First, what are personality disorders?
Personality disorders are labels created by mental health professionals to describe groups of people with ways of thinking, behaving, and seeing the world that do not fit the societal norm. A person seen as having a personality disorder has longstanding challenges with relating to other people and can find it difficult to fit in and meet the expectations of others.
While some people find a diagnosis of a personality disorder helps them understand themselves, for others, it can feel a very unwelcome label. In fact many mental health care professionals themselves are opposed to saddling clients with a personality disorder. Why is this?
The positive side of a personality disorder diagnosis
Let’s start with what the benefits of a personality disorder diagnosis can be.
A label can be useful, working as a good shorthand and reference point for doctors and healthcare workers to communicate with. And, if you have a personality disorder diagnosis, you can be saved having to tell your whole life story and personality to each practitioner you work with.
Some people find being offered a diagnosis a great relief if they have suffered for a long time with behaviour they can’t control or understand. It can feel like you finally know where you are standing, and have a platform to now work from.
A diagnosis of a personality disorder can also help others understand you. Perhaps your family really struggle trying to understand you, but now they have a reference to try, and they can seek out support and information to improve their relationship with you.
And last but not least, a personality disorder diagnosis can also help sufferers to feel less alone in the world. It can be a sort of comfort to know there are others out there who suffer in the same way they do and who might see the world like they do. It also means you can find information you need and perhaps finally find the specialist help that can then help you move forward.
Why is a diagnosis of a personality disorder controversial?
Many people feel that our personalities are too complex and individual, and too composed of personal life experience, to be distilled down to a diagnosed ‘disorder’ if they don’t fit an expected pattern.
The word ‘disorder’ itself can sound limiting and negative. It’s really a word of exclusion, with a focus is only on what is different and ‘wrong’ with someone. It does not encompass a person’s strengths and resilience, but carries the implication that one’s personality is faulty.
And when our personalities are so much of what we are, who wouldn’t feel upset, or potentially hopeless and invalidated and rejected, by that thought?
A diagnosis can also lead to a client overlooking their strengths and only identifying with their weaknesses, or feeling they are powerless to change. It can feel harder for the person to trust their sense of self or to have self-worth, and can mean they now see all problems in their life as their fault.
A personality disorder diagnosis can provoke the habit of looking through all of one’s life experiences from the tinted lens of “I have a personality disorder”. Suddenly, experiences that might have once been seen by the person as valuable, or something they learned from, are now seen as ways they were ‘doing things wrong’ or ‘can never really change’.
Some mental health care professionals point out that the negative focus of a personality disorder diagnosis is far from useful when it comes to treatment and to trying to help someone learn to manage their life better.
The client can be left feeling unable to believe they can grow or change if they have a personality disorder, and the therapist can waste a lot of time trying to encourage any self belief. Whereas if the diagnosis is not made, and a person is just aware their personality is just difficult, a practitioner has a better chance of helping them recognise their strengths, have a balanced view of themselves and life, and find ways to move forward.
A personality disorder diagnosis also raises the question of just who can say what is and isn’t right in a personality. It doesn’t help that the requirements for diagnosis are constantly being changed by the health boards that publish them.
This then raises the question of what is ‘ordered’ vs ‘disordered’? This itself is something that changes according to cultures and the present norms of society. And then what is the difference between someone who has a troublesome personality, and one who has a disorder? There are so many grey areas that it begs to question how accurate some diagnoses can really be.
The Stigma of Personality Disorders
On top of all else there is the stigma that any mental health diagnosis can sadly still bring, let alone one of a personality disorder. They are some of the least understood mental health conditions, not helped by a media that focuses only on worst case scenarios and makes movies that are far from accurate (read more on this in our article Mental Health in the Media).
Some personality disorders are more understood and accepted than others, such as obsessive compulsive disorder versus the often misunderstood (and misnamed) borderline personality disorder. Other personality disorders, such as antisocial personality disorder, can leave one completely ostracised or feared by others. What are the implications of this on the patient’s future?
Worst is that stigma and discrimination exists towards personality disorders even in the mental health industry itself. For a long time there was the idea in the mental health community that those with personality disorders were untreatable or a waste of time, and sadly, this attitude can still be found.
There is also the idea that certain personality disorders, such as borderline personality disorder, mean someone is too difficult or manipulative to work with. It’s not uncommon even now for someone with BPD to be told by a psychotherapist they would be too difficult to work with, or that they don’t take on clients with the disorder.
Keep this in mind when it comes to personality disorders…
Perhaps the important thing to remember is that a diagnosis is not all of who you are. It cannot describe your wealth of experiences, or predict the strengths you’ll develop in the future.
And also, mental health diagnoses are by no means an exact science. A personality disorder is not really an illness that can be identified across all sufferers in a microscope, but really just a term to describe a group of people with similar behaviour patterns. And it’s a term created by another group of people, namely mental health researchers.
It’s someone else’s idea of what is wrong with you. Your life, and your viewpoint on what is right and wrong with you, and what you do and don’t struggle with, is really, at the end of the day, up to you.
So the best piece of advice, if a diagnosis has upset you, might be to not focus on the label. Focus on getting the support and help to manage your life that works for you and helps you feel better.
Have you or a loved one had a diagnosis of a personality disorder? Would you like to share how you feel about the diagnosis of personality disorder? Do so below.