How to open up the topic of personality disorders in conversation

In this video/post, I discuss the presuppositions that you must work through before discussing personality pathology, followed by a little taste of what you’re getting into.

Readership: All
Length: 1,000 words
Reading Time: 3.5 minutes

How does your personality become “disordered”? (Length: 21:00)

In order to have a conversation about personality disorders and the development of them, there are two steps of topics that you need to address first, before you can get to this topic.

  1. Does personality exist?
  2. Can it be disordered?

If you ever want to talk about personality pathology with anyone, then these topics need to be addressed in this order.

1. Does Personality Exist?

The question of whether personality exists is actually a very controversial topic.  If you talk to 10 different health professionals about whether personality exists, you’ll get 10 different answers.

My perspective is that, yes, it exists.  Secondly, how do we define it?

The simplest way I can describe personality is like this.

If you put person 1 into environmental stimulus A, then you will get behavior X.  And no matter how many times you do this, you will always get behavior X, with only a little bit of variance.

In fact, this observation/assumption that people have certain preferred behaviors forms the whole basis of psychology.

So you need to come to a loose agreement on this point before proceeding to the next step.

2. Can Personality be Disordered?

Here, we can talk about personality like it is a constitutive physical element of a person, like a liver or pancreas, all of which can have a pathology.

If there are different types of personality disorders, then they can be identified as discrete pathologies.  In psychology, this is called differentiating.

The way we define these disorders is by the descriptions in the Diagnostic and Statistical Manual of Mental Disorders (DSM).  This is called diagnosing.  As the name implies, the way that these criteria are created are both rationally and statistically derived.

In studies of personality, it has been widely found that people who have behavior A also have behavior B.  This is called clustering, which is also described in the DSM. It should be noted that there are also individuals who don’t fit into a cluster.  They appear to have pathological behaviors from many clusters, and so the pathology is not easily identifiable.

Once you can agree about whether a person displays behaviors that match a certain cluster, then you are at the point where you can begin to discuss a specific personality disorder.

Dealing with People who have Personality Pathologies is Difficult

We can imagine this as a sliding scale.  On one end is the person who has the perfect personality, and on the other end is the completely mad psychopath.

A person with a perfectly developed personality might be described as always knowing how to handle any situation, no matter how ambiguous or weird it is.  They have no difficulty in coping skills.  They always manage other people with just the right amount of sophistication and assertiveness.  Such a person does not exist.  All people have some degree of personality pathology, which is another way of saying that no person has a perfectly developed personality.

We talk about personality disorders as a cluster of maladjusted behaviors that causes problems for that person and/or others.  We also talk about this as being an ego syntonic behavior, which means that the person is unaware of how they are causing problems for others.

In contrast to other psychological pathologies, like Alzheimer’s, Autism, schizophrenia, etc., a personality disorder is the clinicians’ way of calling the person a supreme jerk.

Your neural pathways become less and less plastic as one grows older, so the old proverb, “You can’t teach an old dog new tricks”, is actually true.

A personality pathology is the way you are, and if the way you are is ‘broken’, then that is a trait that is not likely to change.

So this is why personality disorders are so difficult to deal with.

Can Personality Pathologies be Remedied?

The diathesis stress model is based on the fact that we don’t know the exact percentages of factors that contribute to a personality disorder, environment and genes and heritability.  Personally, I estimate this to be 90% heritability and 10% environment, and science is slowly coming around to this estimation.

Richard Grannon is a big fan of Freud, and they both claim that behaviors are slowly grown, and then adamantly defended after they are engrained.  The iceberg analogy applies here.  There are a lot of things lurking beneath our conscious awareness, and as one grows older, their ego becomes increasingly invested in not changing those subconscious issues.

Are people with personality disorders completely incapable of comprehending and/or changing their pathology?  No, probably not in most cases.  But because they have built up an ego investment in these maladaptive coping skills and fortress of defenses around these traits, it is very VERY difficult to address, and it is unlikely that they will be able to change it.

Digging deep into the issues that cause a pathology are by nature very painful, so most people will instinctively resist this process.  Going back to the medical model, it’s like a surgery.

