I CAN’T HELP IT if I’m afraid of everything!

PREVIOUS: Psych Disorders (#3)

POSTs: EGO States – summary

SITE: Re. PSYCH terms used as swear words

HUMOR: Hollywood PDs, as “Cars in the parking lot”

 

2. NEUROSES

3. PERSONALITY DISORDERS (PDs)
They are a group of 10 PMES mental/emotional illnesses, consisting of maladaptive internal experiencing (Es) thinking (Ts) & behavior (As) that deviate from norms & expectations of the person’s culture. These PDs make it very hard for the sufferers to accurately understand or relate to people & situations.

To put this category in perspective, it’s useful to place them in the hierarchy of mental states – from Highest to Lowest functioning:
1. Healthy —-> 2. Neurotics —-> 3. Personality Disordered (PD)—-> 4. Sociopaths/Psychopaths —-> 5. Psychotics (who are not at all in reality) 

PDs are pervasive & inflexible (unlike neuroses), have an onset in adolescence or early adulthood, are stable over time (consistent, persistent), & lead to emotional distress or impairment of ‘normal’ functioning.
— PDs are about 15% of the US population, 10% worldwide
— They are usually chronic, & difficult to treat
— A person can be diagnosed with more than one personality disorder, usually from the same cluster. (Skodol, 2005)
— Identifying the specific PD a person has (Axis I of the DSM) can help clinicians identify the risk of suicide & other psychological problems (any on Axis II), which often accompany PDs

●  All human traits range from
healthy & adaptive <—> to unhealthy & maladaptive.
PDs fall into the orange & red sectors, because their damage effects every part of a person’s life, usually as a result of an ongoing traumatic childhood. They tends to severely limit success in school, relationships, social encounters, work…. 

OVERVIEW – Main Symptoms of PDs
a. Distorted thinking patterns (CDs)
b. Over / under – regulated impulse control
• Odd / eccentric behavior patterns
• In some cases, periods of losing contact with reality (dissociations)
c. Interpersonal difficulties
• Avoiding other people, feeling empty & emotionally disconnected
• Trouble sustaining stable & close relationships, especially with partners, children & professional helpers

d. Problematic emotional responses
•  Overwhelmed by distress, anxiety, anger & worthlessness
• Difficulty managing uncomfortable/painful emotions, especially without self-harming – so may use cutting, being promiscuous, belligerent, withholding, abusing chemicals… in order to ‘cope’ – but rarely harm others physically. There are exceptions in some, such as torturing animals & bullying

CLUSTERS – CHART
Based on descriptive similarities, PDs are grouped into:
A – 3 “odd, eccentric” types: socially awkwardness & withdrawal (MORE….)

These PDs are dominated by distorted thinking, & in extremes they go:
— from eccentricity to fantasy
— from being lonely to schizoid hiding
— from distorted thinking to delusion, to paranoia
— from projective identification to projecting guilt on to others…..

Paranoid (2%) “The world is hostile so don’t trust anyone, & deal with people by being angry & attacking.”
Schizoid – “The world is scary so I withdraw from it (people), & don’t show any emotion or other needs/feelings”
Schizotypal – “The world is too scary, so I withdraw from it (people), & being a bit crazy, I don’t think clearly”

B – 4 “dramatic, emotional, erratic” types
UNDER- controlled: People in this cluster share the pattern of little or no  impulse control & have trouble emotionally regulating  themselves. This can include failure to plan ahead, or to consider the long-term consequences of their actions. At the extreme they can end up getting  into trouble (like breaking the law), & hurting others.

Antisocial (3%) “You can’t trust anyone & life’s unfair, so I take advantage of people & do whatever I like”
Borderline (1-2%) “Relationships & life are very unreliable, so I frantically do anything to keep people around”
Histrionic (2-3%) “I must be the center of attention, so I will be dramatic, flirtatious & highly emotional”
Narcissistic (1%) “I have always been told that I’m very important & the best, so I feel & act that way”

C – 3 “anxious, fearful” types  
OVER- controlled: This group shares a pattern of social inhibition, a deep sense of inadequacy, & hyper-sensitivity to other people’s negative opinions. They’re afraid to try new things lest they embarrass themselves, & get ridiculed or outright rejected. They hold back around others, so can come across as uptight & snobbish. They lack spontaneity, since every action must be considered for its potential to cause themselves emotional pain (MORE….)

Avoidant (1-10%) “Life is scary & rejecting, so I feel worthless & withdraw ”
Dependent (0.5%) “I am worthless & can’t cope with life, so I cling to others & do what they tell me”
Obsessive/compulsive (1-8%?) “Everything around me is chaotic, so I have to be in control of myself & everything in my life, by being orderly & a perfectionist”

Other PDs not in DSM IV
— Cyclothymic: Mood swings from Hi to Lo, with evenness in between – not as extreme as Manic-Depression
— Masochistic (self-defeating): A need to fail, deliberately putting obstacles in ones own way to induce frustration, grief, setbacks & suffering

— Passive-aggressive: See POSTS
— Sadistic: Deriving pleasure from harming or humiliating others, using aggressive, cruel, demeaning & manipulative behavior

NEXT: Personality Disorders (Part 4b)