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Personality Disorders, Stigma, and Pop Psych


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Greetings, people with personality disorders in the place to be! I am called Protagonist, and I have bipolar disorder, but I've met my share of folks with personality disorders and some of my friends have one or the other. Lately I have been very curious about Axis II diagnoses and personality disorders in particular because it is one area of psych that I know little about, so I have been researching.

I went to the library to look them up, and I was very, very, very disturbed by what I found.

Every time I've researched my own diagnosis (bipolar,) I run into survivor memoirs, Patty Duke's biography, books like "Bipolar Disorder for Dummies" and volumes on various treatments and their supposed effectiveness.

I look up personality disorders, and what do I find? There are maybe TWO books that explain borderline personality disorder for those suffering with it and other interested parties, and none on any other disorder. Every other book had some really ridiculous title like "Surviving Sociopaths" and "Saying Goodbye to Personality Disordered Individuals," and featured this long, oversimplified checklists so that the reader could discover whether some person they didn't get along with was, in fact, "personality disordered." There were about THREE books that flat-out compared people with Antisocial Personality Disorder or Borderline Personality Disorder to vampires. I'm not making that up: VAMPIRES. What. The. Hell. (Insert sparkle joke here, Twilight fans.)

Every single one of the read like some kind of bizarre Axis II safari. It might as well have been that dead crocodile guy saying, in an enthusiastic accent, "Be very quiet! We're hunting the RARE American Borderline in his natural habitat!" I think what bothered me the most was the books that seemed entirely focused on "helping" people identify and avoid those with personality disorders. Half the time, it did not even sound like the authors considered these folks human. They made huge generalizations and never once wrote about how these disorders happen and how they're treated. It was all, "Sociopaths are incapable of knowing right from wrong, or even caring about other human beings," and "Borderlines thrive on drama and manipulation - don't get caught in their web!"

How the hell do you guys put up with this shit? If someone wrote some book on how to identify and avoid the "dangerous and violent manic depressives," I'd flip out. I know that bipolar disorder has much less stigma nowadays, but the amount of stigma these assholes seem to be attaching to personality disorders seems way worse than anything I've seen before.

Do these pop authors really think that telling everyone to "avoid personality-disordered individuals" will somehow help the situation? I realize that it takes a special type of friend to really be there for someone when they're struggling with mental illness and that some folks would probably just make things worse. But having people treat you like a vampire with leprosy just CAN'T be good for anyone.

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I still remember when I got diagnosed as having borderline personality disorder. I cried and cried and felt like such an utter freak. I got right on the net to research it and my heart just sunk. It wasn't until I had group therapy that I realised that the average sufferer was a very sensitive caring person with a horrendous childhood and a crap set of coping mechanisms, most of which had never had to chance to learn how to do any better.

I think that knowing people with the disorder, and seeing how totally courageous and strong they can be helps me know deep down that I am not a freak after all. I also hold out great hope because it is possible to recover from the disorder, as I have. BPD is really just the unfortunate bad luck of not having been given tools to deal with life. What is great is that once people have those tools, they can make a great success of themselves and be so much more empathetic and considerate than 'regular' people.

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  • 4 weeks later...

Heh, gotta love those stigma attached to personality disorders. After reading several books about these disorders and internalizing them, I'm still struggling arguing with my psychiatrist whether I'm a decent human being or a subhuman personality that deserves nothing but death.

Try reading some material by Sam Vaknin who diagnosed him self with Narcissistic personality disorder. (Self-diagnoses... what a wonderful thing...) He painted a really ugly picture about NPD in his book Malignant Self Love: Narcissism Revisited. Google Books put a preview of that book at [link=http://books.google.ca/books?id=OP1rmM_eSRkC"'>http://books.google.ca/books?id=OP1rmM_eSRkC" target="_blank]http://books.google.ca/books?id=OP1rmM_eSRkC[/link]. Just to give a brief description of personality disorder Vaknin posted on Open-Site Internet Encyclopedia:

Characteristics common to all personality disorders

Patients with personality disorders share certain characteristics:

1. Except those suffering from the Schizoid or the Avoidant Personality Disorders, they are insistent and demand preferential and privileged treatment. They complain about numerous symptoms, though they frequently second guess the diagnosis and disobey the physician, his treatment recommendations and instructions.

