of anyone in this hell hole would ever miss them, if anything they’d be WELL RID OF THESE USELESS PIECES OF ACTUAL HUMAN SHI-- oh, hi yes can I have a pack of Marlboro Reds, please? Lovely day, isn’t it?” and the time it takes to exchange warm pleasantries with the idiot checkout girl, walk home, and have a cigarette, just so happens to be the exact same amount of time it took to cool off, calm down, and pretend like nothing ever happened. 

[a-trauma-fox]

so i have a question... do you think one can have c-ptsd and schizoid pd at the same time? and what that may look like?

hi anon, thank you for your question :)

the short answer is: you can have both, but i don’t know exactly how it looks together. i found out some stuff that might give you a clue though.

schizoid pd is a pretty rare diagnosis that it seems has been a little neglected by the research community. to be fair, people with schizoid pd often don’t seek treatment because they see no reason to, they usually go to a professional with another problem like depression or anxiety and then get the additional pd diagnosis.

i didn’t find any studies specifically about the co-occurrence of schizoid pd and c-ptsd.but i found a link in a study about c-ptsd subtypes (Internalizing and Externalizing Subtypes in Female Sexual Assault Survivors: Implications for the Understanding of Complex PTSD, Miller and Resick 2007):

so basically, how people react to trauma is very different and depends on what kind of other baggage and resources they bring to the table. some don’t even develop ptsd or anything. the study revealed three groups - one with “simple” ptsd, and two with complex ptsd: internalizers and externalizers.out of those who develop cptsd, some might react more with anger and rage (externalising), some more with shame and sadness (internalizing). that also extends to how they deal with people and shape their relationships.

in the internalizing c-ptsd subtype that was revealed in the study, people were more depressed and anxious than the externalizers. they tended to have few friends, be aloof and distant from others and prefer to spend time alone. they were very sensitive to others possibly judging them negatively and often felt inadequate. they had trouble identifying and describing their emotions. they also had a higher comorbidity of avoidant pd and schizoid pd than the other groups, which doesn’t surprise me at this point.

the internalizing thing didn’t stop this group from having the most severe hyperarousal symptoms, probably like anxiety and feeling overwhelmed easily, but they didn’t say.it is possible to have any form of c-ptsd and schizoid pd together though, the internalizer thing is just more frequent.

so yes, people can have schizoid pd and c-ptsd at the same time. i have never consciously met a person with schizoid pd though, so i don’t feel qualified to speculate how both could look together in a person. i hope the paragraph above gives you an idea how the c-ptsd part can look!

i see that some characteristics of schizoid pd are close to typical c-ptsd symptoms as well, and these are:

not wanting or enjoying close relationships

feeling little if any desire for sexual relationships

feeling like you can’t experience pleasure

having difficulty expressing emotions and reacting appropriately to situations

can seem emotionally cold to others

may appear to lack motivation and goals

the thing with c-ptsd is, that it can take on so many forms and if you have it, you can read through a lot of diagnostic criteria for other stuff and be like “oh i have that symptom… that too actually…oh god……” all the time. but these symptoms can still come exclusively from c-ptsd.the characteristics of a personality disorder, according to the dsm-5, must not be better explained by another mental disorder. emphasis on “better”.

so if symptoms are trauma-related or part of a personality disorder OR a trauma-related part of someone’s personality OR a mix of the above… that’s for them to find out carefully. i guess the most effective way is together with a professional.

i hope this is a bit helpful!

sources:schizoid pd characteristicsfull text of the cptsd subtype studygeneral criteria for personality disorders

[real-did]

(Part 1) I'm trying to figure out exactly what to talk to my doctor about and I'm sifting thru a lot of symptoms to try and narrow it down. I know there is more than one personality in my head, and that I frequently disassociate and have most symptoms for DID but since they can also be symptoms for other things. A lot of things I read say that a common symptom is having people you don't recognize call you by a different name and I was wondering (...)

