Tuesday, July 3, 2012

Sandusky drawing Much-needed Attention to Personality Disorder...

(This post is continuing to evolve.  Please feel free to add comments and discussion...  Note that Dr. J (not a medical doctor, so see your medical doctor if needed)

One good arising out of the public horror at the Sandusky trial is attention to personality disorders (See, for example, http://thedailyreview.com/news/sandusky-evaluated-for-personality-disorder-1.1331252 (Accessed July 3, 2012).  In my opinion, there is a great need to do more research on personality disorder.  Many people are hurt by people with personality disorders.  These victims often get blamed instead of the abusers...Why didn't they see the, "red flags."  Only a small percentage of populations have personality disorders.  The set of personality disorders is difficult to diagnose and cures are not certain.  So, few researchers work in this tiny field.  Those that do may themselves be sucked into the drama of the person with "personality disorder.  They, too, in addition to other victims, are conned.  Yet, people with personality disorders are able to hurt streams of people as they gratify themselves.  Still, they often see themselves as perfect and not as having any mental illness.

One of the better-known personality disorders is, "narcissistic personality disorder (NPD)."  Let's take a look at "NPD.".

People with narcissistic personality disorder show, a "persistent pattern of grandiosity, hypersensitivity to the evaluation of others, and lack of empathy that begins early in adulthood and is present in a variety of contexts," and they exhibit a variety of symptoms:
  •        react to criticism with feelings or rage, shame or humiliation
  •        take advantage of others to achieve own goals
  •        have a grandiose sense of self-important
  •        hold a belief that his/her problems are unique and can only be understood       .      by other special people
  •       have a preoccupation with fantasies of unlimited success, power, beauty,   intelligence, or ideal love 
  •       have unreasonable expectations of especially favorable treatment
  •       require constant attention and admiration
  •       be unable to recognize and experience how others feel
  •       be preoccupied with feelings of envy

Yet, "The cause of Narcissistic Personality Disorder is unknown at this time," (Source: 

http://nyp.org/health/psychiatry-narciperso.html.   Accessed July 3, 2012). 

Let's look at that again, the, "cause of Narcissistic Personality Disorder is unknown at this time," (Source:  http://nyp.org/health/psychiatry-narciperso.html.   Accessed July 3, 2012).  Eek!  Doesn't that make you feel sorry for the victims and also for the perpetrators...  No help for them in sight.  A video about this disorder is found at http://evl.vcsd.k12.ny.us/safevideos/Video.aspx?id=FFgoGtt7wu4, and it states that people with this disorder often fail to go get help because they think they are so special and wonderful already.  In actuality, they tend to hurt a lot of people, have a hard time forming relationships, and, they also have a fragile sense of self (Source:  http://evl.vcsd.k12.ny.us/safevideos/ Video.aspx?id=FFgoGtt7wu4. Accessed 1 Oct 2012).

How about other personality disorders?  Consider, "...there are very few empirical data about histrionic character disorder but a vast literature on antisocial personality disorder,"  (Source:  Davison, Gerald, C. and John M. Neale, 2001.  Abnormal Psychology.  "Personality Disorders."  P. 359).   Sure, there are a few that work with people with personality disorders, like NPD, antisocial personality disorder, histrionic character disorder, or other personality disorders, but, not many.  Much of what has been available on the internet is either anecdotal evidence, people's own stories, or earlier studies, such as those of Karen Horney.  Although the terminology  and groupings of what is now called, "personality disorder," have changed since Karen Horney's book, I believe she truly understood the disorders and that her classic book on human growth is well worth reading.  You may have to read each page several times, but, there is a treasure trove of information on each page.

The state of the knowledge base on personality disorders (previously called, "character disorders") indicates a need for research that is not always linked to immediate profit.  It also indicates a need for health insurances to better handle mental disorders, for longer periods of time.  Would your insurance cover more than five sessions, for example, if you needed them?  Someone with Borderline Personality Disorder or Narcissism might not even reveal his or her problems during that time (Source:  Davison, Gerald, C. and John M. Neale, 2001.  Abnormal Psychology.  "Personality Disorders."   Pp. 357-379 ).   Can we find out if levels of divorce and crimes are related to personality disorders?  Can we prevent tragedies like Sandusky's and of the many victims who knew him if we study more of these disorders?

So what are other personality disorders and how do we go about studying them?  Do we see people with personality disorders in the technical literature?  Do we see them in the literature of language arts? 

