Personality disorder

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Personality disorders are a type of mental disorder defined by the American Psychiatric Association (DSM-5) as "an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment."

Both genetic predispositions and environmental factors (e.g. childhood sexual/emotional abuse or neglect) can play a role in the development of personality disorders. In a sense, they can be thought of as coping mechanisms taken to the extreme. It is not uncommon for someone to have more than one personality disorder at the same time.

Personality disorders often inhibit a person's ability to function successfully in society, but are, by and large, not harmful to society (with certain exceptions). Megalomania, fear of interaction, belief that one is destined to be something "great", trouble with relationships, and unstable self-image are all aspects that can lead to a diagnosis of "personality disorder."

Cluster A Disorders[edit]

Cluster A personality disorders involve eccentricity (usually considered to be the black sheep or the least common of the official 10 personality disorders).

Paranoid Personality Disorder[edit]

For more information, see: Paranoia

Paranoid personality disorder (PPD) involves an extreme suspicious belief or a conspiracy theory that other people, world governments, or central banks are going to try to harm people with PPD, but that is relatively impervious to evidence to the contrary.

Schizoid Personality Disorder[edit]

Schizoid personality disorder (SzPD) is characterized by inhibited emotions and a preference for being solitary. Someone with SzPD may be very aloof, unemotional, and uninterested in making any friends or becoming lovers with anyone very much, kind of similar to a classic autistic person (not a person with Asperger's syndrome), despite schizoid PD being a psychiatric disorder and autism being a neurological disorder.

Schizotypal Personality Disorder[edit]

Schizotypal personality disorder (StPD) is characterized by extreme eccentric behavior and beliefs. People with StPD may realize that they are experiencing delusions of seeing ghosts and magic, or they may be unsure and decide to follow along with them "just in case." In other words, they believe that supernatural beings or things are real without evidence. Their odd mannerisms may be perplexing to other people. StPD is confused with a mental or psychotic disorder, schizophrenia.

Cluster B Disorders[edit]

Cluster B personality disorders often involve dramatic traits (usually considered to be the most popular or the most common of the official 10 personality disorders).

Antisocial personality disorder[edit]

See the main article on this topic: Psychopath

Antisocial personality disorder (AsPD or APD) is sometimes referred to as "sociopathy" or "psychopathy", with those affected called "sociopaths or "psychopaths".[note 1] People with this disorder show little concern for others and experience shallow emotion. They are also prone to lying, stealing, torturing, and being destructive to others. Thus, these people are likely to become charlatans, shysters, and other deceitful persons. It is estimated that 60-80% of some prison populations consist of people who suffer from AsPD. Symptoms tend to peak during the late teenage years and early 20s. They sometimes improve on their own by a person's 40s.[1]

From 1917 to 1990, U.S. immigration law banned gay people from entering the country, on the grounds that they were psychopaths. Congress intended the term "psychopathic personality" to designate homosexuals as well as people having psychopathic disorders, as that term is generally understood.[2]

People with AsPD are often difficult to spot and blend in due to their "superficial charm" to look normal. They may disregard the rights of others and often break the law and are criminals.

Borderline personality disorder[edit]

You know you're borderline when you fluctuate between fearing abandonment and encouraging it.
—Jaen Wirefly[3]

Borderline Personality Disorder (BPD) involves intense emotions and fear of abandonment. People with BPD may go to drastic lengths to avoid abandonment (real or perceived) and experience tumultuous emotions. These include a profound feeling of emptiness, depression, furious outbursts, fear, shame, and more.[4] People with BPD may act in extreme, manipulative, or otherwise inappropriate ways, and may lack the self-awareness to realize that this is wrong.

The prevailing theory about people with BPD is that their perceptions (e.g. splitting, regarding a person as all good or all bad) and resulting behavior toward those they have devalued is the result of subconscious defense mechanisms, rather than the kind of purposeful malice exhibited by those with AsPD. Indeed, many sufferers of BPD have lost companionship and friendships due to doing what they simply believed was the right thing or what they had to do, even if lying or other sorts of destructive behavior is involved.[note 2]

Randi Kreger's Stop Walking on Eggshells and Splitting alleges that BPD can be a reason why people make false allegations of rape and domestic violence, although there is no evidence to support this and there are some people who suffer from BPD who can actually be victims of such things. Rates of false allegations of rape are the same as any other crime.[5] Dana Becker argues, "the BPD diagnosis has been used in court to institutionalize and/or medicate women involuntarily, deny them custody of their children, and have their parental rights terminated. Women diagnosed as having BPD have also frequently been discredited as witnesses in court cases involving rape or sexual abuse."[6]

