In psychology, we have a kind of diagnosis called “personality disorders.” These include Narcissism, Borderline, Avoidant, Dependent, Paranoid, etc. There are 10 of three types. You may suspect yourself or a loved one of having a personality disorder, but you’re unsure if their behavior is extreme enough. Or, maybe you’re afraid of counseling because you don’t want to be put in a box. You may wonder, are personality disorders on a spectrum, or are they black and white?
We’ll answer those questions today.
The American Psychiatric Association describes a personality disorder as a “way of thinking, feeling and behaving deviates from the expectations of the culture, causes distress or problems functioning, and lasts over time.”
The pattern includes at least two of these:
I have done extensive work and writing on one of them, Narcissism. WebMD provides this basic definition: “Narcissism is extreme self-involvement to the degree that it makes a person ignore the needs of those around them. . . . They also do not understand the effect that their behavior has on other people.” I also often speak on borderline, another personality disorder.
The DSM-5, the counselor’s go-to reference for mental illnesses, includes ten disorders:
All of these have some combination of the list of patterns given above. Those patterns must interfere with the person’s life enough to cause distress or seriously inhibit their lives.
While well-established, I don’t want anyone to think of diagnoses like boxes.
Psychological diagnosis can sometimes give the false impression of speaking identity into people. Sometimes, diagnosis can make people feel stuck and put in a box, making it a part of their identity. They might say to themselves wrongly, “I’ll never have lasting friends because I’m anti-social.”
At most, any diagnosis is a descriptor, not an identifier, and really, a diagnosis is only a shorthand for internal communication. That internal communication helps a therapist help you become freer.
Medical professionals and insurance companies out there, please refrain from defining, cursing, or incarcerating someone with a diagnosis, psychological or otherwise.
Imagine a group of Paleontologists who get tired of saying, “Hey, I found another one of those really big dinosaurs with big teeth, little front legs, really big hind legs…” So, they gave that dinosaur a name: T-Rex.
In the same way, mental health professionals got tired of saying, “I saw another client today with a poor sense of identity and a severe fixation on abandonment and extreme emotional and relational responses,” and they gave that combination of traits a name: Borderline Personality Disorder.
Many of us, heck, maybe all of us, have some traits from the list of descriptions of personality disorders. The most severe problems come when a single person possesses multiple–and that’s the definition of personality disorders. How they combine and how severe they are makes up the specific disorders.
In that case, it’s fair to say diagnoses are on a spectrum. In a strange way, everyone is on a spectrum of personality disorder–nobody has a “perfect” personality. Of course, those imperfections usually don’t distress us in our daily lives. When they do, that’s when counseling and a diagnosis can benefit you.
If other people have pointed out some of these behaviors, or if you see them in your loved ones, consider going to counseling. In addition, if your parents or spouse might have a personality disorder, you should see a therapist to help you unpack that relationship. If you think you might have a disorder, speaking to a licensed therapist is the best way to find out.
We have several counselors who specialize in personality disorders in various locations in Texas, including myself. We won’t put you in a box. We’re here to come alongside and lead you to freedom. Our therapists are trained and ready to help!