How about other personality disorders?                

There are different categories or clusters of personality disorders:
  • Odd/Eccentric, 
  • Dramatic/Erratic, and,
  • Anxious/Fearful  (Source:  Davison, Gerald, C. and John M. Neale, 2001.  Abnormal Psychology.  "Personality Disorders."  Pp. 357-379).
Let us look briefly at each of these clusters in turn.  These are not complete lists, so, use them as starting points for further research into personality disorders.

  • Paranoid Personality Disorder
    • suspicious of others
    • unjustified doubts about trustworthiness of others
  • Schizoid Personality Disorder
    • do not appear to enjoy  nor desire relationships with others
    • experience few pleasurable activities
    • indifferent to praise, criticism and sentiments of others
    • appear aloof
    • are loners
  • Schizotypal Personality Disorder
    • may have odd beliefs or magical thinking
    • may believe they are clairvoyant or telepathic
    • may have unclear use of words
    • suspicious
    • may be paranoid
    • may have illusions
    • may occur with other personality disorders (narcissistic, avoidant, borderline, paranoid)
  • Borderline Personality Disorder
    • impulsivity and instability in relationships, mood, and self image
    • emotions are erratic and can shift abruptly
    • very hard to live with
    • unpredictable
    • cannot bear to be alone
    • have fears of abandonment
    • demand attention
    • undeveloped sense of self  
    • remain unclear about their values, loyalties, and choices
    • transient psychotic symptoms
    • may have relatives with schizophrenia or schizotypal personality disorder
    • likely to also have an  Axis I mood disorder
    • comorbidity with other personality disorders is likely (For example, with narcissism)
    • addictive (sex, or drugs,or alcohol, or other addictive behaviors) 
    • often depressed with feelings of emptiness 
    • living from one emotional disaster to the next
    • crave intimacy but repel it when they find it
    • perhaps had inconsistent love and attention during childhood or other adverse childhood experiences (parents may be high in neuroticism).
    • dysregulation and invalidation, diathesis for emotional dysregulation (child abuse (sexual and non-sexual), wants and feelings are discounted and disrespected.
    • fragile egos
    • frontal lobes do not metabolize glucose well (research shows increasing serotonin helps)
    • split their world into all good, all bad dichotomies failing to integrate positive and negative aspects 
    • has intolerable anxiety and fear
    • About 50% of people with this disorder can get well...They have to want to get well.
  • Histrionic Personality Disorder
    • overly dramatic and attention seeking
    • draw attention to themselves with clothes, make-up, or other external features
    • may be unable to give supporting details to back up ideas
    • emotionality and seductiveness may have been encouraged by parental seductiveness
    • parents may have thought sex was dirty yet to be desired and conveyed this to the child
    • exxagerated displays of emotion
    • need to be the center of attention
    • pre-occupation with sex
  • Narcissistic Personality Disorder
    • have a grandiose view of their own uniqueness and abilities
    • self-centered (an understatement)
    • expect others to do special favors for them without giving back a fair shake
    • have extreme reactions to criticism
    • lack of empathy
  • Antisocial Personality Disorder and Psychopathy
    • conduct disorder
    • continued antisocial behavior in childhood

  • Avoidance Personality Disorder

  • Dependent Personality Disorder

  • Obsessive-Compulsive Personality Disorder  

(Source:  Davison, Gerald, C. and John M. Neale, 2001.  Abnormal Psychology.  "Personality Disorders."  Pp. 357-379 ). 

Our way of dealing with life's challenges...  our style of relating to other people...  Fluctuations in personality  occur, however, when these patterns of personality are long-standing, pervasive, dysfunctional, and concerned with bolstering the ego, rather than being honest and deep patterns of interacting with others,  then, a personality disorder might be determined to exist (Source:  Davison, Gerald, C. and John M. Neale, 2001.  Abnormal Psychology.  "Personality Disorders."  P. 358).

Ability to diagnose personality disorders is improving as diagnostic criteria are refined and structured interviews are developed (P. 359).  Since people with personality disorders are often experts at lying and conning people, including therapists and counselors and doctors, friends and family, they are hard to diagnose in the time frames allowed by courts and by insurance companies.  Many slip through the cracks and go on to hurt more and more people.  Symptoms of some personality disorders are not stable over time.  For example,  person with borderline personality disorder adapts his cunning nature as situations change (Pp. 359 and 362).

