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Personality Disorders CAN Be Overcome

CognitiveScience Tuesday, October 5, 2004 . This is a SciScoop post by Ricky James

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What is particularly fascinating about this finding is that the change is not explained by exposure to conventional treatments or the presence of another form of mental disorder, such as anxiety, depression, or other illnesses. The subjects in the study were examined carefully for personality disorder features at three time points over a four year period and a complex statistical procedure known as growth curve analysis helped to detect the changes that were happening in the subjects. The nature of the study design helped to assure that any observed change in the personality disorder features was not due to artifacts or shortcomings that plague other studies.

Personality disorders are conditions that reflect serious disturbances in social and occupational functioning and the nature of the disturbance is part and parcel of a person’s personality. The personality disorders do not represent episodic disturbances, unlike other forms of mental illness such as schizophrenia, bipolar illness, or major depression. They are relatively common among the public, with approximately 10% of the population affected (a fact also discovered previoulsy in Lenzenweger’s laboratory), and they make up a large proportion of those individuals seen for treatment by practicing mental health professionals. “Although the disorders are common, with 1 in 10 people affected, the good news is that we now know the disorders can change with time,” states Lenzenweger. The recent emergence of specialized treatments for the personality disorders coupled with these new findings creates new hope for those affected with the conditions.

Common personality disorders are borderline personality disorder, which is characterized by unstable personal relations as well as self-destructive and impulsive behavior. Narcissistic personality disorder is characterized by grandiose self-importance and disregard for others. There are ten well-defined personality disorders according to the American Psychiatric Association.

8 Responses to Personality Disorders CAN Be Overcome

BigZaphod

October 5th, 2004 at 2:01 pm

This doesn’t actually seem that surprising to me, but maybe that is because I’ve never considered having unstable relationships, or impulse behavior and the like to be disorders but rather a sign of either laziness or ignorance.  The reason I say laziness is that change and growing up is hard, and many people would rather not do it.  It seems like our culture teaches us that things that are hard are often not worth doing anymore.  Witness all of the adverts for products that make even simple things "even easier!"  If it is even remotely an inconvenience, then it is seen as a negative.  Changing your attitude or taking control of your own impulses isn’t too convenient and so therefore it isn’t highly rewarded or reinforced.

To me, the fact that these personality issues are being recognized as something changeable is a sign that, maybe, in some small way, our culture is starting to come around and heal itself, to a point.  Not that it is 100% broken, mind you, just that it feels like maybe it has had a slight head-cold for the last 40 years or so.  :-)

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Anonymous

October 6th, 2004 at 12:51 am


This doesn’t actually seem that surprising to me, but maybe that is because I’ve never considered having unstable relationships, or impulse behavior and the like to be disorders but rather a sign of either laziness or ignorance.

To be blunt, you don’t know what you’re talking about. There is an enormous, enormous difference between the type of behavior described by borderline personality disorder and the typical examples of “impulsive behavior” or “tendancy towards unstable relationships” that are seen in the public at large.
A one- or two-sentence description of BPD symptoms doesn’t serve to get across what it is or what it’s like; it certainly doesn’t communicate enough for you to feel you understand it well enough to make the kind of statements you do in your post (which, quite frankly, are equivalent to saying that “suicidal people should just feel better, dammit”).

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Anonymous

October 6th, 2004 at 2:27 am

Should just feel better damnit.

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gypsysoul

October 6th, 2004 at 8:13 am

to joke about something as devastating as suicide.

Do try to spell the colloquial “dammit” correctly next time you attempt such hilarity.

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BigZaphod

October 6th, 2004 at 9:47 am

Well, perhaps instead of attacking me and calling me an idiot, how about you help enlighten me since, apparently, you have a FAR greater understanding of these things than I do!

Ironically, you have no idea what my own personal history or experiences are and yet you claim to know based on one post where I didn’t even tell you if I did or did not have personal experience with personality disorders.

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Sweetwind

October 6th, 2004 at 10:10 am

I saw it as making fun of the conversation, not making fun of suicide.

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gypsysoul

October 6th, 2004 at 12:06 pm

I guess I didn’t catch the humor of the conversation.

