Can People With Personality Disorders Change For the Better?

Perhaps it’s because, in my blog, I seem to slam people with personality disorders that some of my readers, friends and colleagues wonder if personality disorders can be treated. I am often asked if individuals with PDs can change. The simple answer is, yes, it is possible.

Often times, success has been achieved with a combination of medication and therapy. If I ever find any statistics on prevalence rates for success I will share them with you. However, in the meantime, I want to share with you a story of an incredible woman who has helped countless people with borderline personality disorder (BPD). Her amazing insights came from her own battle with the disorder that she kept hidden up until 2011 when she ‘came out’ about having BPD. It just goes to show how strong the stigma of having a personality disorder is, so remember never to use a person’s diagnosis pejoratively.

And, just to set the record straight, yes, I have been hurt many times by people with PDs, but I don’t think that they are necessarily bad people. I have friends and family members who meet the criteria for having various different personality disorders and I love them for who they are…I just don’t always like their behaviour, nor will I allow myself to be abused by them in any way.

This post is dedicated to a friend who ‘Can’t Dance’ (you know who you are), but I would never hold this against her 😉

Here’s the brilliant article by Lily Katz:

Leading the way out of hell

Lily Katz
February 27th 2012

Marsha Linehan, UW professor and director of the Behavioral Research and Therapy Clinics (BRTC), said she was wrongly diagnosed with schizophrenia, though she showed symptoms of borderline personality disorder.

Marsha Linehan, UW professor and director of the Behavioral Research and Therapy Clinics (BRTC), said she was wrongly diagnosed with schizophrenia, though she showed symptoms of borderline personality disorder.

It’s 1961. Sitting in the back unit of the Institute of Living — a mental health center in Hartford, Conn. — Marsha Linehan made a promise to herself at age 17 that would help guide the rest of her life.

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“I made a vow to God that I would get out of hell, and when I got out of hell, I would go back and get  people out,” Linehan said.

For much of her adolescence and young adulthood, Linehan struggled with her mental health. Although she was never diagnosed with borderline personality disorder (BPD), Linehan experienced several of the symptoms, such as severe depression, self-harm, and suicidal thoughts.

Linehan, a professor of psychology and director of the Behavioral Research and Therapy Clinics (BRTC) at the UW, is known internationally for developing a therapeutic treatment called dialectical behavior therapy (DBT). It is now a widely used treatment for BPD. Before she was able to begin developing DBT, however, Linehan began treating herself.

The path to recovery

Linehan grew up in Tulsa, Okla. Because Linehan suffered from amnesia, she is unable to recall much of her childhood but said she was a good student, extroverted, and experienced no serious traumas. Yet as a teenager, she began to experience chronic headaches, depression, and frequent thoughts of suicide.

“You’d have to think of the very worst moment of your life, and then think of that moment being every moment of your life,” Linehan said. “It’s a suffering that’s sort of unimaginable, unexplainable, undiscussable, indescribable.”

But indescribable it isn’t, Linehan recently proved, when she stood in front of an audience at the Institute of Living and told her story publicly for the first time. Linehan said telling her story was one of the most difficult things she has ever done.

“I didn’t want to die a coward,” Linehan said. “That’s the beginning and end of it. I had no desire whatsoever to tell my story. I just didn’t want to be a coward.”

One of the worst experiences Linehan recalled was at a mental health clinic in Cook County, Ill., where she was put into seclusion.

“I was out of control — went out of control and didn’t have any way to get in control,” Linehan said. “I also thought I was more than one person. I never thought I was doing anything; I thought it was someone else doing it all.”

Shocked at the way she and others were treated, Linehan attempted to assist other patients in the clinic and began to think about how she would help others when she got out.

Linehan would spend most of her time at the clinic trying to keep another patient quiet because the workers would threaten to put her in seclusion.

“However, I couldn’t keep her quiet one day, and they came and got her,” Linehan said. “She started screaming and saying, ‘I’m waiting for my father,’ but she was 85, so of course the chances of her father coming were nonexistent. I’ll never forget this [hospital aide] saying to her, ‘Your father is six feet under.’”

Eventually, Linehan left the mental health center in Cook County, but only with the help of family members. The clinic refused to discharge Linehan, so she took them to court. The judge eventually allowed her to leave the mental health center if she agreed to be under the care of her brother.

After numerous visits and stays at various clinics and hospitals, Linehan’s path to recovery finally began at the Cenacle Retreat Center — a retreat for nuns in Chicago. The nuns offered Linehan a room, good food, kindness, and the space to connect with her own spirituality in a way that would turn her life around.

“I’ve always been spiritual,” Linehan said. “The core of me is spirituality, really. I may not look that way to anyone else or even act terribly spiritual, but it’s the more central relationship of my life.”

“Being Christian, I was sharing in the suffering of Christ,” Linehan said. “So I thought that some people get this part, some people get that part, and I got the suffering part. So I was kind of willing. I’ve always been in love with God. I’ve been in love with God my whole life.”

One day, Linehan was sitting in a small chapel at the retreat. A nun walked by and asked her if she needed help, but Linehan declined, thinking that no one could help her.

Suddenly, Linehan heard the voice of God.

“I was looking at the crucifix. The crucifix became gold, and the room was gold, and it was God speaking to me,” Linehan said. “I suddenly realized that God loved me, and I was totally transformed. God’s spoken to me quite a few times in my life, but not like that.”

It was a revelatory and transformative experience that enabled Linehan to love and connect with her inner self in a way she never had before, she said. Her recovery was sudden, though other recoveries from personality disorders often take more time. What she needed was to love herself and accept the struggles of her past.

“It was a little bit like being in love with someone your whole life, and then finding out they’re in love with you too,” Linehan said. “If you practice willingness, acceptance, and love, you too will be transformed.”

Developing DBT

She got her degree, began teaching, and, most significantly, developed DBT — a treatment for a population that was previously underserved. Her approach combines three strategies: radical acceptance, behavioral therapy, and mindfulness.

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Linehan stands in front of the BRTC, where she is working to further develop Dialectical Behavior Therapy and other therapies for severe personality disorders.

“I was trained as a behavioral therapist, and I believed in behavioral therapy just about as much as I believed in God — I’m not kidding,” Linehan said. “And so I decided I would cure [BPD]. … When I started my career, there really were no effective treatments. So I spent my life trying to develop effective interventions that helped people get out of hell.”

But the development of DBT came with obstacles. In the early stages, Linehan used treatment that didn’t work, and patients would become angry and unmanageable. After seeing her patients’ negative reactions, Linehan realized that she needed to incorporate radical acceptance into the mix, a therapy that involves teaching patients complete and total acceptance of themselves and the events that have occurred in their lives.

Linehan realized that she wasn’t skilled enough yet to practice DBT on patients and decided to take a leave of absence.

She traveled to two different monasteries, where she learned mindfulness. This, Linehan realized, was the third and final aspect that needed to be incorporated into DBT.

Linehan conducted a randomized clinical trial to test her approach and had her manual written by 1985. Over time, other clinicians began to see that the approach worked where others had failed.

“I have the absolute, utmost respect and admiration for her,” said Elaine Franks, Linehan’s assistant, friend, and the administrative coordinator at the BRTC. “I respect her for her creative, scientific mind. I admire her for her ambition and her diligence.”

The BRTC is a group of UW clinics that focus on the development of therapies, including DBT, for people with chronic personality disorders.

Another key component of DBT is the skills group. The purpose of the skills group is to teach patients skills that can help them cope with the challenges of daily life. Each patient also has a primary therapist and a group therapist. The job of the group therapist is to teach patients skills, while the job of the primary therapist is to make sure the patients are actively utilizing them in day-to-day life. Phone consultations with therapists are also available to clients who may need help.

The next step

After many years of research, testing, and trial and error, Linehan’s treatment method was finally complete. She was contemplating, at age 50, what was next in life.

It was her birthday, and Linehan was sitting at home, going through the box of her newly published books. Suddenly, God spoke to her again.

“You have kept your promise,” the voice said.

Linehan took this as a message from God that her mission on Earth — helping others improve their mental health — was complete.

“I spent six months waiting to die,” Linehan said.

But six months later, still very much alive, Linehan realized she had to figure out what she was going to do for the rest of her life. She decided to continue developing treatments and helping those who struggle with personality disorders.

Linehan is now director of the BRTC. The clinics’ primary focal point is DBT, but they are also working on various other projects, including High Risk for Suicide Adolescents and another project that is focused on certifying and accrediting individuals and groups to administer DBT.

“The number of people who are able to access really good DBT training is limited,” said Dorian Hunter-Reel, one of Linehan’s postdoctoral fellow students who works at the BRTC. “Frequently, the clinicians who think they know DBT maybe [have only] read her book or maybe … [have only taken] a course on DBT.”

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Linehan received her Ph.D. in psychology at Loyola University in 1971.

Hunter-Reel, who is specifically involved with treatment development for clients with comorbid alcohol disorders, has enjoyed working with Linehan over the years.

“There’s a group of people who clinicians tend to avoid or can be hard for clinicians to work with, and she created a model that allows clinicians to work with clients who are high-risk,” Hunter-Reel said. “Her scientific contribution has revolutionized treatment for a whole subset of the population.”

Knowing that someone had to do it, Linehan told her own story to make known the struggles of those with BPD.

“I’m passionate about the fact that science is good,” Linehan said. “But it turns out, in essence … I’m a teacher more than I am a scientist,” said Linehan, with a smile on her face.

Click here to read original article in The Daily.

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Jimmy Savile: What a Sick, Strange Little Man

Disclaimer: Images of Jimmy Savile may induce nightmares and/or vomiting

The many creepy faces of Jimmy Savile. The world is a slightly safer place now that he is pushing up daisies

The many creepy faces of Jimmy Savile. The world is a slightly safer place now that he is pushing up daisies

First of all, *bleugh*…Jimmy Savile might have thought he was brining sexy back, but he just made a little bit of sick creep into my mouth whilst cropping the above photo.

Everything about the man is repulsive…he looks like the love child of The Crypt Keeper and Ozzy Ozbourne, but that’s not the least of it…he’s an abhorrent child molester and rapist.

Jimmy Savile (far right) looks like the love child of The Crypt Keeper and Ozzy Ozbourne

Jimmy Savile (far right) looks like the love child of The Crypt Keeper and Ozzy Ozbourne

For those of you who have never heard of Jimmy Savile, he was an English DJ, television presenter, media personality and charity fundraiser.

He has been described as a “prodigious philanthropist” and was honoured for his charity work of which it is said he amassed an estimated £40 million. Savile has also earned the title of “predatory sex offender” for being one of the most prolific sex offenders in Britain’s history.

A joint report by the NSPCC and Metropolitan Police, “Giving Victims a Voice“, stated that 450 people had made complaints against Savile, with the period of alleged abuse stretching from 1955 to 2009 and the ages of the complainants at the time of the assaults ranging from 8 to 47. The suspected victims included 28 children aged under 10, including 10 boys aged as young as 8. A further 63 were girls aged between 13 and 16 and nearly three-quarters of his victims were under 18. Some 214 criminal offences were recorded, with 34 rapes having been reported across 28 police forces. ~ Wikipedia

This sick, strange little man was appropriately born on Halloween 1926. It’s only been since his death on 29th of October 2011 that most of the allegations against Savile have come to light.

He was able to destroy countless lives over a period spanning six decades. Whereas Savile raised £40 million for various charities, I wonder if it’s possible to estimate the price his victims have had to pay for his deviant acts of self-gratification over all these years. There is no way to put a price on mental health or a life free of abuse.

Posthumously, Savile will always be remembered as a monster of the worst kind. It’s no wonder that even now, more than a year after his death, he continues to make news headlines around the world…

Savile in an iconic looking pedophile pose

Savile in an iconic looking pedophile pose

Ever since I saw a documentary on Jimmy Savile being interviewed by the brilliant, Louis Theroux, as part of his ‘When Louis Met…‘ series, I have been meaning to write a post on this deplorable creature’s personality. The documentary was first aired in April 2000, but narration by Louis Theroux has since been updated to compare some of Savile’s responses during the then interview to the multitude of investigations in sexual abuse that have since arisen.

It’s not every day you see such a weird personality profile becoming a “national treasure” and a very successful media personality. With this in mind, I thought Savile would be a great example of one of the more eccentric personality disorders, called schizotypal, mixed in with comorbid narcissism. Here’s the current DSM-IV-TR (2000) criteria for STPD (which will very soon be superseded by the new DSM 5 criteria due to be released for publication in May 2013):

DSM Criteria for Schizotypal Personality Disorder (STPD)

Schizotypal Personality Disorder (STPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster A (odd or eccentric) Personality Disorder.

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for close relationships, as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Ideas of reference (excluding delusions of reference).
2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or “sixth sense”; in children and adolescents, bizarre fantasies or preoccupations).
3. Unusual perceptual experiences, including bodily illusions.
4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical, over elaborate, or stereotyped).
5. Suspiciousness or paranoid ideation.
6. Inappropriate or constricted affect.
7. Behavior or appearance that is odd, eccentric, or peculiar.
8. Lack of close friends or confidants other than first-degree relatives
9. Social anxiety that tends to be associated with paranoid fears rather than negative judgments about self.

At the very beginning of the interview with Louis Theroux, Savile and Theroux had the following discussion:

Louis Theroux: Were you that keen and excited to be involved in this project? 
Jimmy Savile: Yes, yes. 
Louis Theroux: Why? 
Jimmy Savile: I don’t know, I don’t know. But I quite like the idea of it. Because I’m odd, you’re different, that’s not a bad double. Between us we should be able to do something.

He sure as hell is odd. A little further into this post, I have included some more weird things Savile stated in the interview that will give you an insight into his schizotypal-narcissistic personality.

For those of you unfamiliar with the DSM-IV-TR (2000) criteria for NPD, here they are (again, soon to be superseded in May 2013 by DSM 5):

Narcissistic Personality Disorder (NPD) – The DSM Criteria

Narcissistic Personality Disorder (NPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as an Axis II, Cluster B (dramatic, emotional, or erratic) Disorder:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
3.believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
4. requires excessive admiration
5. has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
6. is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
7. lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
8. is often envious of others or believes that others are envious of him or her
9. shows arrogant, haughty behaviors or attitudes

Here’s some more of the strange ways in which Savile thought about life and himself:

Louis Theroux: Do you live here on your own?
Jimmy Savile: Yes!
Louis Theroux: So you don’t have a wife and family?
Jimmy Savile: No. None whatsoever. I leave that to other people.
Louis Theroux: Why?
Jimmy Savile: Haven’t the faintest idea. I don’t know. But I do like the idea of getting up in the morning with just me to look after and going to bed at night and not having any brain damage.
Louis Theroux: Why would you have brain damage?
Jimmy Savile: Because, the girls I know specialize in brain damage. Wonderful, that’s what makes them interesting…
Louis Theroux: What does that mean? I don’t understand what that means.
Jimmy Savile: Well, they drive me potty.
Louis Theroux: Really?
Jimmy Savile: Oooh, aye!

I love the brilliant broadcaster Louis Theroux!

I love the brilliant broadcaster Louis Theroux!

[Jimmy is packing to go on a cruise ship]
Jimmy Savile: Cigars, bigger ones for the TV and newspapers.
Louis Theroux: Why is it better to have a big one for the TV and the newspapers?
Jimmy Savile: Cos it sticks out more on the television.
Louis Theroux: [holding up a packet of Durex, smirking] Pack of condoms, is that…
Jimmy Savile: Whoa! Hope springs eternal in the human breast. Especially if you’re single.

Jimmy Savile (foreground) with Louis Theroux

Jimmy Savile (foreground) with Louis Theroux

A Peculiar Lifestyle

Even as an adult, when he wasn’t “on the road”, Savile lived with his mother up until her death in 1973. He referred to his mother as ‘The Duchess”, and he still preserves her room and her dresses in the same manner as she did when she was alive. “I loved the Duchess. She was totally special”, says Savile when remembering how he lived with her his “whole life” as if it were normal for all men to live with their mothers well into their late 40s. He describes his mother’s “golden hair” as being “the envy of many ladies” right up until her death. His mother was the most important person in his life and he flatly denies ever having a relationship with a girl…”not even for a week”.

Savile with his mother whom he affectionately referred to as 'The Duchess'

Savile with his mother whom he affectionately referred to as ‘The Duchess’

Why Not Watch ‘When Louis Met…Jimmy’?

This clip of some of Savile’s weird behaviour toward Louis Theroux, is a must to watch so that you can see first hand how strange his personality is. It’s a short clip (a little over 2 minutes), so check it out:

If you have the time to watch the full documentary, I highly recommend it. ‘When Louis Met…Jimmy‘ has been voted one of the top 50 documentaries of all time in a survey by Britain’s Channel 4. Here it is thanks to Vimeo:

The Ugly Truth

So if you’ve now seen the diagnostic criteria for STPD and NPD and watched even the short clip of ‘When Louis Met…Jimmy’, you can see for yourself that Savile was an odd mish-mash of these PDs.