The only way a person is going to change is if they run into a situation in which their maladaptive traits become extremely costly to them, and then this motivates them to change.  Even then, the stuff deep down inside that is causing their pathology will probably remain, and they will simply change their social behaviors in order to find a new coping mechanism.  It’s classical conditioning like Pavlov’s Dog.

One of the best treatments for this is Dialectical Behavioral Therapy, as presented by Diane R. Gehart in this video.

Related

Shawn Smith and Richard Grannon have a lot of knowledge about the topic of personality disorders.  I’d like to make a viewer interactive session with the three of us.  If you are interested in learning more, I recommend you to check out their YouTube channels.

This entry was posted in Disorders, Health, Introspection, Psychology, Relationships. Bookmark the permalink.

9 Responses to How to open up the topic of personality disorders in conversation

  1. Oscar says:

    Scott,

    Let me see if I understand this correctly. Everyone has some disordered personality traits. Is that analogous to how we all have some physical disorders? For example, we all carry some genetic defects (some more significant than others), and we all carry some physical defects caused by environmental factors, such as injuries, poor diet, etc.

    Am I understanding that correctly?

    Like

    • Scott says:

      If you look at it from a Christian world view it makes sense doesn’t it?

      Sin has corrupted everything to some degree

      No one can develop a perfectly healthy personality in this world

      Like

      • Oscar says:

        Yes, it does. That was my next thought. Which, apparently, means I’m actually following, which is an accomplishment, for an engineer.

        Like

  2. Joe2 says:

    We talk about personality disorders as a cluster of maladjusted behaviors that causes problems for that person and/or others. We also talk about this as being an ego syntonic behavior, which means that the person is unaware of how they are causing problems for others.

    Perhaps, but not for all individuals. From my experience, there are individuals who are fully aware their maladjusted behaviors cause problems for others. These individuals are also skillfull in keeping these behaviors under control until they get what they want or are in a position where the risk of repercussions is minimal. For example, soon after the wedding the husband finds out his wife acts like a “supreme jerk” and exhibits behaviors which she had kept under control during the engagement. Or a supervisor at work who acts like a “supreme jerk” but is protected due to family or political connections.

    The only way a person is going to change is if they run into a situation in which their maladaptive traits become extremely costly to them, and then this motivates them to change.

    The threshold at which they become “extremely costly” is different for each individual. For some, the threshold could be set so high making it unlikely to ever be crossed and provide motivation to change.

    Liked by 3 people

  3. Jeff Barnes says:

    I only read the post, didn’t watch the video. This is a topic I have spent a fair amount of time thinking about. I am familiar with some of Richard Grannon’s content. I agree with Oscar’s comment. Sin has disordered us both physically and mentally hence it is toxic for Christians to over spiritualise psychological struggles. Also I agree with Joe and would add that while those with personality disorders lack self-awareness or insight into their self-defeating behaviours, certain personality disorders namely narcissist personality disorder are very much aware that they are causing problems for others.

    “The diathesis stress model is based on the fact that we don’t know the exact percentages of factors that contribute to a personality disorder, environment and genes and heritability. Personally, I estimate this to be 90% heritability and 10% environment, and science is slowly coming around to this estimation.” I would have fair amount of skepticism as to what this statistic means because without context and qualifications it is misleading or meaningless.

    The problem with modern psychology and psychiatry is that too much focus is given to managing symptoms instead of healing wounds. The single most important disorder there is, is not even mentioned in the DSM, I wonder why. Fortunately there are many educators on the internet who recognise the centrality of complex post traumatic stress disorder and that if the trauma underneath is healed over time than magically all these other diagnosis of behavioural symptoms fall away to a great extent. Unfortunately many of those in power don’t want people to heal from their problems but to be chained to them, so you can be exploited. The capitalistic system doesn’t care about your soul it only cares that you remain a functional cog in the machine.