(Part 2) if people have alters that don't take on different names?? Because besides that I seem to have everything else? So this is really confusing me. Also I was wondering if it's possible to have an alter fronting for you but still be aware of it like you're sort of watching a movie?? Sorry to ask you this but Google is giving me a lot of conflicting information.

---

Hey, no worries! I’m happy to help. 

Having people call you by a different name typically means people met you when an alter was fronting and you lost time. You introduced the body under one name, and then they recognize you based on that. This doesn’t happen to everyone! Fronting and alters work differently for everyone, and this “symptom” is a bit outdated using a dramatic model of DID that not everyone fits. 

Alters don’t necessarily have different names, but they do have separate identities and personalities separate of moods. It’s not unheard of for some people with personality disorders to mistakenly characterize their sharp moods as alters- not helped by the fact that emotional amnesia is a common symptom of PDs. I’d want you to discuss that with a doctor first- BPD is a lot easier to treat, and if what you’re experiencing as alters fits more as overly characterized moods, then that would definitely be easier on you. It’s something to look into. Dissociation is also a common secondary symptom of BPD and other PDs. 

There’s also OSDD, which is a catch-all diagnosis for “almost DID.” There are a couple different subtypes (DID without amnesia, DID with more vague alters, etc), and they largely work the same way DID does (and can be just as bad, to clarify, I’m not comparing symptoms). OSDDs aren’t given nearly enough attention and that might fit your symptoms best. It’ll be harder to find a therapist/doctor who’s experienced enough in diagnosing DDs to help you with this. 

There’s also DPDR (a dissociative disorder) and bipolar (which can have dissociative symptoms too). I’d personally recommend you look into OSDD/DDNOS more, just because the majority of people with DID do have differently named alters. It’s not necessarily a requirement but part of having fleshed out and strongly characterized alters- if you don’t have that, you might not have DID, and that’s not a bad thing! There are a lot of people with OSDD/DDNOS on tumblr that you might be able to compare symptoms with. There’s also a chance you have DID and your alters haven’t opened up to you enough yet (they have names that you don’t know). You might have abnormally presenting BPD or something else. Be gentle with yourself and document your symptoms. 

About your last question, backseat cofronting is pretty common! Feeling like that can also be a general dissociative symptom, so that unfortunately doesn’t narrow it down any more, but it’s not at all uncommon in people with DID. 

Please ask more questions if you need to. I’m here for you, whatever you’re diagnosed with. 

[theclasssessionssamblog-blog]

blog 9/16/2019

Abusive ad hominem

Argue against something by

attacking the person arguing for it

. . .in contrast to arguing against the thing itself

…..John Nash’s mathematics

…..can’t be Nobel prize-worthy

…..because he has schizophrenia

. . . . .(see movie A Beautiful Mind)

. . . . .logical fallacy?

 I think it’s a bit of a logical fallacy, if we could test the math and it works then it all fine. But I usually take anything psychotic people say with a lot of salt.

 …..Amy Winehouse’s music sucks

…..because she’s in the “27 club”

. . . . .logical fallacy?

 Yes music is subject

…..Jimi Hendrix’s music is great

…..because he’s in the “27 club”

. . . . .logical fallacy?

Although Jimmy is great, it’s not because he was in the 27 club. 

…..We shouldn’t do the project like Irving suggests

…..because he’s totally uncool

. . . . .logical fallacy?

Yes, 

 I do think that these are pretty bad ways to approach arguments. I suppose if your a good speaker, it would be very easy for people to fall for these. 

   Tu toque ad hominem

tu toque = “you also” in Latin

Example:

…..A parent says, don’t smoke, it’s unhealthy

…..The kid says, “but you smoke”

. . . . .“Practice what you preach!”

. . . . .“So I don’t believe you!”

Politics is full of examples:

…..Al Gore’s house was once found to be energy-inefficient

. . . . .Is that an argument against the

existence of global warming?

