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My Disorder Definitions
© 2006 Richard, 21CP Author and Publisher
[Tears & Healing naturally has a focus on the emotions and decisions we face living with a disordered partner. But this is only half the picture. Good decisions also require an understanding of why our partners act as they do, and what the prospects are for change. After answering this question many, many times, Meaning from Madness emerged to offer a new, straightforward perspective on what motivates the disordered behavior and the prospects for improvement with treatment.
When I wrote Tears and Healing, my focus was mainly on borderline personality disorder. My readers, however, quickly educated me. The experience of living with an abusive, disordered partner or family member is very similar across three disorders in what they call Cluster B of Axis II. In addition, I often see the wildcard disorder of addiction (which most often shows up as alcoholism) as a compounding factor in many situations.
This essay, based on Meaning from Madness, describes the three most common personality disorders that I hear about from my readers: borderline, narcissistic, and antisocial (sociopathic). I begin with my own perspective on the essential dynamic that drives each of these disorders, then I present the actual definitions that come from the APA (American Psychiatric Association) reference book, the DSM-IV (Diagnostic and Statistics Manual).
Understanding what disorder you’re dealing with is a critical. It allows us to get some handle on why our partner behaves as he or she does. It also gives us some bounds on the reasonable probability of change - something we all hope for yet are most often frustrated about. Having a good picture of these things allows us make projections about what the future may hold, and thus allows us to make decisions about the future with some confidence.
Add In Love and Loving It in a package to get the picture on you, your partner, and future relationships.]
My Definition of the Abusive Personality Disorders
In my writing and in supporting people who have been in abusive situations, I consistently see three personality disorders that lead people to behave abusively. These are what I call the abusive disorders, and they are borderline, narcissistic, and antisocial (sociopathic) personality disorders. Here, I want to give both a practical explanation of these three disorders, plus their "official" diagnostic definitions. In my practical explanations, I'm trying, not be exhaustive, but to highlight the essential dynamic that I see as unique to each of these disorders. This dynamic is essentially a key concept that can be kept in mind in thinking about these disorders.
Remember that personality disorders are defined by the presence of a minimum number of "diagnostic criteria", which basically are behaviors with some underlying motivation. These are defined in the APA (American Psychiatric Association) reference book, the DSM-IV (Diagnostic and Statistics Manual) and I’ve included copies of those criteria after this essay. However, current thinking about these disorders is that they occur in a continuum of severity, with less severely impacted people having what is called a "personality style", and the most severely impacted being diagnosed with a personality disorder. Thus, the essential dynamic I describe may help you identify a personality style where the criteria may not necessarily be met.
The Essential Dynamics
Both borderline and narcissistic personality disorders are driven by grossly hypersensitive reactions to perceived threats. Borderlines perceive a threat of significant people abandoning them, and react very strongly to protect themselves either by stopping the abandonment or pushing the perceived abandoner out of their significant space. Narcissists find safety in presenting an image of perfection to others, and react very strongly to any threat to that image, usually by attacking and demeaning the person making that perceived threat. Sociopaths, in contrast, have a total LACK of sensitivity to the needs and feelings of others. Sociopaths may be aggressive or passive or in between, but in all cases lack a sense of conscience or remorse. Their actions tend to be more measured than those suffering with borderline or narcissistic personality disorder, but their measure of goodness of actions completely lacks concern for others and is based entirely on the impact they perceive their actions will have on themselves.
Borderlines fear abandonment and react strongly to actions they perceive indicate that they are being abandoned.
Narcissists fear that their perfect image in others' eyes will be damaged, and react strongly to any threat to that image.
Sociopaths lack remorse and conscience and choose actions only with regard to their impact on themselves.
These are not the same words you may hear used by others, but I think they capture the essence of these disorders.
What follows are the official definitions of these disorders. Although you may be cautioned otherwise, do not shy away from assessing these criteria in someone close to you. In reality, partners or close family have far more necessary knowledge of a person to assess these criteria than any mental health professional can ever have. If the criteria make sense, then evaluate the fit. Most people are reasonably able to determine which of these disorders is likely present in a partner or family member. With that information, you can research and learn what the prospects are for improvement and what such a healing process would be like.
DSM Definitions - The Abusive Personality Disorders
This mailing originally included the text from the DSM of their definitions of these disorders. In their zeal to protect you from unwanted email, the major email systems (i.e. AOL) simply won't accept email in this kind of format with the words that appear in those definitions. Go figure. They will let these links go through, so I'll share these by proxy. Needless to say, these aren't blocked in Meaning from Madness and you can get the whole picture I paint, in much greater detail, in the book.
An index to the DSM Definitions of ALL disorders is on this page:
http://www.mentalhelp.net/poc/view_index.php?idx=26
http://www.mentalhelp.net/poc/view_index.php?idx=26
© 2006 Richard, 21CP Author and Publisher
“Our deepest fear is not that we are inadequate.
Our deepest fear is that we are powerful beyond measure.
It is our light, not our darkness, that most frightens us.
We ask ourselves: who am I to be brilliant, gorgeous,
talented and fabulous? Actually, who are you not to be?
You are a child of God.
Your playing small doesn't serve the world.
There's nothing enlightened about shrinking
so that other people wont feel insecure around you.
We are born to make manifest the glory of God that is within us.
Its not just in some of us, it is in everyone." - Marianne Williamson
Fallen Officer Kenneth Collings
http://hometown.aol.com/azterri/kenny.html
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