We talked a little about the personality disorders with particular emphsasis on the problems of the people in Group B, the wild ones, narcissists, histrionics, borderline, sociopaths.
So one of the commenters who has some experience, admonished me for not mentioning Dialectical Behavior Therapy. I never had heard of it. Glad she mentioned it.
I would have said, any counseling that helps he personality disorder mature in social skills and awareness is on the right track, but the Dialectic Behavior Therapy actually looks pretty intelligent and useful.
Good stuff. The Dialectic has other meanings in philosphy of history, as promoted by Hagel. I like the methods described by the proponents of the Diatlectic counseling therapy for personality disorders, it’s kind of like intense parenting.
http://psychcentral.com/lib/an-overview-of-dialectical-behavior-therapy/0001096?all=1
For many therapists the difference between a personality and a “personality disorder” is which label gets money out of an insurance company. The important difference we need to know, for safety reasons, is whether people are taking drugs known to cause suicidal behavior in a minority of patients (Tegretol) or murderous behavior in a minority of patients (Prozac and its many chemical “clones”).
Mike, me and my lovely wife hope you are right.
Narcissists tend to seek political office so we end up with far too many. Unfortunately this particular narcissist is well positioned to do lots of damage to our country. It is my hope that 2014 is a good year for conservative politicians seeking elected office.
thanks for your insightful comments.
I too am convinced that we have a narcissistic and extraordinarily mediocre man in the white house. the product of not only a disfunctional family situation, but more.
he was mentored by a sociopathic bisexual pornographer communist named Frank Marshall Davis, and enabled by many who allowed him to slide by on an affirmative action agenda.
Jack Cashill has reviewed and critiqued his writings and finds him an illiterate, unable to even do the basics like make the subject agree with th predicate. I would also comment that, for a man who claims a Columbia and Harvard law education, where is the writing and the erudition.
there is none.
personality disorders allow for an extraordinary attitude about one’s accomplishments and achievements. I would say that Obama is emblematic of how personality disorders are dominant in political life.
Consider the many narcissists that have graced the political stage.
Agreed that we have a major problem in our society. In a representative democracy, our elected officials are a reflection of the voters that elected them. Obama has Narcissistic Personality Disorder, though not officially diagnosed and released in his public presidential medical record.
Dr. Sam Vaknin is an expert on Narcissistic Personality Disorder and he was one of the first to flag Obama as a malignant psychopathic narcissist.
Dr Ablow, a psychiatrist that contributes to FoxNews is concerned that we’re raising a generation of deluded narcissists:
http://www.foxnews.com/opinion/2013/01/08/are-raising-generation-deluded-narcissists/
Whenever a problem produces multiple responses, no doubt that is due to the frustration that people have trying to make a difference.
GET THIS–I THINK THAT PERSONALITY DISORDERS ARE A MAJOR CONCERN FOR THIS SOCIETY–WE HAVE A PRESIDENT WHO HAS A PERSONALITY DISORDER.
Now that’s something to consider.
A good list of emerging treatment options for personality disorders can be found here: http://bpdresourcecenter.org/treatmentOptions.html
They include the following:
Transference-Focused Psychotherapy
Dialectical Behavior Therapy (DBT)
STEPPS
Schema-Focused Therapy
Supportive Psychotherapy
Dialectical Deconstructive Therapy (DDT)
Mentalization-Based Therapy (MBT)
My experience with a few of those has been positive, however the skill and empathy of the therapist is key to maintaining the delicate balance required to maintain the relationship with the patient while still challenging the patient to work and grow. Also very important is whether the therapist is taking steps to maintain their own energy reserves during their work with these challenging patients, and if they are doing their peer reviews (where they change to the patient role with a senior therapist to help them with their own baggage that’s triggered during conflict with a challenging patient).
One way to think of it is like de-programming of a cult member. They may always struggle, but some can overcome and thrive.
Keep in mind that some children just don’t “drink the kool-aid” that the borderline mother is feeding them. Those children don’t have the words for it but sense that something isn’t right with mom. Those children are very recoverable, particularly with early intervention. Children’s minds are evolving and adapting throughout their development into adults so there’s hope for them if exposure to the borderline parent is controlled and appropriate therapy happens.
