Personality Disorders Gender Bias

Uploaded 8/27/2010, approx. 3 minute read

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

Ever since Sigmund Freud, more women than men sought therapy. Consequently, terms like hysteria are intimately connected to female anatomy and alleged female psychology.

The Diagnostic and Statistical Manual, DSM, the Bible of the psychiatric profession, expressly confesses to gender bias. Personality disorderssuch as borderline and histrionic, are supposed to be more common among women. Luckily, the DSM is pretty even-handed.

Other personality disorderssuch as narcissistic, antisocial, schizotypal, passive compulsive, schizoid and paranoid, these other personality disorders are more prevalent among men.

But why this gender disparity to start with? Why some personality disorders are more common among women than others among men?

Well, maybe personality disorders are not objective clinical entities at all. Maybe they are culture-bound syndromes. In other words, maybe personality disorders reflect biases and value judgments and prejudices of the prevailing culture.

Consider patriarchal societies, but triarchal societies are also narcissistic. They emphasize qualities such as individualism and ambition, and these are identified with virility. So, we would expect to find these qualities among men rather than among women.

Since they also define pathological narcissism, the preponderance of pathological narcissism would be among men. Women, on the other hand, are widely believed to be emotionally labile and clingy, and this would tend to explain why there are more women among borderline personality disorder and dependent personality disorder patients.

Another possible reason is that upbringing and environment, the process of socialization and cultural mores, all play an important role in the pathogenesis of personality disorders.

These views are not fringe. Serious scholars such as Kaplan and Pantoni claim that the mental health profession is inherently sexist.

But then again, that may not be the case. Genetics may be at work. Men and women do differ genetically. This may account for the variability of the occurrence of specific personality disorders in men and women.

Ultimately, I think the problem is the ambiguity and equivocation of the diagnostic criteria. Some of the diagnostic criteria for personality disorder are ambiguous. Some of them are even considered normal by the majority of the population.

Consider one of the diagnostic criteria for histrionic personality disorder. It says that the histrionic consistently uses physical appearance to draw attention to self.

Well, who doesn't do that in Western society? Everyone. So everyone ought to be labeled a histrionic.

Why when a woman clings to a man, this is labeled co-dependence. But when a man relies on a woman to maintain his home, take care of his children, choose his attire, and from his ego, this is called companionship.

This observation was made by Walker in 1994. Even structured interviews and psychological tests fail to remove gender bias. The less structured the interview, the more fussy the diagnostic criteria, the more the diagnostician relies on stereotypes. This was discovered by Widiger in 1998.

Gender bias is everywhere, especially since the psychiatric profession was overwhelmingly invented, written, researched, studied, propagated by males. Women have been caged into niches of mental health diagnosis.

Certain personality disorders are female personality disorders. Others are male personality disorders.

And it is not surprising that many, finally, scholars and laymen alike finally say that there are no such things as personality disorders.

It's all cultural. The Diagnostic and Statistical Manual Committee is currently considering this possibility. And we are heading for a revolution in the science of personality disorders, which may also remove a lot of the gender bias hitherto so painfully apparent.

If you enjoyed this article, you might like the following:

Borderline Woman as Dissociative Secondary Psychopath

Borderline Personality Disorder and Psychopathy may not be as different as previously thought. Recent studies suggest that Borderline and Histrionic Personality Disorders may be manifestations of secondary type psychopathy in women. Survivors of Complex Post-Traumatic Stress Disorder (CPTSD) also exhibit psychopathic and narcissistic behaviors. Borderline Personality Disorder can be described as a subspecies of Dissociative Identity Disorder, with mood lability and emotional dysregulation being outward manifestations of changes in self-states.

Labile: Borderline Personality Disorder and Narcissism

Borderline personality disorder is a controversial diagnosis that is often found among women. Some scholars believe it is a culture-bound pseudo-syndrome invented by men to serve a patriarchal and misogynistic society. Patients diagnosed with the disorder have chaotic lives and stormy, short-lived, and unstable relationships. Borderlines are impulsive, reckless, and display wildly fluctuating self-worth, self-image, and affect.

