(Stillness in the Storm Editor) As one who studies psychology, I’ll be the first to tell you that it’s hardly perfect. Especially on the clinical side, drug companies and other interests have diluted the true power of understanding the nature of our being. This being said, there is much within the accumulated knowledge of psychology we can gain wisdom in studying. With this in mind, consider the following.
It should be noted that psychological disorders are identified via a taxonomic system. What this means is that the disorders are arbitrary definitions of real things. For instance, ADHD is a clinical diagnosis that describes several different behaviors that psychiatry deems unhealthy. But this opinion about the behaviors associated with ADHD isn’t the only one. Some psychologists believe that the symptoms of ADHD are actually signs of natural development or distortions of consciousness related to an unhealthy culture. I share this latter opinion. So while the phenomenon of ADHD is real, the behaviors, the definition in psychology appears to be, at the very least, inaccurate.
As a matter of fact, the below article reveals that within psychology much debate exists about how to classify maladaptive responses to life—psychological disorders.
This underscores the difference between truth and knowledge, between a map and the territory. It’s an essential part of understanding how we relate to reality.
Knowledge is a representation of truth, held within the mind. The representation isn’t the truth itself, clearly. For instance, your memory of some experience is akin to a kind of mental recording. The recording clearly isn’t the same thing as the experience. But the recording, no matter how poor in quality it is, gives you something to work with, an initial impression. For example, You might not know if it’s raining outside from the sound of water hitting your window in the morning, but that sound is enough to get you interested in checking. And from there, you can make a better decision.
I’m suggesting to you that all the various broken forms of knowledge we have in our world are the same.
In this instance, we’re discussing psychological disorders. They might not be perfect, and hardly are, but it’s at least a start. It at least gives our minds something we can initially chew on. The task from here is to take what we have to work with, no matter how broken, and begin the process of refining it and making it better. This is what mental alchemy is all about.
With this in mind, I invite you to explore consciousness by taking a glance at what psychology has discovered and defined in relation to psychological disorders.
– Justin
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by Staff Writer, October 5th, 2019
Summary: With at least 6% of the general population and up to 60% of psychiatric patients having a personality disorder, a new report looks at the biological causes and treatment options for personality disorders.
Source: The Conversation
Filmmakers know personality disorders make for compelling viewing. Think of attention-seeking Scarlett O’Hara in Gone with the Wind (1939). Or the manipulation and callous disregard for others in Silence of the Lambs (1991), The Talented Mr. Ripley (1999) and Chopper (2000). Then there are the fears of abandonment and emotional instability in Fatal Attraction (1987) and Girl, Interrupted (1999).
Cinema is less adept, however, at showing the ordinary joys, heartache and sometimes suicidal despair of the friends, workers or relatives we might know with personality disorders.
What makes a personality ‘disordered’?
Personality describes individual characteristic patterns of thinking, feeling and behaving. A personality disorder is a class of mental disorders that are diagnosed when these patterns are repeatedly and seriously inflexible and dysfunctional, over an extended period of time.
Personality disturbances have long been recognised through history. Narcissism takes its name from the Greek myth of 50BC. Beautiful Narcissus was transfixed by his reflection in a pool of water. The longer he stared, the more he was driven by both passion and heartache. Over time he died in this state of self-absorbed despair.
People with personality disorders behave and perceive themselves, and others, in a markedly different way to most in their culture. These ideas and behaviours tend to develop in adolescence or early adulthood and are enduring. This can cause significant distress and impairment in all facets of life.
How common are they?
Personality disorders represent one of the most prevalent and severe mental health conditions. Around 6.5% of Australian adults will have a personality disorder over their lifetime. Data samples of more than 21,000 people worldwide, including Europe, the Americas, Africa and Asia, show a similar prevalence of 6.1%.
About 40% to 60% of psychiatric patients have a personality disorder, with similar rates in drug and alcohol units and prisons.
Personality disorders account for about one in four mental health emergency visits and inpatient hospitalisations.
How are they diagnosed?
Personality disorder is a diagnosed mental illness included in both the World Health Organization’s International Classification of Diseases (ICD-10, 1994) and the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5, 2013).
Although there is considerable individual variation, four broad areas of difficulty are common:
- regulating emotions, such as sudden surges of anger or despair
- disturbed relationships, such as being aloof or overly familiar
- confused thinking: difficulty understanding the self and misperceiving others’ intentions
- associated problem behaviours, such as impulsiveness with drug use, promiscuous sexual behaviour, or self-harm.
What are the causes?
Personality disorders appear to have both genetic and environmental causes. Individual genetic differences in temperament and attachment patterns early in life seem to play a role, as some people appear pre-wired to be more hypersensitive or ambivalent about bonding with others.