There is also hope for the child if the enabler parent turns things around. Sometimes we were naive in our first marriage and we learn and get things right when we pick a good woman in our second marriage. With that comes a new family system and a new opportunity to help the children to learn a new way of living. The child in that case is often drawn to the genuine caring of the new mother figure in your home, as she fulfills something they have been missing their whole life: a caring mother that respects them as person instead of an object to be used.
I’ve dedicated the last decade of my life to correcting my errors through improving boundaries, studying parenting and psychology, working closely with the treatment providers, and advocating for the children in court when needed. Unfortunately mental health providers have told me it’s rare for a parent to do that. Hopefully all of the hard work has helped to create an environment for some recovery in the children. You can lead a horse to water but you can’t make them drink. Sometimes though an IV solves that problem when a life depends on it.
When a borderline self injures and shows up at the ER, you’ll patch them up and send them home and they’ll be back. Medication doesn’t help them and in fact may de-inhibit them, resulting in escalated destructive behavior. Hopefully the social worker or MD involved in the case can talk privately with the spouse of the patient and guide that person towards some resources. Books on BPD, professionals with experience with BPD, even a support group like AlAnon family groups can be helpful. AlAnon reinforces the messages of self care and boundaries, which a spouse very much needs. In my case, the only message I got at the ER was from one wise old social worker that pulled me aside and told me that I was in for a long, hard road ahead.
Sometimes you’ll see child patients in the ER with a borderline parent. Munchausen by proxy is closely related to those with personality disorders. They can be persuasive in advocating for giving their children powerful medications, questionable treatments, and claim all kinds of symptoms that don’t present with the child in front of the doctor. The book “Sickened” does a great job describing the dynamics from the child’s point of view.
Thank you for teaching the younger doctors to have good boundaries. In fact, one of the nurses, LVN’s, MA’s, or EMT’s that they work with may be the one with the personality disorder. That profession seems to attract it’s fair share of personality disordered individuals. I believe that’s because the job creates a facade of the person being someone caring when in fact the opposite is true. Keep an eye out for those staff that you hear complaints about yet you see them as an excellent staff member. Often times they perfect around authority and are covertly cruel.
I just have an interest in personality disorders because they burn all their bridges in the main stream medical community, so they end up being emergency department patients and very burdensome–they work over young providers who are well meaning, so they are easy victims for the manipulative. I have to warn them–set the boundaries, don’t let them get your goat.
Helps them survive the most difficult patients they have to deal with–not the sick ones, which are a joy for a well trained physician, the persoality disorders suck the life out of you.
In families they do the same thing and they do, as you point out, leave behind children who will never be right. always troubled.
Your thing about the child of an unpredictable volatile parent is right, and remember, the spouse of a personality disorder is either gone or a punching bag too. No hope for the child, who’s stuck.
Clarification on this statement:
“The child will present as very hurt, sorry, and emotionally destroyed when something doesn’t go their way.”
The child presents this way so that the borderline parent won’t consequence them or will reduce the consequence. Keep in mind that that the borderline parent’s version of consequences are sometimes abusive. Also the borderline parent’s ongoing emotional/psychological consequences that the child receives has developed a hair trigger fear in him/her.
The child’s natural response after years of fear is to try to minimize the impending doom in some way. This behavior pattern becomes ingrained and used by the child in all situations where they fear consequences.
The survival strategies used by the child of a borderline in their earlier years of life are appropriate given their circumstances. As they become older and have relationships outside of the family of origin, these survival strategies don’t match the situation and are inappropriate. The problem is that the patterns are already set.
The child of a borderline has to develop self awareness for these patterns, flag them when they are active, and replace them with more appropriate strategies. That’s no small feat but it is possible, if the child has a desire to overcome.
One of my son’s grew up as the weak, helpless, and ill child in order to get his needs met. After entering puberty I put him into martial arts and he grew the desire to overcome feeling weak and scared. After many years of martial arts, weekly appointments with the right psychologist, and a home environment with appropriate boundaries, expectations, and loving support, he’s finding his way out of Borderland. His older brothers, not so much, but for him, he’s overcoming. There is hope, particularly if you start treatment at a younger age.
You wrote the post that kicked off my barfing out all of my thoughts on the topic. Thank you for that. 🙂
Wow. Wish I said that.
In my opinion, personality disorders are passed multi-generationally through dysfunctional and abusive relationships between parent and child.