. . . . .Is it an argument

against reducing CO2 output?

…..”Politician z‘s argument is wrong,

s/he’s a Democrat/Republican/whatever”

…..what about,

This is a very tricky fallace. Yes it is a logical fallacy, but  studies have suggested that people really dislike hypocrites. According to it, people dislike hypocrites more than just liars. It is seen as trying to get ahead on false virtue, rather than just denying negative attributes. While it is a logical fallacy, if you want anyone to listen to you argument, you can’t be a hypocrite on the issue.   Link to Study: https://journals.sagepub.com/doi/full/10.1177/0956797616685771

Scenario 1a (you are on the jury and the jury is discussing a verdict):

. . . “Take the defendant’s lawyer’s argument with a grain of salt – being paid to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

. . . “The defendant’s lawyer’s argument is wrong – being paid to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

Scenario 1b (you are on the jury and the jury is discussing a verdict):

. . . “Take the plaintiff’s lawyer’s argument with a grain of salt – it’s their job to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

. . . “The plaintiff’s lawyer’s argument is wrong – it’s their job to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

Both I think are logically incorrect. Public lawyers aren’t worth much, but always take what happens in court with a grain of salt. As for scenario 1, i'm more inclined to believe the defendant, as many prosecutors are just looking for extra prosecutions to boost their careers. We need prosecutors, but a bunch just want a good record, and if the defendant didn’t hire a lawyer, he’s not gonna do well with a public one. 

 Logical Fallacies: “argumentum ad hominem”

Posted on October 3, 2011 by Daniel Berleant

(Updated 9/16/2019)

What is a Logical Fallacy?

…..Literally, a reasoning mistake

…..Example:

. . . . .You say the square root of 100 is 10

. . . . .Someone wishes to argue otherwise

. . . . .They say you flunked arithmetic in 3rd grade

. . . . .People start to doubt that sqrt(100)=10!

. . . . .This is crazy, right?

. . . . .It happens all the time…

. . . . . . . just not as obviously

. . . . .Example:

. . . . . . .Someone suggested a warning sign

…that some chemical additive might be hazardous

…based on experiments giving it to animals

. . . . . . .Ad hominem response related to hypothetical poor animal experiment design

. . . . . . .Result:

No response

Discussion ended

… and … no warning sign!

. . . . . . .This was a highly effective (ab)use of ad hominem argumentation

. . . . . . .(so why didn’t I/someone point this out?)

…..Politicians do it a lot

. . . . . . Some use it more than others

…..Roman politicians were experts!

…..People fall for it frequently

…..This one’s called the ad hominem argument

…..Latin for to the man

…..The Romans taught oratory in school

. . . . .How to use logical fallacies

. . . . .to manipulate public opinion

. . . . .was part of their education!

. . . . .That’s why many have Latin names

Ad hominem arguments

Just one of many logical fallacies

…..There are dozens

Argumentum ad hominem is one of the most important

…..Ad hominem arguments are particularly common

…..There’s an entire wikipedia entry on them

Example

(from an email exchange

whose only real value was in

providing an example for you folks!):

[ML makes some claims that global warming doesn’t exist. Then he wrote…]

ML: Anybody who claims otherwise is ignorant, uninformed, or lying.

PD: Ooh – is this the choose-your-own-ad-hominem part of the show?  Can I play too?

[more stuff deleted]

Example 2:

An ethics student (Sp 2017) cited a debate between Bill Nye and Ken Ham as containing interesting examples of ad hominem statements (warning: it’s long)

There are various types

…..Example:

. . . . .ad feminam

The animal experiments example was a type

Why?

Let’s look at some

…..types

…..examples

Abusive ad hominem

Argue against something by

attacking the person arguing for it

. . .in contrast to arguing against the thing itself

…..John Nash’s mathematics

…..can’t be Nobel prize-worthy

…..because he has schizophrenia

. . . . .(see movie A Beautiful Mind)

. . . . .logical fallacy?

