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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Relationship
Satisfied Customers: 7664
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I am trying to help my Niece whom I love very much. She has

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I am trying to help my Niece whom I love very much. She has the same problem my dad had as he got real sick late in life. As my mom said people who are suffering and experiencing a great deal of physical and emotional pain seem to take it out the most on the people they love the most. I'm trying to help my niece and she is just 45 years old and I am 65. She was obviously abused much as she grew up in a very unhealthy home an experienced much sexual abuse. Now her hip needs surgery and she has a lot of physical pain there. I am trying to help her and I provide nearly all of her financial support, and I every provide her with a safe place to live in my home. I know she loves me deeply as I have know her for 31 years. Yet she seems to take out all of her anger on me and it is wearing me out. Is there some kind of diagnosis for this sort of thing so I can do research to try and find practical ways to help her?
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Dear friend,

I believe that I can help with this situation.

I would have to have some more information to be more certain about what is going on.

People who are abused or neglected or abandoned or experience or witness other trauma usually have a few reactions to it that affect their lives.

The first that comes to mind, because of her extreme anger, is Borderline Personality Disorder (BPD) which is often triggered by fear of abandonment whether this abandonment is real or imagined.

A person with this disorder can suddenly fly off the handle with violent outbursts of anger. They sometimes injure themselves by cutting, and some can have a reckless quality to their lives.

Because of strict rules of confidentiality, therapists cannot give you information or even the diagnosis. This is a federal law (HIPAA).

The other possibility is Posttraumatic Stress Disorder and could lead to some anger too, but is characterized by panic attacks, flashbacks, nightmares, being on high alert and easily startled, and several other symptoms.

Let me give you the official diagnotic criteria for BPD from the psychiatric diagnostic manual called DSM-IV.


1. Frantic efforts to avoid real or imagined abandonment.

2. A pattern of unstable and intense interpersonal relationships characterised by alternation between extremes of idealization and devaluation.

3. Identity disturbance - markedly and persistently unstable self-image or sense of self.

4. Impulsivity in at least two areas that are potentially self-damaging, e.g. spending, sex, substance abuse, reckless driving or binge-eating.

5. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour


6. Affective instability due to a marked reactivity of mood, e.g. intense episodic dysphoria, irritability or anxiety, which usually lasts for between a few hours and several days.

7. Chronic feelings of emptiness

8. Inappropriate, intense anger, or difficulty controlling anger, e.g. frequent displays of temper, constant anger or recurrent physical fights.

9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Anyone with six or more of the above traits and symptoms may be diagnosed with Borderline Personality Disorder. However, the traits must be long-standing (pervasive), and there must be no better explanation for them, e.g. physical illness, a different mental illness or substance misuse.

If this is the case, let me suggest a book that will give you insight on the disorder, and another one that your niece might like to read about a young woman's descent out of the clutches of BPD.

The third book is a form of self-therapy that could be used by a therapist to help her with trauma from the past. It is a workbook about dialectical behavior therapy.

Product Details

Stop Walking on Eggshells: Taking Your Life Back When Someone You Care About Has Borderline Personality Disorder... by Paul Mason MS and Randi Kreger

Product Details

Get Me Out of Here: My Recovery from Borderline Personality Disorder by Rachel Reiland






Product Details

Mindfulness for Borderline Personality Disorder: Relieve Your Suffering Using the Core Skill of Dialectical Behavior... by Blaise Aguirre MD and Gillian Galen PsyD






Product Details

The Dialectical Behavior Therapy Skills Workbook: Practical DBT Exercises for Learning Mindfulness, Interpersonal... by Matthew McKay, Jeffrey C. Wood and Jeffrey Brantley



If you have further information to add, or need clarification, please get back to me.


Warm regards,



Elliott, LPCC, NCC and other Relationship Specialists are ready to help you
Customer: replied 3 years ago.

You have been most helpful. Thank you so much. The symptoms my life with Tracy seem to not follow the borderline personality disorder much at all, but seem to be right in line with the post traumatic stress disorder. What little you told me fits her to a tee.


Thank you so much.

Here are the symptoms for PTSD:

309.81 DSM-IV Criteria for Posttraumatic Stress Disorder

A. The person has been exposed to a traumatic event in which both of the following have been present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others (2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event.

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(3) inability to recall an important aspect of the trauma

(4) markedly diminished interest or participation in significant activities

(5) feeling of detachment or estrangement from others

(6) restricted range of affect (e.g., unable to have loving feelings)

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep
(2) irritability or outbursts of anger
(3) difficulty concentrating
(4) hypervigilance
(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than one month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:
Acute: if duration of symptoms is less than 3 months
Chronic: if duration of symptoms is 3 months or more

Specify if:
With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

and here is a workbook:

Product Details

The PTSD Workbook: Simple, Effective Techniques for Overcoming Traumatic Stress Symptoms by Mary Beth Williams PhD LCSW CTS and Soili Poijula PhD

Best wishes

Elliott, LPCC, NCC and other Relationship Specialists are ready to help you

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