For Professionals & Researchers

Clinical tools, research frameworks, and community for advancing the TSD paradigm

The TSD Framework

Traumatic Stress Disorder (TSD) proposes a paradigm shift: what we currently diagnose as PTSD, CPTSD, and Cluster B Personality Disorders are manifestations of a single underlying phenomenon—present-tense survival governance.

Core Insight

The nervous system doesn't know the threat ended. A Survival Self seized executive control during trauma, exiling the Core Self. Treatment is the process of restoring sovereignty.

Four Patterns

  • Abandoned Monarchy (Borderline)
  • Fortress City-State (Narcissistic)
  • Predatory Fiefdom (Antisocial)
  • Theatrical Court (Histrionic)

Four Diagnostic Criteria

1. Altered Sovereignty: Survival Self governs, Core Self exiled
2. Neurobiological Recalibration: Hyper/hypo-arousal oscillation
3. Somatic Dominion: Emotions as visceral events
4. Temporal Collapse: Past re-lived in present

Diagnostic Code: 309.89 (F43.9) • Staging: PreTSD → TSD (Active) → PostTSD (Integration) • Treatment: Somatic, parts-based, sovereignty-focused

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Why TSD Matters: The $280B Case

F31.9: Bipolar Disorder, Unspecified

This single "unspecified" diagnosis code costs the U.S. $280 billion annually. It represents diagnostic uncertainty—we treat symptoms without understanding mechanism.

TSD Offers Specificity

Many "bipolar" presentations may be TSD with Oscillating Survival States—not endogenous mood disorder, but trauma-based nervous system dysregulation.

Clinical Mapping

  • Manic: Hyper-arousal survival state (fight/flight energy)
  • Depressive: Hypo-arousal shutdown (freeze/collapse)
  • Rapid Cycling: Unstable Survival Self governance
  • Mixed Episodes: "Wired but frozen" - The Unfinished Gesture
  • "I'm not myself": Altered Sovereignty - Core Self exiled

If 20% of F31.9 is TSD: $56B in misdirected treatment. Patients could achieve PostTSD integration instead of lifelong symptom management.

Clinical Question: Before defaulting to bipolar diagnosis, ask: "What is the nervous system trying to survive?"

Research & Validation Opportunities

We're actively seeking research partners to validate the TSD framework. This is an open collaboration—not proprietary. If you're a researcher, academic institution, or health system interested in studying TSD, let's partner.

Priority Research Questions

  • • What % of F31.9 patients have undiagnosed trauma histories?
  • • Do F31.9 patients respond better to SE+IFS vs. standard bipolar treatment?
  • • Can we predict which "bipolar" patients are actually TSD using somatic/trauma assessments?
  • • What is the long-term outcome of TSD treatment vs. traditional management?
  • • What is the economic impact of reclassifying trauma-based "bipolar" as TSD?

What We Provide

  • • Complete diagnostic framework (DSM proposal format)
  • • Assessment tools (AI-powered bipolar-TSD screener)
  • • Data collection infrastructure (secure, HIPAA-compliant)
  • • Community of potential study participants
  • • Funding assistance (help with grant writing)

Proposed Study Design (RCT)

Population: Adults diagnosed F31.9 with trauma history + poor medication response

Intervention Group: TSD treatment (SE + IFS + neurofeedback) + pharmacotherapy as bridge

Control Group: Standard bipolar care (mood stabilizers + supportive therapy)

Primary Outcome: Sustained remission at 12 months

Secondary Outcomes: Quality of life, medication burden, cost per patient, PostTSD achievement

Implementation Roadmap for Health Systems

If you're a hospital administrator, clinic director, or health system leader interested in adopting the TSD framework, here's how to implement it within your organization.

1

Pilot Phase (Months 1-3)

  • • Train 3-5 clinicians in TSD assessment (use our toolkit)
  • • Screen 50-100 "treatment-resistant" or F31.9 patients
  • • Track: Time to assessment, patient satisfaction, preliminary outcomes
  • • Cost: Minimal (training materials provided free)
2

Scale Phase (Months 4-12)

  • • Train all trauma/mood disorder clinicians (20-50 people)
  • • Integrate TSD screening into standard intake
  • • Partner with us on outcome tracking
  • • Expected: 20-30% of "bipolar" patients reclassified, better outcomes
3

Optimization Phase (Year 2+)

  • • Publish case series or pilot study results
  • • Adjust billing/documentation workflows
  • • Calculate cost savings (reduced medications, fewer hospitalizations)
  • • Share learnings with broader TSD community

ROI Projection: If 20% of F31.9 patients are TSD and treatment costs drop from $250K+ lifetime to $50K (trauma-focused, 18-24 months), health systems save $200K per correctly diagnosed patient.

Media Kit & Press Resources

One-Sentence Summary

"Traumatic Stress Disorder (TSD) is a proposed diagnostic framework that reclassifies many 'bipolar disorder' and 'personality disorder' diagnoses as trauma-based survival responses, potentially redirecting $280 billion in annual U.S. healthcare spending."

Key Statistics

  • $280B/year spent on F31.9 (Bipolar, Unspecified)
  • 40-60% don't achieve sustained remission
  • 20-60% of F31.9 may be TSD (trauma-based)
  • $200K+ potential savings per correctly diagnosed patient

Story Angles for Journalists

  • Economic: "The $280 billion diagnostic error"
  • Clinical: "What if 'bipolar' is actually trauma?"
  • Patient: "Treatment-resistant? Or misdiagnosed?"
  • System: "Psychiatry's $280B blind spot"
  • Tech: "AI-powered trauma assessment challenges DSM"

Target Publications

  • • Psychology Today, Medscape, STAT News
  • • The Atlantic, New York Times (Health section)
  • • Psychiatric Times, JAMA Psychiatry
  • • TechCrunch (AI health angle)

Press inquiries or collaboration opportunities?

Contact via Community

Coming soon: LiveKit Town Hall Chambers, Clinical Council, Real-time Case Consultation

Building the infrastructure for live collaboration