Not knowing what to write about, I took out one of my psych. texts and looked at the index. (I like doing that with books. I also love to read the bibliography. Does that made me strange?)
I saw a list of personality disorders. I thought, Aha! I went to the chapter and there they were, at the end. This is fitting as in the scheme of things, these are not the kinds of problems you'd prefer, as if you had a choice. Ha!
In defining these particular disorders, the authors mention that a personality consists of an individual's unique, long term behavior patterns. Most of us have personalities. Well, we all do. Sometimes we don't like the other person so we just call them a drip.
They go on to define personality disorders as:
"Maladaptive and inflexible patterns of cognition, emotion, and behavior that 
generally develop in late childhood or adolescence and continue into adulthood: they are more stable than clinical disorders such as schizophrenia, depression, and bipolar disorder." I will add that anxiety and depression are also clinical disorders.
"The distinction between clinical and personality disorders is somewhat arbitrary, however, and many people with personality disorders also suffer from clinical disorders."
The rest of what they wrote is even more technical and unlikely to be helpful.
What the distinction refers to is the availability and likelihood of treatability.
If you have a clinical disorder, there are usually medications, behavioral and cognitive therapies that are helpful in treating and controlling the illness.
People with personality disorders are unlikely candidates for change or help. Oh my. There are people we can't help? Not us. Not Americans. We can do anything. We can fix anything. Or so be would like you to believe.
There is therefore a really good reason that terms like these not be bandied about by the magazines, papers, TV, and our friends. You might say that if the public doesn't know the difference, then it doesn't actually matter what terms they use, and I suppose there is an argument for that. The problem happens if a person seeks help for a loved one. One who does have a personality disorder. As a general rule, The personality disorders never ever come in on their own. They don't have a problem. And what helping hand is likely to say, sorry, we can't help you or the person you're concerned about. How that works out in the world is, yet again, another story for another time.
I also want to point out how difficult actual diagnosis is. The definition mentioned that some people suffer from more than one condition and then, it is not easy to call. That may have been one of the reasons I hated to diagnose anyone when I was in practice. The other was that I didn't take insurance so I didn't have to.
If I had a patient, unless they were blatantly a particular disorder, (like a borderline personality), it didn't matter to me. I tried to look at the person sitting in front of me and work on whatever they gave me.
If you read the literature, I think the average stay with a psychologist was 22 visits. A psychiatrist was shorter, like 9, but that was before they were primarily medicine dispensers. I just tried to look up these figures since they sound wrong. I couldn't find them. Nothing even close.
Anyway, I had several patients that I saw for several years. Again, I'm not judging. And as to whether or not someone improved, I wasn't a very good judge of that. Sorry. That's probably not what you all would like to hear. Too many variables and sometimes, they finally "get it" years after you've seen
them.
What I looked for was, to see if they seemed to be functioning better outside my office. That might have meant fewer fights with coworkers, staying at their jobs, changing their jobs or making better choices in who they dated. You get it, things like that.
And those things don't happen after 9 or 20 sessions. Not unless you don't really have any problems.
And oh my. *AD. I haven't used that for some time. Another digression, and a long one it was. But, I hope it was helpful in some insight into how a non-traditional therapist used to work.
BACK TO DISORDERS:
As was mentioned, personality disorders are at the end of the scale for help.
We used to joke about the difference between neurotic disorders (a term they no longer use) and character disorders (a term they no longer use).
Substitute clinical and personality and you'll get it.
Back to the joke. How do you tell the difference between a clinical disorder and a personality disorder?
The clinical disorder drives themselves crazy. The personality disorder drives everyone around them crazy. A bit facile, but fairly true.
I'd like to use this one as an example. It's the one that is really tossed about these days. Everyone knows someone who is narcissistic. And that's probably true. Whether or not it's a personality disorder, well, there's where the ballgame changes.
Most of us have at least a few narcissistic traits. A trait is just that. An aspect of your personality. It doesn't define you, it's just a part of who you are. Like
being concerned with your appearance,being self-centered or exuding self-confidence doesn't make you a narcissist. In fact, you should have these traits so that you show that you have self-love. Something we all need, and many do not have enough of. As a matter of fact, these traits make us more attractive to other people.
It's when they are in extreme excess that it problems are created.
The definition of a N.P.D. is:
A disorder characterized by having an extremely positive and arrogant self-image and being extraordinarily self-centered. Then it goes on to explain;
" They have an exaggerated sense of self-importance and are grandiose, sometimes to the extent of believing they are "God's gift to humanity"." As a result, they often make unrealistic and unreasonable demands of others and ignore others' needs or wishes. They may be quite successful and climb the career ladder quickly, but their narcissism often isolates them from others."
That was the nice way of putting it. They can be male or female, but for example, I'll use a male.
Nicole meets Tom. Tom has an air of self-confidence. Nicole is impressed and starts to fawn over Tom. Tom likes this because he loves when people validate how awesome he is. Tom is nice to Nicole and they start to date.
Tom expects Nicole to worship him. He expects that she will agree with everything he likes and do everything he wants to do. If Nicole is a little insecure, she may well leave her own opinions and "self" behind. She wants so much to please Tom that she complies with his desires. They fall in love. Well, Nicole falls in thrall, and Tom falls in love with being worshipped.
They marry. The cracks may begin. If Nicole shows any difference of opinion, Tom will become upset. He may withdraw his attention or actually punish her.
And there begins the pattern of the relationship.
Nicole doesn't understand. When she tries to talk to Tom, he tells her its her. He's fine. If she is vulnerable enough, she believes him. Maybe she seeks help.
She tries everything. Nothing works. Tom doesn't change. Maybe he gets worse. Angrier and more punitive.
You may know this couple. You may be this couple. Or at least seem like them.
That's where the self-help troubles come in. You don't know if he's a "real" narcissist or what the problem actually is. And as in all things. There are varying degrees.
THEORY:
Pop culture gives us information that we should take at face value. People tend to believe what they keep hearing and seeing. The tidbits become facts and part of our belief systems.
We are more willing to believe a talking head on TV, than an actual professional.
This is likely because we feel as if we know these people since they are in our homes.
Therefore, when we meet a new person, an actual professional, a therapist of some kind, we tend to want them to verify what we already know. Unless there is an immediate rapport, the new person can be written off and not seen again.
My conclusion is that people want help. They unfortunately have preconceived notions of what it should look like. If it doesn't fit, they don't want it.
Then, they blame everyone else for their problems and can't understand why things never change.
CONCLUSION:
No one knows everything. That includes experts. However, you ought not believe so much of what you hear and see. Especially if it's in or on the media. Like this. What the hell do I know about you?
So, that being said. Be cautious in what are thrown around as "facts". Be wary of whatever the latest frenzy is.
As for romance. If he's too good to be true. Run. Even if before the engagement or marriage, he is Mr. Perfect. And, especially if he or she denigrates you, hurts you and tells you how much you are loved. Run.
| Just like this was what was chasing you. |