Some people have voiced concerns about BPD being over-diagnosed in order to dismiss angry or unhappy women.[note 3] Quinn Capes-Ivy argues, "could that 'inappropriate anger' be not a disordered way of thinking, but valid female rage against a world which devalues women and things which are thought of as 'traditionally feminine'?"[7] BPD was described by Gillian Proctor as "the latest example of a historical tendency to explain away as 'madness' the strategies some women use to survive oppression and abuse."[8] Jennifer Reimer argues, "the portrayal of 'borderline women' in films in the late 1980s and early 1990s, such as Fatal Attraction, and Single White Female, as well as books like I Hate You, Don’t Leave Me, played a significant role in the stigmatization of so-called 'borderline' women."[9]

Some men's rights writers, such as Paul Elam, aka a MGTOW asshole, argue that people with BPD know what they are doing and often enjoy it, saying to never "breed with a BPD woman."[10] This has generated some push back, with people arguing that it is dehumanizing and unkind to talk about women with BPD this way.[11]

More recent studies have provided evidence that BPD is at least partly genetic in origin and has measurable biological effects that challenge its classification as a personality disorder. Specifically, people with BPD have been found to show a combination of unusually high levels of activity within the amygdala[12] and reduced prefrontal cortex activity, which would result in disproportionate emotional responses that cannot be regulated effectively.

Histrionic Personality Disorder[edit]

Histrionic personality disorder (HPD) involves a need to be the center of attention. Someone with HPD may go to great lengths to be an attention-seeker by being seductive and flamboyant, and feel like they are performing on a stage or a Broadway theater at all times. Someone with HPD can be mostly found in Hollywood or in the porn industry as an actress, showing off her or his body in a very sexual way to arouse others, so they won't feel uncomfortable being a meddler in everyone's business. Some people with HPD will even commit rape against underage kids overtly in a large crowd, even if it means getting arrested to make everyone remember people with HPD forever.

Narcissistic Personality Disorder[edit]

Narcissistic personality disorder (NPD) involves being highly self-centered and entitled. Patients classically show an extremely arrogant affect, which often conceals profound private fears of worthlessness. They tend to focus on their social status and have an inflated sense of self-importance. The main objective of people with NPD is acquiring emotional validation from others (often called "supply"). This manifests as manipulative behavior, demanding that others listen to every single accomplishment that narcissists have achieved (or feel that they have achieved), seeking control over others, and holding grandiose, often unrealistic goals for reaching the top of life's hierarchy (such as via business or politics). Bigoted attitudes are common, since this gives the narcissist an easy way to feel superior to others (e.g. being racist, sexist, ableist, homophobic). Victims who recognize and begin resisting a narcissist's manipulation will be discarded immediately and replaced with new sources of "supply." As with many victims of emotional abuse, people who have suffered at a narcissist's hands may develop PTSD, anxiety, and depression. Children of narcissists are at risk of adopting aspects of NPD themselves to cope with their parents' unrealistic expectations and a lack of unconditional love.

An example of the grandiose narcissist is Donald Trump, the covert narcissist being Hillary Clinton, and the malignant narcissist being Adolf Hitler. A few cases in popular culture are the grandiose Stringer Bell from The Wire and virtually every member of the Lannister family from Game of Thrones, the covert Walter White from Breaking Bad and Jimmy McNulty from The Wire, and the malignant Dennis Reynolds from It's Always Sunny in Philadelphia.

At times, people conflate the word "narcissist" with "abuser" often, like how they conflate "psychopath" with "abuser". The truth is that not every abuser is a narcissist, other abusers can have any of the cluster B personality disorders, such as HPD, BPD, or AsPD (as well as their flying monkeys or fearful enablers), and that not every narcissist behaves like the classic aggressive abuser (people with covert NPD more often show passive-aggressive behavior). NPD is no joke: The condition is highly stressful to have, as one consistently seeks validation and supply to prop up a pathologically unstable self-image. NPD also carries a high risk of suicide, and at least one study has found that patients with NPD who attempt suicide tend to choose deadlier methods[13]. It's also one of the most overused terms in Psychiatry; It's safe to say the person using the term does not like the person making the term relatively meaningless overtime, no thanks to the rise of Youtubers such as Doctor Ramani. This is unfortunate, because NPD is one of the harder things to deal with, as therapists and anyone in a narcissist's personal life would attest.