It is a marvel to me that he was a very successful entertainer until I remember that he was also a pedophile who obviously had an insatiable appetite for sexually assaulting as many children/women across Britain as was humanly possible. As a children’s television presenter he had unlimited access to as many victims as he desired…he wasn’t just going to let such an opportunity slip through his fingers. In fact, the television programs were just a means to gaining the power and a cover for gaining the access he needed to become the world’s most prolific sex offender.

“Some people get hold of the fact that Jim likes looking after cadavers and say, ‘Aha, Jim’s a necrophiliac!’. I’m not a necrophiliac.” ~ Jimmy Savile

Whatever, Jimmy, you inhuman scrap of ipecac…just as long as you are a cadaver, Britain is a much safer place.

Please note: This post in no way infers that people with STPD or NPD are sex offenders. Sexual offending is not a criterion of either personality disorder discussed above.

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Personality Disordered Individuals: Bringing Out The Worst In You

Maybe Bruce Banner was in a relationship with a personality disordered individual?

Maybe Bruce Banner was in a relationship with a personality disordered individual?

Here’s a story that will hopefully sharpen up your personality disorder radars and alert you to the possibility that you may currently be in or were once in a relationship with a PD.

Last year a friend divulged to me that his girlfriend likely had borderline personality disorder. Through numerous discussions with him, it was very clear to me that she did indeed have a very severe case of BPD.

Borderline Personality Disorder (BPD) – The DSM Criteria

Borderline Personality Disorder (BPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as an Axis II, Cluster B (dramatic, emotional, or erratic) Disorder:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

1. Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5]

2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

3. Identity disturbance: markedly and persistently unstable self-image or sense of self.

4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5]

5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.

6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

7. Chronic feelings of emptiness.

8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

The Girlfriend

She had major problems, but had no insight so she blamed them on my friend, whom she was in a relationship with at the time. This woman had experienced a difficult childhood. Occasionally she was viciously violent and had even stabbed my friend in a fit of rage one evening (she minimise this of course, saying my friend had walked into the knife). She had lived a reckless life and had been taken advantage of and raped a few times as an adult. She always accused my friend of infidelity when he was always faithful to her. He loved her dearly, but she was convinced, despite his best efforts to continually prove it to her, that he never did. She would bring up his childhood traumas and call him vile names, wishing that he would “crawl into a hole and die”. She took over my friend’s life and controlled his every move. She would read through his text messages and delete friends and their phone numbers on his mobile. She would verbally abuse him and tell him to “leave”, but would berate him even more when he did leave the house, even if it was momentarily, saying that he had “abandoned” her. She would destroy his belongings and gifts that she had given him. Other times, she would threaten to set his belongings on fire if he did not come home immediately when she wanted him. She would accuse my friend of having a negative look on his face when he was serenely watching television. She would set psychological traps for him to test her twisted theories. She was emotionally labile (ie up and down) to the extreme. She was always worried about her weight and not having big enough breasts (despite having had a boob job) or being unattractive. She would be impulsive and do outlandish things like cut all of her hair off after experiencing difficulty with her work colleagues. She would cut herself with knives and drink petrol. She often threatened to kill herself and told my friend that it would be his fault if she did.

She was incredibly manipulative, controlling, needy, paranoid, abusive, impulsive and psychologically dangerous. If you asked my friend, she was also incredibly beautiful, good in bed, intelligent, and ‘special’ compared with other women. This is how she kept him ‘hooked’ on her like she was her own special brand of heroin. Without her, even though he knew she was destroying him, he would go into a type of withdrawal and look for any excuse to return to her to get his ‘fix’. The drama she caused was both traumatic and salaciously seductive.

Bringing Out the Worst

This BPD girlfriend would purposefully antagonise my friend and yell at him, “hit me” or “kill me”.

One day my friend did physically assault her. He is a bodybuilder and he pushed her hard, from one side of the bed over to the other side of the room. She immediately called the police. He was immediately horrified by his own actions. He had never assaulted a woman before. He had broken one of his most important values and was terrified of himself and what this relationship had brought out in him.

My friend took full responsibility for his violence toward her. He did not blame her for his actions in any way. He did however recognise that this relationship brought out the very worst in him. He saw himself enact things he never thought were possible in a loving relationship. He had never assaulted any of his previous partners nor had he felt the urge. He knew that being in this relationship was unhealthy and that it brought out the very worst in him. Although he loved her, he knew that a line had been crossed and that whereas he was still very much in love with her, that he had to learn to start letting go of this toxic love for both their sakes.

I too have noticed that with personality disordered people I am never completely myself. In fact, I have become things that I truly detest. This just gives the personality disordered person more fodder to use against you; to blame you for all that is wrong with the relationship, never having to accept any responsibility for their own bad behaviour. My friend’s BPD girlfriend repeatedly asserted that there was nothing wrong with her, though convinced him that he was an alcoholic and that he should get counselling for this and other psychological problems. She thought that because she had been to university and could hold a job that there was nothing wrong with her. Her insightlessness was pathological and just another one of her iron-clad ego defences to preserve her good feelings about herself.

I saw my friend bawl his eyes out on many occasions and drink to calm his anxieties. He was so confused. He was a mess.

What Being With a Personality Disordered Individual Feels Like

In this post I have used a real example of a woman with BPD in a relationship with a non-PD. However, BPDs are not the only type of personality disorder that will bring out the very worst in you…they all have the potential to do that.

There is a very strong ‘push-pull’ force in any relationship with a personality disordered individual. They can make you feel amazing one minute and insecure the next. They cannot control their own emotions but they’ll certainly hijack yours 🙂

You can never quite relax around them. You must always be on guard lest you make an unforgivable error that they will never forget. The ironic thing is, that even though you are so hypervigilant (or walking on eggshells, as I like to refer to it), you will probably feel like you’re screwing up this relationship like never before. You will have an inordinate amount of regrets over things you have said or done, leading you to feel that any problems are entirely your own stupid fault.

They will highlight your mistakes like a first year text book. But don’t you dare ever remind them of the hurt they have caused you…you might just make them feel guilty for what they have done and remind them they are not perfect. They do not possess enough emotional maturity to integrate this into their character.

You will be accused of being unforgiving and perhaps even that you are lying. You’ll feel as though you are going crazy, but you’re in fact, perfectly normal.

You will probably begin to pick up some of their PD traits, which are sometimes referred to as fleas (my mother has always said, “If you lay down with dogs, you are bound to get fleas”…it is true). You will wonder why the hell you have become so needy or abusive when you have never been like this in any other relationship.

The moral of this story is that if you get too close to someone with a personality disorder, such a relationship will very likely bring out the very worst in you. And if the personality disordered individual is anything like my friend’s former girlfriend, they may even taunt you and dare you to become a creature you will despise.

On that note, have a nice day, and remember to be kind to all people!

SLRfullblg

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The Ripple Effect: Can You Afford to Have a Relationship With a Personality Disordered Individual?

When I worked in prison the offenders were often taught about ‘The Ripple Effect’ to help them understand the far reaching consequences of their offending behaviour.

‘The Ripple Effect’ teaches that “when the offender does something it impacts a wide variety of people, not just those directly affected, or their families, but many people they do not even see”.

Water drops with ripples

You don’t have to have anti-social personality disorder and be in a CBT treatment program for offenders to benefit from knowing that everything that you’ve ever done, whether it was good, bad, or unclassifiable, has had an effect in this world.

I will never know how much suffering and grief I have personally caused on this planet, but the older I get, the more I try to maximise the positive influence I have and reduce the damage I have done and will undoubtedly continue to do.

‘The Ripple Effect’ can be used for immeasurable good too. The good we do can influence more good, rippling out into infinity. In fact, even if the drop to cause the first ripple was damaging, say, for example, some kind of abuse, then one of the subsequent ripples could begin creating further positive ripples. This is how new laws are introduced after such heinous acts are committed. I am reminded of Amber McIntosh and how she has been tirelessly crusading to stop malicious scammers like Marci Rose by having the Thomas Doty Law introduced. Some good people like Ms McIntosh interfere with the negative ripples so that something good can come from something so very bad.

The First Poisonous Drop

Rewind to a year ago…I was blissfully unaware of the trauma I would be put through in the coming months for befriending the woman who eventually became my ex-friend. As it turns out, she had a personality disorder, or OCPD to be more specific. She had some traits of other personality disorders too, but the OCPD was the friendship devourer.

I’m glad I didn’t know what laid ahead for me. Bad things are better left as surprises. Anticipating them is psychological torture.

I hope one day the memory of the first metaphorical drop being released onto calm waters dissolves into the background fog of my mind. Having a good memory is said to be both a blessing and a curse. In this instance, it’s clearly a curse.

To understand when the first ‘drop’ occurred, check out my post: Retrospective Analysis of a Friendship With an OCPDed Individual.

After the friendship had been devoured, it was like I had been poisoned…weakened from being treated like garbage. The world became my enemy because it provided an infinite amount of reminder cues for the loss of what I thought was a friend. In short, I was traumatised. Consequently I was psychologically very unwell and unable to continue my job at the time.

The Financial and Psychological Costs

To me, money is great. It allows me to travel and have a certain amount of freedom to follow my dreams and enjoy life, but it’s not everything. Without health, who cares about money? In fact, if you’re not very healthy, you may not even be able to work. The money you do have may be spent trying to improve your quality of life. Such was the case for me when I became traumatised.

I couldn’t wash my clothes without breaking down. I couldn’t talk without breaking down. I couldn’t do the grocery shopping without breaking down…you get the picture. It wasn’t good.

I made a doctor’s appointment to get written off for a few weeks sick leave in order to get my life back together. I immediately flew off to be with my younger brother who was understanding and supportive. He didn’t ask any questions which is exactly what I needed at the time. Unfortunately, I had used all my sick leave up prior to taking these few weeks off work, so the leave I took was unpaid. Lost wages were the last thing on my mind at the time.

I was still struggling immensely when I went to stay with my brother. I even thought that I’d chosen the wrong profession and that I was probably just screwing people up more than helping them.

I couldn’t eat and sleep very well, though I forced myself to consume food and tried various natural sleep aid remedies. I continued to lose weight and feel like I was going insane. I was really trying to get better and use every psychological skill I could recall to shift my extreme anxiety and subsequent depression. Despite giving it my all, I was a mess when it was time for me to return home…back to all the triggers for my emerging anxiety disorder.

I immediately returned to my doctor who agreed that I was not fit to return to work. I had never taken prescription medication before, except for antibiotics, had been resisting the idea of going on antidepressants. I knew that either I lose my pride and go on antidepressants or I would have to quit work. I chose the antidepressants. No one wants to see a psychologist who clearly is more of an emotional wreck than them 😉 Medication was my last hope at maintaining my employment.

When I returned to my doctor, he kindly respected my judgement and asked me what antidepressants would be best for me. I had never been on antidepressants before, but I’d done my research and liked the look of Zoloft (Sertraline) because it had been shown to be efficacious in trials with people with PTSD and OCD. I was experiencing trauma and although I didn’t have OCD, I had one of the primary symptoms: obsessional thoughts. My doctor immediately agreed to prescribe me 50mg of Zoloft. He gave me the rest of the week off work to adjust to the medication. Plus, I was still too scarily emotional to return to work as a psychologist.

The Physical Costs

After my doctor’s appointment, I drove to the pharmacy and filled my script for Zoloft. I took my first tablet as soon as I got home. I began feeling extremely dopey and fatigued. I didn’t mind. Feeling dopey immediately removed the crippling anxiety. Being fatigued just meant that I could fall asleep, which I was happy to do!

When I woke up a few hours later, I felt even more dopey. My thoughts were so clouded and I couldn’t think properly. It was like my brain and my mouth were disconnected…I couldn’t get my words out. My emotions were almost completely shut down. My blood pressure was high to the point that taking a few steps make me feel like I was going to keel over. My head was pounding. I was way off balance and I felt as though I might fall over when walking. My jaw was clenched all the time. Time felt like it had slowed down significantly. I was nauseous and completely lost my appetite for a few days. I had ongoing diarrhoea for the next few weeks. I had muscle weakness and tremors for the next few weeks. After initially causing me to sleep for a few hours, the medication then gave me insomnia for the next week or so. Surprisingly, on the first day of taking the medication, I felt better than I had in weeks because the anxiety was instantly gone! With no anxiety, the depression also disappeared.

After a few days I began to get my appetite back with full vengeance! I needed to put some weight back on because I’d got down to 42 kgs.

I decided to cease taking the antidepressants four weeks ago because I had dealt with my anxieties and related trauma and no longer felt I needed them. In the end, I took antidepressants for almost four months (October 2012 to February 2013). Even though I weened myself off the medication, I still got SSRI discontinuation syndrome. The way it has manifested in me is that I feel off balance when I’m standing or moving. It’s just like that feeling when you get out of an elevator and you still feel like you’re moving up or down…I have that feeling in my head most of the time. My body’s electrical circuitry also feels like it is sending pulses through my brain and body. The end of my tongue went a bit numb for a few weeks, just like it feels immediately after licking a battery.

I also have had auditory hallucinations in the form of weird sounds like bugs chirping when the pulses go through my brain and send me feeling like my head has just been riding an elevator. This was so annoying when trying to concentrate at work. I learnt to drown out the hallucinations with noise. I took my earphones to work just so I could type my notes up without feeling like I was so distracted by the noise and going insane. The overall effect was that I felt exhausted before the day ended. I also couldn’t think too straight and almost (accidentally) killed myself on two consecutive roundabouts when driving home one evening.

My head is still playing up and I still have the auditory hallucinations, though they are less frequent and less severe. They don’t bother me so much anymore. I’m hoping they will go completely in the not too distant future. Fingers crossed.

Cost to Clients, Friends and Family

Well my clients certainly had to fend completely for themselves in the time I was off work, which altogether would have amounted to about four weeks. These are people who need help and were relying on me. I hate any of my issues affecting anyone else in the slightest degree, so I really wasn’t happy that my problems had also impacted on their treatment. Aside from myself, of all the people caught up in the negative ripple, I think my clients incurred more damage than anyone else.

Supportive friends and family have been superb, but they’ve all had to listen to me become totally nutty and obsessed with how to detect and avoid being hurt by personality disordered individuals like my ex-friend. I’m sure they have got sick of me on more than one occasion.

I know I’ve freaked a few friends out in the past few months when they saw me crumble when they had always perceived me as so strong. I’m proud to say that I never took my trauma or anxiety out on my friends or family…my work colleagues even said they couldn’t tell anything was wrong with me at all, until I told them I couldn’t work anymore whilst crying over the phone.

A big thanks to all the friends and family who helped me through this difficult time…you know who you are. I’m almost 100% better now too 🙂

Summary of Costs

I’ve lost over AU$6000 in wages through sickness and being unable to work. I also reduced my hours for two months while I was readjusting to work, which left me out of pocket by a few more thousand dollars. I spent more than a few hundred dollars in getting to my brother’s home (flights and taxis) when seeking some support and company at the peak of my suffering. I’ve spent over AU$100 in medication and other more natural remedies. I didn’t have to, but wanted to acknowledge the support some key people have played in being there for me during one of the only times I’ve really needed support and kindness in my life, so I spent a few more hundred dollars in flowers. I also spent AU$150 on two counselling sessions. The financial costs for me in the space of just a few months was enormous, but it could have been worse if I’d had to surrender my job.

My mental and physical health have perhaps taken the biggest beating of all. No one is worth the kind of suffering and pain my friend so callously inflicted on me.

My friends, family, colleagues and clients have also been affected by the ripples in various different ways. I became someone who people could no longer rely on as any kind of support because I needed it so badly myself at the time.

The crazy thing is that my ex-friend, the one with the ongoing personality disorder, is oblivious to all the damage and destruction she has caused. Completely and utterly unaware. When I have attempted to give her a small bit of insight into the effect some of her actions have had on me she has denied what she has done or minimised it. She has no idea and doesn’t want to know either. She just goes merrily about her way without another thought for her actions. How utterly bizarre.

Believe me, no one can destroy your life like a PD!

The Positive Ripples

After all is said and done, I have learnt an incredible amount along the way. I began reading and researching personality disorders more than ever before. I started this blog on the advice of a friend (thanks again, Nerida 🙂 ) which has in turn given me the opportunity to process my own emotions, educate others and validate the experiences of many other people who have gone through similar suffering at the hands of some personality disordered person.

My own nutty obsession has helped me to educate and be more compassionate toward my clients too. I now have an appreciation for what people go through when taking medication to better their mental health status and also what their bodies go through when they cease taking the medication.

Friends, family and colleagues contact me now when they are dealing with a personality disordered client, family member, coworker etc. I’ve been able to help non-PDs stop personalising all the abuse and mistrust they receive from PDed loved ones. I have always known what personality disorders were since studying psychology, but I’d turned a blind eye to PDs to a large extent, not wanting to over-pathologise. What I actually did was under-pathologise by not recognising or acknowledge the pathology that exists all around us.

