Tuesday, July 18, 2017

Personality disorders, it's the truth that sets us free

For a good few years now I've been reflecting on what makes for a person to have a particular personality.

The medical community like to put various personality disorders into Clusters and this make sense. Various personality problems, such as abnormal levels of anxiety, can be found in Cluster C, for example.

It seems highly probably that if it's one thing, it could well also be another too. For example, there may be an anxiety issue or depression or a mood disorder but there may also be something else, like an excessive need for control, and this might be given another name.

If, for example, an individual was primarily concerned with himself or herself, or his or her needs, to the detriment of others, Narcissistic Personality Disorder is worth considering. It makes diagnosis tricky. It makes sense to be aware of co-morbidity.

In the first episode of Season 6 of Suits which I recently watched, Mike Ross, the man who has been working as a lawyer without actually attending law school, is being processed in jail. In the course of that processing he must fill out a psychological questionnaire. The person in the jail asking him to do this tells him that his answers suggest he is a narcissist. He goes on to make the improbable assertion that jail time will have him come out in two years time a better man, implying that they can 'fix' the trait.

It's not impossible. Awareness is key. Unless you can get a person to see into their own personality issues, then the exercise is a waste of time. But, if some awareness is gleaned, with very hard work and a willingness to co-operate advances can be made.

According to the professionals that work with people day in and day out, the prognosis is not encouraging, however. With every day that passes in a person's life acting, thinking and believing as they do, the behaviors are more set, like a glue that holds a tile to a wall.

I've pondered what happens to make a person so uncomfortable in life that they devise many variations on normal behavior and see it as the new normal. There seems no other explanation than that they did not receive the absolutely fundamental needs of a child.

Whilst most people would agree that personality disorders relate to damage in childhood, probably occurring when they did not receive adequate warmth and acceptance from their parents or caregivers, some people do not accept this as fact.

I read on a chat board for OCPD (Obsessive Compulsive Personality Disorder) that one mother disagreed vehemently that she was in any way to blame, since her child demonstrated a need for total order in her life well before three years of age. Some people who left comments felt that the mother's response, aggressive and dismissive, suggested some sort of personality problem that may have been transposed onto the child. I think there are genetic factors that are passed down from one generation to the other, but not necessarily biologically.

I'd like to pose a scenario. Perhaps a young man served in WW11. He never did manage to open up about his feelings relating to the carnage he witnessed. Back home and resettled in peace time, he becomes a father. He treats his son very severely, locking him away in a cupboard or in the chicken coop when he is naughty. To his mind, this sort of treatment isn't so bad, but to the little child whose world is his home and school, he has come to see that the world is a dangerous place. He develops an anxiety disorder.

As an adult the little boy's parenting style is better, but far from good. One part of his brain recognizes the damage caused to him but it is still difficult for him, with no good role model, to know what is good parenting. Perhaps spanking his children whenever anxiety overwhelms him doesn't seem so bad. He is not, after all, locking them in the chicken coop. He knows not to do that. But, still, spanking to his mind, is perfectly appropriate.

Perhaps his  small son one day dares to share his feelings about something that is on his mind, an observation, nothing more. Does the father have the capacity to see it for what it is, a little boy trying to understand his world, or does he take umbrage to the comment, a potential slight? If so, what is the message to the little boy? It is simple. It is dangerous to share feelings, even with one's own flesh and blood.

Not having been given the opportunity to attend college or university himself, for his father didn't agree to this, the father of the little boy now takes education very seriously. On the surface, this is a good thing. He wants for his little boy what he could not have himself, a noble and caring thought towards his child.

But, what if the little boy's anxiety that started at home in his earliest years makes it difficult for him to attend to school work? What if he doesn't bring home the grades the father wants? Is the father careful about his choice of words or does he tell the little boy that he will never amount to anything, causing the little boy much more anxiety? Now, the little boy questions his own abilities. Now, he becomes obsessed with good grades.

What if he punishes the little boy for small mistakes? Does the little boy see his father for what he is, damaged? Of course not. Children don't think like that. He tries especially hard to please this man who seems so terribly hard to please and in the course of these attempts he determines that he will check everything, order everything. He will go over every detail because in this way he may not be admonished. He may, one day, receive some praise. This is the way the world works, he determines. Control of everything is paramount.

His life, his father's life, his grandfather's life, all were precipitating factors for a condition he will carry with him to his grave, Obsessive Compulsive Personality Disorder.

No-one can sort this for he will never acknowledge it as a problem at all. Being obsessive and compulsive is his learned way of making it through this world. He certainly won't seek treatment for it. He won't ever know how his spouse and children suffered because of it.

What I like to think is that in time the condition will no longer be passed down to future generations. Although the world of psychology warns that the prognosis is bleak there is the power of knowing the truth and speaking the truth.

The little boy may never know or acknowledge the truth but the world wide web now a part of our modern life has given us all opportunities to know the truth and thus to speak the truth. Secrets wound, for generations. It's the truth that sets us free.

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