2. They feel unique, are affected with grandiosity and a diminished capacity for empathy. Consequently, they regard the physician as inferior to them, alienate him and bore him with their self-preoccupation.

3. They are manipulative and exploitative, trust no one and find it difficult to love or share. They are socially maladaptive and emotionally labile.

4. Disturbed cognitive and, mainly, emotional development peaks in adolescence.

5. Personality disorders are stable and all-pervasive – not episodic or transient. They affect all the dimensions of the patient's life: his career, his interpersonal relationships, his social functioning.

6. Though the patient is sometimes depressed and suffers from mood and anxiety disorders - defenses - splitting, projection, projective identification, denial, intellectualization - are so strong, that the patient is unaware of the reasons for his distress. The character problems, behavioral deficits and emotional deficiencies and instability encountered by the patient with personality disorder are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behavior objectionable, unacceptable, disagreeable, or alien to his self.

7. The patient is prone to suffer from other psychiatric disturbances, both personality disorders and Axis I disorders ("co-morbidity"). Substance abuse and reckless behaviors are also common ("dual diagnosis").

8. Defenses are alloplastic: patients tend to blame the external world for their misfortune and failures. In stressful situations, they try to preempt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the external world to conform to their needs.

9. The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from a Borderline Personality Disorder and who experience brief psychotic "microepisodes", mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and general fund of knowledge.

Source: [link=http://open-site.org/Health/Conditions_and_Diseases/Psychiatric_Disorders/Personality" target="_blank]http://open-site.org/Health/Conditions_and...ers/Personality[/link]

There are some actual psychotherapy-related websites that encourage people to avoid Cluster B personality-disordered individuals as far as possible. Joseph Carver identified these individuals "losers," and described their behaviours at [link=http://counsellingresource.com/quizzes/loser/index.html"'>http://counsellingresource.com/quizzes/loser/index.html" target="_blank]http://counsellingresource.com/quizzes/loser/index.html[/link]. His articles about "losers" are so popular that now he has a website, [link=http://www.loserrx.com"'>http://www.loserrx.com" target="_blank]http://www.loserrx.com[/link], where he encourages people to diagnose each other and put strict boundaries from them. Here are some advice this guy gives to PD individuals:

If you have a Cluster B diagnosis, there is a good chance that your personality and behavior has damaged others, often emotionally, physically, socially, and even financially. With Cluster B personality disorders, your friends and family may need to take steps to protect themselves from your behavior. Cluster B behaviors and difficulties are outlined in my [link=http://counsellingresource.com/distress/personality-disorders/index.html" target="_blank]Personality Disorders[/link] article on this website. In Cluster B disorders, treatment often involves a recognition of not only the behaviors and attitudes, but how they damage those around you. If you accept and understand that your Cluster B issues are harmful to those around you, you can consider operating as though you were medically contagious. When we are medically contagious, we keep a safe distance from those we love, encourage them to be cautious when around us and follow protection procedures; we understand their concerns for our situation and their need to protect themselves, and we understand that our loved ones may have already been harmed by our behavior.

When Cluster B individuals are honest with themselves, they recognize why family and friends:

  1. keep their physical distance,
  2. encourage professional help,
  3. protect their finances/assets,
  4. seek the help of law enforcement,
  5. are reluctant to help due to our past behavior,
  6. emotionally distance themselves for their own protection, and
  7. don’t believe our promises and excuses.
Like a person who is bankrupt, a Cluster B personality disorder often must reestablish their credit with those around them. They don’t require hospitalization, but they recognize that they must fix their behavior, not the people around them. You’re not required to end friendships, but you are required to acknowledge that your personality traits will interfere with those friendships.

Source: http://counsellingresource.com/ask-the-psy...protect-family/

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Well, that's a lot of negativity!

From Mental Health America regarding personalisty disorders:

There is Hope

The more you learn about personality disorders the more you will understand that they are illnesses, with causes and treatments. People can improve with proper care. By seeking out information you can recognize the signs and symptoms of a personality disorder and help yourself or someone you know live a healthier more fulfilling life.

Medline Plus has a lot of links that look interesting.