I feel good about what I have been able to achieve over the past few months since almost losing myself completely.

I’ve lost some of my ego in the process, which isn’t such a bad thing. I was made to be humble and brought to my knees, which in turn made me teachable. I have learnt a hell of a lot in a short space of time. I’m determined to keep learning and to never make the same mistakes with befriending someone like my ex-friend again.

I don’t think people should never be friends or have relationships with PDed individuals, I just want people to know what they are getting themselves into ahead of time, rather than in the fallout later on. Informed decisions are the best decisions!

This post is dedicated to two people: firstly my brother who was there for me when I needed his support. He has continued to listen to me ramble on about all things personality disordered over the past few months with a very open mind 🙂

Secondly, a big thank you to my coworker, Chris, for letting me come and talk your ear off about the PDs in my personal and professional life when you have more than enough work to do already 😉 Listening to me and showing that you care has meant the world to me 🙂

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Learning About Psychopaths: Immaturity…It’s Never a Good Sign

psychopath-advisory

A friend of mine, who is soon to be divorced from her psychopathic husband, recently said to me that whilst dating the said psychopath she found his immaturity endearing. I recall the two of them picking me up from the airport a few years ago. He was driving her car like a maniac to the point where I was actually telling him to keep his eyes on the road. I was genuinely fearing for my safety for the duration of the trip. He thought it was funny and appeared to be having the time of his life.

We all knew he was just a big ‘boy’ in an adults body, which I am sure has it’s charms in the right situations, but it gets a little old when there’s bills to pay and he can’t keep a job, though chose to spend what little money he did have on X-Box online gaming credits. Immaturity starts to dissolve a relationship when such ‘boys’ do not have the emotional maturity to work disagreements out like an adult. Instead he would lie incessantly, blame her for all his weaknesses, take out his frustrations on her dog (by which I mean abuse and eventually kill her dog), sign up with online dating sites to “talk” with women about his marital problems, and sit around on the couch whilst his pregnant wife who was very unwell did all the cleaning. Due to his blatant disregard for his responsibilities, my friend almost ended up living in a communal women’s refuge centre with a newborn baby…which is only one step better than living on the streets.

Before he and my friend married, we all knew he was a little immature and had a few issues, but hey, nobody’s perfect, right?

I had been a psychologist for many years before my friend began dating this douche, but I hadn’t fully developed my sensitive radar for detecting personality disorders back then. I wish I’d been sharper. If I knew then what I know now, I would have screamed at my friend to stay away from him and never become engaged to him let alone marry the jerk. I would have begged and pleaded for her to never see him again. I wouldn’t have cared if it ruined my friendship with her…I would have done anything to warn my friend. If I’d been a little more astute, perhaps she could have ‘dodged a bullet’, moved on from him and met a real man instead?

Oh, hindsight! Where were you when I needed you?!

After all my friend has endured with this horrible psychopath over the past few years, she is now repulsed by immaturity and it’s no wonder! Detecting immaturity has become part of her radar warning system when incoming psychopaths are near.

Detecting immaturity on the PD radar

Detecting immaturity on the PD radar

Just so that we’re all on the same page, a psychopath is a common term for Anti-Social Personality Disorder (ASPD). Here is the diagnostic criteria for ASPD found in DSM-IV-TR (2000):

Antisocial Personality Disorder (ASPD) – The DSM Criteria

A pervasive pattern of disregard for and violation of the rights of others occurring since age 15, as indicated by three (or more) of the following:

  1. Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
  2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
  3. Impulsivity or failure to plan ahead
  4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults
  5. Reckless disregard for safety of self or others
  6. Consistent irresponsibility, as indicated by repeated failure to sustain steady work or honor financial obligations
  7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

The manual lists the following additional necessary criteria:

  1. The individual is at least 18 years of age.
  2. There is evidence of conduct disorder with onset before age 15 years.
  3. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.

I think a lot of people get confused over the meaning of ‘anti-social’. ‘Anti-social’ is the opposite of ‘pro-social’ which means law abiding and positively contributing to society. Anti-social does not mean a person is opposed to socialising. In fact, ASPDs can be gang members or big company CEOs.

Prosocial behaviour, or “voluntary behaviour intended to benefit another”, consists of actions which benefit other people or society as a whole, such as helping, sharing, donating, co-operating, and volunteering. These actions may be motivated by empathy and by concern about the welfare and rights of others,  as well as for egoistic or practical concerns. Evidence suggests that prosociality is central to the well-being of social groups across a range of scales. Empathy is a strong motive in eliciting prosocial behaviour, and has deep evolutionary roots ~ Wikipedia

The terms ‘psychopath’ and ‘sociopath’ are also often used interchangeably. What is the difference you may ask? Not a lot if you’re in a relationship with one. In truthfulness, there is no difference so far as diagnostic criteria go. However, the term sociopath is usually used in reference to an individual that exhibits ASPD traits that are believed to have manifest as a result of the environment, whereas psychopaths are ASPDs whose genes have created the disorder. In other words, Nurturists who believe ASPDs are ‘created’ would use the term ‘sociopath’, whereas Naturists who believe ASPDs are ‘born that way’ would use the term ‘psychopath’. Many people who use the terms ‘psychopath’ and ‘sociopath’ interchangeably are not making a statement about the heritability of ASPD, but are just talking about people who can do some of the worst things imaginable and still sleep soundly at night. Potato, potato; tomato, tomato…

Contrary to what the media would have you believe, psychopaths are rarely killers. They are usually seemingly ‘normal’ people such as your boss at work, a used car salesperson…or if you’re really unlucky, they may even be your partner.

Anyway, back onto my musings about immaturity…your average garden-variety psychopath is painfully and visibly immature where it matters most: emotionally.

Immature

– adj
1. not fully grown or developed
2. deficient in maturity; lacking wisdom, insight, emotional stability, etc
3. geography  a less common term for youthful

They are immature in that they are often unable to obtain or maintain employment and so many other things, but what stands out to me the most is that they are immature in the way they do not possess adult skills manage conflict, such as taking responsibility and admit fault for their actions, listening with intent to understand the perspective of another, the ability to empathise, etc.

What makes a person an emotionally mature adult? It is our ability to feel our own pain and process this effectively coupled with learning new skills and methods of coping each time any emotion passes our way that builds emotional coping skills and maturity. When we are in touch with our own pain we gain insight into how our actions influence others. If we are a non-personality disordered individual, this is how and when we begin to develop empathy for others. Because, when we are in touch with our own emotional pain, we certainly would not want others to feel the same way (unless you’re a psychopath…or a BPD seeking vengeance).

We then develop mindfulness in our communication and behaviour toward others in order to carefully avoid inflicting the same kind of pain we have also felt, on another human being. For some, empathy turns into compassion when they are subsequently moved into action so as to alleviate the burdens and suffering of others.

The development of compassion is the pinnacle of emotional maturity. It takes us one step further than empathy, which solely gives us valuable insights into the subjective experience of another without obligation to assist them in any way.

It’s not just psychopaths that are emotionally immature…I’d have to say it’s a trait common to all the personality disorders. Just by nature, personality disordered individuals either do not experience the full range of emotions, are unable to manage their emotions or have other emotional problems. When in therapy, personality disordered individuals are taught to ‘get in touch’ with their pain and suffering, to learn to sit with and endure the course of any emotion, and to accept full responsibility for their own emotions.

All personality disordered individuals will experience a drop in empathy when they are under stress or pressure. They will only think of themselves and be blind-sighted to the experience and emotions of others. Everything will begin to revolve around the personality disordered individual (if it doesn’t already) and your opinions, experiences, emotions and thoughts will be considered unimportant and will likely only serve to frustrate them further. Their ability to care for anyone but themselves will exit the building. Get ready to be blamed and criticised to within an inch of your life.

Don’t expect them to apologise once the stress dissipates…it’s still always all about them and your feelings don’t matter. If they do apologise, don’t expect them to never again repeat their apathetic and critical behaviour…next time they can’t cope with their emotions, they’ll influence you to believe that your thoughts and feelings are worthless all over again.

Beware of emotional immaturity. It is never a good sign.

For some personality disordered individuals, especially borderlines, their emotional sensitivity is high and their ability to process and manage emotions is very low. To manage their emotions they will often develop unusual ways of releasing their emotional pain, such as by ‘cutting’ their skin and spilling their blood or will find remedies that produce instantaneous numbing effects such as drinking and drugs.

Chemical Induced Psychopathy

When people drink and take drugs to excess they are usually trying to numb some kind of emotional pain. Unfortunately they don’t get to choose which emotions they want to shut off or want to feel, so guilt dissolves and they become capable of all sorts of dodgy things. This is what I would call the chemical induced psychopath. Their sober personality is not psychopathic, but under the emotion-numbing effects of substances, they lack remorse or empathy. Scarily, they are then capable of anything and everything that a sound-minded individual would never do.

Chemical Induced Emotional Immaturity

People think that drugs and alcohol help them to manage their emotional suffering when in actual fact, substances just alleviate the sufferer of feeling the pain and developing adaptive strategies for processing their emotions. Drugs and alcohol stunt emotional progression. If someone develops an ongoing substance abuse problem at age 16, then when they go to rehab at the age of 33, they will still have the emotional maturity of a teenager. Such people, whereas they are not necessarily psychopathic, they are emotionally immature.

Is immaturity ever a good sign in an adult? No, no it is not. My dear readers, consider yourself warned! 😉

Here’s a card I found last year that I really liked but would have a hard time giving to anyone…

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The moral of this story: Immaturity can be charming, but can also be damn near soul destroying when it never goes away.

Thanks for reading this post! Remember to tell everyone who will listen about personality disorders and how they can break your heart into a million tiny pieces if you get too close.

Oh, and in case you are wondering, my friend and her baby are doing really well! They live in a really nice area in a modern unit that has enough space to have a spare bedroom that I can sleep in when I visit 🙂 My friend, this post is for you…you know who you are 😉 Love you lots!!! ❤ xox

Be kind to yourself and everyone with whom you come in contact 🙂

Want to read more about psychopaths and how to recognise them?! Check out the best WordPress blog on the topic at Dating a Sociopath. Here are some specific links to pages within this great blog:

I highly recommend you check this blog out ASAP! Enjoy 🙂

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Is The Tea Towel Wet or Red?

Can't a tea towel be both red and wet?

Can’t a tea towel be both red and wet?

To answer this, I would have to see the tea towel in question.

It is entirely possible that the towel is indeed wet and red! Being wet does not change the fact that the tea towel could also red; similarly, nor does being red exclude the possibility that the tea towel is wet.

What’s all this talk about wet tea towels on a website devoted to educating people on personality disorders?

Lend me five minutes of your time and I’ll explain…

Most people can grasp the concept that a tea towel can be both red and wet, so why, when we see in the media, that someone has committed a heinous act such as murdering their own children, do we ask if someone is mad or bad, like they must be one or the other?

Just like the tea towel, ‘mad’ and ‘bad’ are not mutually exclusive. That is, it is possible for a person to be both mentally ill (ie ‘mad’) and have a comorbid (ie co-occurring) personality disorder (ie ‘bad’). In fact, many people with personality disorders also fulfil criteria for one or more mental health problem.

This does not mean, however, that they are ‘mad’, which is a common term to imply that an individual has a psychotic disorder, such as schizophrenia, that may at times render them otherwise not-in-control of themselves.

Having a mental health problem does not equal ‘madness’ per se. The vast majority of people who fit the criteria for a mental health problem (such as depression, social phobia, PTSD, anorexia, etc) would not be considered ‘mad’ by lay or professional standards, unless they were experiencing hallucinations or delusions that alter their perception of reality.

And, in case you were wondering, yes, it is possible for a person to be ‘bad’, which implies having a personality disorder, without suffering a comorbid mental health problem.

Hmm…perhaps I’m making this a little confusing. Traditionally, mental health problems such as mood and anxiety disorders (to name but a few) have been differentiated from personality disorders, which were considered to be ‘behavioural disorders’. With advances in neuroscience and personality disorder (PD) research, such a distinction is rapidly becoming outdated because PDs are increasingly considered to be genuine mental health conditions.

Even so, if we were to continue to distinguish between PDs and mental health conditions, PDs are far more represented in the global prison population than those traditionally labelled as ‘mad’.

Anders Breivik: Mad or Bad?

Mad, bad or both?

Mad, bad or both?

On July 22, 2011, Norwegian Anders Breivik killed 75 people, as a statement against Norway’s liberal immigration policies. He was a member of an extreme right wing group and a product of a dysfunctional childhood. But was he rational and deliberate, or just mad?

That’s the question the court will have to answer at the end of Breivik’s ten-week trial.

Competing views

In January 2012, two court-appointed psychiatric experts conducted extensive assessments of Breivik’s mental state. After 36 hours of interviews they handed down a 234-page report that concluded Breivik suffered from a paranoid schizophrenic disorder and was acting on his delusional beliefs.

But following appeals from lawyers representing the interests of victims, the court sought the opinion of two further mental health experts. Contrary to the past assessment, the second set of experts determined that Breivik was not psychotic, or severely mentally handicapped at the time of assessment, nor at the time of the offending.

All the experts agreed that Breivik was an extremely high recidivism risk. (Click here for article Source)

Interestingly, studies, such as the 1996 General Social Survey in the US, have found that many have a negative view of people with mental health problems and erroneously exaggerate the “threat” or “impairment” associated with the mentally ill. There is research to suggest that even when mental illness is controlled for within a population, low socioeconomic status is a better predictor of criminal offending behaviour.

Having worked in prison myself, the vast majority of the inmates I worked with had low-level literacy skills, minimal education, a history of abuse and neglect, and were raised in socially disadvantaged families and neighbourhoods. A very small percentage had some form of psychotic disorder…they were definitely the exception.

I have often heard people speculate that in order for a human being to commit an extreme atrocity, they must be ‘sick in the head’, believing that your average human being could not commit such an act. This is not true.

The vast majority of people who are sent to prison for terrible crimes are considered sane in the eyes of the law and psychiatry. Their personality pathology usually explains, though never justifies, their abhorrent behaviour meaning they are more likely ‘bad’.

The truth of the matter is that many offenders have antisocial personality disorder (ASPD, also known as psychopathy or sociopathy), avoidant personality disorder (AVPD), or borderline personality disorder (BPD) (or a combination of PDs). Whereas they may have a comorbid mental illness, it is unlikely to be a psychotic disorder such as schizophrenia that could possibly render them as ‘mad’ (even with a schizophrenia diagnosis, an individual may not be considered ‘mad’ or habitually out of touch with reality).

Hopefully this post adds some clarification to the confusion over how people who are technically sane are often the ‘bad’ ones to commit the most atrocious crimes.

Please Note:  Whereas Cluster A personality disorders within the DSM-IV-TR are colloquially referred to as the ‘mad’ PDs, violence toward self and others is not included in the diagnostic criteria for this sub-group (ie Schizoid PD, Schizotypal PD and Paranoid PDs) nor are they commonly represented in the prison population. Violence toward self and others is in fact part of the diagnostic criteria for for ASPD and BPD; however, not everyone with BPD or ASPD commit offences or are violent toward themselves or others.

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Radical Acceptance for BPDs and Non-BPDs

Radical Acceptance

Definition: Letting go of fighting reality. Accepting your situation for what it is.

Despite popular belief, adversity and trials do not aways make us stronger. Sometimes they destroy people to the point that they are never able to resume pursuit of their goals and ambitions. Others are never able to have relationships or work again. Some people end up in psychiatric wards for years…others never leave the safety of their own home. Plenty of people can no longer go on living and choose suicide.

‘What doesn’t kill you only makes you stronger’, is not a truth. If it were true, there would be no such thing as trauma. We would all be getting more resilient as we got older. Alas, this does not always happen.

There are only a few options that we have when we encounter major life problems. We can: 1) try to change the problem, 2) change how we see the problem, 3) accept the problem, or 4) do nothing and continue to feel unhappy.

There are some problems, such as past childhood traumas, that we cannot change, no matter how much we wish that our lives had been different. It is possible to change how we perceive the problem, but what if there is no issue with how you see the problem (perhaps your current view is not exacerbating your problem) and it is still negatively affecting you? Reframing the way a person might perceive their childhood trauma will not necessarily take the suffering out of the traumatic event.

When we accept something, it does not mean that we have suddenly learnt to like the problem. It means that we simply (not that acceptance is a simple process) acknowledge the reality of the problem and we stop struggling with trying to change something that we have no power to control.

Radical acceptance is a type of acceptance that is not for the faint-hearted. It’s brilliant though, because it gets us to stop fighting a reality that we would rather not accept. Without acceptance of the things we cannot change we will never be truly happy…we will have a life of struggle.

A metaphor to help explain radical acceptance:

Radical acceptance is not simply a cognitive stance or cognitive activity; it is a total act. It is jumping off a cliff. You must keep jumping over and over because you can only accept in this one moment. Therefore, you have to keep actively accepting, over and over again in every moment.