…..Amy Winehouse’s music sucks

…..because she’s in the “27 club”

. . . . .logical fallacy?

…..Jimi Hendrix’s music is great

…..because he’s in the “27 club”

. . . . .logical fallacy?

…..We shouldn’t do the project like Irving suggests

…..because he’s totally uncool

. . . . .logical fallacy?

Tu toque ad hominem

tu toque = “you also” in Latin

Example:

…..A parent says, don’t smoke, it’s unhealthy

…..The kid says, “but you smoke”

. . . . .“Practice what you preach!”

. . . . .“So I don’t believe you!”

. . . . . . . .  so there, gramps!

(Source: web.archive.org/web/20141002204651/http://uhaweb.hartford.edu/KRAKYTA/C0048330-Kids_smoking_cigarettes-SPL.jpg)

…..is there a logical fallacy there?

Politics is full of examples:

…..Al Gore’s house was once found to be energy-inefficient

. . . . .Is that an argument against the

existence of global warming?

. . . . .Is it an argument

against reducing CO2 output?

…..”Politician z‘s argument is wrong,

s/he’s a Democrat/Republican/whatever”

…..what about,

Scenario 1a (you are on the jury and the jury is discussing a verdict):

. . . “Take the defendant’s lawyer’s argument with a grain of salt – being paid to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

. . . “The defendant’s lawyer’s argument is wrong – being paid to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

Scenario 1b (you are on the jury and the jury is discussing a verdict):

. . . “Take the plaintiff’s lawyer’s argument with a grain of salt – it’s their job to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

. . . “The plaintiff’s lawyer’s argument is wrong – it’s their job to give a one-sided argument”

. . . . . .logical fallacy, or logically ok?

Scenario 2 (politicians)

. . . . .”Take politician X’s argument with a grain of salt, s/he took campaign money from the ___ industry”

. . . . . .logical fallacy, or logically ok?

. . . . .”Politician X’s argument is wrong,

s/he took campaign money from the ___ industry”

. . . . . .logical fallacy, or logically ok?

 I think it’s a logical fallacy, but I would be skeptical, it doesn’t mean the politicon is wrong though. 

Summary:

. . . “ad hominem” means “to the man”

. . . it does not mean “invalid” or “valid”

. . . often it is an invalid/sneaky/sleazy argument trick

. . . . . . (remember its full name:

argumentum ad hominem)

. . . . . . ethical?

. . . sometimes it is logically reasonable

I don’t think its logicall reasonable, but not totally unreasonable either. I think people should no that it isn’t logical, but there’s a reason we are more skeptical of people when they have bad character, hypocrates or getting payed. 

 literally, “to the woman”

Example:

…..Comedian Caroline Picard is a big football fan

…..Suppose a woman critiques a team

…..A fan doesn’t like the comment

…..response 1:

. . . . . .argue it on technical merits

…..response 2:

. . . . .dispute it by saying,

“not so – women don’t know football”

. . . . .that’s an “ad feminam” argument!

. . . . .what is the logical flaw?

. . . . .is it ethical?

I think it is a logical flaw to use response 2. I don’t think you can rationally use age,sex, or really anything that doesn’t really add to the agrument. That’s a silly way of thinking.

 Circumstantial ad hominem argument

Saying that

the arguer is biased,

therefore

the argument is invalid

subtype: conflicts of interest

“That’s just PR spin;

they’re paid to say that”

. . . . .is that argument “to the man”?

. . . . .is it logically fallacious?

The American legal system

based on paying people to argue one side

it’s “adversarial”

Other countries have different approaches

Does the adversarial approach affect the believability of the argument?

Can you think of a better method?

I don’t think you really can have a better system, maybe you can set up like france and have an inquisition, which means that the court does investigations, but I don't know enough about it. I think that we should have fines for smaller crimes, such as drug possession or public intoxication. I’m sure there are many others. This could stop a lot of the court trials and free up the court system a bit. You spend too much money and defendants for can’t afford to get a lawyer get a bad deal with the current system, plus judges need to get there cases done. This is why I don’t hold someone hiring a lawyer against them. 