There is little research on whether NPD is treatable, or which therapeutic approaches might succeed. People with NPD are less likely to seek treatment in the first place; NPD is often diagnosed when a patient is being treated for a different psychiatric problem, such as suicidality. Therapeutic modalities that are effective in BPD have recently begun being adapted for NPD, with some studies showing promising results[14], but no one method has been proven to be superior or reliable. NPD's symptoms make building a therapeutic alliance hard, and it is extremely difficult for patients with this disorder to recognize that their distress is of their own making[15].

Some experts have analyzed Donald Trump's behavior and suggested that he is very likely to have NPD.[16][17] Critics have pointed out the iffy ethics of armchair diagnosing public figures,[18] and argued that people with mental disorders might not appreciate being compared to Donald Trump.[19][20]

Gender issues with BPD and AsPD[edit]

Three-quarters of those diagnosed with borderline personality disorder are female. There is some speculation that because of gender stereotypes, a person manifesting certain thought and behavior patterns (e.g. impulsivity, inappropriate anger, paranoia, refusing to distinguish fiction from reality, hypocrisy, lying, reckless disregard for safety of self and others) is more likely to be diagnosed with BPD if female and antisocial personality disorder if male. A distinction sometimes drawn between BPD and AsPD is that those with BPD "act in" by harming themselves mostly, while those with AsPD "act out" by harming others.[21] Though that doesn't preclude the former from acting violent towards others or the latter from committing self-harm, of course, as illustrated by murderer and alleged kitten killer Luka Magnotta, a young male adult diagnosed with borderline personality disorder.

With regard to the criteria, a major distinction between BPD and AsPD is the AsPD requirement "there is evidence of Conduct Disorder with onset before age 15 years." There is sometimes comorbidity between BPD and AsPD,[22] and men who physically abuse women often have borderline and antisocial traits.[23] According to the DSM, another difference between BPD and AsPD is that people with BPD are manipulative to gain the concern and nurturance of caregivers, while people with AsPD are manipulative to gain power, profit, or some other material gratification. Also, people with AsPD tend to be less emotionally unstable and more aggressive than people with BPD.

Anakin Skywalker of the Star Wars prequel trilogy is often held up as an instructive example of how BPD presents in males.[24] As for females, the show Crazy Ex Girlfriend is about a woman with BPD.[25] Interestingly, the show just started off with the main character being... odd, to say the least, but going with whatever behavior would make for the silliest song for a musical sitcom. In the later seasons, they brought an actual psychiatrist to consult and determined that the lead character fits the criteria of having BPD to the letter.

Cluster C Disorders[edit]

Cluster C personality disorders are characterized by fear.

Avoidant Personality Disorder[edit]

People with avoidant personality disorder (AvPD) avoid social situations due to feelings of inferiority and feelings of not being accepted by anyone. They tend to be overly sensitive about what people think of them. They also believe in the best of everyone having some good in them or they even believe that treating some abusers as people will make them become civilized human beings. However, most dramatic people never want to change to suppress their malicious behavior to treat others with empathy and to respect others' social boundaries, and if they did, they will revert to their old self. AvPD is often confused with social anxiety disorder, which has many symptoms, such as trembling, dizziness, fast heartbeat, dry mouth, excessive sweating, and shortness of breath, that makes it different from AvPD.

Dependent Personality Disorder[edit]

People with dependent personality disorder (DPD) rely on other people to take care of them and make decisions for them in order to feel secure. They will always say "yes" or "I agree" to follow everything of what they are told by their caretaker or ruler to avoid feeling alone or abandoned (not exactly the same reason as people with BPD). Furthermore, they choose to never have an opinion of their own to disagree or say "no", and they never choose to look at both sides of the story to see who is telling the truth or not. Otherwise speaking, they always believe what one person (mostly a dramatic abuser) says to them as their only source of news, instead of other sources that are logical or factual. Although an abuser harasses a victim, people with DPD will act like "good cops" by covering up every conflict that happens between them to deceive the general public that the world is all shines and rainbows, allowing an abuser to continue on getting away with hurting others.