Rickyjames stated on Sciscoop last December that his mother had committed suicide some years ago and that the event still had consequences in his life.  I couldn’t help but think of Ricky as I read the ULF comment, and I didn’t see the  remark as funny.  

Gee — I’ll try to lighten up.

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Anonymous

October 6th, 2004 at 2:38 pm


Well, perhaps instead of attacking me and calling me an idiot,

I didn’t call you an idiot. I said you didn’t know what you were talking about. There’s a difference.


Ironically, you have no idea what my own personal history or experiences are and yet you claim to know based on one post where I didn’t even tell you if I did or did not have personal experience with personality disorders.

Of course I have no idea whether you have personal experience with personality disorders. Nevertheless, if you had a clue about them — or about borderline personality disorder in particular, since that’s the one whose poor description (in the article) you seized upon — you wouldn’t make statements like the ones you made. Unless you were just trolling, of course, which I suppose is possible.

The DSM-IV spells out the classic diagnostic criteria for the various personality disorders (in the U.S., anyway; the criteria differ in subtle ways in the UK, and I’m not sure about other places). People are often somewhat shocked when they read these sets of criteria, because each personality disorder contains criteria which, at first, look like things to which all of us could say “hell, I do that.” The difference, of course, apart from the presence of multiple of the criteria, is severity. It’s one thing to have an anger management problem; it’s another to consistently demonstrate anger inappropriate to the situation
that’s so severe that you pose a threat to others or to yourself. It’s one thing to seek attention from others; it’s another to literally mutilate yourself with knives as an attention-getting method. It’s one thing to be generally distrustful of others; it’s another to be completely unable, to the point of literal physical paralysis upon considering it, to have
a deeper relationship with someone than one does with the checkout clerk at a 7-11 purely out of paranoia.

That said, Borderline Personality Disorder is a particularly difficult personality disorder to pin down and describe in a satisfying way. This is not because borderlines don’t really have a psychiatric problem, or that their problems aren’t extraordinarily severe. It’s because the diagnostic criteria (in the DSM, there are nine criteria, five of which must be present for diagnosis) differ so strongly in nature that different subsets of them can bear little resemblance to each other. There is a stereotype for BPD: Glenn Close in the movie Fatal Attraction. But it’s a bad stereotype. The diagnostic criteria for Borderline Personality Disorder certainly takes her in; but you can remove some of the criteria, add others from the list that her character didn’t manifest, and arrive at a set of symptoms that don’t bear much resemblance to her, but are considered those of a borderline. If you wish to see this more concretely, consider examining Janice
Cauwels’ book Imbroglio, a serious treatise on BPD written with both
clinicians and laypeople in mind. The book contains a number of
chapters which are case histories of real-world borderlines; the
differences between the symptoms shown by the cases chosen is
phenomenal. Each bears little or no resemblance with any of the
others.

In fact, the enormously varied way in which borderlines present is in some sense emblematic of an enormous debate within the psychiatric community as to whether BPD actually exists as a unique disorder (as opposed to its victims actually being misdiagnosed victims of different disorders). For example, the psychiatric disorder most akin to Borderline Personality Disorder (in both theoretical causes — e.g. backgrounds of physical/sexual abuse during childhood — and in presentation) is Post-traumatic Stress Disorder (and as a former emergency medical services volunteer, you’re gonna have a tough time convincing me that PTSD is simply “laziness or ignorance”); many shrinks feel that lots of borderlines are simply PTSD sufferers who have been misdiagnosed.

Because of this uncertainty, most of the BPD gurus in the psychiatric community (Linehan, Gunderson, Kernberg, etc.) have developed additional criteria for differential diagnosis of BPD that they then go and argue about at conferences — criteria that, even if the DSM requirements were met, must be present in their opinions for diagnosis of Borderline Personality Disorder to be made.

I can go on at length about this, but I’m not sure what else to say. There are numerous web resources about the various personality disorders that actually don’t suck. But the important thing to remember when reading any list of symptoms or diagnostic criteria is the issue of severity. One of the symptoms of cancer is “pain.” Well, we’ve all suffered pain; but fortunately, most of us have not suffered pain the way cancer patients have and do. That’s the distinction that you have to remember when you read things like “instability in relationships” or “transient, stress-related paranoia.”

HTH.

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