Something Else
Last issue, we held up a mirror. You saw the signs — maybe recognized yourself in some of them. Now we go one layer deeper: not just that something shifted in you, but how it shifted. What it actually looks like from the outside. And why what you’re calling your personality might be something else entirely.
You want to know why you’re feeling so damned alone, misunderstood, and hopeless?
First, it's family and friends who don’t understand why you are so withdrawn. Then you question yourself: “How can I go from having a great day to ballistic in the blink of an eye?” The last hit to your emotional stamina: a therapist, who's following all the guidelines and diagnostic manuals, misses by a mile.
We’re labelled, sometimes appropriately, only by outward actions, not inner drivers. The source of your behaviors.
Hothead? Yep, you lose your temper at nothing. Did you just go from mingling cordially at a family get together, only to be found isolated in the back yard or a spare room later? “Oh, he’s just depressed.”
My favorite: it’s just an episode, he’ll be fine in a few minutes.
Then we finally give in and go to see a therapist—despite the failed previous attempts, or hearing horror stories from friends with PTSD.
You answer the intake questions, tolerate another battery of 2–3 hour long “assessments,” and *poof* the system kicks out your diagnosis: you have obsessive compulsive disorder with narcissistic traits.
Wait. What!?!? I’m not narcissistic, am I?
“Well, Mr. Joyner, you fit the diagnostic criteria.”
“Meaning?”
“You’re exhibiting the correct symptom clusters.”
“Okay, what now?”
“We begin treatment immediately.”
Only the treatment isn’t for your trauma or PTSD. And it’s wrong. Real wrong.
Why? They never asked if you’d ever been through anything that rocked your world. Everyone—family, friends, doctors—concluded what is wrong with you relying on your behaviors and never bothered to look inside.
That, my friends, is what I mean by garbage out…garbage in.
I said mistreatment is bad…real bad. Read on…
OCD with narcissistic traits gets treated with Exposure and Response Prevention — ERP. The premise is that your obsessive thoughts are creating a false alarm, and your compulsive responses are feeding the loop.
So the treatment pushes you toward the thing that scares you, holds you there, and waits for the anxiety to burn off. The idea is your brain learns the threat isn’t real.
Your nervous system didn’t get wired for false alarms. It got wired under actual fire. Childhood that felt like a combat zone. A relationship that dismantled you piece by piece. Deployments where the threat was everywhere, the body counts added up, and your “decompression” time from 6–12–18 month-long deployments? Honey do’s and never ending questions: What was it like? Did you kill anyone? Did you see any get killed? Were you SCARED?
ERP tells your nervous system the alarm is broken. Trauma therapy understands the alarm was installed correctly — it just never got the all-clear signal.
So when they run ERP on a trauma survivor, they’re not quieting a false alarm. They’re pushing someone who’s already been through hell back toward the edge and calling it treatment.
You probably already know…just another load of manure piled on top of the misunderstandings of you. And here’s the kicker—you start believing the shit:
I am broken...nothing can help me.
I’m worthless, unchangeable.
Maybe my partner is right, I’m too lazy to change.
What’s the point of going on, if it never gets better? (They treated for narcissism incorrectly, which can make you a nihilist. Good deal, yeah?)
It’s hard to win a fight when you can’t see who’s throwing the punch.
I’ve got a better solution for you…
How about we learn to understand what PTSD/CPTSD actually is and how to engage it. In our language, not the unnecessarily scientific, pretentious, aloof language of professional psychoanalysts, therapists, psychiatrists, and licensed social workers.
Would this mean anything to you: It seems you’re utilizing Experiential Avoidance to maintain your current Homeostasis.
Translation: You don't like to talk about your past.
You’re never going to get this from The Echo Chamber or The Imprint’s Echo.
We’re just talking across a kitchen table. One brother to another.
No one understands your survivor better than you.
Did your survivor just go through something that would have rocked your world, but they say “I’ve been through worse” or “I’m fine.”
If they’re truly narcissistic, when they’re not in an episode, are they providers or parasites? If they only have depression, did they always have it…or did it start after their last deployment or the loss of someone structural in their life?
Symptoms of PTSD/CPTSD and many other disorders overlap, so misdiagnosis—to a point—is not unforgiveable, but mistreatment is. Make sure you do your best to ensure they aren’t getting treated for a related disorder while missing the trauma piece.
It literally could be the difference between good and bad outcomes.
A Lighthouse doesn’t carry, they spot danger areas to be avoided. You may be the only one in the room who will see them.
This issue, or article, is highlighting a known problem in the mental healthcare community. I want you to be aware of pitfalls along the way to your healing from PTSD/CPTSD. Every obstacle I can point out, will make your journey more navigable…not easier, just less BS.
The story I told in this issue — misdiagnosis, wrong treatment, a survivor left holding the wreckage — is real. It happened to me. It happens every day.
The villain isn’t all mental healthcare professionals…it’s a damn broken map.
CPTSD isn't even recognized by the DSM-5 — the primary manual American clinicians are trained on and required to use. A clinician can be fully competent, genuinely caring, and completely current in their training — and still be working without the tools to see what's actually in front of them. The system handed them an incomplete instrument and told them to navigate.
The struggle is real. And the field knows it.
Research shows that 92% of patients with a principal PTSD diagnosis carry at least one other active psychiatric condition simultaneously. Symptom clusters genuinely overlap. Sorting them correctly requires expertise and experience.
This is why my number one recommendation, if you think or suspect you’ve been traumatized, is to search for experienced, trauma-informed therapy specialists.
Start by using the Cherry Picking A Therapist checklist.
They are out there. Finding one is worth every failed attempt that came before. Don't let a broken system cost you a good clinician.
I'll be here every Sunday.
Bring whatever you're carrying.
Email me at admin@paxmentispublishing.com if there is a trauma or PTSD-related issue you would like me to speak to.
References
Billings, J., & Nicholls, H. (2025). PTSD and complex PTSD, current treatments and debates: A review of reviews. British Medical Bulletin. https://pmc.ncbi.nlm.nih.gov/articles/PMC12466117/
Journal of the American Academy of Psychiatry and the Law. (2019). A systematic approach to the detection of false PTSD. https://jaapl.org/content/early/2019/06/10/JAAPL.003853-19
TandFonline. (2025). Understanding barriers in supporting service users with complex post-traumatic stress disorder: A pilot survey. https://www.tandfonline.com/doi/full/10.1080/20008066.2025.2516286
The Permanente Journal. (2025). Prevalence and health care utilization of posttraumatic stress disorder. https://www.thepermanentejournal.org/doi/10.7812/TPP/24.191
If you’re in crisis right now, please reach out. Call or text 988 (Suicide & Crisis Lifeline). You don’t have to be at the edge to call — if the weight is heavy tonight, that’s enough reason.