Here are some examples of the issues between parent and child:
– overly enmeshed relationship (inappropriate boundaries)
– overly expectant of the child to fulfill the parent’s emotional void
– push/pull because of the parent’s blacking and white thinking (idealizing and vilifying)
– physically, emotionally, and/or sexually abusing the child during punishments due to the vilifying mindset (potty training gone wrong and using enemas as a punishment)
– neglectful while the parent is using an addiction to numb their unbearable emotions (mom passed out on the couch after taking her Xanax or narcotics)
– neglectful while the parent is focused on someone/something else (a borderline parent can only focus on one object at a time)
– overly protective as the parent projects her fears on to the child (you can’t go outside to play with the other kids because you’ll get hurt)
– Punishing the child for not conforming to the borderline parent’s distorted view of the world
– The parent watching for emotional reactions out of the child that shows what the child cares about and makes them most vulnerable. The borderline parent then takes that knowledge and exploits it for her own goals. This teaches the child to hide his or her true self. Often you’ll see the child’s face become a blank mask when his/her fear is triggered. This is a self protective response to past emotional attacks.
– The group relationship patterns are pretty similar to how a cult leader controls his/her group. The children are played against each other to keep them divided.
All of this together is emotionally and psychologically abusive towards the child. There’s a long list of warning signs and indicators in children in this situation so I won’t go into that. The same things that suggest abuse apply here.
In the end, the only thing consistent in the parenting style is the inconsistency. This leaves the child in a high state of uncertainty, hyper vigilence, hair trigger fear response. PTSD basically. Over time, the child tries to find some way to survive the persistent fear and develops inappropriate coping strategies.
In an effort to get his/her basic needs met, he/she will develop maladaptive patterns of behavior. Those may present in a number of ways:
– The child will present as weak, helpless, or illness to try to bring out caring from the borderline parent.
– The child will present as very hurt, sorry, and emotionally destroyed when something doesn’t go their way. This encourages a caring person (teacher, other parent, grandparent, etc) to minimize the consequences of their actions. Because of this, they tend to not learn the lesson of cause and effect.
– The child will go to great lengths to please the borderline parent, basically existing to serve the parent, hoping that by being exactly what mother wishes will lead to mother caring for the child
– The child will avoid things that trigger a feeling of fear, shame, guilt, sadness,or anger as these feelings either lead to an attack from mother or a storm of overwhelming emotions. This presents as a child that never speaks of negative emotions and never shows anger. They are left living a life devoid of the full spectrum of emotions.
– After hitting puberty, the child often transitions into some type of addictive behavior pattern in an effort to numb the overwhelming anxiety. This can manifest in drugs, alcohol, sex, obsession with porn, obsession with video games, self injury, etc. Breaking addictive patterns in children is very difficult.
You may ask where the other parent (father) is, in this situation. Typically the father is an enabler of the borderline mother. This is often due to insecurity on the part of the father. The borderline mother will tend to attack that insecurity of he speaks up. The father has to learn to have strong, clear boundaries and consistently reinforce them. This is challenging as typically he will have PTSD from living with the borderline wife.
When they divorce, the battle over child custody and coparenting will often result in the borderline mother using the children as a weapon against the father. The children will be positioned by the borderline mother to choose between parents or suffer greatly. This results in the children rejecting the father in small or large ways. This will aggravate the PTSD in the children and the father further. And thus the multi-generational cycle continues.
It is possible for the non-borderline parent to help the children recover to some extent, if the children are given the control on how much contact they have with the borderline parent and good treatment (psychologist with experience). The non-borderline parent has to become advanced in parenting skill and psychology. In essence, you create a mini residential treatment program in your own home. This is difficult and most parents don’t have the drive, time, and means to do it.
Depending on how severe the situation and acting out behavior is, long term residential treatment may be needed to try to overcome these deeply ingrained patterns of behavior. Even with residential treatment, the impulse to follow these patterns pull at the child through their whole life because they were implanted in the child from birth.
This concludes another long winded post that’s drifted off the original topic a bit. Hopefully there are some useful nuggets in there for some people struggling with similar situations.
I agree with some commenters that personality disorders are made and multigenerational, and that often they are not the result of abuse but enabling.
The mother protects and enables the personality disorder rather than teaching proper social sense. So everytime the kid is in trouble or troubled, its’ because of the other people.
