Normal Personality and Personality Disorders

Uploaded 2/9/2011, approx. 4 minute read

My name is Sam Vaknin. I am the author of Malignant Self-Love, Narcissism Revisited.

We keep using the phrase personality disorder, but what is a personality and what is a disorder?

In their Opus Magnum, Personality Disorders in Modern Life, Theodore Millon and Roger Davies define personality as a complex pattern of deeply embedded psychological characteristics that are expressed automatically in almost every area of psychological function.

The Diagnostic and Statistical Manual, text revision 4, published in the year 2000 by the American Psychiatric Association, defines personality traits as enduring patterns of perceiving, relating toand thinking about the environment in oneself that are exhibited in a wide variety of social and personal contexts.

Laymen often confuse and compute personality and character and temperament. These three are distinct entities.

Our temperament is the biological genetic template that interacts with our environment. Our temperament is a set of in-built dispositions we are born with, our temperament. It is mostly unalterable.

Though recent studies demonstrate that the brain is far more plastic and elastic than we thought, still temperament is fairly much built in.

In other words, our temperament is what the ancients used to call our nature.

Our character is largely the outcome of the process of socialization, the acts and imprints and edicts of our environment and nurture, and how they work on our psyche during the formative years, 0 to 6 and in other lists.

Our character is the set of all acquired characteristics we possess, often judged within a cultural, societal context.

Sometimes the interplay of all these factors results in an abnormal personality.

Here we come to the question of what is a personality disorder?

Personality disorders are dysfunctions of our entire identity, tears in the fabric of who we are. They are all pervasive because our personality is ubiquitous and permeates each and every one of our mental cells.

So when we talk about personality disorder, in the background lurks the question, what constitutes normal behavior? Who is normal and what is normal?

We have to compare a disorder to order an abnormality to normality or normalcy.

Well first there is what may be called the statistical response. Statistical response is that normal is what is average and what is common, but this is unsatisfactory and incomplete.

Conforming to social edicts and mores does not guarantee normality.

Think about anomic societies and periods in history such as Nazi Germany or Stalin's Russia. Model citizens in these hellish environments were the criminals and the sadists. They were the cream of society. They were the elite. So were they normal?

Well within the context of Nazi Germany and Stalin's Russia they were normal.

But I don't think any of us would think that SS guards in concentration camps and butchers in Stalin's Gulag were normal people.

Rather than look to the outside for a clear definition of what is normal, many mental health professionals ask, is the patient functioning? Is the patient happy? Or in professional terms is the patient egosyntonic? If he or she is both functioning and happy then all is well and all is normal.

Abnormal traits, behaviors and personalities are therefore defined as traits, behaviors and personalities that cause dysfunction and cause subjective distress or unhappiness.

But of course this falls flat on its face at the slightest scrutiny.

Many evidently mentally ill people are rather happy and they are reasonably functional. Even psychotic schizophrenic, paranoid have long stretches of time where they are completely functional and many of them are happy.

Some scholars reject the concept of normalcy altogether. The anti-psychiatry movement objects to the medicalization and pathologization of whole swaths of human conduct.

Others prefer to study the disorders themselves or rather to go metaphysical by trying to distinguish them from an imaginary and ideal state of being mentally healthy.

Even though it is a highly fictionalized account of what it means to be normal, I subscribe to the letter construct.

I believe that we should compare all modes of functioning and all modes to a completely ideal non-existent definition, sort of a construct, an invention of a normal person, a normal psyche, mentally healthy.

I much prefer to delve into the phenomenology of mental health disorders, traits, characteristics, impact on others, functions, dysfunctions, distress, happiness.

I prefer to observe than to analyze or build theories.

I think the role of psychiatry in psychology is to heal, not to make psychiatrists and psychologists famous for the grandiose theories and ideas.

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The Habit of Identity

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MMPI-2 Psychological Test: Controversial, but Hard to Fake

The MMPI-2 test booklet has 567 items, but a rough assessment can be made based on the first 370 queries. The items are arranged in scales, and the responses are compared to answers provided by control subjects. The nature of the deviation determines the patient's traits and tendencies, but not their diagnosis. The test results place the subject in a group of patients who reacted similarly, and the validity scales indicate whether the patient responded truthfully and accurately or was trying to manipulate the test. The clinical scales measure various mental health issues, and the interpretation of the MMPI-2 is now fully computerized.

