Disorders of Personality

Familiar Personality Disorders (PDs) include narcissistic, antisocial, dependent, histrionic, borderline, and avoidant ones, although about 10 conditions are recognized by psychiatrists and psychologists as PDs.  Everyone knows that individuals with this type of disorder have a problem - except for them. They often seek professional treatment only after persuaded to do so by another person.

PDs are among the most difficult cases to successfully treat. They don't exist apart from an individual's core personality, like something like an anxiety disorder does; rather, they wind through a person's entire personality and, generally speaking, IS the personality, not just an adjunct to it.  It is estimated that about 40 percent of individuals suffering from a PD can find some improvement with a combination of medication and some form of 'talk' therapy. 

The cost to society resulting from PDs is great.  Individuals suffering from a PD are often perpetrators of spousal and child abuse and other forms of violence, creating unhealthy living conditions for others. Even if they are able to be persuaded to undergo therapy, they may continue to deny that they have a problem, preferring to list everything that is wrong with everyone else - blaming everyone else, or the situation, for their problems.  They seek therapy under duress, often using the sessions in order to bolster their claim that they don't have a problem;  that it is others - their spouse, their colleagues - who are to blame for the way they act and that their actions are completely justified.  They are usually self-absorbed, believing that they have every right to be because they're 'so hard done by' at home, or at work.  When the therapist doesn't provide them with the expected validation for their behaviour, they simply fire the therapist.

PDs are extremely complex and as noted above, difficult to treat.  They are often heritable conditions, but can also come about as a result of conditioning during a person's early years because of things like childhood abuse or some other trauma.  A PD doesn't usually manifest itself until the late teenage years;  however, earlier signs may simply have been missed by parents.  Alternatively, because a parent may have the disorder, they can't see that anything is wrong with the child.  Even when environmental factors such as child abuse take place, it is hard to determine whether the reason the child ended up with, for example, a narcissistic personality disorder, was simply because of the abuse which led to self-loathing and low self-esteem - to then be covered up by self-aggrandizement - or that the abuse ended up manifesting as it did because it triggered the heritable condition.  In other words, that is how the abuse manifested itself in that particular child due to genetic factors, whereas in another child it may have manifested itself in another type of PD, or in anxiety or depression.

According to Jeffrey Kluger's article "Pain, Rage and Blame" in a special edition of Time magazine, "personality disorders are ego syntonic:  individuals believe that the drama, self-absorption, and other traits that characterize their condition are reasonable responses to the way the world is treating them." (1)  As a result, because the patient doesn't accept that there is something wrong with them - as they do when they have something like panic disorder or a phobia - how can they accept the treatment required to give them any chance at all towards healing?

While antidepressant and anxiety medications do little to change something as fundamental as personality, they may help to smooth out the rough edges, to calm the stress that comes from living so disordered a life.  Once some patients feel less stressed, they may be motivated enough to take on the harder work of a therapy like cognitive behavioural therapy in which new ways of thinking and reacting about life situations are taught, and then utilized, in order to enable patients to repair what is not working in their lives.

D.

(1) "Pain, Rage and Blame", Jeffrey Kluger, Time magazine special edition: "Your Brain:  A User's Guide", p. 52.

On Stress and the Brain

Stress inhibits neurogenesis (the formation of new neurons) in the brain.  Help!!!

Aerobic exercise (which increases the availability of oxygen and nutrient-filled blood in the brain, nourishing the brain) increases neurogenesis.  Yeah!!!


D.

In the Words of Eckhart Tolle: Meaning and Purpose

I am not a follower of Eckhart Tolle, but found this passage to be of some importance.  It reads as follows:  "As soon as you rise above mere survival, the question of meaning and purpose become of paramount importance in your life.  Many people feel caught up in the routines of daily living that seem to deprive their life of significance. Some believe that life is passing them by or has passed them by already.  Others feel severely restricted by the demands of their job and supporting a family or by their financial or living situation.  Some are consumed by acute stress, others by acute boredom.  Some are lost in frantic doing;  others are lost in stagnation.  Many people long for the freedom and the expansion that prosperity promises.  Others already enjoy the relative freedom that comes with prosperity and discover that even that is not enough to endow their lives with meaning.  There is no substitute for finding true purpose." (1)

D.

(1)  Eckhart Tolle, A New Earth:  Awakening to Your Life's Purpose.  New York, Pengin Group, 2005, p. 257.

Iphones, Blackberries and Other 'Smart' Devices

According to a recent article in the journal, Cortex, we are not addicted to our mobile devices, we are in love with them.  (Gleaned from brain imaging studies.)

D.

Should She or Shouldn't She

I recently came across a letter I wrote a while back in response to an article in the January 2005 issue of Canadian Living Magazine. I thought that the contents of the letter would make a good post for this particular blog.  So, here it goes.  (You'll be able to figure out, from the contents of the letter, what the article I was responding to was all about.)

Dr. David Posen "missed the mark" with his usage of the word "should" in "Happy New You" (paragraph 3, page 54, January 2005).  Even though he was trying to convey to us some examples of positive reprogramming of that little inner voice, the word "should" carries with it too many connotations of guilt and obligation to form any part of a healthy relationship with ones self.  It is never the right word to use for positive self-talk or reinforcement.  Better phraseology would be "my needs are important" or "I think I will do that for myself because it is something I enjoy doing".  In fact, one could even argue that he contradicts the initial content of his previous paragraph where he mentions standing up to the "shoulds" and "musts".  Even when trying to use "should" in a positive manner, as Dr. Posen attempts to do when he writes, "I should be able to do something for myself...I should start taking better care of myself" the feelings of guilt and obligation still lurk beneath these suggested phrases.  Such feelings perpetuate the process of "beating ourselves up" because we should be taking better care of ourselves, but we are not.  This can only detract from the goal of achieving a "happy new you".  The less we fill our heads with "should messages", the more at peace we will be.

D.