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Diagnosing Personality Disorders?

Sometimes I can't help myself - who are you to diagnose a mental health problem??? It takes psychiatrists who are medical doctors specialising in mental health in the same way a cardiologist specialises in heart health - intense and prolonged assessment to diagnose a mental health condition.

Even your GP doesn't provide a diagnosis of mental health conditions - they provide provisional diagnoses only - which means it needs to be confirmed by a psychiatrist via further assessment.

So can you? The answer is, with full respect, absolutely not! Just because you can identify a set of symptoms the formal diagnostic guides tell us indicate a mental health condition, does not mean that is applicable to any particular person.

Do you know that low mood and an inability to stop crying could indicate a physical disorder? Do you know that overwhelm+exhaustion is the most common 'cause' of mis-diagnosed depression? Do you know that personality disorders don't technically exist?

Decades ago people judged and commented on each others social standing, personal attributes and physicality via pathetic statements like, "oh but iaren't they from xyz background / xyz racial group / xyz side of town...? That explains a lot you know...." which we now rightly consider to be ignorant and contemptible.

Instead, what we now do is use pseudo-intellectualism and pop psychology to go round telling people "well he is narcissistic you know, what would you expect, better stay away from him, or better yet, let's stab him in the guts..."

It makes me so angry!! Every one of us has traits of numerous personality disorders that show up when we're being Little Me - the Me who's run down, tired, stressed and fed up, the Me who's copped too much or dealing with too much. You probably know your own Little Me pretty well, and have likely covered your Little Me with more socially sterile attributes, or some other psychologically acceptable safety blanket. But we all have them - traits of a variety of 'personality disorders' that show up when we don't want them to. Most likely you've worked hard to get rid of them, sterilise them, hide them ... whatever...

That doesn't mean you have a diagnosable mental health problem though and it certainly doesn't mean you have a so-called personality disorder. It just means you're human, and being human. And I don't mean inadequate, inferior or imperfect - I mean wholly loveable, vital and leaning into life itself.

Let me give you an example from my own life. Ordinarily I'm a pretty quiet kind of person and my friends most often tell me I don't do drama enough (& yes, I'm learning to be a bit more dramatic in my language over recent years...) but there have been 2 occasions where you could quite accurately label me histrionic. Once in a carpark (oh so embarrassing) and once in my lounge room (oh so shameful). On both occasions my emotional pain overwhelmed me entirely. Histrionic? Yup. For about 5 mins.

But if you knew me, you'd put that in perspective. You'd know I'm so not that. And you'd probably be aware and able to give me a hug, find out what was going on behind my inadequate, fear/anger fuelled actions and simply be my friend. Pass me the chocolate would you....

If you didn't know me, you might say 'she's sooooo histrionic, she's got problems' and judge me harshly, maybe even step away from me. All for 5 mins of a heartfelt, desperate need to say what needed to be said openly and honestly, despite intense vulnerability. On both occasions the driver of my response was a terminal illness that had me fear-bound and grief-struck. Not a mental health complaint. But if you don't know me well and only observed my behaviour in those few mins, what would you think?

What about Whatshisname - the bloke who's constantly telling everyone how great he is, how lowly everyone else is? Did you call him narcissistic? Do you label him with a personality disorder? Do you acknowledge his other traits or his strengths that make him human and just as worthwhile as everyone else? Or do you only see his ugly bits? Or maybe you're defending against him so you don't have to deal with any of that. If you can stop seeing him only for his ugly bits you'll be able to relate better with him and ignore those ugly bits, instead work with them too and be better able to stand your own.

Remember in professional environs, how we get on together impacts absolutely everything, and a professional imperative is the choice to bring out each others strengths, not belittle or denigrate their inadequacies. When you bring out others' strengths at work you enable their best work, when you bring out others' strengths in personal environs you enable their best lives. Win. Win. Win.

So do you judge people on their reactive responses? Do you call them personality disordered? Do you judge them and treat them as though they're inferior beings?

Think about this - Dr Bessel Van Der Kolk, a psychiatrist and considered by many a global leader in trauma care - says 87% of all personality disorders are misdiagnosed trauma responses. 87%! That's huge! If you're a thinking person you've already registered that the rate of trauma is massive and that people are overwhelmed with all the so-important stuff we expect of ourselves and each other, and you've probably already come to the conclusion we have to think differently about each other. We have to relate differently, to be differently if we want our lives to transcend the ugly...

So what do you think about diagnosing someone as a personality disorder? Do you think it's rude? Contemptible? I think you do, I hope you do. Goodonya for not doing that anymore.... :)

 

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