If radical acceptance is jumping off a cliff into the deep abyss, then there is always a tree stump coming out of the cliff just below the top and the minute you fall past you reach out and cling onto that stump. And then you’re on another cliff’s edge, asking perhaps, “How did this happen?” Then, you jump off the cliff again.

Radical acceptance is the constant jumping off, jumping off, jumping off and jumping off, yet again. Radical acceptance is also the nonjudgmental acceptance of the repeated grabbing onto the tree stump. ~ Marsha Linehan (founder of DBT)

Radical acceptance is a skill taught to people with borderline personality disorder (BPD) as part of DBT treatment. As with most therapeutic tools, they are as relevant for the general public as they are for individuals in treatment.

Like my OCPDed ex-friend would often say, “life is unpredictable”. She felt scared by this. I encourage you to feel excited by the unpredictability of life. It means that even when you least expect it, there is probably something exciting right around the corner. By the same token, when life really couldn’t get any worse, go jump off a metaphoric cliff…keep jumping…keep hoping that there is some branch jutting out of the cliff that will catch you. Keep jumping…keep hoping that by ‘letting go’ of things you cannot change, you will find acceptance and a better future.

Be kind to everyone you meet; they all have their problems. If you can’t be kind, please do no harm.

Keep jumping!

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16 Things to Look For in a Friend (or Partner)

Be slow to fall into friendship; but when thou art in, continue firm and constant ~ Socrates

I adore my friends! If you are one of them, then you would already know how much you mean to me. I can’t take for granted their kindness and support they give me, or how they give it so freely.

Friends truly are the family you get to choose. I have been blessed to have had so many wonderful friends over the years. I’ve also had a few that I would have been better off never meeting because they have been so damaging. None have been so damaging as the person I refer to in this blog as my ‘ex-friend’ the chameleon and cruel deceptor.

I want to share with you what I have learnt about what makes a true friend. Please read this with a flexible mind and allow yourself to be truthful about how some of the people you currently refer to as ‘friends’ could be snakes that will eventually bite you.

Here are the things I admire in my closest friends:

1. Loyalty: You really want a friend who has the loyalty of a dog…someone who will be there for you through thick and thin. They would never denigrate you when you’re not around, or throw away your friendship like yesterday’s news. They don’t care what you look like and they genuinely love you for who you are, not what you can offer them.

The counsellor, Mary, that I went to see a few times last year asked me, “Can a friend ever really become ‘not a friend?'”. She made a good point. Someone who is a real friend will continue to love you…even when they get frustrated with you. They will always stand by you.

2. Integrity: A friend who is an honest and steadfast person who can experience the full range of emotions, but doesn’t change to impress whomever might be around. To have integrity, an individual must possess values, a moral code and a personal set of ethics. A person who has integrity doesn’t do the ‘right thing’ because people are watching, they do what they believe to be right regardless. Having integrity is not about keeping up appearances.

If a friend does not possess integrity, you cannot trust them. If you are not already aware of the potential a person who lacks integrity has to negatively influence your life, just stick around. They will eventually hurt you too.

3. Emotional maturity: We develop emotional maturity when we are in touch with our own emotional pain. Even though life isn’t always easy, and we have all had such different experiences of life, all humans (except maybe psychopaths) share a common understanding of what it is like to feel the whole spectrum of emotions. We can all relate to feeling sad, angry, lonely, jealous, guilty, remorseful, shocked , fearful and joyous to name a few.

Many people are not in touch with their own suffering and emotional pain because they choose to suppress it with drugs or alcohol, gambling, gaming, pornography or any other addiction. Many people also use the ego defence mechanisms of denial, projection and blame because they lack the maturity to feel or perhaps integrate their imperfection into their illusory perception of themselves (as is the case often with people who have OCPD, NPD, ASPD and BPD).

When we are in touch with our own pain we have a lived experience of what it is like and how horrible it can be that we do not want to induce such a feeling in others, nor can we stand idly by and watch another suffer. Because of this, emotionally mature people feel compelled to relieve the suffering of others…not contribute to it…this is what we refer to as compassion.

A person who is emotionally mature accepts responsibility for their actions and can admit when they are wrong. They do not blame, nor do they make excuses for their mistakes. They can accept criticism and are mortified if they have hurt someone unintentionally. Emotionally mature people have good interpersonal boundaries at home, in the office and in their social life.

4. Respectful: A true friend will love you for who you are, not because of some superficial coincidence, such as a similar taste in music or being members of the same church. No person on this planet can legitimately claim that they love you if they do not respect you. We are all born to different families in different cultures, with different experiences and values. A friend should never have to agree with everything you think, say or do…but they need to respect your feelings, beliefs, values, goals, ideas, plans, history, race, gender and sexuality.

My recent ‘ex-friend’ with OCPD could never accept my emotions or opinions if she could not relate to them in any way. She would sometimes get angry with me if I felt a certain way, especially if her words or behaviour had influenced me to feel hurt. If I had different opinions than her, then she would get frustrated with me and call me, “opinionated” and “stubborn”. I’d never had a friend that would get mad with me for having my own opinion. I always respected her opinion even if it differed from mine. My ego never got in the way of me respecting her unique ideas. I learnt that it was better to hide my opinions because she had once directly told me that she did not like hearing my opinions. She would still often ask me for my opinions, but most of the time I chose to deny that I had any personal views for fear of her criticism, rejection or disapproval.

Oddly enough, she thought that if she showed me understanding, her validation would mean that she agreed with me. Not so. I found it incredibly frustrating to explain to her why I felt a particular way, going to lengths to explain/justify my experiences or beliefs that had influenced my emotional state. Needless to say, I could tell that my ex-friend was egocentric and lacked respect and empathy. If you have a friend who is ever like this, then know that they are not a true friend.

Love does not exist in isolation. To be true, it must be accompanied by respect.

5. Thoughtful and Kind: We all need to feel special. When people remember us on our birthdays, sad anniversaries, graduations, Christmas, New Year, when we’re sick, when we’re promoted, when our beloved animals die and so on, we feel their love and it helps us to recognise that we are worthwhile. Some friends can make us feel the opposite of special when they forget us or are purposefully cruel. You deserve to feel important and to receive kindness from your loved ones, including friends!

Last week it was my birthday. My friends and family gave me thoughtful presents, touching cards, creative sms messages, and phone calls. Even my colleagues wished me well and were interested to hear how I spent my birthday (because I had the day off work). Friends attended my birthday celebrations throughout the day and were very kind to me. I felt special and appreciated…which is a nice feeling 🙂

6. Someone who is there for you through the good times and the bad: This is fairly self-explanatory. If someone is only interested in being your friend when everything is fine, then they are not really a friend. If a good friend abandons you because you are going through a rough patch, then they have done you a favour. They are a waste of your time. They were only ever using you. You really do find out who your friends are when the going gets tough.

A lot of people with personality disorders find it very difficult to manage stress and may even blame you for being “negative” or “stressful” to be around when your life is not perfect. Sometimes people with OCPD will abandon you if they perceive you as contributing to their stress levels. In other words, when the going gets tough in your life, some of your ‘friends’ will kick you to the curb, even if you have a history of positivity and happiness.

Over the years, just knowing that my friends are there for me is enough. In October 2012, I was going through utter hell after being rejected my my ‘ex-friend’. Another friend brought me a zombie movie over, candy, chocolate and Valium to show that she cared about me through a very difficult time. Other friends listened to me, organised counselling for me and offered their homes to me. A true friend is always there for you no matter what because they love you for you…not for how perfect or positive our life is.

7. Someone who possesses mental flexibility: People who are intrinsically rigid minded are very ‘black and white’ thinkers and do not make for very good friends or partners. People who are rigid minded can find it difficult to understand that good people can do ‘bad’ things and make mistakes once in while without becoming a ‘bad person’. No one will ever have empathy for you if they do not possess flexibility of mind.

8. They understand you and accept you for who you are: I found a quote by Jim Morrison that says, “A friend is someone who gives you total freedom to be yourself”. There is no greater freedom that we can afford ourself than to be true to ourselves. There is no greater freedom that we can afford others than accept them for who they are. Acceptance is an amazingly beautiful thing.

My ex-friend was always suspicious when anyone was kind. She really believed that people would only be kind to her because they wanted something in return. She found it extremely difficult to understand that I only wanted to help her because I wanted to relieve her burdens. She eventually believed that every act of kindness I had ever sent her way was because I had an “agenda”. I tried to explain that I was only ever kind to anyone because I cared. At the time, her suspicions of me truly broke my heart. I knew my reasons for being kind…as confusing as this has been for me, I have come to accept that my ex-friend never actually saw who I was…she never knew me…she didn’t believe me when I told her that I was kind to her and others because I care…she never saw me as a kind person. She thought I was manipulative and that I wanted to make her “dependent” on me. My ‘ex-friend’ eventually ended the friendship because she saw me as a monster who wanted to harm her. If a ‘friend’ has been given enough opportunities to see your true character, but still cannot see who you are inside, then they do not genuinely accept you.

Personality disordered people have iron-clad ego defence mechanisms and unique brain neurophysiology that predispose them to thinking very differently than the average person. They will never truly understand you or think like you. In fact, during periods of extreme stress, they may treat you like someone they do not know at all. Such people may firmly believe that they know you, even when you get the distinct impression that they are way off mark.

Furthermore, anyone who tries to change or control you does not accept you for who you are. They undermine your ability to make good choices for yourself and influence you to feel unworthy of their time and attention. Anyone who makes you feel like this is not worth the effort. Surround yourself with good people who are occupied with reflecting on their own behaviour and personality rather than criticising others. There will always be people who do not accept us the way we are…my advice is to avoid friendships with such people.

9. You can trust them and they trust you: If a person is routinely suspicious of others’ kindnesses, then there is something amiss with them. Perhaps they do not believe that trustworthy people exist, because they cannot be trusted? If you have always been trustworthy to a friend, maybe their inability to trust says more about them than you.

Trust is the foundation of any relationship…without this, you’re screwed! It is an awful feeling not to be trusted by someone whose only reason to distrust you is their own insecurities. Nothing you do or say will ultimately influence them to trust you. Not being believed and having ulterior motives attributed to your every action can have a detrimental impact on your self-esteem.

If you get a gut feeling that you cannot trust a particular friend when you otherwise have a trusting relationships with other people, ask yourself why you feel like this. Don’t turn a blind eye to your instincts. Listen if what they say and do is congruent. Do they contradict themselves frequently? Are they hypocritical? Do they criticise people, including other friends and family members, behind their backs frequently? Are they honest in all their dealings with other people? Do they ever justify being dishonest in certain circumstances?

And here’s the big tell-all question about trust…do you trust this friend more with your bank card than your emotions? If so, then you clearly cannot trust this individual with the important stuff…in other words, you do not trust them with you. A friendship with such an individual will come to a nasty end eventually.

10. You feel you can tell them anything without fear of judgment or abandonment: Again, this is self-explanatory. If you feel that you are walking on eggshells, then you are unable to be yourself in this relationship for fear that ‘something bad may happen’. Do not allow yourself to be held emotionally ransom.

Even the best relationships will require renegotiation of boundaries or discussion to resolve any conflict or hurt feelings that have occurred in the relationship. If you feel hurt by something your friend (or partner) has done and are fearful that if you discuss it with them they may criticise your feelings or threaten to abandon you, then such an individual has major psychological problems. No matter how good your communication or conflict resolution skills are, you will never be able to resolve problems with this person. You can choose to suppress your hurt and allow your boundaries to be violated or you can choose to be real about the limitations of this friendship and move on. Your welfare is essentially up to you.

11. Has insight, will admit when they’re wrong and apologise: Even a broken clock (an analogue clock for the purpose of this analogy) is right twice a day. If you find that a friend criticises you, but never apologises when they make mistakes or influence you to feel hurt (whether it is intentional or not), then understand this: they will always put their ego and pride above you.

In the same way that it is not possible for anyone to be wrong all the time (as in the clock anology), then the opposite is also true: no one is right all the time either. We all make mistakes and need to exercise humility to acknowledge this fact. Many people with personality disorders have not developed the emotional maturity to manage feelings of guilt and remorse (ASPDs possess a pathological inability to experience these emotions, let alone acknowledge they did something wrong).

When my ex-friend ended our friendship the first time she denied that she had done anything hurtful toward me because she experienced a reduction in her stress symptoms…in other words, her strategy, no matter what collateral damage was incurred, had worked for her, so who gave a stuff about my feelings? She did not care that she had destroyed me emotionally because she had perfected the art of apathy. Needless to say, she never apologised to me. Knowing that she did not care about me messed with my head. A simple apology would have benefitted me so much at the time because it would verify to me that she cared about how I felt. Her lack of apology and justification of her behaviour (she actually also denied ever ending friendship even when I had the email to prove it) demonstrated to me that she could not care less about me. Never before have I had such a good friend treat me as though I was utterly worthless like she did when she chose to ignore my pain and justify her extreme behaviour.

When people do not apologise, this is a good sign that they do not care about you. Instead, they value never being wrong. To acknowledge they made a mistake would be too much for them to handle. It requires maturity and healthy boundaries to apologise. Personality disordered individuals like my OCPD ex-friend, lack emotional maturity and bend boundaries to suit their ever changing moods.

For people to admit they are wrong, they first need to have insight into their own behaviour and how it affects others. No insight should always be a deal breaker.

12. Good sense of humour: For a friend to have a good sense of humour does not mean they have to be hilarious or quick witted. It means that they can appreciate that life doesn’t always have to be serious. Life can be really difficult sometimes. At the moment my colleagues and I are waiting every day to hear whether we too have lost our jobs under the new government’s “restructuring” (a euphemism that means they are culling jobs like there is no tomorrow) plan. Some colleagues have already lost their jobs and morale is sometimes low while we wait to find out if we are next. Tough times can be balanced with good humour by seeing the funny side of the scenario.

Friends that possess a good sense of humour allow us to ‘let our hair down’, to have fun and to be funny! 😀

13. Can effectively manage stress: It’s an odd concept to me that people will often say they feel that being in a relationship helps “balance” or “even” them out. My ex-friend even once said the same thing to me about our friendship. Rest assured that this is not a good sign and try not to be too flattered if someone says this to you. It just means that they cannot handle life’s stressors without relying on your relaxed mood to chill them out. By the same token, if they rely somewhat on your influence to help them relax when you are just being your usual calm self, you will probably also be rejected by this person during times when you are feeling a little stressed because you no longer providing them with comfort and you will cease to have the mood stabilising effect they have come to rely on.

We all need to develop the ability to self-soothe in adaptive and sustainable ways (ie without relying on anyone to do this for us) when we are stressed. When people cannot effectively manage stress, they can be very volatile and stressful people to be around. They allow themselves to be controlled by their own anxieties and will push you around with their fear if you give them half a chance.

Common maladaptive ways that people cope with stress include substance abuse, gambling, sexual addiction, crime, blame, trying to control others, shutting down, overeating, starving oneself, impulsive spending, getting into a new relationship rapidly, terminating relationships and so on.

14. Has empathy: Unless a friend has the ability to see things from other people’s perspectives instead of their own very narrow and extremely limited experience, then they will never properly understand you and are likely to be judgmental and critical. A person who has empathy can ‘take a walk in your shoes’ so to speak. They have the ability to see your situation from your perspective though they may never have had a similar experience, nor may they have responded to an experience in a similar way. Regardless, when empathic, they can non-judgementally gain some insight and perspective into your world without being you.

You can tell if a friend lacks empathy if they criticise your feelings or decisions because they would not have felt the same way in a similar situation, nor would they have made a similar choice. A lack of empathy will destroy any relationship. Get out as soon as you can.

15. Both shares of themselves and listens to you: I realised very early on in the relationship with my ex-friend that she would only ever ask me questions to set the stage for talking all about herself. I would try to answer her questions and while I was talking she would cut in and start on a tangent about the thing that was already on her mind. She had an agenda for any question that she posed…it was always just so she could talk about herself. She would rarely listen when I spoke about my life, but she had mastered turning every conversation into how it related to her. Boring!

16. Not a victim nor an island: People who habitually present themselves as victims have major psychological issues, as do people who believe they are independent and do not need others for anything, ever. It’s good to be independent, but at an extreme level, this is just another name for having rigid boundaries, commonly known as ‘walls’

I hope this post has been useful in assessing your friendships and perhaps relationships.

This list comprises the very minimum requirements in what a friend should possess to be a ‘true friend’. And remember, to have such a friend, you need to be that same kind of friend.

Please sign up to my blog to help me educate the world about personality disorders. Tell your loved ones all about it. Post links on Facebook or Twitter! Help me get the word out. Understanding personality disorders may be the missing piece of the puzzle that your friend or loved one has been searching for.

