[Shadowsinsideme]

hi -

my name is becka. Im 18. I usually post on the schizophrenia boards because i have been diagnosed with paranoid schiz (though at one time i wondered if i had Schizotypal personality disorder)

anyway, i've never really been able to understand why they are called personality disorders. Maybe i just dont know enough about it all. When someone says "you have a personality disorder" it's like they are saying there is something wrong with you as a person,or your charactor. I read in a book called "surviving schizophrenia" that schizotypal PD use to be called borderline schizophrenia. That seems to make more sense. Schizotypal seems much more like a milder form of schizophrenia than a personality disorder. I read that In the UK, schizotypal is simply called "schizotypal disorder" it is not classified as a personality disorder, but as a schizophrenic disorder.

A lot of these personality disorders--from what i've read of them-- seem more like they should be classified as mild psychotic disorders.

...any thoughts on this? Anyone know why are they called personality disorders and not some other kind of disorder?

thanks

-Becka

[Overcastbutclearing]

I found this online. Hope it helps a little.

What Is A Personality Disorder?
A personality disorder is identified by a pervasive pattern of experience and behavior that is abnormal with respect to any of the following two: thinking, mood, personal relations, and the control of impulses.

The character of a person is shown through his or her personality - by the way an individual thinks, feels, and behaves. When the behavior is inflexible, maladaptive, and antisocial, then that individual is diagnosed with a personality disorder.

Most personality disorders begin as problems in personal development and character which peak during adolescence and then are defined as personality disorders.

Personality disorders are not illnesses in a strict sense as they do not disrupt emotional, intellectual, or perceptual functioning. However, those with personality disorders suffer a life that is not positive, proactive, or fulfilling. Not surprisingly, personality disorders are also associated with failures to reach potential.

The DSM-IV: Diagnositc and Statistical Manual of Mental Disorders (American Psychiatric Association) defines a personality disorder as an enduring pattern of inner experience and behavior that deviates markedly from the expectation of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.

Currently, there are 10 distinct personality disorders identified in the DSM-IV:

Antisocial Personality Disorder: Lack of regard for the moral or legal standards in the local culture, marked inability to get along with others or abide by societal rules. Sometimes called psychopaths or sociopaths.
Avoidant Personality Disorder: Marked social inhibition, feelings of inadequacy, and extremely sensitive to criticism.
Borderline Personality Disorder: Lack of one's own identity, with rapid changes in mood, intense unstable interpersonal relationships, marked impulsively, instability in affect and in self image.
Dependent Personality Disorder: Extreme need of other people, to a point where the person is unable to make any decisions or take an independent stand on his or her own. Fear of separation and submissive behavior. Marked lack of decisiveness and self-confidence.
Histrionic Personality Disorder: Exaggerated and often inappropriate displays of emotional reactions, approaching theatricality, in everyday behavior. Sudden and rapidly shifting emotion expressions.
Narcissistic Personality Disorder: Behavior or a fantasy of grandiosity, a lack of empathy, a need to be admired by others, an inability to see the viewpoints of others, and hypersensitive to the opinions of others.
Obsessive-Compulsive Personality Disorder: Characterized by perfectionism and inflexibility; preoccupation with uncontrollable patterns of thought and action.
Paranoid Personality Disorder: Marked distrust of others, including the belief, without reason, that others are exploiting, harming, or trying to deceive him or her; lack of trust; belief of others' betrayal; belief in hidden meanings; unforgiving and grudge holding.
Schizoid Personality Disorder: Primarily characterized by a very limited range of emotion, both in expression of and experiencing; indifferent to social relationships.
Schizotypal Personality Disorder: Peculiarities of thinking, odd beliefs, and eccentricities of appearance, behavior, interpersonal style, and thought (e.g., belief in psychic phenomena and having magical powers).
According to Dr. Sam Vaknin, author of Malignant Self-Love: Narcissism Revisited, individuals with personality disorders have many things in common:

Self-centeredness that manifests itself through a me-first, self-preoccupied attitude Lack of individual accountability that results in a victim mentality and blaming others, society and the universe for their problems
Lack of perspective-taking and empathy
Manipulative and exploitative behavior
Unhappiness, suffering from depression and other mood and anxiety disorders
Vulnerability to other mental disorders, such as obsessive-compulsive tendencies and panic attacks
Distorted or superficial understanding of self and others' perceptions, being unable to see his or her objectionable, unacceptable, disagreeable, or self-destructive behaviors or the issues that may have contributed to the personality disorder
Socially maladaptive, changing the rules of the game, introducing new variables, or otherwise influencing the external world to conform to their own needs
No hallucinations, delusions or thought disorders (except for the brief psychotic episodes of Borderline Personality Disorder)
Vaknin does not propose a unified theory of psychopathology as there is still much to learn about the workings of the world and our place in it. Each personality disorder shows its own unique manifestations through a story or narrative, but we do not have enough information or verifying capability to determine whether they spring from a common psychodynamic source.