 “You want us to get out of Iraq?

Well, Iran wants us to do that, too!”

…..“So we should not reduce troops”

. . . . .logical fallacy?

…..“So your argument is traitorous”

. . . . .logical fallacy?

…..“So your argument is wrong”

. . . . .logical fallacy?

  All of these are logical fallacies that don’t even make much sense. I suppose that it’s true that iran wants us to get out, but that is only an argument, It’s get insane when the argument is called traitorous.  

[researching01]

Neck Pain and Headaches: The Link and How To Find Relief - Tony Gentilcore

New Post has been published on https://headacheshelp.com/trending/neck-pain-and-headaches-the-link-and-how-to-find-relief-tony-gentilcore/

Neck Pain and Headaches: The Link and How To Find Relief - Tony Gentilcore

Neck Pain and Headaches: The Link and How To Find Relief

Share This:

Whenever one of my clients or athletes walks in and starts to say something to the effect of “hey, my neck is really bothering me…..”

….I immediately put my fingers in my ears and start yelling “lalalalalala, I can’t hear you.”

Okay, kidding.

Neck stuff can be tricky if not terrifying, and I know my limitations as a strength coach. 90% of the time I refer out to clinicians more qualified in this department, but that doesn’t mean there aren’t some “first step” actions I can take to hopefully help and provide some relief.

In today’s guest post by Dr. Michael Infantino he provides some insights that are well within many strength coaches/personal trainer’s scope of practice.

Neck Pain and Headaches: The Link and How To Find Relief

Today I want to help you figure out if your neck is the source of your headache and how to treat it. Headaches, similar to many other diagnoses, can lead you down a rabbit hole of confusion.

So many subtypes of headaches exist that it becomes overwhelming to actually go about treating them. Luckily, the link between your neck and headaches is becoming more recognized.

I regularly see patients who are referred for suspected cervicogenic headache. Cervicogenic headaches imply that the neck is the cause of your headache.

This can be tricky because most headaches will actually result in some type of neck tension. This isn’t to say that treating the neck in these scenarios is a waste of time. It may resolve neck pain.

It just isn’t the answer to resolving your headaches.

Assuming that your headaches are cervicogenic in nature, what is the next step? Treating your neck pain is only one piece of the puzzle. We need to get to the route of the problem. Blaming your headaches solely on your neck is somewhat naïve. You need to consider how your lifestyle may have resulted in your neck pain and headaches.

Remember, everything affects everything. When our neck hurts we start wondering what ligament, muscle, nerve, disc or bone may be injured. Often times neglecting the actual cause of neck pain.

Photo by John Torcasio on Unsplash

Injury and inflammatory processes local to the neck can occur for a multitude of reasons. It is not always secondary to trauma. Most of us start wondering if we slept in a bad position the night before or think back to a neck injury we sustained twenty years ago.

“That must be the problem! I used to play way to hard in pee-wee football [#glorydays].”

Instead, we need to consider the BIG 3. Sleep, nutrition and exercise. Ask yourself these questions.

How has my sleep been?

How about nutrition?

Have I been neglecting exercise or neglecting recovery?

Most problems start with sleep, nutrition and exercise. If you are missing the mark in any one area expect problems. Missing the mark in multiple areas? Now we have BIG problems.

How To Diagnose Cervicogenic Headaches?

Here’s your sign…

It is more common for cervicogenic headaches to be located on one side of the head, but not always. In some cases, people will sustain a whiplash injury or concussion. Headaches associated with these injuries are often multifactorial. However, we have often seen improvements by treating each suspected cause.

Treating your neck in these situations tends to do wonders.

Considerations For All

Posture… blah, blah, blah. I know we hear about it all the time.

You need to be cognizant of your posture.

This doesn’t mean that you need to sit at attention all day.

My biggest pet peeve is hearing that an “ergonomic specialist” told you that you needed to sit like a statue… all day. “Tall, chin tucked, flat back, shoulder blades pinched…” You’re kidding right?

As always, “poor posture” is not necessarily the culprit when it comes to pain.

Staying in one position for too long is the problem.

This doesn’t mean you have free reign to sit like the Hunch Back of Notre Dame. Studies have shown that a forward head position can increase the frequency of headaches (C Fernández-de-las-Peñas, 2006).

We often overlook the fact that our posture can have a huge impact on how we feel. Picture someone that is sad or depressed. What does their posture look like? Now think of someone confident and enthusiastic. What does their posture look like? How you position yourself can really play into how you feel physically and emotionally.

Tip: Change position every twenty minutes. Taking a walk can do wonders. Drinking a lot of water can force bathroom breaks. If you are stuck in a car shift positions often. Add some neck motions, some back arches, etc.

Be creative… and safe.

With a forward head posture normally comes tense muscles. Doing a quick scan to see which neck motions and shoulder motions feel more limited can make a huge difference.

Multiple studies have found a correlation between cervicogenic headaches and tightness of the sternocleidomastoid, upper trapezius, scalenes, levator scapulae, suboccipitals, and pectoral muscles (Page, 2011).

The picture below keeps things relatively simple.

Stretch the tight muscles and strengthen the weak ones. We will give more guidance on this in the next section.

Strengthening the neck has shown to improve neck pain and cervicogenic headaches.

Pain, poor posture and trigger points can alter the strength, endurance, timing and proprioception of the muscles around your neck.

Once you address trigger points and flexibility, restoring strength and endurance around the neck can happen relatively quickly.

The more research we have, the less specific it seems we need to be with these exercises (Ask, 2009; Jull, 2009; Gross, 2009; Van Ettekoven, 2006). Studies have shown that specific neck and upper body strengthening can be just as effective as general strengthening (Anderson, 2011).

Some medical providers will argue for the use of “deep cervical strengthening” using a biofeedback cuff.

A what!?

This is basically a rigged up blood pressure cuff. I love using this with patients because it teaches them how to realign their neck without using a lot of big muscles. If you do not have a blood pressure cuff have no fear. Gently performing chin tucks while attempting to avoid large muscle contractions will do.

[Watch the Neck Pain and Cervicogenic Headache Strength video below for more details on chin tucks].

Telling someone they need to breath a specific way comes with some challenges.

We don’t always know why they have adopted an upper chest breathing strategy. It could be postural or even developmental. Some of us adopt certain postures because of work requirements or cultural norms. Other times it could be related to how we breathe; mouth vs. nose breathing.

Studies show that mouth breathers more commonly present with forward head posture.

It seems that a forward head position helps increase respiratory strength by using neck and chest musculature (Okuro, 2011; Int J Neiva PD, 2009).

So a forward head position is good?

No, this is a compensation that leads to increased tension and trigger points.

The emphasis placed on diaphragmatic breathing has been great over the past few years. We also need to make sure people are learning how to perform nose breathing. Besides helping improve oxygenation and preventing forward head posture, it has many other wonderful benefits. Since this is not the main topic of today I digress.

How To Test & Treat Yourself

The goal here is to keep things QUICK and DIRTY.

We will go through (1) motion and (2) strength testing.

Do you need to do all of these tests?

Absolutely not.

The benefit of testing and retesting is to see if you are actually making change. If your motion and strength improve after a couple weeks without resolution of headaches we need to go back to the drawing board. Consider seeing a skilled medical provider.

If you are short on time just go right to the “Ouch Test.” This is when you roll some inanimate object on your neck in an effort to identify trigger points. With a smile on your face of course.