Here are links some with borderline personality disordered individuals in their lives, either self or other loved ones,  might find beneficial:  

Personality Disorders and Literature

In literature, characters may share traits with individuals with personality disorders. Shallowness, failure to bond, lying often, betrayal, trail of victims...  Here are some examples with links to the books.

Narcissus (Νάρκισσος)  ...  Greek Myth

Sources:  http://www.flickr.com/photos/bramapp/131945049/.  Accessed July 3, 2012;
Source:  http://en.wikipedia.
.  Accessed July 3, 2012 

Narcisism is found in many examples in the literature.  Here are some examples modified from http://en.wikipedia.org/wiki/Narcissus_ (mythology)#Narcissus_in_literature, Accessed July 3, 2012).  If you go to that site, you can also find references to examples from film and music.  (Note:  In addition, advertisements to these books, and other related works, are included, purchases from which support the development and continuation of this blog on science literacy.  Using the overlap of science and literature can  increase the love of science among more people.)

  • Novel by Oscar WildeThe Picture of Dorian Gray   is the classic "selling of the soul" story, but, remind students that originally the mental illnesses were often understood from a religious context as there was not the science known to understand them otherwise.  As knowledge is revealed, we understand more, thus the change of name of the disorder from , "character," to , "personality," disorder.
  • Paulo Coelho's The Alchemist starts with a story about Narcissus.   The Alchemist
  • Rainer Maria Rilke visits the character and symbolism of Narcissus in several of his poems.
  • Seamus Heaney references Narcissus in his poem "Personal Helicon"in "Death of a Naturalist":
  • Harry Potter character Narcissa Malfoy, the mother of Draco Malfoy, was named after Narcissus, and was described as being incredibly vain and arrogant.
  • William Faulkner's character "Narcissa" in "Sanctuary (novel)", sister of Horace Benbow, was also named after Narcissus. 
  • Hermann Hesse's character "Narcissus" in "Narcissus and Goldmund" shares several of mythical narcissus' traits, based on his intellect rather than  physical beauty.
  • A. E. Housman refers to the 'Greek Lad', Narcissus, in his poem Look not in my Eyes from
  • A Shropshire Lad "...variety of daffodil, Narcissus Jonquilla, which like Narcissus looks sadly down into the water"   
Source:  http://en.wikipedia.org/wiki/Narcissus_(mythology)#Narcissus_in_literature, Accessed 3 July 2012.  

Another book is The Mask of Sanity by Cleckley which has featured a person with psychopathy (Source:  Davison, Gerald, C. and John M. Neale, 2001.  Abnormal Psychology.  "Personality Disorders."  P. 366).

Another resource on narcissism is by Alice Miller: The Drama of the Gifted Child: The Search for the True Self.  "This book could also have been named The Trauma of the Gifted Child. This sort of home environment often produces people with Borderline Personality Disorder."  Source: http://bachdevelopment.com/bach22.html, Accessed 14 Sept 2012.  

Karen Horney mentions additional examples in literature of other character disorders which we now classify as personality disorders, removing the religious concept of selling one's soul to the devil, from the name of the disorders where, often, the people with these disorders lie, even to themselves, and without full consciousness.


Personality Disorders in the 
Technical Literature

Let's look now for the technical literature on personality disorders.  Here are some names and dates to get you started:
  • Kohut 1971; 1977
  • Gunderson, Golb, and Austin 1981
  • Herman et al. 1989
  • Modell 1984 “survivor guilt”
  • Beck and Freeman 1990
  • Millon and Davis 1996
  • Jellema 2000
  • Akhtar and Thomson 1982
  • Hollander et al. 1993
  • Dimaggio et al.  2002
  • Kernberg 1975
  • Key et al. 1968
  • Ross et al. 1998
  • Spitzer, Endicott and Gibbon 1979
  • Wagner, Linehan, & Wassan 1989
  • Zarnarini et al.  1998
Giancarlo Dimaggio has advanced the studies on personality disorder.  He has many journal articles and books.  Here are some of his books:
Here are some abnormal psychology books including Davison, Gerald, C. and John M. Neale, 2001.  Abnormal Psychology.  "Personality Disorders," referenced above :

Link on Reddit is http://redd.it/117uo5

(c)2012  J S. Shipman .  All rights reserved.  All blog posts on this blog are copyrighted.
This post is dedicated to mcbmbrebjbgb and to any individuals with personality disorder(s).


1 comment:

"2" said...

Here's a link to check out on another terminology for these disorders: