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.

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.

“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.

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.”

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.

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

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

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…

• Jimmy Savile abuse: Number of alleged victims reaches 450 – BBC News (12/12/2012)

• Sir Jimmy Savile: He raped me as a teenager claims woman – The Telegraph (03/10/2012)

• Jimmy Savile caused concern with behaviour on visits to Prince Charles – The Guardian (29/10/2012)

• Jimmy Savile: National treasure in life, reviled ‘sex abuser’ in death – CNN (11/01/2013)

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!

[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

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’

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.

Related articles

• Savile claims ignored for 50 years (bigpondnews.com)
• Letter exposing Savile as a paedo was buried by Scotland Yard because he was famous (thesun.co.uk)
• Who’s next? “Very high-profile figures” set to be arrested within weeks by Jimmy Savile cops (mirror.co.uk)
• “Forget about it”: What police told Jimmy Savile rape victim as vital evidence ignored for 50 years (mirror.co.uk)
• Police ‘could have stopped Jimmy Savile’ as far back as 1964 (metro.co.uk)
• Jimmy Savile investigator offers to help round up 1980s paedophile ring (independent.co.uk)
• Police’s Savile ‘failings’ exposed (bbc.co.uk)
• Jimmy Savile sex crime police ‘to arrest more celebrities’ in Operation Yewtree probe (metro.co.uk)
• Police, prosecutors and hospitals: How Jimmy Savile’s victims were let down by every authority (itv.com)

Personality Disordered Individuals: Bringing Out The Worst In You

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!

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”.

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 🙂

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

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

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…

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:

• Top 15 Signs You Have Been Dating a Sociopath
• Catching a Sociopath in a Lie
• Biggest FearFor a Sociopath – Well There Are Two
• The Sociopath Mask of Charisma
• The End of the Relationship, Ruining and Smear Campaigns

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

Is The Tea Towel Wet or Red?

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?

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.

Related articles

• What is a Personality Disorder? (dechirementblog.com)
• How Do I Know If I’m Normal? (dechirementblog.com)

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!

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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