Thanks for reading! 🙂

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Personality Disorders: A Metaphor

Beware of snakes

I grew up in a desert with red sand dunes and real tumble weeds. Kangaroos and emus were commonplace. I used to take great delight in overturning old rocks and lifting fallen tree branches in search of scorpions and lizards. Some of the most poisonous snakes in the world were offered up as macabre gifts on our porch from our beloved cat.

Whereas I was never afraid of snakes as a child, I was taught to have the utmost respect for these amazing creatures because they could end my life in a matter of minutes. A snake has every right to be on this planet as I do, but unlike me, their behaviour is entirely instinctual and geared toward survival. They cannot be tamed or reasoned with. I knew that if curiosity ever got the better of me and I attempted to handle a snake I would have their fangs pressed into my flesh and venom would be injected into my bloodstream, ending my life all too soon.

There are millions of people on this planet that look no different to you and I, but they operate more similarly to a snake than does the average human being. They slide their way into our lives as venomous creatures, hell bent on survival and gratifying their own needs with no regard for anyone else. Such people have the ability to destroy us if we allow ourselves to get too close to them. We may choose not to see them as snakes and perhaps perceive them as less harmful entities that deserve pity because they are so despised. Then one day this person sinks their fangs into your flesh, pumping venom into your wound, and you can no longer subscribe to the illusion that they are a more heavenly creature. Finally you see them just as they are…just as they have always been…a snake.

Below is a story a good friend relayed to me when discussing the various attempts she has made to have a relationship with her personality disordered mother. We only get one mother and my friend would desperately love to have a real and loving relationship with the woman who brought her into this world. But alas…each time she instigates contact with her mother she is left feeling devalued and angry at herself for believing that if she changed her approach with her mother that they might have a connection. The truth is that her mother is a snake…she lacks compassion, has no empathy and no desire to be any different. She is who she is. No one can change her because she sees no reason to change. My friend has had to estrange herself from her mother for her own sanity. I do not blame her. I think she has made a very good decision to stay away from her damaging, apathetic mother.

Here is the story…

The Indian and the Snake

Many years ago, Indian youths would go away in solitude to prepare for manhood. One such youth hiked into a beautiful valley, green with trees, bright with flowers. There he fasted. But on the third day, as he looked up at the surrounding mountains, he noticed one tall rugged peak, capped with dazzling snow. I will test myself against that mountain, he thought. He put on his buffalo-hide shirt, threw his blanket over his shoulders and set off to climb the peak. When he reached the top he stood on the rim of the world.

He could see forever, and his heart swelled with pride. Then he heard a rustle at his feet, and looking down, he saw a snake. Before he could move, the snake spoke.

“I am about to die,” said the snake. “It is too cold for me up here and I am freezing. There is no food and I am starving. Put me under your shirt and take me down to the valley.”

“No,” said the youth. “I am forewarned. I know your kind. You are a rattlesnake. If I pick you up, you will bite, and your bite will kill me.”

“Not so,” said the snake. “I will treat you differently. If you do this for me, you will be special. I will not harm you.”

The youth resisted awhile, but this was a very persuasive snake with beautiful markings. At last the youth tucked it under his shirt and carried it down to the valley. There he laid it gently on the grass, when suddenly the snake coiled, rattled, and leapt, biting him on the leg.

“But you promised…” cried the youth.

“You knew what I was when you picked me up.” said the snake as it slithered away. (Click here for original story)

Personality disordered individuals make up somewhere between 10-20% of the general population (perhaps more). It’s clear from these figures that such people will continue to be a part of our lives whether we like it or not. Whereas there are many treatments available to treat the various personality disorders (PDs), many people will go to their graves with their personality disorder, never truly knowing how many lives they damaged along the way. Many personality disordered individuals lack insight into their illness and will never be diagnosed or receive treatment…such people will remain snakes. They will not change without ongoing therapy.

It is easy to take pity on people with PDs when they discuss their childhood like it’s an audition for the role of victim. I’m not sure why we condescend to people with PDs in this way. Most people with PDs don’t have insight into their disorder, nor do they see any need to change. However, they may want you to change and they probably do not care that their behaviour is damaging you…without therapy it is unlikely they will ever change or become compassionate toward you. Instead, they will continue to act as snakes. No clever rehearsed speech will get them to transform into a puppy.

All personality disordered individuals have developed the most rigid ego defences to guard against insight building discussions. It is too much for many PDs to admit their problems are bigger than they think and they are not ready or willing to begin facing the worst parts of themselves.

All people have the ability to change, but not many have the insight or good judgment to actually make change occur.

Remember that there are multitudes of snakes amongst us. If you pity them you are likely to be bitten.

Remember to treat all people in the same manner I was taught to deal with snakes…with the utmost respect…especially people with personality disorders. Do not harm them. Do not pity them.

My advice is to limit how close you get to people with personality disorders and how much of yourself you invest in the relationship. A healthy amount of fear might just keep you safe. Take heed to what your instincts (not needs or desires) are telling you to do.

And remember, snakes don’t just stop sliding on their bellies because you haven’t seen them for a while or because you are willing to give them another chance. Love will not change the snake either…only therapy can bring about such a lasting transformation.

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Consider This a Warning…

warning-yellow-tape-featured

A year ago, when I became friends with the new woman at work, I felt both drawn to her and anxious around her at the same time.

I have worked in prison and rehab and have never experienced such a strong conflicting visceral reaction upon exposure to any individual. I couldn’t put my finger on what I was feeling at the time, but in hindsight I wish I had have paid more attention to my instincts. I couldn’t make sense of how I felt so I ignored my inner warning system.

Don’t make the same mistake I did.

Looking over my initial interactions with with this woman who ultimately betrayed me and is no longer a friend, I realise that I had her true nature pinned down very soon after becoming acquainted with her. I thought she was “sweet” but felt uneasy and anxious around her, though I couldn’t understand why I felt this way. My sub-conscious was noticing things that I was barely aware of. The most basic reptilian part of my brain was screaming at me to ‘STAY AWAY’ from her. I sincerely wish that I had listened to my instincts and not rationalised my way out of acknowledging my primal anxieties. I will never make that mistake again.

Let my experience be a warning to you.

The following comprises a few excerpts I could really relate to from Dr Roger Melton’s article titled, Romeo’s Bleeding: “When Mr. Right Turns Out To Be Mr. Wrong. Take time to familiarise yourself with your inbuilt warning signs for detecting people that will ultimately harm you.

People with Borderline Personality Disorder (BPD), Obsessive Compulsive Personality Disorder (OCPD), Narcissistic Personality Disorder (NPD) and Antisocial Personality Disorder (ASPD) can be quite charming and send off alarm bells in our minds simultaneously. Even though Dr Melton is only referring to BPDs in the excerpts below, I caution you that not everyone who influences your internal warning system to be triggered in such an extreme manner has BPD…they may have one or a combination of the personality disorders I mentioned above.

The important message to remember is that there exists a whole range of people that will cause you immeasurable grief if you only pay attention to the positive parts of a new relationship; choosing to ignore your gut instincts that are desperately trying to alert you to proceed with unwavering caution. Learn to listen to your instincts.

“If someone with a Borderline Personality Disorder attempts to draw you into a relationship, there is a very simple, concrete way to know it. Pay attention to your stomach. Even though he may initially seem sweet, attentive and empathic, you will likely perceive a subtle tightening in the pit of your abdomen, like a small rock you’ve suddenly noticed in your shoe-barely noticeable, but there.

Listen to that rock, because it is the voice of instinct, and it’s trying to tell you something. Listen to your fear and start scanning for an incoming missile. The Borderline is often a tough target to initially confirm, but close attention to his attitudes and behaviors and an emotional position of calm neutrality can help you confirm his threat-potential. And if Borderline is confirmed, get out of there before it’s too late.

Particularly sensitive and adept therapists often describe a typically paradoxical reaction, commonly experienced by most people when first meeting someone who is Borderline. While feeling gently or tenderly drawn toward him, there is simultaneously an almost inconspicuous sensation of a vague knot in the pit of the stomach, as mentioned earlier. A more general description might be that a person feels that he or she too quickly likes someone and feels a faint sense of unease or dread toward him at the same time.

If you experience such mixed sensations when first meeting anyone, ask yourself why you simultaneously liked him so quickly and felt uncomfortable. If it’s difficult to answer either question, put your radar system on high alert and scan closely the next time you meet him. If he is Borderline and has locked onto your sympathetic nature, that next encounter may not be too far away.”

Click here for a link to the original article, written by Dr Melton. I highly recommend you read it now.

Don’t make my mistake. You have been warned…

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Rethinking Tabula Rasa…

English political philosopher and physician, John Locke (1632-1704)

English political philosopher and physician, John Locke (1632-1704)

Parents wonder why the streams are bitter, when they themselves have poisoned the fountain ~ John Locke

I have a great deal of respect for philosophers such as John Locke (no, not the dude from the tv show ‘Lost’, but his historical namesake), the Englishman whose contributions and theories went on to influence many, including Thomas Jefferson, who referred to Locke as one of “the three greatest men who have ever lived”. It has often been said the United States Declaration of Independence was born from the political philosophies of Locke, which had already taken root in the minds of the people at the time of the American Revolution.

Tabula Rasa

Locke is famous for his idea that the mind is a blank slate, known as tabula rasa; the notion that each mind is moulded by sensation and reflection as a result of experience rather than innate ideas and knowledge.

Blank slate...an accurate metaphor for the human mind?

Blank slate…an accurate metaphor for the human mind or just a fine-grained, foliated, homogenous metamorphic rock better used for achieving that rustic look in your new home?

There’s a part of me that would love to believe that such an idea was indeed a fact. It would certainly lay to rest racist theories on intelligence because it would mean that our underlying cognitive faculties were identical, regardless of race, and that environmental factors such as poverty or abuse would account for variations in knowledge, wisdom and intelligence. It would also mean that individuals and societies would blossom under the nurturing principles of morality and ethics. Unfortunately, it would also mean that people were doomed to immoral behaviour and distorted beliefs if raised in abusive homes with substandard conditions. There would be no such thing as ‘breaking the cycle’…only perpetuating ‘the cycle’ would be possible…or so I assume…

Questions, questions, questions…

I guess the concept of tabula rasa brings to mind a lot of questions, such as how personality traits remain stable throughout the lifespan if a person is a blank slate that experience is constantly altering?

Does our blank slate ever become saturated by experience (ie when does it stop being ‘blank’?) or can it be constantly written on throughout the course of a person’s life?

At what point, if ever, does the malleability of tabula rasa wear off and blank potential is then replaced by hard-wired experience? If not by genetics, how do we account for the anomalies that clearly render a person intellectually impaired from birth?

Would Locke suggest that intellectual impairment is caused by a congenital impediment of the senses which would directly effect the acquisition of knowledge? If so, how is it possible that Locke could espouse sensory anomalies can be present at birth, but believe that our personalities, preferences, etc emerge from the potential of an identical blank slate?

When I think over the many people we refer to as some of history’s finest minds and greatest people, I recall that many of them had difficult childhoods and suffered many tragedies that would certainly place them at a disadvantage in staking success, yet we still stand on their shoulders many years after their deaths and acknowledge them as people who exhibited great wisdom and contributed profoundly to the progression of society.

Helen Keller is an example of someone whose sensory input only came from her ability to taste, smell and touch after she lost her vision and hearing at the age of 18 months. She said of herself as a child that she was “less than an animal”. Despite her limitations she had great intelligence and went on to accomplish more than I ever will with all my senses intact. Keller went on to become a brilliant humanitarian, study, write books, become a lecturer, revolutionise support available to the blind and deaf, and much more. Take that tabula rasa! There was a innate determination in Keller that propelled her into greatness 🙂 How else would such disabilities render her successful? Many other people with the same afflictions and more support will perhaps never achieve the same wisdom and knowledge that Keller did.

Whether assuming tabula rasa is correct or not, it does not alter the fact that as a psychologist, I guess I would be considered an ‘environmental factor’ in the nature/nurture debate. Tabula rasa would further purport that my job it is to write on that somewhat used blank slate and exert my influence to undo the wrongdoings wrought by experience that has caused all kinds of psychopathology. In fact, believing that people have the potential to change is a fundamental belief of psychology. Nevertheless, where it exists within my clients, I cannot help but observe the glaringly obvious brain pathology underlying dysfunctional behaviour that cannot be accounted for simply as the product of environment.

Borderline personality disorder (BPD) is a perfect example of the heritability of personality where genetics play a very significant role. Contrary to popular belief, childhood trauma, abuse or neglect is not necessary for the traits of such a volatile personality disorder to manifest. It is true that a great many borderline adults have grown up as children in dysfunctional environments which further impair their emotional, vocational and social functioning, but not all BPDs have experienced this. Functional MRI scans show us that there are indeed differences in the brains of BPDed individuals when compared to their non-BPDed counterparts. A little further into this post I’ll introduce some studies that have proven this.

It’s easy to dismiss a radical adoption of tabula rasa as a notion of folly, but I guess Locke didn’t have the same insights into genetics and neuroscience that we possess today 😉 We now know for a fact that genes and environment account for any number of characteristics or traits…not just environment! In fact, there is a lot of evidence to say that we are who we are because of genetics to a very large extent. Thanks to our emerging understanding of neuroplasticity, brain pathology (whether viewed as genetic, environmental or both) does not necessarily have to doom us. Such a leap in understanding of how the brain works has provided new hope that we are still in control of our fleshy bodies and brains…some of us just need a little more assistance to triumph over the limitations thrust upon us by our genetic predispositions (which do not always provide us with any adaptive advantages in life).

Twin Studies

I have always been fascinated by twin-studies where identical twins are separated at birth and raised in completely different family environments.

Twin studies offer insight into the role genetics play in personality manifestation

Twin studies offer insight into the role genetics play in personality manifestation

These studies have obliterated the postulation that we have no innate predisposition. If we know the environment for each identical twin was completely different, we can then isolate and study the variable of genetics because this is the only common denominator (aside from them sharing the same womb simultaneously).

One outstanding example of the effect of genes in the manifestation of personality is T.J. Bouchard’s study on the “Jim Twins”.

The “Jim Twins”

The Jim Twins

The Jim Twins

“Jim Lewis and Jim Springer first met February 9, 1979, after 39 years of being separated. Both were very nervous at first, but now consider the reunion “the most important day of my life.” Amid the euphoria over their rediscovery of each other, they came across astonishing similarities in their lives and behavior. Both had been adopted by separate families in Ohio, and had grown up within 45 miles of each other. Both had been named James by their adoptive parents, both had married twice; first to women named Linda and second to women named Betty. Both had children, including sons named James Allan. Both had at one time owned dogs named Toy.

These parallels made them perfect candidates for behavioral research, as did their only short aquaintence with one another before they were inducted into a study of reunited twins. The parallels were only the first in a series of similarities which would go to the heart of the influence of heredity and environment on human behavior. Dr. Thomas Bouchard of University of Minnesota studied the personalities and attitudes of the twin Jims, and the resulting similarities were again astonishing. In one test which measured personality variables (tolorance, conformity, flexibility), the twins’ scores were so close that they approximated the averaging of the totals of one person taking the test twice. Brain wave tests produced skyline-like graphs looking like 2 views of the same city. Intelligence tests, mental abilities, gestures, voice tones, likes and dislikes, were similar as well. So were medical histories: both had high blood pressure, both had experienced what they thought were heart attacks, both had undergone vasectomies, and both suffered from migrane headaches. They even used the same words to describe these headaches. 

The twins discovered they shared alike habits too. Both chain-smoked, both liked beer, both had woodworking workshops in their garages. Both drove Chevys, both had served as Sheriff’s deputies in nearby Ohio counties. They had even vacationed on the same beach in the Florida Gulf Coast. Both lived in the only house on their block. The same patterns shared by the Jim Twins occurred time and time again.” Click here to view original article.

Bouchard’s study on the “Jim Twins” is one of many such studies that demonstrates similarities in terms of personality, interests and attitudes are due to genes rather than environment. The converse can also be inferred…that differences between identical twins raised apart must be due to environmental factors.

The Brain

The fact that there is variation in the size and functioning of various brain structures in each individual should really come as no surprise to anyone. If we can inherit obvious physical characteristics from out parents, such as long fingers or curly hair, then it seems logical that we must inherit brain phenotypes too.

Whereas the human body consists of the same structural components (ie one head, two arms, two legs, two eyes, a nose, skeleton, skin, brain, etc), the gene pool is so varied for any given trait that these basic components may look very different from person to person, providing them with their own unique look, though still retaining the same ‘parts’. For example, everyone has a nose, but your nose is just one of many possible nose shapes…probably similar to that of one or both of your parents. Similarly, we may all have a body, but everyone’s body is genetically programmed to be a different height and so on. The same is true for the brain…we all have one (presumably ;)), but physically there are slight variations that make us who we are. For some, the differences manifest as chronic mental illness or other disorders.

The amygdala is often holding the smoking gun when we are talking about the brain’s role in psychopathology, such as depression, post-traumatic-stress disorder (PTSD), phobias, borderline personality disorder, depression, and so on. Abnormal functioning of the amygdala is also thought to cause neurotransmitter (serotonin) imbalance, developmental problems and autism.

