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BD as a misdiagnosis of other personality disorders


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*Trigger warning for discussion of sexual abuse and rape

Hello,

I am a woman diagnosed with bipolar II at age 24. Some background on me:

I experienced severe trauma at a formative period of my life (a terrible autoimmune disorder between ages 12-14 that in the end nearly killed me; in the beginning, despite many visits to doctors including specialists such as endocrinologists, I was told it was "all in my head" and sent to psychiatrists and psychologists; my disorder--Hashimoto's toxicosis, which resulted in extremely high thyroid--led to behavioral problems which I think were distinctly "unladylike" and I got the distinct impression I was being "resocialized." I didn't do drugs or join a gang, I just refused to stay in school because my teachers and school were terrible--I would ditch to go to the library and read books--and I talked back to teachers and other authority figures, etc., although not to those whom I respected. I fought a lot with my father and sister, likely due to his preferential treatment of her when I was growing up; I was always a tomboy and always disobedient, though not to be "bratty" and get attention, just because I liked doing stuff on my own time and was very curious and adventurous and didn't know why I had to abide by what seemed to me to be adults' arbitrary rules. Read up on "childism" to understand more about the nature of the parent/child hierarchy; I understood this at a young age and rebelled against it, though not maliciously. My father took this personally and favored my obedient younger sister; although as I grew older I became well-adjusted, outgoing, got good grades and participated in extracurricular activities, and became an obedient, "good" child, when I got sick I think this resentment came out in the way I targeted my father and sister for my angry outbursts. I have blocked most of this out, though my family has never really forgiven me. My disease was discovered by my dermatologist when my legs swelled to twice their normal size and sheets of skin began peeling off; by that time I was going two weeks without sleep, had a resting pulse of 120, had hand-eye coordination that was inches off, and could not climb stairs without fainting. I had a constant feeling of light rushing through my head, uncontrollable tremors, and experienced phantom bee stings that caused real swelling. All in all, I was messed up physically, but sent to psychologists and psychiatrists--who put me on Ritalin, the worst drug possible for someone with high thyroid--instead of being tested for autoimmune disorders, which should have been obvious; I feel this was due to medical sexism, "oh she is just an adolescent girl being an adolescent girl," although the year before this started I had been a happy, cheerful eleven-year-old, and I had obvious physical symptoms. I also tried to kill myself during this time because I was afraid I would be schizophrenic, though I failed and never told my parents).

In any case, after I was given medication to bring my thyroid down (I was told I would then have low thyroid that would cause me to have to take Synthroid all my life, but went into what the doctors described as "spontaneous remission;" I believe I still struggle with borderline low thyroid because of the damage done to my thyroid when my autoimmune antibodies were attacking it), I lost weight, my skin cleared up, my behavioral problems went away, and I became suddenly a pretty teenage girl. I got positive feedback from my father for dressing, looking and acting "better" (more feminine). I think during this incredibly traumatic period (as well as when I was very young, five or six) I had internalized some idea of myself as "bad," or deserving of punishment. I also desired approval from my father and this extended to other men (classic "daddy issues").

All of this led to me being sexually victimized constantly throughout my teenage years (actually, I was first molested at age six--if you count grooming and kisses on the mouth from a man in his forties as molestation--and molested again at age nine, and again at age thirteen). I was first sexually abused and raped when I was 17, by the man I lost my virginity to, a 24-year-old who took advantage of how sexually submissive I was and "groomed" me for sex (he viciously attacked and sodomized me in the shower once, and used to have sex with me in my sleep as well; I would go over to his place just to hang out with him and his friends, and he'd shove me in the other room and unzip his fly. When I told him I wanted a more "serious relationship"--i.e., to actually be his girlfriend, rather than a piece of meat--he told me I was "too young for him").

As a result of all this, I have been revictimized frequently. Sometimes it's when I'm looking for it, even if subconsciously (Freudian repetition compulsion), but often when I am completely minding my own business; just as people who have been mugged once are more likely to be mugged again, people who have been raped once are more likely to be raped again, particularly if they have never dealt with their trauma and particularly if they were abused when young. There is an "aura" or energy that predators pick up on (which is not to blame the victim, but simply to be aware of it; I have been singled out for sexual assault on the subway, at work, at clubs and parties, when completely minding my own business, and whether I'm happy or sad doesn't seem to make a difference; I think that the fact that I will "freeze up" and not do anything about it must be something I transmit in my energy). I have been sexually assaulted by friends and acquaintances (I am including in this everything from sexual menacing to unwanted groping to rape). 