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Hey, Protagonist. If you're looking for alternate therapeutic approaches that don't treat Axis II/Cluster B as a caste of untouchables, I'd recommend the work of Bill O'Hanlon, one of the original "solution-oriented therapy" and "inclusive therapy" people (shading into acceptance/commitment stuff), who writes at great length about the total BS of 'writing off' people with Axis II disorders, or, for that matter, schizophrenia. Or bipolar disorder. Or any other general significant craziness. His Solution-Oriented Therapy for Chronic and Severe Mental Illness is an under-appreciated gem, and it should be required reading for anyone who works with us (IMO.) (Actually, hey, VE, can we put this in the store? Tim Rowan is the primary author.)

He's not of the "let's all stop our meds and dance around the Maypole" school of thought, but his willingness to be inclusive has been so refreshing at times... ditto for any of the 'third wave' therapists, actually. So I think things will change, slowly.

I'm mentioning this because I've been re-reading O'Hanlon lately for some systems design things, and I'd forgotten how nice it is to read someone who's not saying doom and gloom about All Things Axis II. And you know, the guy's right. People DO get better, damn it. They might not get 100% better, but they do sort of regress to the mean and get out of the extremes of the curve that you see in the personality disorders.

THought of your post when I was working on that project last night, and then Stacia's post bumped the thread.

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Before being dx'd with BP, I was seeing my fam doc for depression. I mentioned once that maybe I had Borderline Pers. disorder, as I'd been reading a bit about it and thought some of the symptoms fit. He said 'oh no, you're not Borderline- when we refer Borderline patients to psychiatrists they want to run out the back door!" He went on to say other very disparaging things. He's a blabbermouth so I learned to take things he says with a grain of salt (he's not my GP anymore) but what an ignorant generalization!

I'm now in a DBT Skills Training Group. most of the women have BPD (it was designed for them, initially) and am learning a lot more about the illness. I'm appalled at what your're saying is out there in Stigma-land. The women in my group are a fine bunch of ppl.

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  • 2 weeks later...

My boyfriend went looking online for stuff about BPD after I told him about my diagnosis. He said he found a lot of "my ex was a BPD and ruined my life -- STAY AWAY."

Luckily for me, he is reasonable enough to ignore that... ^^;

People love to diagnose their ex with a personality disorder. It's this whole mentality of "you made me sad, there must be something wrong with YOU. Your personality is BROKEN."

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  • 3 weeks later...

I am a psychology major myself. Personally, the term "personality disorder" in and of itself is nothing short of disgusting in my eyes. It is as if the individual with the "disorder" is inherently bad. It's infuriating.

How does the DSM-IV classify personality disorders? Here is a list:

Cluster A (Odd) : Schizotypal, Schizoid, Paranoid

Cluster B (Dramatic): Antisocial, Borderline, Histrionic, Narcissistic

Cluster C (Anxious):Dependent, Obsessive-Compulsive, Avoidant

Odd? Dramatic? Anxious? How are these derogatory terms useful in helping an ailing individual achieve a more stable mental health status?

Overall, Axis II

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My new(ish) tdoc doesn't seem to believe in BPD. From what I can tell, because of the high correlation between trauma and BPD occurrence, she thinks BPD is really just extra symptoms of PTSD.

I can see the overlap... but I don't think she's quite right. PTSD defines more my anxiety problems, where BPD defines my interpersonal problems. I think that's an important distinction.

Personality disorders should be relabeled "interpersonality disorders" or something. They all seem to focus somewhat on the effects of the disorder on interpersonal relationships...

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  • 3 weeks later...

There is one and only one book I have ever found that gave any kind of justice to BPD. It is a book called "I Hate You, Don't Leave Me". When I was first diagnosed with BPD, my therapist recommended this book. I sat down to read it and the more I read the more I thought, Oh my god- this is me! This is what's wrong. I had been diagnosed with everything under the sun and when I read about those diagnoses I knew that wasn't me.

Greetings, people with personality disorders in the place to be! I am called Protagonist, and I have bipolar disorder, but I've met my share of folks with personality disorders and some of my friends have one or the other. Lately I have been very curious about Axis II diagnoses and personality disorders in particular because it is one area of psych that I know little about, so I have been researching.

I went to the library to look them up, and I was very, very, very disturbed by what I found.

Every time I've researched my own diagnosis (bipolar,) I run into survivor memoirs, Patty Duke's biography, books like "Bipolar Disorder for Dummies" and volumes on various treatments and their supposed effectiveness.

I look up personality disorders, and what do I find? There are maybe TWO books that explain borderline personality disorder for those suffering with it and other interested parties, and none on any other disorder. Every other book had some really ridiculous title like "Surviving Sociopaths" and "Saying Goodbye to Personality Disordered Individuals," and featured this long, oversimplified checklists so that the reader could discover whether some person they didn't get along with was, in fact, "personality disordered." There were about THREE books that flat-out compared people with Antisocial Personality Disorder or Borderline Personality Disorder to vampires. I'm not making that up: VAMPIRES. What. The. Hell. (Insert sparkle joke here, Twilight fans.)

Every single one of the read like some kind of bizarre Axis II safari. It might as well have been that dead crocodile guy saying, in an enthusiastic accent, "Be very quiet! We're hunting the RARE American Borderline in his natural habitat!" I think what bothered me the most was the books that seemed entirely focused on "helping" people identify and avoid those with personality disorders. Half the time, it did not even sound like the authors considered these folks human. They made huge generalizations and never once wrote about how these disorders happen and how they're treated. It was all, "Sociopaths are incapable of knowing right from wrong, or even caring about other human beings," and "Borderlines thrive on drama and manipulation - don't get caught in their web!"

How the hell do you guys put up with this shit? If someone wrote some book on how to identify and avoid the "dangerous and violent manic depressives," I'd flip out. I know that bipolar disorder has much less stigma nowadays, but the amount of stigma these assholes seem to be attaching to personality disorders seems way worse than anything I've seen before.

Do these pop authors really think that telling everyone to "avoid personality-disordered individuals" will somehow help the situation? I realize that it takes a special type of friend to really be there for someone when they're struggling with mental illness and that some folks would probably just make things worse. But having people treat you like a vampire with leprosy just CAN'T be good for anyone.

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There is one and only one book I have ever found that gave any kind of justice to BPD. It is a book called "I Hate You, Don't Leave Me". When I was first diagnosed with BPD, my therapist recommended this book. I sat down to read it and the more I read the more I thought, Oh my god- this is me! This is what's wrong. I had been diagnosed with everything under the sun and when I read about those diagnoses I knew that wasn't me.

I have that book. It's old but helpful. I have found that the library sucks where this topic is concerned, at least libraries not in metropolitan areas. Big bookstores have much more to offer, if you wanna sit down and have a cup of coffee and read while you're there (or spend the $8-$30 or so on a book). I have seen several books that are plain out rude when it comes to PDs, though, and that offends me.

How do I deal with it? I really don't. About 10 or 15 friends, plus family, know about what's going on with me, and I know that's not a lot, but spreading general awareness by talking about it (not specifically about me, but just in random conversation) will help decrease the stigma over time. Also, if every person with BPD or another PD tells 10 or 15 friends, plus family, that's that many more people who will be aware.

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  • 2 weeks later...

If you have a Cluster B diagnosis, there is a good chance that your personality and behavior has damaged others, often emotionally, physically, socially, and even financially. With Cluster B personality disorders, your friends and family may need to take steps to protect themselves from your behavior. Cluster B behaviors and difficulties are outlined in my [link=http://counsellingresource.com/distress/personality-disorders/index.html" target="_blank]Personality Disorders[/link] article on this website. In Cluster B disorders, treatment often involves a recognition of not only the behaviors and attitudes, but how they damage those around you. If you accept and understand that your Cluster B issues are harmful to those around you, you can consider operating as though you were medically contagious. When we are medically contagious, we keep a safe distance from those we love, encourage them to be cautious when around us and follow protection procedures; we understand their concerns for our situation and their need to protect themselves, and we understand that our loved ones may have already been harmed by our behavior.

When Cluster B individuals are honest with themselves, they recognize why family and friends:

  1. keep their physical distance,
  2. encourage professional help,
  3. protect their finances/assets,
  4. seek the help of law enforcement,
  5. are reluctant to help due to our past behavior,
  6. emotionally distance themselves for their own protection, and
  7. don’t believe our promises and excuses.
Like a person who is bankrupt, a Cluster B personality disorder often must reestablish their credit with those around them. They don’t require hospitalization, but they recognize that they must fix their behavior, not the people around them. You’re not required to end friendships, but you are required to acknowledge that your personality traits will interfere with those friendships.

Oh. My. God.

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