As you can see in the picture below, there are two amygdala (plural is amygdalae); one in each hemisphere, attached to the end of the hippocampus in the region of the temporal lobes. If you were to stick a thin metal rod through each eyeball, right into your brain, and then stick another long metal rod in one ear, through your brain and out through your other ear, the two points where the metal rods intersect are where your amygdala are positioned (don’t do this at home, kids!).

The amygdala

The amygdala (Source: http://www.PositScience.com)

The amygdala is part of the brain’s emotional processing region, known as the limbic system. It  is linked to emotional processing (such as fear response), memory, motivation and aggression. It is also important for the secretion of hormones, pleasure, arousal and the formation of emotional memories (such as fear conditioning). It is basically the part of your brain that signals a danger response and allows you to experience the whole range of emotions. Without the amygdala we would never feel fear and may respond with curiosity, placing ourselves in harmful situations.

One such woman who has been dubbed ‘The No-Fear Woman’ has a rare congenital condition known as Urbach-Wiethe disease which destroyed her amygdalae by the time she was a pre-teen. Scientists have been studying this woman for more than 20 years in the hope that her condition may offer insights into how to treat or prevent problems with anxiety such as post-traumatic stress disorder (PTSD).

MRI scans of SM's brain. The small arrows around the centre of each image is pointing to black spaces were the amygdalae are absent

MRI scans of The No-Fear Woman’s brain. The small arrows around the centre of each image is pointing to black spaces were the amygdalae should be

Researchers wrote the following about ‘The No-Fear Woman’, whom they refer to as the initials ‘SM’, in the medical journal, Current Biology:

“As it turned out, SM has encountered numerous events that would be considered fear-inducing or even traumatic in nature. For instance, she has been held up at knife point and at gun point, she was once physically accosted by a woman twice her size, she was nearly killed in an act of domestic violence, and on more than one occasion she has been explicitly threatened with death.

What stands out most is that, in many of these situations, SM’s life was in danger, yet her behavior lacked any sense of desperation or urgency. Police reports obtained from the local police department further corroborate SM’s recollection of these events and paint a picture of an individual who lives in a poverty-stricken area replete with crime, drugs, and danger. Of note, SM has never been convicted of any crime, but rather has been the victim of numerous crimes. Moreover, it is evident that SM has great difficulty detecting looming threats in her environment and learning to avoid dangerous situations, features of her behavior that have in all likelihood contributed to her high incidence of life-threatening encounters.”

Here’s an example of one of SM’s “life-threatening encounters” reported by the Associated Press:

A man jumped up from a park bench, pressed a knife to her throat and hissed, “I’m going to cut you.”

SM, who heard a church choir practicing in the distance, looked coolly at him and replied, “If you’re going to kill me, you’re going to have to go through my God’s angels first.”

The man suddenly let her go. She didn’t run home. She walked.

“Her lack of fear may have freaked the guy out,” Feinstein said.

But it also got her into that situation in the first place, he noted. SM had willingly approached the man when he asked her to, even though it was late at night and she was alone, and even though she thought he looked “drugged out.”

Clearly, SM is lucky she is still alive. The ability to feel fear is an adaptive response to ensure survival. But what happens if you have a hyperactive amygdala that signals danger constantly? Such is the case with people who have BPD.

BPD is sometimes also referred to as an emotion dysregulation disorder because people with the condition experience emotions intensely and have extreme difficulty regulating them. If you ask a person with borderline personality disorder what their biggest fear is, it’s usually that people will discover how hyper-sensitive they are and will use this knowledge to harm them…they are so afraid of feeling hurt. Paradoxically, people with BPD often hurt themselves, abuse the people closest to them and sabotage good relationships.

For people with BPD, the inability to regulate emotions may also be related to another structure in the brain called the insula or insular cortex. The anterior insula receives a direct projection from the basal part of the ventral medial nucleus of the thalamus and a particularly large input from the central nucleus of the amygdala. Additionally, the anterior insula itself projects to the amygdala. The insula is said to “determine how intensely we experience negative emotions”, which for people with BPD is always ‘intense’ and almost impossible to manage. Normally the orbital prefrontal cortex would mediate emotional responses from the amygdala and inhibit aggression; however, in people with BPD this important part of the brain is under-active.

If you’ve ever seen someone with BPD go from happy to enraged and aggressive in two seconds (I’ve seen it more times than I can count or want to remember), then you will understand how scary the consequences of such brain circuitry can be. It certainly explains the personality of BPDs. I don’t think John Locke had a borderline in his family or he would have thrown the concept of tabula rasa out the window as soon as it popped into his head.

“It’s not just that they have too much drive from their emotions,they seem to have less of the ‘brakes’ to try to curb those emotions and to help regulate their intensity.” ~ Anthony C. Ruocco

It’s clear that adaptive amygdala activation, as with other brain structures, operates within a set of limits…little to no activation places survival at risk and so does hyper-activation.

One of the most interesting things about the amygdala is that its size is positively correlated with aggression across species…that means that the bigger the amygdala of an animal, the more aggressive it will be. Also, if you castrate a male human, their amygdala shrinks by more than 30%!

Oddly enough, I also found an article that says you are more likely to have a large and complex social network (eg your friend may have more than one role in your life such as also being your work colleague) if you have a bigger amygdala! Hmm, this is a real red herring in the search to understanding how anomalous brain structures contribute to psychopathology and personality in general.Perhaps the people with larger amygdalas in the social networking study had overactive or normally functioning prefrontal cortexes? Having a larger amygdala certainly doesn’t seem to assist many people with BPD in complex real-life social networking (ie not Facebook or Twitter).

Many people with BPD destroy their interpersonal relationships and may not have many, if any friends. Oftentimes BPDs will rely on their partner to fulfil all their social needs and cling on to this person with all their might. Then there are the borderlines like my mother who have good long-lasting friendships most of the time and reserve their aggressive and violent BP traits for their family and/or partner.

There are many other fantastic studies on the brain and BPD that I’ll probably include in another post 🙂

After all is said and done, one thing is for sure though; our personalities are largely determined by our brain and how it’s functioning, rather than environmental factors per se, unless the environmental factor (such as a chemical substance) alters brain functioning.

Some Final Words…

If you are the parent of an individual whom you have raised in a loving and nurturing home, with appropriate boundaries, free from abuse and neglect, then I hope you take solace in knowing that you are probably not to blame for the dysfunction in your offspring’s personality or their damaging behaviours. We are not born as blank slates. If you have children, you will know this is true. We are all so different from birth. Locke’s quote at the beginning of this post, “Parents wonder why the streams are bitter, when they themselves have poisoned the fountain”, may hold merit in some circumstances, but not all.

Whereas I do not believe in the notion that we are all born as blank slates at birth, I believe that the plastic nature of our brains means that we are not entirely controlled by our genes or our early life experiences. We are unique at birth in temperament and other personality characteristics. In a way our minds are blank at birth in that their knowledge of the world outside of the womb is entirely new, but the foundations of our personality have already begun to take shape in our brains.

Still, no matter what I know about neuroscience and genetics, I think I like the idea of a tabula rasa at this stage in my life. Perhaps it’s just a romanticised notion that allows me to believe that this year is a new start for me…a way to shake off and heal from the wounds of the past and start over with all the promise of a blank slate 😉

“Although the world is full of suffering, it is full also of the overcoming of it” ~ Helen Keller

I’d love to hear any feedback that you might have… 🙂

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Obsessive Compulsive Disorder vs Obsessive Compulsive Personality Disorder

OCD or OCPD?

OCD or OCPD?

A few weeks ago I said that I’d write a post on the difference between obsessive compulsive disorder (OCD) and obsessive compulsive personality disorder (OCPD). I thought I’d do this to clarify what I mean when I say that my ‘ex-friend’ had OCPD.

There are a few similarities, but otherwise OCD and OCPD are very different disorders.

Now, to start from the top, OCD is primarily classified as an anxiety disorder (Axis I disorder), whereas OCPD is a personality disorder (Axis II disorder). Sufferers of both conditions experience difficulties managing anxiety, but people with OCD feel distressed by the obsessions and subsequent compulsions, whereas, people with OCPD believe that their way of thinking and doing things is correct and enhances their life.

I’ll outline the DSM-IV-TR (2000) criteria for both conditions so that we’re on the same page. Here goes!

Diagnostic criteria for Obsessive-Compulsive Disorder (DSM-IV-TR)

A. Either obsessions or compulsions:

Obsessions as defined by (1), (2), (3), and (4): 

(1) recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress

(2) the thoughts, impulses, or images are not simply excessive worries about real-life problems

(3) the person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action

(4) the person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

Compulsions as defined by (1) and (2): 

(1) repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly

(2) the behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

B. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.

C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.

D. If another Axis I disorder is present, the content of the obsessions or compulsions is not restricted to it (e.g., preoccupation with food in the presence of an Eating Disorders; hair pulling in the presence of Trichotillomania; concern with appearance in the presence of Body Dysmorphic Disorder; preoccupation with drugs in the presence of a Substance Use Disorder; preoccupation with having a serious illness in the presence of Hypochondriasis; preoccupation with sexual urges or fantasies in the presence of a Paraphilia; or guilty ruminations in the presence of Major Depressive Disorder).

E. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Approximately 1-2% of the population have OCD and it is roughly as common in men as it is in women (unless the OCD begins in childhood, then it is more common in males). People are most likely to develop OCD in the 18-24 age range. Research has shown that genetics have a role to play in the manifestation of this disorder.

Also, it is possible for an individual to exhibit obsessions and compulsions without the sufficient frequency to warrant an OCD diagnosis.

To further complicate things, some OCD sufferers experience ‘obsessional rumination’ as their sole symptom, and as such, they do not perform any behavioural compulsion. For example, some OCD suffers experience distressing obsessions about murdering a loved one or sexually assaulting a child.

Not surprisingly, sufferers of this disorder then become concerned that they will act on these thoughts. If this were true, prisons would be full of people with OCD (and they are not) and there would be a high correlation between this disorder and antisocial personality disorder (which there is not). The big difference between people who harm others or molest children is that they experience pleasure when considering such thoughts, even if they do not want to continue doing these acts. Conversely, people with OCD spend more time trying to prevent themselves from inflicting harm on others and they do not find their obsessions at all pleasuarble.

More commonly, people with obsessive-compulsive disorder (OCD) fall into one of the following categories:

  • Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
  • Checkers repeatedly check things (oven turned off, door locked, etc) that they associate with harm or danger.
  • Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen or they will be punished.
  • Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
  • Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use (Source: www.helpguide.org)

Dr Jeffry M Schwartz Provides An Insight Into The Brain of Someone With OCD

Schwartz developed new insights into OCD by comparing brain scans of people with OCD and those without it, then used these insights to develop his new form of therapy—the first time, to my knowledge, that such brain scans as the PET helped doctors both to understand a disorder and to develop a psychotherapy for it. He then tested this new treatment by doing brain scans on his patients before and after their psychotherapy and showed that their brains normalized with treatment. This was another first—a demonstration that a talking therapy could change the brain.

Normally, when we make a mistake, three things happen. First, we get a “mistake feeling,” that naggingsense that something is wrong. Second, we become anxious, and that anxiety drives us to correct the mistake. Third, when we have corrected the mistake, an automatic gearshift in our brain allows us to move on to the next thought or activity.

Then both the “mistake feeling” and the anxiety disappear.

But the brain of the obsessive-compulsive does not move on or “turn the page.” Even though he has corrected his spelling mistake, washed the germs off his hands, or apologized for forgetting his friend’s birthday, he continues to obsess. His automatic gearshift does not work, and the mistake feeling and its pursuant anxiety build in intensity.

We now know, from brain scans, that three parts of the brain are involved in obsessions.

We detect mistakes with our orbital frontal cortex, part of the frontal lobe, on the underside of the brain, just behind our eyes. Scans show that the more obsessive a person is, the more activated the orbital frontal cortex is.

Once the orbital frontal cortex has fired the “mistake feeling,” it sends a signal to the cingulate gyrus, located

in the deepest part of the cortex. The cingulate triggers the dreadful anxiety that something bad is going to happen unless we correct the mistake and sends signals to both the gut and the heart, causing the physical sensations we associate with dread.

The “automatic gearshift,” the caudate nucleus, sits deep in the center of the brain and allows our thoughts to flow from one to the next unless, as happens in OCD, the caudate becomes extremely “sticky.”

Brain scans of OCD patients show that all three brain areas are hyperactive. The orbital frontal cortex and the cingulate turn on and stay on as though locked in the “on position” together—one reason that Schwartz calls OCD “brain lock.” (Excerpt taken from Norman Doidge’s The Brain That Changes Itself, 2010)

Now for a look at OCPD…

Diagnostic criteria for Obsessive-Compulsive Personality Disorder (DSM-IV-TR)

Obsessive-Compulsive Personality Disorder (OCPD) is defined by exhibiting at least four of the following:

1. Preoccupation with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.

2. Showing perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).

3. Excessive devotion to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).

4. Being over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).

5. Inability to discard worn-out or worthless objects even when they have no sentimental value.

6. Reluctance to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.

7. Adopting a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.

8. Shows rigidity and stubbornness.

[For the World Health Organisation’s (WHO) ICD-10 diagnostic criteria for OCPD, which they call Anankastic Personality Disorder, click here. Also use the same link to find out more about OCPD/Anankastic PD including Millon’s Compulsive Subtypes]

Speaking in more lay terms, people with OCPD often display the following traits, some of which are not mentioned above, but are common attributes of how the disorder manifests in everyday life:

  • ‘perfectionistic’ to an unhealthy degree and will often abandon a task if they cannot do it ‘perfectly’
  • if they have children, they will see their offspring as extensions of themselves and will expect their children to be ‘perfect’ or ‘the best’ in any pursuit (eg sports, music, academia, etc), often demanding their children keep practicing until they make no mistakes
  • may not want to have children because they see them as getting in the way of their career
  • they like to highlight their achievements and take great pride in the occupation (often they would not know who they are without their occupation because this is how they identify themselves) and climbing vocational hierarchies
  • they are drawn to positions of prestige and jobs that can produce rapid efficacy/outcomes
  • highly moralistic, judgmental and critical of others
  • they believe that what they think is always correct and other people should do things their way or share the same beliefs, morals or values (they’re the kind of people that are right even when they’re wrong). Thanks to their iron-clad ego defences, they are blind to their own faults
  • difficult to please
  • they think there’s ‘only one way to skin a cat’ and are not interested in your way of performing a task
  • black and white thinkers (they will either love you or despise you…they can easily change to hating you and cutting you off completely if you cease to be ‘perfect’ or cause them ‘uncertainty’)
  • attempt to control their environment and other people (they can be highly controlling to the point of being domestically violent) to avoid ‘uncertainty’ (which causes them great anxiety)
  • highly opinionated (perhaps even to espousing their beliefs about controversial or offensive topics at inappropriate times or places), though may easily adopt the stance of the status quo (so that they can be seen to be ‘right’) if they do not have an opinion on any given topic
  • hold grudges and recall past conversations with uncanny accuracy because they obsess over these details, especially if you did or said something they don’t agree with
  • have rigid rules (that are often very strange to others) that they impose on others
  • are highly stubborn
  • often have difficulty accepting kind gestures from others for fear that people are trying to control them or take away their independence
  • fiercely proud of their independence
  • some are extremely uncomfortable with physical affection (such as hugging whether it is in public or not)
  • they often have narcissistic traits and may obsess over getting their hair ‘just right’
  • they may not allow other people to perform tasks (such as washing the dishes or stacking the dishwasher) because they believe no one else will do it as well as them
  • they often find it difficult to delegate tasks or work as a member of a team
  • highly resistant to learning new methods of performing tasks once they have established the ‘right way’ to do it
  • enjoy making lists, charts and schedules to the point that they spend too much organising to the point they may neglect the actual task
  • find it difficult to accept when people have opinions that conflict with their own
  • they may be obsessed with being ‘on time’
  • difficulty relaxing, preferring to work instead
  • they fear a lack of order or not being ‘in control’
  • may suppress emotion for fear of appearing ‘weak’
  • find ways to work on vacation or make leisure activities have some kind of purpose, such as a competition or reading work-related reference books whilst at the beach (traditionally called Type A Personalities)
  • demand the same high standards of others who they may deem as lazy or incompetent
  • People with OCPD are unaware of the disorder until it is pointed out to them…even then they may be resistant to accepting the diagnosis from a qualified professional
  • likely blame others
  • difficulty or refusal to accept responsiblity when hey have made a mistake
  • unlikely to apologise
  • lack empathy
  • will only show understanding if they have personal experience with the same problem (only then will another’s suffering be deemed as acceptable by the OCPD sufferer)
  • may demonstrate a victim mentality at times and laud their successes in spite of ‘not being handed everything on a silver platter’
  • a ‘neat freak’
  • prone to catastrophising (ie ‘making mountains out of molehills’)
  • may exhibit jealously or hate toward people they believe are ‘undeserving’, especially if they have not had to ‘work as hard’ as they did for their successes
  • may work overtime, spend a lot of time at the gym and be uncomfortable with ‘having nothing to do’ (so they will always appear to be excessively busy)
  • may not have many friends or not see the value in friendships
  • difficult to get close to
  • do not like to rely on others
  • their minds are inflexible
  • emotionally immature
  • reluctant to forgive
  • may issue ‘punishments’ to others for lack of compliance with rules or imperfection
  • miserly with money and lack generosity
  • they may be highly judgmental of people with mental health or weight problems (regardless of whether they have problems in these areas themselves)
  • only want to associate with people who meet their high standards of beauty or success (also a narcissistic trait)
  • are commonly narcissistic
  • likely to suffer bouts of depression, anxiety and sometimes an eating disorder

Not all people with OCPD will possess all of the above traits, but they are extremely common in individuals with this disorder. You are more likely to see the traits of any personality disorder really emerge whilst the PDed individual is under stress. Their personality may appear to ‘change overnight’. People with OCPD often fear intimacy, but crave it at the same time…though they are very unlikely to admit this. They are deeply sensitive souls who find it hard to trust others. They crave control and for the world to be ‘predictable’.