Obsessive Compulsive Personality Disorder[edit]

People with obsessive-compulsive personality disorder (OCPD) feel the need to micromanage things. They believe in perfectionism, orderliness, and rules. They are also a workaholic (a word derived from "alcoholic"), meaning they almost never spend time on vacations with family members or friends and they always strive to achieve 100% correct on their assignment in their own way at work or school. Sometimes, they are even very strict by forcing others to work near endlessly at the cost of their freedom and human bond experience with one another. Many people confuse OCPD a lot with OCD (obsessive-compulsive disorder), which is an anxiety or mental disorder that involves with repetitive behavior (e.g. frequent handwashing, checking on the door 5 times if it's locked or not, aligning objects to make right angles) that OCPD lacks.

External links[edit]

Notes[edit]

  1. Psychopathy and sociopathy are sometimes considered to be somewhat different personality disorders.
  2. However, violence and BPD correlating is very, very rare, some even learning to detest it due to the destructive environments they grew up in.
  3. In this sense, BPD might be seen as a successor to female hysteria if not for BPD being an actual mental health problem that has been demonstrated to actually exist.

References[edit]

  1. http://www.nlm.nih.gov/medlineplus/ency/article/000921.htm
  2. http://openjurist.org/716/f2d/1439/in-the-matter-of-petition-for-naturalization-of-richard-john-longstaff
  3. Borderline Personality Disorder Quotes
  4. http://www.nhs.uk/Conditions/Borderline-personality-disorder/Pages/Symptoms.aspx
  5. "Some statements may be exaggerations, such as a woman accusing her husband of 'strangling her' when he touched her neck… One woman lied that she had been raped to get her boyfriend's attention when he had not been paying enough attention to her." https://www.psychologytoday.com/blog/stop-walking-eggshells/201112/why-some-narcissists-and-borderlines-lie
  6. Borderline Personality Disorder: The Disparagement of Women through Diagnosis
  7. Borderline Personality Disorder - a feminist critique, the f word
  8. BPD: not just a feminist issue
  9. Borderline Personality Disorder, Feminism, Mentally Impaired?
  10. BPD: Sick, or just crazy asshole?
  11. Pushing Back: Women with Borderline Personality Disorder Deserve Love
  12. https://doi.org/10.1016%2FS0006-3223%2801%2901075-7
  13. Blasco-Fontecilla H, Baca-Garcia E, Dervic K, et al. Specific features of suicidal behavior in patients with narcissistic personality disorder. J Clin Psychiatry. 2009;70(11):1583-1587. doi:10.4088/JCP.08m04899
  14. Stern BL, Yeomans FE, Diamond D, Kernberg OF: Transference-focused psychotherapy (TFP) for narcissistic personality disorder, in Treating Pathological Narcissism. Edited by Ogrodniczuk J. Washington, DC, American Psychiatric Publishing, 2012
  15. Ronningstam, E., & Weinberg, I. (2013, April 1). Narcissistic personality disorder: Progress in recognition and treatment. Psychiatry Online. Retrieved September 23, 2022, from https://focus.psychiatryonline.org/doi/full/10.1176/appi.focus.11.2.167
  16. ‘Is Trump a psychopath? I’d call him a narcissist’ by Zoe Williams (Tuesday 23 August 2016 13.29 EDT) The Guardian.
  17. Does Trump Suffer from Narcissistic Personality Disorder?
  18. Trump's mental health and why people are discussing it
  19. What You Should Think About Before You Tweet #DiagnoseTrump
  20. Why The "Diagnose Trump" Hashtag Hurts People With Mental Illness
  21. 10 Myths about Borderline Personality Disorder Dispelled
  22. "de Barros et al found that while antisocial individuals tend to engage in more property crimes, borderline individuals tend to exhibit more episodes of aggression and physical violence. The authors concluded that criminals with pure antisocial personality are more calculating and exhibit more detailed planning, whereas those with BPD experience more impulsive and explosive episodes of violence. Again, one would assume that combining the two disorders would result in a very criminally combustible outcome." http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2790397/
  23. http://www.ncbi.nlm.nih.gov/pubmed/8436362/
  24. https://www.livescience.com/10679-psychology-darth-vader-revealed.html
  25. https://medium.com/@adeelamini/watching-the-borderline-the-acute-pain-of-being-a-crazy-ex-girlfriend-fan-with-bpd-9670de4a6552