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Volume XX, No.1
February 2018
Personality Disorder: The Myth
I heard an interview of an author who had written about what he called
“high conflict personality disorders.” According to the interview, the
author is claiming that not all personality disorders are equally
problematic. There are what he calls high conflict personality disorders.
I’m not sure this is of any real value to us. If Sue or Phil can’t ever
get along with anyone, does it help to know they are high conflict
people? Doesn’t that rather go without the saying? The author emphasizes
the need to find ways of getting along with these people, no suggestion is
made that they might eventually change. Which suggests to me that he may not
be accounting for how personality comes to be or how it comes to be
disordered. I want to point out one or two difficulties with this idea.
But first I want to enlighten the reader on the broader subject of mental
health diagnosis, which is central.
Beyond this seeming to me to be another book about nothing, this kind of thing
gets my ire up because it reinforces another mental health myth that paints an
all too esoteric picture of the workings of the mind, and constitutes a barrier
to health. My goal as a counselor, is in part to demystify the issues of mental
health, to unveil the normalcy of behaviors, and make mental and spiritual
health a matter of common sense for as many as possible; and that would be the
vast majority. So what is the myth behind personality disorders, and mental
health diagnosis in general?
To begin with, let’s establish some common sense guidelines. Categories are
only as useful as they are misleading. The benefit of speaking categorically is
that it saves a lot of time. Imagine if someone were attempting to describe the
vivid colors of an extraordinary coastal sunset. It could take a long time to
find the best words to articulate the perfect balance of shades, tones and hue.
And, would there be a point, since it would all be subject to the inference of
the hearer? Most people would say something like, “It was the most amazing
sunset; red sky, against the green ocean.” But, is the sky ever simply red? Is
the ocean ever simply green? We speak categorically to bypass the inconvenience
of situationally less critical specificity. In other words, categories function
by ignoring a lot of information. Mental health diagnoses are categories, and
they ignore a lot of information. Which is precisely why there is so much
overlap of diagnostic criteria.
Mental health diagnoses themselves are made up. The need for diagnosis is
largely in the eye of the beholder. That this is not taught to psychology
students, and thus not made clear to laymen, is a tragedy that goes on
bolstering the mystique and fostering the mistakes of the mental health
profession. Most professionals, and the general public view “mental health
disorders” as they do physical diseases. In fact, the APA (American Psychiatric
Association) has worked very hard to broaden the net of diagnoses, thus ensuring
a robust pool of drug-dependent clients, by redefining the term “disease” to
include almost any type of emotional discomfort. (See
Manufacturing
Depression, Gary Greenberg and
Destructive Trends in Mental Health,
R.H.Wright and N.A.Cummings)
To exemplify how this works, and the error of it, imagine a cloud that appears
to be shaped like some specific animate or inanimate object. Most of us have
seen a cloud the form of which resembles some kind of animal or familiar
shape”: a bear, elephant, question mark, a cross. Suppose we came up with a
name for these appearances; we call them form clouds. Subsequently, whenever we
see a cloud that has an odd or distinctive form, we say something like, “Oh,
look! A form cloud.” But it would be irrational to think that there are certain
kinds of clouds that take on these familiar forms. There is not really any such
thing as a form cloud. We made up the term to represent the phenomena. We
should not waste our time researching and writing about various categories of
form clouds, some of which only take on the shape of animals, and others of
which take on the shape of crosses.
By the same token, once we have agreed to call clouds of distinct shapes “form
clouds,” it should not surprise us that “form clouds” are clouds of distinct
shapes. But again, it would be irrational for us to conclude that we had
discovered an anomaly of nature called a form cloud. Yet this is exactly the
backward kind of thinking we assume when it comes to mental health diagnoses. We
use the term we have invented as if it were a reality we had discovered. Then we
marvel at our genius, when our observations seem to corroborate the term. It is
somewhat analogous to a man viewing the night sky through an observatory
telescope somehow being convinced that he sees stars because stars is the
property of a particular type of lens, and the fact that he is seeing stars
confirms that unique property of the lens. We need to realize that we have
created the entire categorical nomenclature of mental health diagnoses, and to a
large extent the reality of it.
Diagnoses are categories we have made up and superimposed over a natural
continuum, be that a neurological, emotional or behavioral continuum. The reason
there is so much overlap in the symptoms of supposed distinct diagnoses, is that
they are not in fact distinct.
The same can be said of personalities, which may also be arranged along a
continuum; one that represents the full range of human personality
diversity. It is over this continuum the APA has superimposed its constructed
categories of ten personality disorders. This method, by the way, applies to any
personality measuring apparatus you find in self-help books and seminars - the
whole variety of Cartesian Coordinate, x y axis or four-quadrant systems
purporting to identify your personality type. Any time you are presented with
categories such as extravert versus introvert, or love languages and so on, just
know these labels are superimposed over an actual continuous reality. Certainly
the categories seem to exist, because the information beneath is real. But the
categories themselves are not real; the stars are not the property of the lens;
distinct shapes are not the property of form clouds.