They value work, higher learning and success because it is their way of proving to the world that they are intelligent or worthwhile. Furthermore, they are attracted to positions of power, often working as managers or bosses. If you are unlucky enough to work under someone with OCPD, you will notice they have fantastic organisational skills, but are horrible and stressful to work for. They will relentlessly pile you up with work and will criticise your inability to meet their demands. Outwardly, people with OCPD will often appear quite successful, however, on the inside they are often very anxious and insecure.

Approximately 1-2% of the population (it is sometimes estimated to have a prevalence rate around 10%) have OCPD and it is almost twice as common in men than women.

garfieldocpd

The following is a summarised case study of a typical person with OCPD:

A 45-year-old lawyer seeking treatment. His wife was unhappy with their marriage, tired of his stubborn, perfectionist ways. In terms of his work, he was the youngest full partner in his firm’s history, famous for handling many cases at the same time, would not turn down a new case, and was never satisfied with the quality of work performed. Once in therapy, the therapist learned more about the patient. Few secretaries worked for him for very long because he was so critical of mistakes. He was never satisfied by the work done by his staff, to the point where he found himself constantly correcting their briefs and written documents. He could not cope with backed up assignments, because he did not know where to start. Instead, he made rigorous schedules and did not adhere to them, but not for lack of effort. He described his family in a very impersonal fashion, referring to his children as “mechanical dolls” and his wife as a “suitable mate.” He had some affection for them, but it was overshadowed by his impersonal manner (American Psychiatric Association, 2009).

There is a lot of speculation over what causes OCPD. There is evidence to suggest that if you have a parent with OCD, this increases your chances of having OCPD. Having a parent/s who was authoritarian, invalidating or ‘impossible to please’ has also been found to be correlated with OCPD because the child will learn to place unrealistic expectations (ie ‘perfection’) on themselves to gain approval or love. At the end of the day the origins of OCPD are largely unknown and require much more research. I suspect the amygdala of people with OCPD is overactive, which would explain their extreme fear response and desire to control the world to limit their anxieties from becoming realities…though I’m sure the underlying neurobiology is more complex than my postulation.

A Historical Look at OCPD: Where the Term ‘Anal’ Came From

Sigmund Freud

Sigmund Freud

Back in the early 1900s, Freud observed and treated patients with OCPD. From his findings, he noted, “persons with obsessive-compulsive personality disorder are characterized by the three ‘peculiarities’ of orderliness [which included cleanliness and conscientiousness], parsimony, and obstinacy.” He also called it, “a neurosis connected with difficulties at the anal phase in psychosexual development,” and made a distinction between OCD, which he referred to as a “symptomatic neurosis” and OCPD, which he referred to as a “character neurosis”. In 1918, Ernest Jones went on to describe someone afflicted with OCPD as being overly concerned with money, cleanliness, and time. The observations from these men were important at the time, because not much was known about this disorder. Literature begot the term “anal character,” combining the character (personality) neurosis (anxiety), and, according to Freud, OCPD begins development in the anal phase of development (Source: www.brainphysics.com).

If a person can accept their diagnosis by a qualified professional, then treatment of OCPD is possible. As time progresses, untreated people with OCPD have been found to become more rigid and stubborn so treatment should begin as early as possible.

Treatment options for both OCD and OCPD is similar; however, many of the methods utilised in the talking therapies for each disorder is different. SSRIs are also recommended in treatment of both conditions.

Medications such as selective serotonin reuptake inhibitors (for example, Prozac) may help reduce some of the anxiety and depression from OCPD.

However, talk therapy (psychotherapy) is thought to be the most effective treatment for this condition.

  • Psychodynamic psychotherapy helps patients understand their thoughts and feelings.
  • Cognitive-behavioral therapy (CBT) can also help.

In some cases, medications combined with talk therapy may be more effective than either treatment alone (Source: http://health.nytimes.com)

A final note…please be sure to consult your family doctor or psychiatrist before diagnosing or assuming that anyone has OCD, especially children. Many other disorders, such as Attention Deficit Disorder and autism, have symptoms that may appear like OCD. If you are not a medical professional or registered clinician do not label anyone with any disorder. Diagnosis is an art that comes with much training and clinical experience…even the most seasoned diagnosticians do not always agree with each other. Incorrect diagnoses harm people because labels can endure and may stigmatise a person. They may also prevent appropriate diagnosis and treatment leading to more severe impairment. Please never use diagnoses as labels to insult or abuse a person. Doing so just further stigmatises mental illness and may lead to severe consequences for the sufferer.

“Be nicer than necessary to everyone you meet. Everyone is fighting some kind of battle.”

― Socrates

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How Do I Know If I’m Normal?

My experiences over the past year have compelled me to want to warn people of the dangers of being close to someone with a personality disorder (PD) and how to recognise PD traits. My mother has borderline personality disorder (BPD) and close friend of mine, who now wouldn’t spit on me if I was on fire, has obsessive-compulsive personality disorder (OCPD).

In reflecting on the friendship with my ex-friend with OCPD, I recall that I felt extremely anxious around her for months. I wasn’t exactly sure why, but I think it was my body’s way of telling me to stay away from her. I should have listened, but I didn’t. I certainly paid a high price for my error. I hope others can learn from my experience so that they don’t have to suffer the same heartbreak I did.

Very soon after meeting the woman who is known on this blog as “my ex-friend”, I noticed so many similarities between her and my mother. I would tell her this and after a while she became offended by it. She once said to me, “You say I’m like your mother, which is offensive because you say she is borderline”. I reassured my friend that she was not “borderline”, but now I’m actually starting to wonder if she had some borderline traits. She is more similar to my high-functioning borderline mother than anyone else I’ve ever met.

I recently found an article written by Dr Roger Melton, a brilliant psychotherapist who has helped me understand why my mother and ex-friend were perhaps so similar.

Roger Melton is a psychotherapist, teacher and writer in Los Angeles, California. For over twenty years, he has been a leading authority on the psychological impact of violence, dealing with exploitive-type men or women and managing the dangers of high-stress careers and occupations. He has frequently appeared on television and radio, including appearances on 20/20 and PBS. As part of opening relations with the Soviet Union in 1989, he participated in mutual training programs at Moscow University – excerpt taken from BPDFamily.com

In Dr Melton’s article he refers to people that he describes as ‘Controllers’ as personality disordered individuals who exhibit the same control-obsessed behaviours. He says they might differ as to what personality disorder they have, such as narcissistic, antisocial or borderline, but the methods they use to control not only their world but the lives of other people is the same. I would have to add obsessive compulsive personality disorder to the list of PD ‘Controllers’ as well.

My ex-friend would always speak of “uncertainty” as if it were a beast that was constantly hunting her and that she could not be content in life until she had slaughtered this monster. When I created “uncertainty” for her I became ‘the beast’ and she slaughtered me by abruptly ending our friendship. In her mind, she had regained control and as long as she had nothing to do with me, she truly believed she would be okay. My ex-friend was definitely a Controller. So is my mother. I guess that is what made them so similar. They both become anxious when they perceive their life or environment to be ‘out of control’ and they both share similar tactics for managing these anxieties.

I agree with Dr Melton when he says that it seems like narcissists, borderlines and antisocial PDs all took the same college courses in control. He makes a lot of very good points about traits to look out for and how relationships with Controllers develop despite our intuition telling us to stay away from them. I’d like to devote a whole post to the PDs that are control-obsessed for this reason.

For now I’d like to answer the age old question of, ‘What is normal?’, and also take it one step further by answering a question I have been asked hundreds of times, “Am I normal?”. Here’s what Dr Melton has to say:

‘Normal’ is not a good term to describe a mentally sound person, because it seems to imply that there must be a set of obvious, precisely definable characteristics that describe sanity. But, that is not easily the case. There is such an astounding range of differences between the vast majority of healthy individuals in the world that it is impossible to pin ‘normal’ down to an exact and narrow set of behaviors, attitudes or mannerisms. Ironically, one of the things that helps in spotting Controllers is the opposite-their behaviors, attitudes and mannerisms can be defined in predictable, narrow sets of characteristics.

There are certain general characteristics that define a mentally healthy individual. A hallmark of mental health is the ability to tolerate uncertainty, which is demonstrated in our capacity to carefully weigh choices before deciding a course of action. Because we can tolerate the tension that occurs while going through the process of choosing, we can more accurately make a final decision. Mentally unsound individuals cannot tolerate much tension, which is why their actions tend to be irrational and impulsive.

Flexibility grows out of the ability to tolerate uncertainty. A flexible mind is one that can change. To some degree, change is uncomfortable for everyone, but normal individuals find it tolerable and manageable. In contrast, personality-disordered individuals are rigidly intolerant of change, inflicting their will against anything new or different in their lives-or in the lives of those around them. Externally imposed change is threatening, because it reminds them that the world is not under their total control.

Adaptability grows out of flexibility. Normal people are capable of adapting themselves to new situations. Change may make them feel uncomfortable, but they can accommodate themselves to it and adjust. Personality-disordered individuals find it extremely difficult or completely impossible to shift gears when a new situation develops.

Mentally healthy people have the capacity to take appropriate responsibility. Such individuals know how to see the part they may have played in creating a problem, can admit their part in it, can take corrective action to solve the problem and have the capacity to admit they were wrong. They also know how to realistically recognize when they have not played a part in creating a problem. Personality-disordered individuals cannot make those kinds of discriminations around the issue of responsibility. They always blame everything that goes wrong in their life on everyone else, or they do the exact opposite and always blame themselves for everything that goes wrong. Controllers are blamers-self-abusive individuals are blame-takers.

So there you have it folks! If you are an insightful, honest and introspective person, you may be able to answer the question, ‘Am I normal?’ for yourself! Regardless, I hope Dr Melton’s take on what constitutes ‘normal’ will help you spot those among us that are abnormal and may break your heart…

This post is dedicated to my amazing friend; Renee, who is ‘normal’! That’s my professional opinion 😉

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A Tribute to Amber McIntosh: Woman. Mother. Psychopath Hunter Extraordinaire!

Yesterday morning when I arrived at work, I noticed two WordPress notifications on my iPhone.

They were to alert me that someone named Amber McIntosh had commented on my post from earlier this month, titled, ‘Personality Disordered People Can Destroy Your Life…Literally’. The feature of my post was a personality disordered woman named ‘Jonnica Ellis’, which, as it turns out, is just one of her many aliases. Here is a link to my post: Personality Disordered Individuals Can Destroy Your Life…Literally

This psychopathic woman made international news with how she scammed Thomas Doty, a young man dying of cancer, and his family to get closer to the Deadliest Catch reality tv star, Johnathan Hillstrand.

Thomas Doty with his mother, Tiffany

Thomas Doty with his mother, Tiffany

I wrote the post to highlight that personality disordered people are more common than we think and they keep journalists and news companies in business with how newsworthy their abhorrent behaviour is. Without personality disorders (PDs) there would be a whole lot more peace and harmony in this world. I guess a world without PDs would be…well…Utopia 🙂

Still, eradicating dangerous PDed individuals is very, er…’political’, *tongue in cheek*, so I can’t imagine the next Miss America contestant standing on stage in her elaborate ball gown imploring, ‘I would like to shoot all the dangerous psychopaths, narcissists and borderlines in order to solve world hunger and achieve peace on Earth!’ 😉

Eradicating PDs isn’t the answer. We have to live with them whether we like it or not!

Anyway, I digress…back on with my point… 🙂

Please don’t let my musings over all the experiences I’ve had with PDs or the news reports on psychopaths make you despair! There are good people in this world too! 😀

A glowing example of the good in this world is the amazing Amber McIntosh, the woman who commented on my post yesterday to inform me there had been an update in the quest to find out who this ‘Jonnica Ellis’ really is. Ms McIntosh provided a link to a US news article that you can read here. In reading the article, I was excited to discover that Ms McIntosh was a stay-at-home mother in Florida who was so outraged at what ‘Jonnica Ellis’ had done to the Doty family that she took it upon herself to track down the true identity of this psychopathic trickster! And, amazingly, she did it!!! ‘Jonnica’s’ real name is Marci Rose. She’s from Harrisville, a small village in Lewis County, New York.

Psychopathic Marci Rose, aka 'Jonnica Ellis'

Psychopathic Marci Rose, aka ‘Jonnica Ellis’ has been exposed!

Anyone who knows me is aware that I have a very strong sense of justice. That’s why Ms McIntosh made my day yesterday when I found out that she shares my passion for justice, evidenced by her relentless commitment to finding the real ‘Jonnica’ for the late Thomas Doty and his loved ones. Ms McIntosh didn’t know the Doty’s or Thomas, and yet, as a caring, compassionate human being, she poured all her time, energy and talents into tracking down the disgraceful Marci Rose and exposing her to the world!!!

Ms McIntosh began her search by starting up a Facebook page, ‘Who is the SICKO That Called Herself Jonnica Ellis? on which she added a link to my post, ‘Personality Disordered People Can Destroy Your Life…Literally’. Ms McIntosh also alerted me to the fact that Marci Rose had even pressed ‘Like’ on the link to my post that says she’s a psychopath! Here’s a screenshot of it:

Marci Rose 'Likes' a Link to My Blog That Says She's a Psychopath!

Marci Rose ‘Likes’ a link to my blog that says she’s a psychopath!

From what Ms McIntosh uncovered about Marci Rose, she does indeed fit the profile of a psychopath (aka antisocial personality disorder). Sadly, as far as the law is concerned, it appears that Marci will not be subject to any penalty for what she did to the Doty’s. In fact, Marci is likely to slip under the radar again, steal a few more photos of some young attractive woman, make up another alias (or ten) and go scam the masses again. After all that she has done she considers herself to be the victim in all of this! The audacity of this woman is astounding, until I remind myself again that she is a textbook psychopath! Marci lacks remorse and has no insight into her disordered thinking and behaviour.

Even if mandated to receive treatment, Marci may never be rehabilitated. Not all psychopaths can be ‘cured’. It is likely that if she is taught to have empathy, she will just use this as another tool to manipulate others for her own desires. The ability to put ourselves in someone else’s shoes can make a non-psychopath more compassionate. But for a psychopath, it just gives them more insight into ways they could control regular people for whatever their heart most desires.

Marci Rose is a sick person but she is not crazy. She just has no regard for anyone but herself. She has not learnt her lesson. She’s just learnt what not to do next time so that she doesn’t get caught. Laws need to be changed…inaction on behalf of the law condones the kind of atrocious acts Marci committed against the Dotys. Condoning it will just mean that such morally reprehensible behaviour will become more frequent.

I strongly encourage you to read the news article about how Amber McIntosh exposed Marci Rose to the world! Ms McIntosh is a brilliant amateur detective!

Amber McIntosh, this post is for you! Thank you for restoring so many people’s faith in humanity and reminding us that there are some very good people in this world, such as yourself 🙂

I encourage everyone to take on the mantle of Ms McIntosh and be extraordinary!

Be compassionate and kind to people even if they are strangers. And for goodness sake, if you can identify with Marci Rose, and have a little too much in common with her; go and get some professional help before you destroy more lives.

Amber, you are a hero 😉

P.S. An official foundation in memory of Thomas Doty is in the process of being registered at present. In the meantime, if you’d like to donate, you can still do so at www.HealThomas.com

P.P.S. Amber McIntosh is continuing to make this world a better place by pushing to have laws rewritten to make what Marci Rose did illegal. Check out Ms McIntosh’s Facebook page ‘Who is the SICKO That Called Herself Jonnica Ellis? for more information on the proposed ‘Thomas Doty Law’ and see how you might be able to assist with the fundraising. This is a cause worth getting involved with. Ms McIntosh’s altruistic nature is second to none. The world is a better place because she is in it 🙂

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Retrospective Analysis of a Friendship with an OCPD-ed Individual

When looking back over my friendship with my ex-friend who has OCPD, I recall that there were many good times we shared, but they are quickly fading. I learnt the hard way that the friendship was a lie. I served a purpose and when my usefulness expired, so did the friendship.