Motion and Tissue Quality Testing:

1. Flexion/Rotation Test

The goal here is to see if your upper cervical rotation is limited in one direction. Cervicogenic headaches are usually attributed to dysfunction at the upper three cervical levels.

Flex your neck and rotate your head in an attempt to identify a “tighter side.” Keep in mind that what you feel isn’t always real. Give it a shot and consider using a friend to assist or a video camera to identify the direction you are limited in.

If you can’t get your chin to touch your chest we already know your neck needs some work.

2. Rotation/Flexion Test

If you had trouble getting your chin to your chest this test will help you identify if one side is tighter. This time you are rotating and then attempting to touch your chin to your collarbone.

This lets us know if upper cervical flexion is more limited on one side than the other. If you are limited, the assumption is that the opposite side cervical musculature is limiting you. To measure, see how many fingers can fit between your chin and collar bone.

Having objective measures will help you see if you made progress after treatment.

3. Follow The Map

Sometimes a roadmap is helpful for identifying the muscles that may be contributing to your pain and headaches. Being familiar with muscle referral patterns can help remove a little anxiety related to your pain. It helps prevent you from always thinking the worst when pain sets in. With a road map it is easier to get to your destination.

4. The “Ouch” Test

This is a more simple way of identifying which muscles may be triggering your headaches. Use your fingers, a roller stick, Thera-cane, lacrosse ball or whatever to identify tender regions around the upper neck and shoulders.

If a spot actually recreates your headache, you struck GOLD.

If you identify a tender region that does not recreate your headache, it would not hurt to treat it anyway.

5. Strength Testing

Chin Tuck and Lift Test

Treatment. Let’s Get To Work.

1. Soft Tissue and Joint Treatment

Our goal here is to restore motion to the upper cervical region and resolve any trigger points.

2. Strength Treatment

We believe in being better than the average.

Your goal is to be able to hold the chin tuck and lift position for 1 minute, in a curl up position. We work on short duration holds with repetitions to help avoid excessive soreness.

Please do not be a hero and do long duration holds each time you exercise.

This recommendation is not for your general strength routine, only for this rehabilitation plan.

Goal: 1 minute hold in curl up position.

Retest: At the end of each week.

Protocol [See strength video above for demonstrations]:

Phase 1: Chin Tuck and Lift. 5 second holds for 10 repetitions. (5x/week)

When you can perform this with ease and no pain move on.

Phase 2: Chin Tuck and Lift. 10 second holds for 10 repetitions. (5x/week)

When you can perform this with ease and no pain move on.

Phase 3: Curl up + Chin Tuck and Lift. 5 second holds for 10 repetitions. (5x/week)

When you can perform this with ease and no pain move on.

Phase 4: Curl Up + Chin Tuck and Lift. 10 second holds for 10 repetitions. (5x/week)

Headache Diary: Become A Good Detective.         

Using a headache diary is a great way to identify the source of your headache.

If you want to be a good detective you need to take some notes. Noting the time of day, triggers (specific activity, specific movement you made, foods you ate, your mood, etc.), symptoms that preceded your headache, medications used and how you found relief.

Achieving 1% gains in various regions of your life, on a daily basis, is a surefire way to resolve most health issues.

The link between cervical dysfunction and headaches is often overlooked.

Basic maintenance that includes soft tissue work, strength, awareness of posture and proper breathing could be the fix you need. The medical community as a whole has been getting better at addressing the cause of headaches rather than covering them up with medication. Putting a spot light on the fundamental components of health should always be the answer.

Getting sleep, nutrition and exercise right is often the answer to most disease and illness. This will make your life much simpler, not to mention how much better you will feel.

Interested in a FREE home exercise plan. Click to get started today!

About the Author

Dr. Michael Infantino is a physical therapist. He works with active military members in the DMV region. You can find more articles by Michael at .

Did what you just read make your day? Ruin it? Either way, you should share it with your friends and/or comment below.

Share This Post:

Source

Neck Pain and Headaches: The Link and How To Find Relief