Given the comments on the last few blogs, I realized I should probably put in some introductory comments, just to ensure we’re all on the same page.
Personality disorders have been defined as the cause of long term patterns of inner experience and outer behaviour that deviate from the expectations of society. They are all-encompassing, rigid and rarely change over time. They may lead to distress or impairment.
If we look at the terms of this definition we see:
Inner experience: Persons with a personality disorder see the world differently than the rest of us.
Outer Behavior: they behave differently than the rest of us. Because behaviour is usually determined by our inner world, this is to be expected.
All encompassing: these behaviors affect all areas of their lives
Rigid: behaviour is predictable because it is what it is and doesn’t change
Rarely change or time: Personality disordered people don’t understand what all the fuss is about. They think their view of the world is the correct one, so what’s your problem. And why would they change if they’re right?
This area of the Diagnostic and Statistical Manual continues to evolve and change. Certain disorders move into the DSM and then move out and sometimes they move back in. Or, more often, their names are changed to confuse the rest of us. For example, Psychopathic personality Disorder became Antisocial Personality Disorder and now is Antisocial/Psychopathic Personality Disorder. They’ve been called psychopaths, sociopaths and ASPD’s and no one is sure which is which, except the psychiatrists.
The other confusing thing about Personality Disorders arises because they deal with personalities (and we all have one). ALL of the symptoms in this group are found in the general population. It is a matter of degree, duration, and debilitation. Ironically, this is complicated because there are many definitions of personality, many acceptable degrees and ranges of behaviour and little agreement on a working definition of a healthy person.
the DSM-III included 3 clusters of Personality Disorders:
Eccentric Personality Disorders: behavior may appear strange or peculiar to others.
- Paranoid Personality Disorder –generally tends to interpret the actions of others as threatening.
- Schizoid Personality Disorder – generally detached from social relationships, and shows a narrow range of emotional expression.
- Schizotypal Personality Disorder – uncomfortable in close relationships, has thought or perceptual distortions, and peculiarities of behavior.
Dramatic Personality Disorders: intense emotional mood swings and distorted perceptions of themselves along with impulsive behaviors.
- Antisocial Personality Disorder – a pervasive disregard for, and violation of, the rights of others.
- Borderline Personality Disorder –a generalized pattern of instability in interpersonal relationships, self-image, and observable emotions, and significant impulsiveness.
- Histrionic Personality Disorder – displays excessive emotionality and attention seeking in various contexts. They tend to overreact to other people, and are often perceived as shallow and self-centered.
- Narcissistic Personality Disorder –a grandiose view of themselves, a need for admiration, and a lack of empathy that begins by early adulthood and is present in various situations. These individuals are very demanding in their relationships.
Anxious Personality Disorders: fearful and anxious.
- Avoidant Personality Disorder – socially inhibited, feels inadequate, and is oversensitive to criticism
- Dependent Personality Disorder –extreme need to be taken care of that leads to fears of separation, and passive and clinging behavior.
- Obsessive-Compulsive Personality Disorder –preoccupied with orderliness, perfectionism, and control at the expense of flexibility, openness, and efficiency.
Others Not Specified: In layman’s terms this was the category for everybody else that we knew had a disorder but there were no psychological criteria to diagnose and label the behaviors.
In the soon-to-be-released DSM-V the categories are:
- Borderline Personality Disorder
- Obsessive-Compulsive Personality Disorder
- Avoidant Personality Disorder
- Schizotypal Personality Disorder
- Antisocial Personality Disorder
- Narcissistic Personality Disorder
- Personality disorder Trait Specified
You’ll hear all of these terms in day to day use. They are not incorrect, but their meaning has changed in the halls of medicine and education. But for the general public, not so much.You can see over two revisions of the manual that we’ve gone from 10 to 7 categories. Some are combinations, some are refinements but they are the latest and greatest terms in use in the journals and ‘formal’ world of psychiatry and psychology. And the ones that don’t appear in this version of psychiatry’s bible are likely being held for ‘additional study’ and clearer definitions. It isn’t that they don’t exist, but rather, how they are assessed is being fine-tuned.
At this time, to the best of my knowledge, there is no cure for any of these; rather there is therapy and medication and meditation.
We’re going to take a look at these personality disorders, in no particular order, over the next few weeks. If there’s one or two in particular you’d like to discuss sooner rather than later, leave me a note in the comments and I’ll work on it for you.
So what do you think? Do you feel like some of these quick descriptions mark you friend/ex/MIL/ or …? Remember we aren’t going to diagnose anyone but we can talk freely about signs and symptoms and behaviors. Too often we’re afraid to trust our instincts and we keep trying to play nice with people who don’t understand the concept. I’m hoping this series will help you understand some key points to look for and keep yourself out of the hands of an emotional vampire. If you know, or have a sense of what to be aware of, you can make good decisions about the people you let into your life.