Psychological Tests and Structured Interviews: Introduction

Personality assessment is an art form that uses psychological tests and structured interviews to render it as objective and standardized as possible. Most tests restrict the repertory of permitted answers, and the scoring and keying of results are automated. Interpretation is arguably more important than data gathering, and most practitioners administer a battery of tests and structured interviews. Projective tests are far less structured and thus a lot more ambiguous, and the scoring is done exclusively by humans and involves judgment and bias.

Antisocial Psychopath and Sociopath: Antisocial Personality Disorder

Psychopathy is a personality disorder that is characterized by callousness, ruthlessness, extreme lack of empathy, deficient impulse control, deceitfulness, and sadism. It is frequently ameliorated with age and tends to disappear altogether by the fourth or fifth decade of life. Psychopathy may be hereditary and has a strong genetic, biochemical, and neurological component. Psychopaths are abusively exploitative and incapable of true love and intimacy, and they are irresponsible, unreliable, vindictive, and hold grudges forever.

What Is Acting Out? (and Covert Narcissist)

Acting out is a way for individuals to discharge conflicted mental content through action, often as a result of being unable to verbalize or communicate their internal struggles. It is commonly associated with personality disorders and can lead to self-destructive behaviors. Acting out can be seen as a form of somatization, using the body to remember and process repressed memories and emotions. It is important to distinguish acting out from other concepts such as acting in, passage à l'acte, and bad behavior, as they have different implications and meanings.

Morally Insane Psychopath: A Brief History of Psychopaths and Antisocials

The concept of personality disorders began less than a hundred years ago, with the French psychiatrist Pinel coining the phrase "mal de son" to describe patients who lacked impulse control and were prone to outbursts of violence. The term "moral insanity" was widely used for almost a century, but physicians sought to replace it with something more objective and scientific. The diagnosis of psychopathy has been expanded to include people who harm and inconvenience themselves, as well as others. Today, most practitioners rely on either the Diagnostic and Statistical Manual or the International Classification of Diseases to diagnose personality disorders.

Abuse Victim's Body: Effects of Abuse and Its Aftermath

Abuse and torture have long-lasting and frequently irreversible effects on the victim's body, including panic attacks, hypervigilance, sleep disturbances, flashbacks, intrusive memories, and suicidal ideation. Victims experience psychosomatic or real bodily symptoms, some of them induced by the secretion of stress hormones, such as cortisol. Victims are affected by abuse in a variety of ways, including PTSD, which can develop in the wake of verbal and emotional abuse, in the aftermath of drawn-out traumatic situations such as domestic divorce.

People are Like Trees: Roots and Obstacles (by Jennifer Howard)

Psychopathologies are adaptive mechanisms that allow individuals to grow around obstacles and reach a functional equilibrium. Humans are a life form that forms personality structures optimally suited to their needs and outside constraints. Personality configurations may be abnormal, but their existence proves they have triumphed in the delicate task of successful adaptation. Life events contribute to the weaving of the delicate fabric that we call personality.

Psychosis, Delusions, and Personality Disorders

Psychosis is a result of severely impaired reality tests, where the patient cannot tell inner fantasy from outside reality. Psychotic micro-episodes are common in certain personality disorders, most notably in borderline and schizotypal personality disorders, but also in narcissistic personality disorders. Delusions are entrenched and very hard to eradicate, while hallucinations are merely a sensory perception that has a compelling sense of reality of a true perception but that occurs without external stimulation of the relevant sensory organs. Hallucinations are common in schizophrenia, affective disorders and mental health disorders with organic origins.

Is S/he a Narcissist? Use These TESTS! (Compilation)

Professor Sam Vaknin discusses various personality assessment tests in this section. He talks about the three R's test, which helps determine whether someone is a full-fledged narcissist or merely narcissistic. He also discusses the characteristics that attract narcissists to potential partners and briefly touches on the Myers-Briggs Type Indicator (MBTI) personality assessment test. He then discusses the weaknesses and criticisms of the MBTI and Jungian theory. Finally, he talks about the Minnesota Multiphasic Personality Inventory (MMPI-2), the Psychopathy Checklist Revised Test (PCLR), and the Rorschach ink blots test, and notes that personality assessment is more of an art form than a science.

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