It is important to note that some people diagnosed with borderline, antisocial, schizoid, and obsessive-compulsive personality disorders may be suffering from an underlying biological disturbance (anatomical, electrical, or neurochemical). A strong genetic link has been found in antisocial and borderline personality disorders.

Treatment of Personality Disorders
Dr. David B. Adams of Atlanta Medical Psychology says that therapists have the most difficulties with those suffering from personality disorders. They are difficult to please, block effective communication, avoid development of a trusting relationship, [and] cannot be relied upon for accurate history regarding problems or how problems arose (The Psychological Letter, February 2000).

According to the Surgeon General, mental disorders are treatable. An armamentarium of efficacious treatments is available to ameliorate symptoms... Most treatments fall under two general categories, psychosocial and pharmacological. Moreover, the combination of the two—known as multimodal therapy—can sometimes be even more effective than each individually.

By reading the DSM-IV's definition of personality disorders, it seems that these conditions are not treatable. However, when individuals choose to be in control of their lives and are committed to changing their lives, healing is possible. Therapy and medications can help, but it is the individual's decision to take accountability for his or her own life that makes the difference.

To heal, individuals must first have the desire to change in order to break through that enduring pattern of a personality disorder. Individuals need to want to gain insight into and face their inner experience and behavior. (These issues may concern severe or repeated trauma during childhood, such as abuse.)

This involves changing their thinking - about themselves, their relationships, and the world. This also involves changing their behavior, for that which is not acted upon is not learned.

Then, with a support system (e.g., therapy, self-help groups, friends, family, medication), they can free themselves from their imprisoned life.

[sherrih]

Originally Posted by Shadowsinsideme

hi -

my name is becka. Im 18. I usually post on the schizophrenia boards because i have been diagnosed with paranoid schiz (though at one time i wondered if i had Schizotypal personality disorder)

anyway, i've never really been able to understand why they are called personality disorders. Maybe i just dont know enough about it all. When someone says "you have a personality disorder" it's like they are saying there is something wrong with you as a person,or your charactor. I read in a book called "surviving schizophrenia" that schizotypal PD use to be called borderline schizophrenia. That seems to make more sense. Schizotypal seems much more like a milder form of schizophrenia than a personality disorder. I read that In the UK, schizotypal is simply called "schizotypal disorder" it is not classified as a personality disorder, but as a schizophrenic disorder.

A lot of these personality disorders--from what i've read of them-- seem more like they should be classified as mild psychotic disorders.

...any thoughts on this? Anyone know why are they called personality disorders and not some other kind of disorder?

thanks

-Becka

Becka you sound very nice! you shoud right a book!

[deliquesce]

thanks for posting that info, overcast. that was quite an eye opener for me.

[pachyderm]

I too react as though characterizing something as a personality disorder seems to imply blame or judgement of something as being an inherent character fault. But even if that is what the prescribers really mean, that doesn't mean you have to accept their judgement. That may be their problem!

[Sannah]

I think of it as a development issue. During development the person developed in a way that causes a lot of trouble for them (Our development is affected by our environment - the behavior of those around us and how we interact with it). I don't think that our development is written in stone and feel that anyone can find the problem and fix it with a little more development of the area.......

[ECHOES]

Yes I agree with Sannah. I see it as the result of development that is disrupted or incomplete. When we don't get what we needed *when* we needed it, it affects our personality and shows up in our perceptions, our internal experiences, and especially our relationships (from avoiding them to troubled ones).

In therapy, my therapist and I talk about things I experience now and follow the possible trail to unmet needs during developmental years. It's very interesting to explore and helpful too.

[kim_johnson]

Hey. Personality disorders are coded as Axis Two rather than Axis One conditions. Axis One is for mental disorders like schizophrenia, bipolar, depression etc and Axis One disorders are thought to be more episodic in form and more organic. Axis Two disorders are thought to be more pervasive (only other thing on Axis Two is mental retardation) and non-episodic.

It isn't meant to imply anything about ones character or even ones personality (in the ordinary everyday understanding of personality). Just meant to capture the pervasive non-episodic nature of the disturbance.