When I was diagnosed with BD, I was recovering from a rape in college to which I had a hypersexual, self-destructive, promiscuous reaction. I had been put on Prozac for depression and I was diagnosed because an SSRI causing mania is a hallmark of bipolar disorder. I don't think where I was at emotionally was taken into account. It strikes me that every single time I have had a manic, hypomanic or mixed-manic episode it has been related to my experience of rape (either in the aftermath of a rape--not just groping, but a sexual assault--or because I am processing the deeply-buried, never-processed memories of a rape, as I did in a grad school writing program, where I wrote about them for a creative nonfiction seminar). I think my long-standing low-grade depression and sometimes fairly serious depression can also be attributed to something like Complex Post-Traumatic Stress Disorder. I have never had the money to have a serious psychiatrist evaluate me, or take this into account.

At the moment, I have a co-diagnosis of acute PTSD, because last year I became involved with someone with whom I had everything in common--another writer, another teacher, someone who did his master's at my alma mater, with whom I had friends in common--someone who was, at first, extremely supportive of me--who then sexually abused me during the latter half of our relationship, and raped me twice after we broke up. He ALSO has a diagnosis of bipolar disorder; before I met him, he had spent a year in a funk on his parents' couch after deciding to drop out of an MFA program in California and return home. He had begun taking Seroquel, which made him functional again but also, I think, had side effects of which he was not quite aware (mania, for one; when were together he would sleep four hours a night and then pester me to wake up, which kept me in a state of chronic fatigue and made me more susceptible to his manipulations).

When I met him I had just returned from living three years in Mexico, where I had been doing disturbing research for a book which unearthed a lot of my old as-yet unprocessed trauma (I am finally in therapy for rape trauma now, after 15 years of this). I had also had a difficult work environment, had been sexually preyed on my male friends of mine, and had shattered my ankle and torn four ligaments in it (because I was scared of sexual assault by Mexican police--it's a long story) and broken up with my Mexican boyfriend. When I returned to the U.S., I knew I desired a change in career, but I had no supports apart from family and old friends, and knew it would be a long road, and had a burning desire to speak to someone about what I had been through--i.e., years' worth of unprocessed trauma, and how I kept being targeted because of my obvious sexual vulnerability (in spite of my being perceived as "fierce" in other areas of life, and able to stand up for others and for myself in other contexts). I met this guy--we'll call him R--online. I was SO vulnerable that because of our friends in common and common life experience in the town where I'd done my B.A. I told him ONLINE about my experiences with rape in that town, and what a hard time I'd had in college because of it (though I ended up pulling it together and graduating with a 3.75 GPA). I told him this ONLINE. I needed therapy, not a boyfriend. I think most men would have stayed away from me.

We agreed to take things slow and he pretended to be very supportive of me and to care about women's rights and the issue of sexual assault. On our first date because I trusted him I invited him up to my apartment to continue talking. He then pressed me for sex, despite me saying "no" three or four times, until I finally gave in (this is coercion). He "love-bombed" me after that--taking me places, buying me small gifts, pretending to really care about me and my issues (mirroring). I felt things were moving way too fast and felt suspicious of his intentions, particularly as he was getting a LOT of sex (I still tend to relate to men sexually, and it's hard to know whether in a relationship I simply desire a lot of sex or whether it's how I think I'll get men to love me; either way, I am good at sex and also have trouble saying "no" sexually, and I'm hypersexual in a relationship, and he certainly took advantage of all of this). I felt he was not seeing me as a person. He claimed to have "fallen in love" with me. I treated him in a way I later felt bad about, but I think it was because I didn't trust his motives or his "love;" just little things (correcting his grammar, being a little defensive, etc.). I didn't do this after I'd "given in" and decided I'd fallen for him too, but I did in the beginning, which hurt his feelings (and I've dated plenty of men who have been less educated than me and never done this, as I am not a mean person naturally; R and I were equal in terms of educational level). Whereas in the early part of our relationship we had spent time getting to know each other sober, all of a sudden R began wanting to go out all the time and get really drunk (drinking Jack Daniels whiskey). When drunk he would reveal his insecurities to me (that he thought I was smarter than him, or better-looking; I never said any such thing, and always told him I found him attractive and liked his writing, etc.). He was jealous, competitive, insecure, and began to be mean in a sarcastic way. He also became sexually abusive.