The phenomenon of human personality development can be understood as involving a
number of interrelated principles. First, at the root of it all, personalities
are a defense mechanism. The primary existential rule is that I must survive. To
that end, every human belief, emotion and behavior can be seen as related to the
pursuit of safety, security, comfort, sustenance - or as I have elsewhere
stated, value, control and resource. The development of personality is merely an
extension of this pursuit. Second, as to why there are certain types of
personalities, we have already discussed how that this is largely in the eye of
the beholder. Once we are taught there are certain types or categories, we tend
to see personality according to those types. The third principle has to do with
how any individual’s personality is characteristically stronger. For example,
even if you insist there is such a thing as a paranoid personality disorder, not
all such people are equally paranoid, or paranoid of the same things. In fact, we
are all a little paranoid at one time or other. A so-called paranoid personality
is just more paranoid than a “normal person.” Disorder is a matter of degree.
For this reason, I personally do not recognize “personality disorders,” but
prefer to speak of more or less disordered personalities.
To make this very simple, think of personalities as a horizontal row of
symmetric triangles, as many as you like. Imagine a line across the tops of the
triangles, like the snow line across a range of mountains. Everything above this
line we will allow to be called a personality disorder - more correctly though,
a significant degree of disorder within the personality. Imagine a bisecting
line from the peak to the mid base of each triangle. This vertical line
represents the core of the personality, the defense mechanism. Along the base of
the triangle, the distance from the core to a base angle is personality
potential - how far a person can venture from his or her defenses - how
vulnerable he or she can be. If you imagine moving two triangles closer
together, you will see them begin to overlap at the bottom. The degree of
overlap is what we will call relationship potential; one person ventures out
from his or her defenses enough to meet someone else the has done the same. It
is understood, as we imagine moving the triangles closer together, that the base
angle of one triangle will never meet the bisecting line of another. That is, no
person can ever voluntarily be completely vulnerable and defenseless in
relationship to another person.
It is clear now, that the peaks of the triangles must always remain apart,
unrelated and isolated. It is a profound realization that the term personality
in all practicality refers to one thing only - how as a person one relates to other
persons. And so it follows that the term personality disorder refers to the
extent to which one person cannot relate to other persons. Certainly this is a
matter of degree. Which is, again, why I think it more correct to speak of
disordered personality, instead of “personality disorders.” It is also clear
that the higher up the triangle you look, the less distance there is from the
core to the outer edge (hypotenuse). That is, less room for vulnerability. The higher up, the
more restricted, the more the defenses come into play; disordered personality is
fear-based.
If you pick one triangle and think of it as your own personality, you see how
that anyone can be isolated from others by moving higher-up the triangle, so to
speak. What this means in practical experience, is that we are less related when
we see others as a threat; the converse is true as well. Any person feeling threatened by another will behave
defensively. In terms of the triangle we have imagined, the fearful person is up
at the top of the triangle. Or, put another way, when a person is fearful, he or
she is at the top of his or her triangle. So also is the person with a very
disordered personality. The difference is, that the person with the chronically
disordered personality never comes down, never relates well, never has intimate
relationships.
The radio interview guest was suggesting that certain personality disorders are
high conflict personality disorders. This thinking has two errors. First, it
wrongly assumes that the APA assigned categories of personality disorder are
ontological. They are not. These personalities as such are just points along a
continuum, which is verified by the overlap of diagnostic criteria and the need
of a great amount of verbiage in the “Differentiation” sections that accompany
each supposedly distinct disorder. If we see these personality types not as
truly distinct but rather as points along a continuum, then it is no longer a
matter of some personalities being more problematic, but of certain
personality traits being more problematic, and that by degree. But again, a
given trait can be identified at multiple points on the continuum. For example,
paranoia can be found in the antisocial, avoidant, narcissistic, borderline and
paranoid personality.
The second error is that it fails to consider that what we mean by personality
is how we relate interpersonally. And what the APA should mean by “personality
disorder,” is a person who out of fear of others, cannot rightly relate
interpersonally. And so there are not specific ways to deal with each
personality disorder, but rather specific ways to deal with each trait of
disorder, regardless of the specific type of personality. It is very straight
forward, in fact. Because every personality is a defense mechanism and because
every person has the same basic fear and shame, the corrective needs for the
disordered personality are not different from the maintenance needs of the
ordered personality. They are empathy, shared boundaries and shared reality.
These lead to trust, security, belonging, and thus intimate relationship and a
healthy personality. The difficulty, of course, the thing that is so time
consuming and conflictive, is that those with a chronically disordered
personality are that way and often remain that way because they are afraid of
the very thing that will heal personality - other persons.
COPYRIGHT©DANIEL PRYOR 2018
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