I recall one Wednesday at work in late July, a colleague and friend said to me and my (now) ex-friend, “You’re going to get sick of each other sooner or later”. We both laughed at the suggestion. After all, we spent a lot of time together and never grew tired of each other’s company. Our friendship was solid…or so I thought.

The fractures in the friendship began to appear sooner, much sooner, than later. In fact, “sooner” was just the very next evening on the Thursday. As we were still close at the time, I noticed that my friend was stressed and asked her as to what the cause was or how I might assist her.

I guess she lacked insight at first. She said she felt stressed but didn’t know why. Her anxiety and stress was palpable. She couldn’t sit still or relax. She would get up and down, doing goodness knows what. I put on a movie and fell asleep on the couch. My friend still appeared stressed when I awoke. Again I asked her if I could do anything to relieve some of her stress.

She then said to me, “You know why I’m stressed?”

I answered, “Why?”.

She said, “It’s because of you”.

At first I thought she was joking, but then she went on to mention a few trivial matters, such as me not filling up her ice cube trays (she said I was mad that she had no ice in her freezer…WTF?! As if I’d be mad about no ice) and helping around the house if I saw that something needed to be done.

Okay. That seemed reasonable and fair. I could tell now, though, that she wasn’t kidding around. I said I would help out more, but that I’d just taken a sick day that very same day because I was feeling under the weather. She hadn’t finished. She went on to mention the dinners that she had cooked for me and proceeded to tell me how she always was the one to do everything when she was growing up at home and that it’s just the same now with making me dinner and buying groceries.

WTF?! She was making herself sound like such a victim and was comparing me to her mother (who would have belongings repossessed after failing to meet her financial obligations and was a gambling addict) and her brothers (who were both well into their 20s, still lived at home, were unemployed, trashed their mother’s house and smoked weed all day).

I was so offended that she would compare me to her brothers who are just a pair of lazy, freeloading stoners. Being compared to her mother was also offensive, given that her mother was an irresponsible and apathetic adult/parent.

I had done so much good for my friend, and now it seemed like she’d forgotten all of it. Not only that, but obviously she was harbouring resentments against me whilst doing, what I though were kind and thoughtful acts. To top it off, she just wouldn’t stop talking about how hard it was growing up in a house where she was the only responsible person.

I was in shock and felt hurt. I knew that her stress was about more than just me not filling up the ice cube trays or buying a few groceries on my way home from work. I knew that she was stressed at work and that her contract would be ending in 4 months which had sent her into panic mode over the previous few weeks. But still, I felt like I could no longer trust my friend. Unbeknownst to me, even when everything seemed fine between us, she was really jotting mental notes and keeping tally of ‘who had done what’ in her head.

She said that my mistakes were “no big deal”, but it’s obvious that they were worth keeping note of and bringing up at some later date. She clearly saw herself as a victim and that I was like her family whom she was always denigrating.

Anyway, I really didn’t want to sit around and hear how hard done by she was growing up, so I interrupted and said I was going to bed. She could tell I was upset and followed me up the stairs to my room. I told her that it was late and that I was okay. She was freaking out and wanted to find out why I was upset. I just told her that it was too late to discuss it because I had work again in the morning.

I guess I didn’t know how upset I really was at the time. It’s not that her criticisms of me were severe…it was that she had been acting as if everything was fine for some time when really she was resentful toward me. That jeopardised my trust in her. Things weren’t as they appeared. Could I trust her again? Was she now just beginning to show her true colours?

She had always said that she would tell me if she had any issues with me as they occurred, but she didn’t. She was acting like I was a freeloader when I always paid my share for everything and contributed my time and energies into helping her around her home. I’d also bought her things for her home to make her more comfortable and so had my mother.

That Thursday night was the day I learnt that things were not as they seemed with her. Underneath her sweet facade was a highly critical and resentful human being that believed she was a victim. I was gutted.

The next day I spoke to her about how I was feeling. I said that I still felt upset about what she’d said and wanted those feelings to go away. In trying to console me, she mentioned that she had more resentments, such as me not cleaning out the kitty-litter tray of the cat she was looking after for a friend. The cat lived in her part of the house. It was her friend’s cat, not mine. She was the one who had agreed to take care of it for 3 weeks. All she would have had to do was ask me to clean the tray and I would have done so. She never asked. I didn’t know it was stressing her out so much. She mentioned more trivial things that I had or hadn’t done, so instead of consoling me, she influenced me to feel much worse.

Now I knew she was definitely ‘keeping score’ and resenting the hell out of me. Then she decided that I was too annoying with “all [my] emotions” and decided that it would be for both our good if she went away for the weekend. Thanks for making a decision for me without discussing it with me first!

We had originally planned to have some of my friends over for dinner on Saturday night, but I had cancelled it in case she was really harbouring resentment about having them over…I just couldn’t be sure anymore so I thought I’d err on the side of caution. I didn’t want to add to her stress levels. I think she took this badly and decided to get away from me. I needed to discuss and resolve the issues with her rather than just ruminate over them all weekend which I know would make me feel worse. She had decided she would leave town that night and that we would both feel better (maybe she would, but this wouldn’t work for me) about it after a weekend apart. I was even more hurt because it was one of my last weekends that I would have to spend with her before going overseas for 5 months.

I told her that I needed to resolve things and that she was just making things worse by bringing up grudge after grudge that she’d been hiding. I didn’t care that she was going to visit a friend out of town for the weekend…it was her reason for going that was hurtful. It was because she wanted to get away from me and had no desire to resolve things. I wrote her an email at work and told her to go and screw herself…or something to the same effect. I was hurt and upset.

On the way home I called her and told her that she could take her friend’s cat away that weekend with her because I wouldn’t be taking care of it while she was gone. Then I abruptly hung up on her. Later that night I apologised for being so rude on the phone and explained that I was angry that she had just criticised me for not helping take care of her friends cat, which was never my responsibility, then expected me to look after it for the weekend. Regardless of my apology, she never forgot or forgave me for that abrupt phone call. To her, it was the worst thing I ever did and she would bring it up every time I mentioned I had felt hurt by something she’d done to me.

That night, she decided to leave to go to her friend’s house (in a town a few hours drive away) the next morning, which gave us an opportunity to resolve matters. That’s when I really could see how easily persuaded her opinions were by what other people would say. She said that our recent conflict was due to us spending far too much time together. In actual fact, it was because I was beginning to learn that someone I had trusted so much was incredibly untrustworthy and resented me…this hurt and saddened me…this scared her because she thought she was losing her only friend in town…which made me feel terrible that I had disappointed her and scared her so much without meaning to.

I had tried to widen her social network by introducing her to my friends and including her when we went out for a meal, etc. She eventually criticised me for trying to help her meet more people because she saw it as me undermining her ability to make friends on her own. I was just trying to help, but she wouldn’t acknowledge that I might care about her and only have good intentions.

Anyway, we were able to resolve things that night and everything was good and back to normal. Then she brought up more resentments about opinions I had expressed so long ago that I couldn’t remember saying them. I conceded that I probably had said whatever she had a gripe about because it consistent with my beliefs. Again, it was trivial, but it was an issue to her because she didn’t agree with what I’d said. Then, just out of the blue, she said, “I’m tired now. I’m going to bed”. She had just opened another can of worms after we’d resolved the issues and then said she was going to bed. What a jerk!

In Retrospect I Can See All the Symptoms of OCPD

So many times she would get mad about the stupidest of things like whether or not to have children. She believed that children were career killers and that there is nothing as important as work. She is the only person I have ever met that was delighted after having a miscarriage. It’s no wonder that ‘Revolutionary Road’ is one of her favourite movies. She would often talk about how taking a whole box of contraceptive pills would bring on a miscarriage if someone *hypothetically* had an unwanted pregnancy. I was secretly horrified.

If I didn’t agree with her opinions she would keep coming back, even hours or days later with more reasons why having children is a bad idea. I couldn’t have cared less if she had different opinions to me, but she couldn’t stand it. It wasn’t just with me…it was with everyone. She was right and everyone else who didn’t agree with her was wrong. She made it her duty to tell us all just how wrong we were. I would usually just tell her that it’s okay for two people to have different views on any given topic. Now I know that one of the symptoms of OCPD is that sufferers believe that what they think is correct almost all the time. No wonder she wouldn’t let other people have their own opinions.

She even became suspicious and paranoid about everything kind that I had done for her in the past. She said that I must have had some “agenda”, but she didn’t know what it was. She thought that maybe I was trying to keep her in town by buying her things and being kind to her. At the time, I couldn’t believe that she would think like that about me! I guess she never really knew me. She knew that I’d done nice things for heaps of people. I asked her what she thought was my “agenda” with them. She couldn’t answer it, but thought my motives must have been sinister. Even if I apologised she said she didn’t believe I was earnest.

I told her that I was a kind and thoughtful person because that was how I’d been raised. I reminded her that my mother had also bought her household items and gifts, and that she’d even helped her clean her old place before moving to the downstairs portion of my home. I told her that I’d leant to be generous from my mother and that I wanted nothing from her except her friendship. She didn’t believe me. I recalled that the first time I did something nice to her she said that she was wary of accepting anything from anyone because people really had agendas and were just trying to use her in some way. I now wonder if that was true or if her scared brain just made it up.

Anyway, I asked her what benefit my mother could derive from buying things for her and helping her to clean. She couldn’t answer this, but she maintained that I was just trying to control her. She was totally mental! I was really hurt that she thought like this at the time. In fact, when she first ended the friendship, she told me to go downstairs and take back everything I’d ever given her. I wrote her a note explaining that everything I’d given her was hers and that I understood if she wanted to dispose of it, but that that was her decision to make. My friend was clearly morphing into someone else, but at the time I still thought that I was to blame for everything bad she thought about me and the friendship. When I found out she had enough traits of OCPD to warrant a diagnosis I was able to stop taking things so personally, but it still took a long time to recover from all her unkindness, rejection and betrayal.

People with OCPD also define themselves in terms of their career. It makes sense to me why my ex-friend would resent having children and believe that they ruin careers, despite the example of our young, successful manager being a wife and mother. She was so proud always of how “independent” she was…at the age of 26. I didn’t think this was much of an achievement at her age, but she was fiercely protective of her independence and reluctant to accept help from others.

People with OCPD are also highly critical and will harbour grudges, even recalling past conversations verbatim. They obsess over the most trivial things when they perceive things in life as being ‘out of order’. This is especially true when they are stressed. Everything seems to be disorganised and chaotic when they are suffering an episode of stress. Stress is what brings the personality disorder traits out of hiding and you begin to see a whole new side them…this is common to all the PDs. It can be like Dr Jekyll and Mr Hyde.

OCPDers think that their way of doing things is the only correct way. For my ex-friend, she was very closed minded in regard to using new cleaning products or learning new ways of doing things (amongst other things). She had already established that her way was the only right way and she was sticking to it forever! If she didn’t have an opinion on a topic, she would adopt the most popular opinion to avoid being seen as wrong or unintelligent. She was very insecure about her intelligence. She would often look at me for an extended time after espousing some belief…she was constantly gauging my response.

It is unlikely that people with OCPD will admit they are ever wrong or apologise. They are likely to blame you or someone else for their mistakes or problems. This is why my friend blamed me for all of her stress! It wasn’t my fault, but she led me to believe that it was all my fault. They are highly sensitive to criticism, but can be very critical and intolerant of others’ mistakes 🙂 There were many times when she would respond angrily to me after something so inane, such as when I told her to “be safe on the roads” when she was taking a road trip one time. She was stressed at the time and retorted that she was not a child and had been driving for many years. I just wanted her to be safe because I cared about her. I wasn’t trying to criticise her driving skills. I just cared about her.

OCPDers are rigid and unlikely to see the ‘grey’ in life. Everything is black and white to them. They dichotomise everything…even people. In my ex-friend’s mind I was ‘good’ for a time, but when I became “unpredictable” (to use her word), I became scary and ‘bad’ because things were getting messy and not organised the way she wanted it. She was losing control and it stressed her out.

She was already stressed because she was having to look for another job in 4 months…this is a nightmare for someone with OCPD because they define themselves and take much pride in their career and achievements. Like many OCPD sufferers, my ex-friend catastrophised about not having another job, so she began looking for jobs very early and took the first one she was offered, which turned out to be a hasty move that had more costs than benefits (she hated the new job in sales and it paid much less).

Another interesting thing about my friend being OCPD is that after she quit her job at my work (which was in her chosen career) to work in another job in sales, she didn’t update her Facebook page to reflect her new place of employment. In fact, she just left her job and employer the same on her profile, even after she had updated other things on Facebook, like deleting our mutual friends. When she left the city I live in to move back to her home city, she got her old waitressing job back, where she’d worked as a uni student. As far as I know, she still works there but still hasn’t updated her Facebook profile to reflect the job she now has. In the past week she updated her profile to say that she was a previous employee at the place I still work. I guess being a previous employee at my work (in her mind) projects a more accomplished image of herself to her Facebook friends (most of whom are not really her friends but people she now despises and only keeps as ‘friends’ to monitor how ugly or fat they now are…I’m not even kidding…she told me that this is why she kept them as ‘friends’).

My ex-friend was a confused walking-contradiction. She says she hates superficial people, yet she was the one always obsessing over her appearance, her hair (cutting off the split ends at work) and how fat or ugly other people were. She called me up seeking support when she was depressed, anxious and stressed and rejected me a few weeks later for the very same symptoms. She was so proud of herself that she’d moved away from her home city to pursue a career and meet new people, but when she moved back home she said that she just wanted to get back to being her old self. She criticised her best friend back home for being with such a “stupid guy” and continuing to live the same life and have the same problems as she had years ago. When she went back home, she wanted to resume her old life with her old job (that she had criticised to me many times, but when she resumed working there she said she secretly loved it because the staff were like family to her).

She criticised me when I became excessively anxious and depressed in the fallout of her ostracising me and erasing me from Facebook and her life, ignoring me, avoiding eye contact, telling me never to contact her again, saying she did not want to reconcile and a bunch of nasty things about me. However, it was okay for her to be traumatised for 8 months after her last boyfriend (that she dated for 4 weeks) called her a “slut” when he was upset that she was leaving town. She couldn’t even think about him without crying. If we went to a place that they’d once been together, or even drove past a turn off that reminded her of him she would start crying and emotionally shut down. She would totally dissociate and wouldn’t hear a word I said. She and that particular ex-boyfriend had left on fairly good terms, but that didn’t stop her being traumatised over calling her “slut”. What a hypocrite.

Feedback I Have Received About My Ex-Friend Since She Ended the Friendship

I guess when you’re friends with someone, people know not to mention criticisms of your friend to you…until the friendship ends…then everyone tells you what hey really thought!

One of my friends perceived my ex-friend as “fake” when she met her. My Mother noticed the rigidity and stubbornness along with the vanity and emotional immaturity. Work colleagues have mentioned that they found her conceited and unfriendly. People who worked closely with her found her incredibly rigid and uncompromising. They said it was difficult to collaborate with her and easier to just let her work on projects individually, even if they required group input. Many men and women at work say the same thing…that she was very immature. It’s good to know that I wasn’t the only person that had problems with her 🙂

I’ve also heard it be said that she was, “just a pretty face without much going on under the surface”.

People could see what was right in front of me but that I had refused to see. I can also see now that my ex-friend chose me to be her friend from the beginning. She held me up on a pedestal at first, then hated me and put me on a guilt trip because I didn’t live up to her standards as “her only friend”.

Whereas I take responsibility for choosing to be her friend, I see now that she targeted me purposefully. I never ‘used’ her or had “an agenda” with being her friend, but I can see that she certainly had an agenda in befriending me. There’s projection at it’s finest! Damn she has issues!

Concluding Remarks and Next Post

I’ll do a vignette on my friend and what precisely OCPD is in my next post. I’ll also explain how this differs from OCD, which sounds similar, but is a very different condition.

I’m so pleased that I am able to reflect on what turned out to be the worst friendship of my life without any emotion!

Blogging has truly been the most therapeutic medium for me. Knowing that I am helping people through my blog keeps me wanting to write new posts! Getting back to working with my clients and helping them to manage their problems has also helped me a lot. Continuing to be a good friend to all my other friends and listen to their problems and be a support to them has helped me focus on other things beside my own troubles. Spending time with old friends and family who are genuine and love me unconditionally has also been very therapeutic.

If you have managed to get through to the end of this post, then I commend you for your endurance and thank you for the time you sacrificed to read it.

This post goes to Bec. Thanks for listening, for the advice, for the kindness and compassion. Your words and insights have helped me more than you’ll ever know 😉

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