    “The only way a person is going to change is if they run into a situation in which their maladaptive traits become extremely costly to them, and then this motivates them to change. Even then, the stuff deep down inside that is causing their pathology will probably remain, and they will simply change their social behaviors in order to find a new coping mechanism. It’s classical conditioning like Pavlov’s Dog.” For me I had to hit rock-bottom (multiple unresolved mental health issues plus crippling depression) to decide to change my dysfunctional life so I do consider their to some truth to what you are saying. I self-diagnosed myself as having AvPD in one sense or another (depending on the definition and understanding of personality disorders), but my deeper problem was having C-PTSD created by CEN and being part of a narcissistic family system and suffering the abuse and neglect from that. Also I found value in identifying with labels like ADHD, DID, codependency, counter-dependency as well as other dysfunctional psychological states, but at the end of the day most of the healing work was done by confronting the reality of the trauma I experienced, and healing my C-PTSD. My journey of healing started with understanding and engaging with myself and my life (also quitting addictions, then spent some time in self-help which most critically began challenging my immensely powerful inner critic, also had a jordan peterson phase for self-development). Then later I discovered CEN for which it took a while for me to move past the stage of denial of trauma. Then C-PTSD a bit later and that is where you find serious resources for healing; these two blogs I highly recommend: https://www.healingfromcomplextraumaandptsd.com/ and http://www.pete-walker.com/

    I am very grateful to have finally healed from the majority of my trauma, and to a significant degree to be an emotionally and psychologically healthy individual. It is like night and day the difference in daily experience. Quality of internal life is so phenomenologically different, so I think I am significantly more grateful for the baseline healthy and happiness the average person might experience most of their life. In particular I am grateful that I decided to prioritise my mental health and healing over other distractions (I didn’t work for 2 years partly of course not out of choice) so early in my life and that in God’s providence I could work through these issues as a young adult instead of an older man. Now I find it hard to imagine how I experienced my traumatic years, it is so nightmarish compared to the dawn of a new life. ‘Before the resurrection there is always a cross’ I heard from an Orthodox priest and I have certainly found that to be true in my life. First 18 years of my life I was Gollum trapped by a ring of trauma, then I went on a gruelling adventure as Frodo to finally rid myself of the ring, now I see myself as Sam on the way back to the shire to enjoy a peaceful existence in comparison. I will say that my primary way to cope with trauma was dissociation so I ignored most of the pain and lived a life of escapism which of course finally caught up to me. Even still ignoring pain does not mean you are not experiencing it, it just is not in your conscious awareness to a degree. And of course I by no means claim to have an accurate understanding and remembrance of my past, I remember almost nothing of the first 10 years anyway.

    Thanks for listening, I am probably too comfortable being vulnerable on the internet but I of course exercise discretion as to which places on the internet I do share. Whenever I hear someone say the internet can be a dangerous place, I cringe and say to myself the world is a dangerous place what makes you think the internet wouldn’t be either. At least I have more control as to where I go, and as I see it the internet is an amplifier and like any tool can be used for good or evil depending on the virtue of the wielder.

    Liked by 3 people

  4. Scott says:

    Just for full disclosure, the written part of this essay is basically “retelling” of the video, that Jack actually wrote. Not that I mind, it is painstaking work, but there are some things I might not have exactly said exactly that way. 🙂

    Boy you never know what content is going to actually get engaged and by whom. (And how deeply).

    Jeff Barnes and Joe2, thanks for interacting so thoughtfully.

    Jeff– I may have missed it, so for forgive me. But you mentioned “the single most important disorder there is” not mentioned in the DSM, and then did not actually give its name?

    Liked by 1 person

    • Jack says:

      @dsklajic,
      I think Jeff is referring to the trauma that warps the development of one’s personality. I agree that this an important aspect that is often overlooked or not dealt with sufficiently in counseling.

      Like

    • Jeff Barnes says:

      I mentioned it in the next sentence but no worries; it is complex post traumatic stress disorder (I think it is bad name, complex post traumatic stress injury would be better). Many personality disorder are created from repeated childhood trauma best explained by C-PTSD, which varies in significant ways from PTSD which does exist in the DSM.

      Thanks Scott for triggering my lengthy comment. It is not often that the topic of personality disorder comes up so I thought it would be an appropriate time to share some of my thoughts.

      Jack, I have not interacted with any counsellor or therapist in person and with the knowledge I now have I think it was for the best in many respects.

      Two more things that I think here particular helpful in my healing journey are music and eastern spirituality.

      Liked by 1 person

  5. Pingback: Fad Diets and Adjustment Disorders | Σ Frame

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s