I enjoyed and learned from the comments.
It is true that our culture reinforces personality disorder. That’s part of why I mentioned homeschooling and reducing social networking. Current thought in public school revolves around the self esteem movement (everyone is a snowflake) and compliance. Compliance drives living behind a facade, which reinforces people not being their genuine self. The self esteem movement reinforces people getting self worth within doing the hard work to accomplish something worthwhile. Social networking feeds into that as well, which everyone getting their “15 megabytes of fame”. When our society glorifies the likes of Paris Hilton, Kim Kardashian, and Lindsey Lohan, we’ve got some really twisted values.
Another factor that I think contributes is that our education system teaches theoretical and abstract concepts with very little application of knowledge. For example, a student will do 10 years of math, yet if you ask the average high school grad to take two pieces of wood and make a square corner, they won’t know how to do it. They can’t think of applying the concept of the Pythagorean Theorem with a physical object in the real wold. We need to do a LOT more hands on application. I believe that personality disorders develop more with people that are disconnected from the real world around them. It’s harder to stay in that immature, unrealistic mindset when the physical world is smacking you in the fact with reality regularly.
I’m fighting hard to not be fatalistic with respect to the current societal challenges. I’m seeing some push back against the destructive trends. We’re currently in a major battle over who were are as Americans. Tea Party versus Big Government entitlement types. I think that whomever wins that will determine what happens with the overall societal trend.
On a much more personal level, I’ve been fighting my own battle against the trends. My children were raised by me and their biological mother, whom I later found out has a personality disorder (or two). Unfortunately she was the children’s primary caregiver during their youngest years, when patterns of attachment and behavior are strongly shaped. Over the last decade I’ve been the primary caregiver and have been working hard to help them recover from the damage that was done. Personality disorders are multi-generational and I’m trying to help them break the chain. It’s been a tough road and results have been mixed so far. Research has been limited in how to help children of people with personality disorders recover from their maladaptive behaviors and damaged attachment styles. Quite often there’s PTSD in the mix too, as in the case of me and my children. I was ignorant to so many of the issues in parenting and have had to learn much about psychology in order to help my children and advocate for them effectively.
It is my hope that more people speak up and challenge the dysfunction with the personality disordered individuals and the systems that they seem to thrive within (medical, law enforcement, government). If enough of us overcome political correctness we can make positive change happen.
Bringing it back to the original topic of research and treatment of personality disorders…
The good thing about Diaelectic Behavioral Therapy is that it helps to teach the personality disordered person self soothing skills. Personality disordered people are emotionally very reactive and distressed. They try to resolve the distress by trying to manipulate and control their environment including the people within it. By using self soothing skills to reassure and calm themselves, they resolve their distress with less manipulation of others.
Mentalization Based Therapy shows one way to push back against the dysfunction. Borderline Personality Disorder presents in enmeshed relationships. Watch out for inappropriate use of the word “we” or people claiming to be just like you and intimating you. Reinforce the concept of differentiation with those people, that we each have our own unique views.
Combining both methods of treatment would be useful. You still have the problem though of the person not acknowledging that they have a problem. Much like the drinker not viewing themselves as an alcoholic. They have to cause great damage to their life and the lives of others before they acknowledge the problem (if ever). It’s a tough problem to solve, so making changes to how children are raised, educated, and treated has the best shot of helping in the long run.
Sorry about my long winded comment.
Research
very insightful commments, mr. mike. I am not optimistic, since I do believe there is a culture out there that applauds the personaltiy disorder.
And I am sure you have the same problem if you are awake and aware.
DBT (Dielectc Behavioral Therapy and MBT (Mentalization Based Therapy) have both shown some promises with Borderline Personality Disorder. Unfortunaltely few with personality disorders will even go to therapy much less invest in treatment. Public education and social networking reinforce BPD patterns of behavior. We wil see a significant increase in personality disorders in the next generation. Homeschooling, less TV and Internet helps form healthy attachment in ages 0 to 7. We have a lot of work ahead to bring sanity back.
Petrossa, you nailed it. People with these disorders are often so convinced of their superiority, level-headedness, etc., that they can’t possibly conceive the notion that there’s something wrong.
which has as major disadvantage that is shared with all other therapies: Getting the person to accept the need for therapy