The history of borderline personality disorder is interesting. It was found that the relatives of people with schizophrenia who themselves didn't have schizophrenia seemed to have a cluster of personality symptoms that were regarded as schizotypal. Subsequent developments... Hysteria, hysteriod, narcissistic, borderline... These things came to be carved up in different ways.

The origins of borderline personality disorder (the name anyway) was that individuals were thought to have a condition that was 'borderline' or intermediate between psychosis and neurosis where psychosis was thought to be a severe disturbance (characterized by loss of reality testing and delusions and / or hallucinations) and neurosis was thought to be the more ordinary anxieties depressions and phobias that are more common where people have less functional impairment in their occupation in particular.

The distinction between psychosis and neurosis and the conceptualization of borderline personality disorder as being a mid-way condition has fallen out of favor. The main current conceptualization of borderline personality is that labile (unstable) affect / emotion is basically the characterizing feature. Inability to regulate affect, basically.

The schizotypal personality constellation is thought to be more 'odd' and socially aloof than the 'dramatic' borderline constellation...

That being said the current dx system isn't terribly good... And we don't have anything approximating actual divisions in nature captured at present...

[Sannah]

Originally Posted by ECHOES

In therapy, my therapist and I talk about things I experience now and follow the possible trail to unmet needs during developmental years. It's very interesting to explore and helpful too.

Yes! This is how I got better!

[reader1587]

Originally Posted by kim_johnson

Hey. Personality disorders are coded as Axis Two rather than Axis One conditions. Axis One is for mental disorders like schizophrenia, bipolar, depression etc and Axis One disorders are thought to be more episodic in form and more organic. Axis Two disorders are thought to be more pervasive (only other thing on Axis Two is mental retardation) and non-episodic.

It isn't meant to imply anything about ones character or even ones personality (in the ordinary everyday understanding of personality). Just meant to capture the pervasive non-episodic nature of the disturbance.[snipped]

Then why on earth do they use the word "personality"? That was the OP's question, as I understood it. (I'm not trying to come down on you personally it's just that so much of psychological jargon seems so senseless [but their real-world repercussions are all too real].)

Something like a "chronic adjustment disorder", for example, would make more sense to me in indicating something's pervasive quality, rather than "personality".

[Rapunzel]

I think what they are saying is that the patterns are so pervasive that it becomes part of the individual's personality. But I think most agree that personality disorders are mostly related to unmet needs or developmental milestones in childhood. And it would make sense that going back and filling in those holes would be the way to get better.

Ironically, "adjustment disorder" refers to temporary symptoms related to something goin gon currently in the environment. Anything more than six months and it becomes another disorder, not adjustment disorder. Insurance companies usually won't cover adjustment disorders because they assume that they are short-duration and not serious enough to necessarily require treatment. Insurance companies usually won't cover personality disorders because they are considered long-term and too difficult to treat effectively.

[apumic]

It's also worth noting that PDs tend to be pervasive in that they both effect every part of a person's life AND most people suffering from a PD tend not to recognize the problem itself; that is, they may instead see everyone else's perspective as the odd one. A quality that seems to appear in each PD over and over again is a difference in perception. This difference in perception is so pervasive that it is often extremely difficult for the person with a PD to understand that others see the world differently. This makes PDs extremely difficult to treat as the symptoms are mostly felt by other people who interact with the IP!

[Beth1957]

My psychiatrist's take on it is that personality disorder is as good a name for them as any, because everyone has aspects of all of the "morbid" symptoms as part of his/her personality, and can at times display them. He says that it is only when a few of the unhealthy traits come to dominate a person's life & thought patterns, and affect his or her interactions with external reality, that it becomes a "disorder".
Having said that, the lovely man doedn't think labels are particularly important or helpful, other than as a kind of shorthand for a set of symptoms. Bless him

[GrayNess]

I've wondered about why they're called "personality disorders" also but one of the possible reasons I can think of is they've been with you for such a long time and are integrated into you, much like one's personality is integrated. Also, the treatment can involve medications but would also focus on changing how one views things, interacts, etc..., which is similar if not the same as one's personality. As for why it's considered a disorder, I can find multiple reasons. One of them could be society's view on it in that it's inappropriate or violates norms. Another possible reason would be that it's a statistical inconsistency in terms of although many people may have that condition/disorder, it's still an infrequent disorder. Because it's infrequent, and it has maladaptive symptoms or whatnot, put two and two together and we get a "personality disorder". That's my summarized view but there probably is more to the story than just this.