Imaging studies of brain functioning report reductions in amygdala and hippocampal regions, perhaps reflecting the difficulties in regulating emotions and integrating autobiographical memories.
Compounding these difficulties is environmental trauma, including experiences of neglect or abuse during childhood or young adulthood, often found in the histories of those with severe personality dysfunction.
What are the sub-types?
There is little consensus among experts about personality disorder subtypes. DSM-5 lists ten, clustered into three groups:
- the “odd and eccentric” (paranoid, schizoid, schizotypal)
- the “dramatic, emotional and erratic” (antisocial, borderline, histrionic, narcissistic)
- the “anxious and fearful” (avoidant, dependent and obsessive-compulsive).
Yet a section at the back of DSM-5 proposes to reduce the subtypes to six: antisocial, avoidant, borderline, narcissistic, obsessive-compulsive, schizotypal. This was meant to replace the current ten, but deep divisions in the DSM-5 personality disorder working group (two members resigned) forced the DSM committee to move this proposal into an “emerging measures and models” section.
The ICD-11 system due 2017 will likely replace all subtypes with a single disorder – personality disorder – rated on severity: mild, moderate, severe.
This will help overcome the lack of consensus, as subtypes tend to significantly overlap, and will align the ICD system with activity-based or casemix health funding models. Therefore, a diagnosis of severe personality disorder – whatever subtype – will justify funding longer-term and more intense treatments over those with milder severity.
ICD-11 has not altogether abandoned individual differences, allowing four descriptors, likely to be named dissocial (similar to antisocial), negative affective (similar to borderline), anankastic (similar to obsessive compulsive), and detached (similar to schizoid or schizotypal).
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How are they treated?
Research over the past 20 years shows that psychological therapies work for many people with personality disorders. The two-thirds who remain in treatment for a year achieve significant benefits.
But personality patterns are difficult to change. The median duration of evidence-based therapy for adults is about one year – at least 32 sessions – but many require longer programs.
There is little evidence that medications are an effective treatment.
Recently published clinical practice guidelines emphasise the importance of intervening early with adolescents. A diagnosis can be made in young people from about age 13 to 15 if problems persist for more than a year.
New models of care are being implemented, including our own step down model to better manage this disorder. This involves offering a brief personality disorders-friendly psychological intervention within one to three days of crisis, followed by assessment and care planning for appropriate longer-term support.
Narcissism is a key trait in the subset of ‘dramatic, emotional and erratic’ personality disorders. The image is adapted from The Conversation news release.
This model is based on the findings from recent randomized controlled trials that weekly generalist psychological therapies can be as effective as more intensive specialist programs, and are easier to learn and implement.
Psychotherapy can be hard for those involved, especially during the early months, as developing a secure trusting relationship with a psychologist is difficult because of the nature of the disorder.
Research from our team has demonstrated how ordinary therapists go into consultations with borderline and depressed patients with the same desire to help, but with the former, they leave the consultation room more depleted and distressed – even if they are very trained and experienced.
Similarly, family, relatives, and carers of people with the disorder also report significant emotional burden in their caring role.
Maintaining compassion, hopefulness, and patience despite setbacks is important, and better treatments and the experiences of people who have recovered, are now challenging the stigma surrounding personality disorder.
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Funding: Brin F.S. Grenyer receives funding from NSW Health to direct the Project Air Strategy for Personality Disorders.
Source:
The Conversation
Media Contacts:
Brin F.S. Grenyer – The Conversation
Image Source:
The image is adapted from The Conversation news release.
Stillness in the Storm Editor: Why did we post this?
Psychology is the study of the nature of mind. Philosophy is the use of that mind in life. Both are critically important to gain an understanding of as they are aspects of the self. All you do and experience will pass through these gateways of being. The preceding information provides an overview of this self-knowledge, offering points to consider that people often don’t take the time to contemplate. With the choice to gain self-awareness, one can begin to see how their being works. With the wisdom of self-awareness, one has the tools to master their being and life in general, bringing order to chaos through navigating the challenges with the capacity for right action.
– Justin
Not sure how to make sense of this? Want to learn how to discern like a pro? Read this essential guide to discernment, analysis of claims, and understanding the truth in a world of deception: 4 Key Steps of Discernment – Advanced Truth-Seeking Tools.
Stillness in the Storm Editor’s note: Did you find a spelling error or grammar mistake? Send an email to [email protected], with the error and suggested correction, along with the headline and url. Do you think this article needs an update? Or do you just have some feedback? Send us an email at [email protected]. Thank you for reading.
Source:
https://neurosciencenews.com/personality-disorder-treatment-15033/
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