I can appreciate the not wanting to know. I'm like this about the 23 and Me test. But for me the analogy isn't the same.

With this, given what we now see about how the DSM works behind the curtain, my view is that it's little demystifying of DSM definitions. The labels themselves don't hold that kind of power to me knowing no one intended for their use to be all-encompassing, and more still at the picture of several old academics complaining over it. Certainly not so much power that I would never want to know the therapy.

The therapy for what they're calling "disorder" does appeal to me. Because the therapy still matters. That's what's useful. I don't need to believe labels are all encompassing to want to know more about how to treat coping mechanisms that aren't helpful. I just don't call it a personality disorder.

I agree with the aforementioned authors. It's not a "disorder," it's a unique set of coping mechanisms we happen to be using at the moment. And of course I'd want to alter them if they make me or someone else feel crappy.


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As should surprise no one, I'm not a psychiatrist, psychologist, therapist, counselor, or psych-industry professional of any kind, and am probably not even as informed on most "disorders" as the average self-styled expert, or armchair psychiatrist. It's a fun little detail that bears mentioning if for no other reason than as a disclaimer. I only speak for myself.

I just wanted to go on the record to address something that has been bothering me recently on the issue of DSM classifications, particularly as they relate to personality "disorders" within the communities of those who are diagnosed or waiting to be.

Classifications and diagnoses have their place. They're great for guiding medical professionals to an established treatment protocol. They can also be empowering to people looking for answers. Treatment protocols, however evolving, are fine tuned through years of trial and error for showing overall benefit for a handful of traits or features. However, as these labels relate to you and me in any absolute, all-encompassing sense, they fail, and are at least as oversimplifying as the Myers-Briggs types (studies have shown situational variation and overlap between "types" that limits the instructive power of Myers-Briggs). Their power to encapsulate people with a single label is reliably hampered, because that isn't their purpose.

In my trips between several forums, social networks, and message boards, I've been helplessly colliding with a lot of people who are either desperate to hear someone else tell them who they are, or are already unnecessarily carrying the weight of their particular label like it was a dead elephant. I don't say this to be deliberately provocative, and I realize many people are understandably relieved to put a name to their neurochemical imbalances, psychological habits, or routine coping mechanisms, but it's important to keep in view that these names are for those mechanisms, not you as a person.

My therapist calls this "pathologizing yourself," and he warned against it. "There's no good reason to make yourself feel trapped by a word," he would say. Initially I rejected this warning, dismissing it an empty suggestion meant to soften the blow of confronting this new reality of a category I had just been assigned. But as I started reading several self-help books, specifically on ego defenses and personality "disorders" written by industry PhDs, PsyDs and psychiatrists, I began to recognize a common denominator in almost all of their reference to labels. Many of these professionals furrow their brow at the term "personality disorder." The problem is that defining yourself by the limited clinical descriptions of a handful of traits is both unethical to yourself, and grossly inaccurate. Not only can this mistake compound matters, bringing undue anxiety and depression, it can can actually negatively influence your behavior.

Among the books I've read are Why Do I Do That?: Psychological Defense Mechanisms and the Hidden Ways They Shape Our Lives by Joseph Burgo Ph.D. Burgo refers to "disorders" in quotes (as I now do), explaining that everyone uses defense mechanisms, including himself, and with people who use "disordered" coping, they're frequently motivated by the same reasons as everyone else, but just in ways that can be more destructive than others, or sometimes to more extreme degrees. Early traumas can force certain coping strategies where healthier responses weren't an option. But this idea that they're "disordered" people doesn't often scale with the evidence. Most of the people diagnosed with these classifications are treatable, including those with physiological abnormalities. Other books such as the classic, A Guide to Rational Living, and How To Stubbornly Refuse To Make Yourself Miserable About Anything-yes, Anything by Albert Ellis Ph.D describe how damaging it is for people to assume the identity and narrative of clinical labels. He explains one of the first steps in conquering bad coping mechanisms is to stop saying "I have [random "disorder"]" and instead, more accurately say "I use [random disorder's coping mechanisms]."

You might be tempted to say, "well it's all fine and good that you have this opinion, but you're not a professional, and those are just a few books. What about the people who actually write the DSM's diagnostic definitions?" It's a valid question. It's true I'm not a professional, but as I mentioned, every therapist I've encountered recognizes the limitations of labels. Maybe the DSM themselves can shed some light on this confusion. In a NYTimes article written in 2012 (Thinking Clearly About Personality Disorders), a team of experts appointed by the psychiatric association, looking to revise and update the DSM's diagnostic system for personality "disorders" concluded the following:

"The most central, memorable, and knowable element of any person — personality — still defies any consensus.

Some experts argued that throwing out existing definitions was premature and reckless. Others insisted that the diagnoses could not be simplified so much. And some complained that the effort to anchor the disorders in traits had not gone far enough.

"You simply don’t have adequate coverage of personality disorders with just a few traits,” said Thomas Widiger, a professor of psychology at the University of Kentucky.

Dr. Widiger compares the process of reaching a consensus on personality to the parable of the six blind men from Hindustan, each touching different parts of the elephant. “Everyone’s working independently, and each has their perspective, their own theory,” he said. “It’s a mess.”

“It’s embarrassing to see where we’re at. We’ve been caught up in digression after digression, and nobody can agree,” Dr. Millon said. “It’s time to go back to the beginning, to Darwin, and build a logical structure based on universal principles of evolution."

Not exactly the holy grail of cohesion many hold the DSM up as. They couldn't agree with each other, and were often confused by the high degree of overlap with other "disorders."

I'm not saying there isn't utility in having a direction to look for in treatment of certain types of coping mechanisms, emotional instability, disordered thinking, ego defenses, or whatever else, but just do yourself a favor and make sure you aren't blindly consigning yourself over to a paragraph that a bunch of people continue to argue over. Who needs the undue stress? Not this guy. We're all people, not disorders. We may currently be using some clunky coping mechanisms at the moment, but that's it. Put down the stigma bag. That's for the uninformed.