In the beginning of our relationship, he made it clear he knew what rape was ("men always know when they do that to a woman") and talked about how women behaved after child sexual abuse, etc.; he had studied psychology in undergrad and worked in behavioral health, including giving workshops on consent, and knew exactly what he was talking about. I think he began to feel disempowered by or vulnerable because of the "intimate" or "romantic" sex we were having. He began demanding oral sex all the time, and I felt he was doing it to degrade me or have power over me, and didn't want to do it all the time (and stopped being able to have an orgasm--in the beginning he had been an attentive, enthusiastic lover, although I always felt my sexual response felt more exciting to him because it was validating of his "manhood" than anything else--that is, that he was still seeing me as a toy or an object--in any case, that attentiveness soon fell by the wayside); he would then do it to me without asking. He began choking me and pulling my hair even though I asked him not to (well, he had always done that); he became very rough with me, basically. I also felt he was always "directing" me to perform for him, sexually ("can you turn around for me?" "get on your knees" etc.) Sometimes I found this exciting, but sometimes I found it very degrading. I felt sex between us was no longer romantic or intimate but was now all about power and control, and I didn't know what to do about it. He began pushing me for anal sex and treating me, I felt, more like a prostitute than a girlfriend (in fact, the way he began treating me was very similar to the way I had been treated in my first sexual relationship). I told him I did not want to have anal sex with him (my first experience of this was rape, and I felt since then I had always been pressured into it, and felt my partners got off on feeling they were degrading be by the act). He agreed to this and said we did not have to do it "now, or ever if I didn't want to." We had a fight one night because he was always making our schedule and I put my foot down (and also somewhat jealously told him that he was acting single and if he wanted to go out and fuck someone else, he should just do it; he had earlier in the day insinuated he might hook up with some "cute cosplay girl" if I did not go to ComiCon with him, because I was not into comics, as he was).

Now, to be fair, I did plenty of things in this relationship: I did not support some of his hobbies, I could be critical and defensive, and I was annoying him via text-message (in a needy, clingy way--I think wanting that supportive person I'd had such a rapport with in online dating back--not in a mean way; I was saying nice things to him, but nonetheless bugging him). I think I also felt very confused about how he had wanted to spend all his time with me at first but then suddenly wanted to go out all the time and drag me along (you cannot get to know someone at some noisy, crowded punk or hip-hop show, and he suddenly wanted to do this every night of the week). After this one fight, and me being angry with him and telling him I needed some time off, but then sending him angry emails because he dropped off the face of the earth (I didn't mean THAT much time off), he decided to break up with me.

After this, I told him I felt he had been disingenuous in his claims of love (breaking up with me after one fight--I felt what we needed was to talk, without rancor) and that he had been sexually abusive. Early on in our relationship he had sexually assaulted me after I read him a romantic--but very acute, insightful, and revealing--poem; after he sexually assaulted me he immediately admitted it, acted horrified with himself, refused to talk to me or let me touch him, and asked "is this the beginning of the end?" (Note that he did NOT apologize to me or ask me if I was okay). I felt sorry for him and forgave him. We never talked about it. The next day he acted all romantic and publicized our relationship on Facebook. He later had the nerve to say to me--after we broke up--that if "I hadn't been so mad at him about that we could have gone back to having romantic sex," as if it were my fault that he became increasingly "rough," as he calls it (abusive) after that. I think he noted, even in his supposed horror at himself, that my reaction to being sexually assaulted is to dissociate; I freeze up and go somewhere else, making it very easy to abuse me. I think he later took advantage of this when he began to feel that our relationship would probably not work out. I want to add to his manipulations and gaslighting that he was EXTREMELY hypersensitive. I could not say one critical thing to him about something he had done without him running out of the room and indeed out of the apartment (note that we never actually fought with raised voices; he could not handle a raised voice even for a second. I think this is why he broke up with me after our first fight). I was not the pliable/submissive victim (or love object and sex object) that he wanted.

He insisted on friendship after our breakup--insisted--and also told me that I was "projecting onto him because of past abuses" and that he had "been a good boyfriend" and was "pretty fucking special." I softened toward him, and joked around with him (during this time he was telling me that was not sleeping with or dating anyone, but he was actually on Tinder, seducing women; he slept with 6 women in the two weeks we didn't see each other after we broke up). Two weeks after we broke up he called me up, wanting to come over. I said "no," but he wore me down. He came over. I was so happy but also shocked and confused to see him--and didn't know how to feel--that I drank the pint of tequila he brought me immediately with some orange juice. We started to have consensual sex, but he began objectifying my body parts in a frankly repugnant way, and so I stopped (I had been on top) and lay down and started falling asleep (it was very late, and I was physically and emotionally exhausted). He then found some lube somewhere, put me in a hold and began applying it, without asking, trying to prepare me for anal sex. I squirmed and tried to protest, but he went ahead anyway. I screamed in pain and screamed for him to stop and he stopped (saying, "see? I stopped, even though it was really hard"). He had sex with me in the morning without my consent (he slapped me awake, hard, and began having sex with me as soon as he saw my eyes open; I was hungover, and in and out of consciousness). When I finally DID wake up, he informed me that "I feel the need to tell you I have slept with six women since we broke up" (I would NEVER have let him come over if I'd known that). I felt disgusted, as he never uses condoms, and lied to and betrayed, of course (and was still trying to process what had happened the night before and that morning). When I asked him how he even had such success on Tinder (most women don't respond even to the best-looking of men, and he's not that great-looking), he responded that he was "charming," he "listened" and "told them what they wanted to hear." Throughout that day, which we spent together, he continued to rub it in how good-looking these women were, while simultaneously telling me he wanted to come visit me wherever I went. He told me he had a "monster" inside of him. He acted coolly distracted and anxious by turn. I was very nice to him, and understanding. He dropped me off, saying he was going to go out, but then begged later to come over and said he was a bad person because he "knew I wouldn't say no" to him (and in fact, by response to his text was, "you know I can't say no to you, but is it the best idea?") He came over and lay down next to me (asking me "is this okay?"--to hold me), and then bemoaned that "all he ever does it hurt people" and "I have no real friends in town" and "I can't give you what you want" and "a relationship is a cage" and when I began to cry and tell him he had to let me go, he said "but no permanently, though, not permanently."

I talked to my friend after this about feeling that what he had done was "very reminiscent of rape." I had told him I absolutely did NOT want anal sex, and he had not asked, and had held me down; he also had not asked in the morning (quite apart from the fact that he lied even to get up to my apartment). I confronted him about this about a month later, simply telling him I could not be his friend because of "that weekend." I could have been talking about ANYTHING--literally ANYTHING--he did that weekend, but he immediately knew what I was talking about, and stood up, yelling, "The r-word? The r-word? You can't cry after the fact! YOU DIDN'T SAY NO!" He began backing away from me. I simply wanted an apology for his mistreatment of me, but it was absolutely clear that he knew what he had done but didn't care at all about its impact on me. He only cared about himself.

Well, suffice it to say I was deeply traumatized by this. I felt absolute horror that I had fallen in love with such a person. I lashed out at him by harassing him over email, telling him I had never wanted to be raped again and asking how he could do such a thing to me. He sent a police officer to my house because of my email harassment (note that during this time, before we both blocked each other, he friend requested multiple friends of mine on Facebook and created a fake account to stalk me; he also harassed some of my friends on Facebook, not through messages but by liking all their stuff, etc., until they blocked him; he began smearing me to people in the community as a "crazy ex"--he had constantly talked about his other "crazy exes" to me while we were together, while jealously obsessing about their new boyfriends or husbands). I actually contacted one his "crazy exes," someone I had been friends with in the town we went to college in together; she friend requested me on Facebook, and we began a dialogue (he had not abused her sexually and had in fact been rather passive in the relationship with her, but had abused her horribly emotionally after they broke up; they were together three years and even lived together, and were in the same grad school program; he immediately began dating her best friend--likely seduced her with his manipulative, charming, pity-me act--and alienated her from her entire friend group, purposely dragging the best friend to all events he knew she would be at; as with me, he had broken up with her, so what was the point in this cruelty)? He had also gotten together with her (the ex) while still with his ex-wife of 9 years (though telling the new girlfriend they were in fact broken up), so this was a habit of his. I gather he "mirrored" to her as well (and brought out her worst qualities--her temper).

To add to all this, he told me of his sexual infatuations, his tendency to grow bored with current partners and leave them, only to come back when new infatuations wore off (and not count this as cheating), his own sexual assault as a young boy age twelve (by an older girl), and I met his parents; his mother smothered him and spoiled him while his father neglected him and was cruel to him (and struck me as a malingerer who emotionally abused his mother). 

When my ex sent a police officer to my house, I reported him for rape (my friend, who is a lawyer, was there as a witness). The officer believed me, logged all the details of our whole relationship, and told me to "tell anyone I wanted" in the community about him (my friend was a witness to this). Of course nothing came of it, as it's he-said she-said. My ex was crazy for going to the police anyway, as I made zero move to see him, call him, or talk to anyone about him (in fact I went out of my way to avoid him while he went to EVERY venue I might like to go to in the community, and took over local writers' groups, again, trying to blacklist me); the ONLY thing I did was e-mail harass him, and ALL of my emails were about his sexual abuse of me. It was crazy to go to the cops about that ("oh, my girlfriend is harassing me because I raped her").

I was off my meds at this point (I think the fact that I was given a high dose of lamotrigine and buproprion with no titration did NOT help my mental state; I quit cold-turkey). I began therapy, but my therapist had to leave when his wife took a job in another city (I am back in therapy now). I finally got tired of being angry with my ex. I looked at his online dating page, to see if I could see red flags in his profile but also just because I missed him (the him in the beginning) and wondered how the hell this could have happened, when I had gone into the relationship with the best of intentions, and when I had really liked him (not taking into account, of course, his ill intentions, whether he was aware of them or not; I think sometimes he is and sometimes he isn't aware of what he does to people, particularly women). I forgot that he would see this. He immediately contacted me, sensing I was vulnerable (tired of being angry). He asked for another chance, saying we could "leave all that nastiness behind" and he "still loved me." He pressured me into sex and into seeing him immediately. It was stupid, but I went to see him. The second time I saw him, he raped me again. Again, it began as consensual sex, and then he suddenly held me down and anally penetrated me; I asked him to stop, but he put all his weight on me and pushed down on my back to hold me in place. It was physically painful, shocking, humiliating, and dehumanizing, and again I dissociated. 

I should have reported him again, but nothing had come of it the last time (at this point, he has basically admitted it in email). I was re-traumatized and began to have serious nightmares, panic attacks, and flashbacks. I desperately wanted an apology from him, or any sign he understood what he had done to me. He continued to pretend to still love me, and to try to prey on me (and he would forever, if I let him). He still wants to meet with me to "talk about it," if you can believe it, though he smears me to everyone else, calling me a "stalker" who got mad at him for "whatever reason" and who "stalked him because of a misunderstanding." He is now calling himself by a different name, befriending old friends of mine, joining activist groups, and starting literary magazine social activist blogs. He does stand up in which he slanders me, and on Halloween he dressed up in a suit with a sticker that said "I'm sorry" (as a "formal apology") and then told me when he was booed off stage during a costume contest, "See? Everyone hates puns" (he was mercilessly mean to me for my habit of punning and my enjoyment of even the real stinkers). He acts like what he did to me was a joke, when it hurt me immensely--immensely. After a lifetime of being mistreated by men, he pretended to be supportive, kind and caring, and then he raped me (and he preyed on me again at Halloween, taking me home when I was very drunk and ejaculating inside me; his defense of this later was that I "asked him to but was too drunk to remember." I know I didn't ask him to, but great defense!!!) I have no doubt this was not only a power thing but that he thinks if he got me pregnant I would have to "start over" with him, which is what he wants, and so would my friends and family.

In any case, I no longer have anything to do with him (he has pretty much admitted it in email, not that it would hold up in court; I could meet with him and record him, I suppose, but I don't really want to go through the pain of a trial, having been through so much already). He still wants to meet me and claims his smear campaign is just "poetic license" and he's "sorry if he was mean" but he wants to see me to "set things right as best he can" (read: he wants to make himself feel better for what he did to me, and, likely, wants to prey on me again, although in his head it might be "restart a relationship with me").

I am now in therapy to work out a lifetime's worth of this pain. I understand that my original trauma and my relationship with my father and with myself are reasons this has played out over and over, and I plan to work through it so that male sexual violence does not define my self-image, my self-worth, my relationships with family, friends, or my romantic relationships, or my ability to accomplish things in the future (I have lived and taught all over the world and have put myself through graduate school with scholarships in spite of all that's happened to me, and taught a full load at a community college last semester while going through serious PTSD, so I am proud, in fact, of my coping skills, but feel I could do so much more without this holding me back). Of course I need to integrate this into my life, but it does not need to DEFINE my life. 

This is a long post, I know, but I think I may not actually have bipolar disorder at all. I think I may have something more akin to Complex Post-Traumatic Stress Disorder (I have studied this issue quite a bit). I am currently taking drugs for PTSD (which helped with the nightmares, flashbacks and panic attacks immediately), but also starting again on lamotrigine. I know lamotrigine can also be used off-label for depression as well as BD, and I think I certainly do have depression as a result of this, so it's not a terrible thing that I'm taking it; but I think my diagnosis may be incorrect.

I also think my ex-boyfriend has Narcissistic Personality Disorder. There is a scientifically proven correlation between narcissism and rape, and he fits all the other criteria to a T. I think he is a "covert" or "vulnerable" narcissist, and his periods of "depression" are periods of low narcissistic supply and/or failure (he cannot maintain his image of grandiosity at such times), and his periods of "mania" are periods of manic activity in reaction to difficult life events in which he is implicated (now, for example), whereas his periods of stability are, as for most people, periods in which he has a stable relationship/stable friend groups/a steady job in good standing that he feels gives him status, etc. The difference between simply being narcissistic and having the disorder is when it crosses over into pathological behavior, and sexually predatory behavior as well as emotional and sexual abuse of intimate partners seems to me to be pathological antisocial (and self- as well as other-destructive) behavior. There is also the "love-bombing" and "mirroring," in which he gathers intel which he later uses against his partner during the devaluation and discard phase; doing something completely immoral and illegal doesn't seem to bother him when it comes to devaluing and discarding his partners, if he thinks he can get away with it; he raped me as a gesture of power and because of reactance (I refused him anal sex), and his continued desire to see me has to do with both his immense shame and self-loathing, the fact that he still sees me as a high-value target (someone to abuse/narcissistic supply in a pinch), and the fact that he identifies me as an empath who understood him and actually did love him (I think what he feels about our relationship is regret for irrevocably screwing it up, not remorse for what he did to me).

So, tl;dr: I think bipolar disorder is often a misdiagnosis of personality disorders. I think I have C-PTSD and my ex-boyfriend has NPD. What do you think?

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It sounds like you have been through an incredible amount (I did read the long version) - no wonder you are having the struggles that you are having.

You are right that bipolar disorder and CPTSD (and borderline personality disorder) are frequently confused for each other, especially in folks who have experienced a lot of trauma.  Certainly it's possible to have both but it's also possible to be misdiagnosed.  I got misdiagnosed with bipolar disorder once because I got agitated when I took antidepressants (maybe kind of similar to what you experienced) and it resulted in my getting the wrong medications and wrong treatment.  But once I saw some psychiatrists who actually knew about trauma, they thought it was ridiculous.  I am like the least bipolar person in the world.  I'm just really traumatized which interferes with my ability to regulate my emotions.

Which is not to say that that's what's true for you - it's possible that you have BD and CPTSD.  But for me, I definitely did get misdiagnosed.

It's really unfortunate that you don't have the resources to have another psychiatric evaluation and try to get it worked out.

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Hi there, and welcome to crazyboards. To be honest, I skipped down to your tl;dr and took the advice.

We don't and can't diagnose you (or your boyfriend) here. Feel free to keep posting, but I would suggest that you may get more responses with shorter posts. This longer-style writing is generally reserved for our blogs. If you need any help creating one, please let me know! :) 

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Calabash -

As heilmania said, no one here is qualified to propose a diagnosis, but regardless of whether your suspected diagnoses for yourself or your ex-boyfriend are confirmed, you must remain absolutely firm about having nothing further to do with him. The pattern of behavior you describe is manipulative and predatory, and there is no reason to believe that it will not be repeated. Be done with him completely, for you own sake. Be confident in your judgment and refuse to be his victim any longer.

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