Tips: Survive Your Borderline Enchantress

Professor Sam Vaknin discusses coping with borderline personality disorder, including abandonment anxiety and object constancy. He suggests establishing rituals and procedures of presence, permanence, stability, and predictability, involving the borderline in activities that can be misinterpreted as forms of abandonment, and introducing object constancy into the relationship through mementos, programmed reminders, and shared sentences. He also discusses decompensation, acting out, and mood lability in individuals with borderline personality disorder. Finally, he offers advice on how to deal with a partner who has borderline personality disorder, including restoring reality testing, preventing suicide, and countering transient paranoid ideation.

Study: Weak Self of Covert Narcissists, Secondary Psychopaths

A study has found that individuals with Cluster B personality disorders, specifically those with dark triad traits, have a weak, unstable, and unclear sense of self. The study's authors suggest that recognizing these traits is important in predicting behaviors and avoiding destructive, impulsive, and callous behaviors. The study also found that high-level dark triad traits are associated with a weaker sense of self, regardless of gender and age. However, when analyzing sub-traits of narcissism, psychopathy, and Machiavellianism, the study found that vulnerable narcissism and secondary psychopathy are most strongly correlated with a weaker or unclear sense of self.

Body Language of the Personality Disordered

Patients with personality disorders have a body language specific to their personality disorder. The body language comprises an unequivocal series of subtle and not-so-subtle presenting signs. A patient's body language usually reflects the underlying mental health problem or pathology. In itself, body language cannot and should not be used as a diagnostic tool.

Psychosexuality of the Personality Disordered

Sexual behavior can reveal a lot about a person's personality, including their psychosexual makeup, emotions, cognitions, socialization, traits, heredity, and learned and acquired behaviors. Patients with personality disorders often have thwarted and stunted sexuality. For example, paranoid personality disorder patients depersonalize their sexual partners, while schizoid personality disorder patients are asexual. Histrionic personality disorder patients use their sexuality to gain attention and narcissistic supply, while somatic narcissists and psychopaths use their partners' bodies to masturbate with. Borderline personality disorder patients use their sexuality to reward or punish their partners, while dependent personality disorder patients use it to enslave and condition their partners.

Borderline Triangulates with Rescuer to Silence Pain, Abandonment Anxiety

Professor Sam Vaknin discusses Borderline Personality Disorder (BPD) and its similarities to narcissism. BPD is currently thought to be a female manifestation of secondary psychopathy and involves dissociation. Borderlines often have a diffuse identity and rely on their intimate partners to regulate their internal environment. They may engage in dysfunctional attachment strategies, such as running away or triangulation, and experience dissociation during sex or other emotionally intense situations.

Lonely World, Schizoid Future (and Sex)

The schizoid core, characterized by a lack of identity and a void, is at the foundation of personality and character pathologies. Society is gravitating towards a schizoid solution, with people preferring solitude and avoiding interactions with others. The schizoid world is becoming more narcissistic, psychopathic, and autoerotic, with sex being the last remaining vestige of human contact. The future will be a society in flux, with ad hoc self-assembling networks and no concept of institutions, intimate relationships, or politics.

Borderline's Miracle Healing

Borderline personality disorder (BPD) is a mental health issue that affects 1-2% of the general population. Contrary to popular belief, BPD is not untreatable and has a positive prognosis over time. Studies have shown that most patients with BPD improve with time, and by age 45, a significant portion of patients will have healed spontaneously. However, while the disorder may remit, some dysfunctional behaviors persist, and there is a need for a two-step treatment approach: first, tackle the core disorder, and then focus on teaching the recovered patient functional skills.

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.

Transcripts Copyright © Sam Vaknin 2010-2023, under license to William DeGraaf
Website Copyright © William DeGraaf 2022-2023
Get it on Google Play
Privacy policy