From: Dace (edace@earthlink.net)
Date: Sun 11 May 2003 - 19:14:41 GMT
> From: "Lawrence DeBivort" <debivort@umd5.umd.edu>
>
> Hi, Dace,
>
> I have read the personality disorder criteria, and worry at how useful the
> list is. Here is why:
>
> I can well imagine a person who, say, engages in an unusual area of study,
> say the neural net model of information exchange within a government, and
on
> the basis of that concludes that the head of the government is isolated
from
> significant portions of information and thinking, and is instead receiving
> only a small amount of the information, controlled by a handful of people,
> who thus have an easy time controlling the thinking and decisions of the
> head of state. Let us posit that he is correct in his analysis. So, our
> researcher starts warning people about this, and the more ignored he is,
the
> more vociferous he becomes, such is his worry that his government is
making
> or might make dangerous decisions. He finds himself, more and more on the
> outs with his colleagues, friends and family. He gets fired, for not
> tending to his business and forcing customers to listen to his suspicions.
> Friends stop inviting him to parties. He sinks into a depression, over the
> state of his country and over what it has cost him personally. He goes to
> therapy, where he is told that he is delusional by a therapist who has
never
> heard of neural nets and believes that questioning the head of state is
> unpatriotic. He goes to his minister, who tells him that the country is in
> the hands of God and that what he really needs to do is pray for guidance.
> He goes to his sister, who tells him he should confide in his wife, who is
> worried about him. He goes to his wife, who tells him that if he just
> started working again he would feel better about himself. He tries to
> explain neural nets to his friends, who tell him that they can't
understand
> him but why doesn't he come over and have a beer and watch the game. He
> becomes morose, and finds himself taking long drives alone, and sometimes
> crying when he thinks about things too much. He finds himself guzzling
> Klondike Bars, and day-dreaming about the happier times when his mom
> used to give them to him up at the lake in the summers.
>
> Now, the list you cite asks only that an individual exhibit two of the
> criteria listed. But an outside observers would say, I think, that he has
> symptoms of criteria: A 1-4, and B, C, D, E, and F. In other words,
> according to the DSM, he has a personality disorder. But, does he? True,
he
> is alone in his views, but that is because others haven't developed the
same
> expertise and done the same research. True, he is out of sync with
everyone
> he talks to about his conclusions, but, again, it is because they don't
> understand neural nets, or because they don't want to hear 'subversive'
> thoughts. True, it is an enduring pattern, but that is because the danger
> that he is trying to warn people about is persisting.
>
> But does he really have a personality disorder?
>
> Is it not possible for one person to be right, though a thousand tell him,
> over and over again, that he is wrong, or stupid?
>
> Cheers,
> L
Hi Lawry,
Based on the information provided above, no competent therapist would
diagnose a personality disorder. This description does not in any way
suggest a personality disorder or, for that matter, any other mental
illness. Even depression is not indicated because there's a clear-cut
trigger for the feelings of despair. Criterion A-1 is not met simply
because you take a view of the world that's radically different from that of
most other people. The key is that you perceive yourself as some kind of
benevolent deity when your behavior is objectively that of a complete jerk.
Criterion A-2 is revealed when you react with extreme hostility to anyone
who tries to point this out. The example above in no way complies with
criterion B. Not only does the pattern have to be inflexible, but it has to
apply to a "broad range of personal and social situations." It can't just
be an anomoly that's set off by a single, unfortunate situation, as related
above. Criterion C refers to an "enduring pattern," not a single event.
Criterion D demands that the pattern go back at least to early adulthood and
probably adolescence. This is not something that appears during a mid-life
crisis.
Keep in mind that diagnosis with a PD is just the first step. The next step
is to ascertain which of the ten varieties of PD apply in a particular case.
You're looking for things like narcissism, which involves a severe deficit
in empathy, a willingness to manipulate people, arrogance, a sense of
entitlement, grandiosity, etc. Or it could be antisocial tendencies, or
paranoia, schizoia, hysteria, etc. When diagnosing a PD, the therapist
always looks for these ancillary traits. While there's no question that Joe
is suffering from a PD, I've been less certain which form applies in his
case. At first I thought it was narcissism, but with his incessant bullying
I began to think it was antisocial PD. I recently discovered that so-called
"serial bullies" are diagnosable with narcissism as often as sociopathy, so
perhaps it is narcissism after all. Of the the nine criteria for
narcissistic PD, five are required for a diagnosis. I believe that Joe,
based on his behavior on this list, conforms to criteria 1, 4, 7, 8, and 9.
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,
etc
3. believes that he or she is "special" and unique and can only be
understood by 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 expectations
6. is interpersonally exploitative
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
9. shows arrogant, haughty behaviors or attitudes
No doubt a face-to-face relationship with Joe would reveal more evidence of
these symptoms. However, long-distance diagnoses are not unheard of.
Harper's magazine ran a professional diagnosis of the biblical Samson, who
clearly reveals all seven criteria of antisocial personality disorder. US
army psychiatrist Walter Langer diagnosed Hitler with antisocial PD during
the war without ever having met him.
As Dr. M. Scott Peck pointed out in *People of the Lie*, the very idea of
"human evil" would not exist were it not for "malignant narcissism."
Traditionally, what's evil is things like earthquakes and plagues and swarms
of locusts. Human beings aren't supposed to be evil. When they are, like
Hitler or Saddam or George W. Bush, they probably harbor a personality
disorder. (For a psychiatric analysis of W., see
http://www.counterpunch.org/wolman1002.html).
Finally, keep in mind that the DSM-IV contains only diagnostic criteria, not
general descriptions. For a really insightful discussion of clinical
narcissism, see http://www.halcyon.com/jmashmun/npd/traits.html. This is
the "traits" page of Joanna Ashmun's website. Like me, she's had a lot of
personal experience with narcissists and knows how to spot one.
> From: Jkr438@aol.com
>
> In a message dated 5/9/2003 2:54:46 PM Central Daylight Time,
> edace@earthlink.net writes:
>
>
> As I've stated before, Joe is clearly diagnosable with a personality
> disorder. The diagnostic criteria are listed on page 633 of the DSM-IV:
>
> A. An enduring pattern of inner experience and behavior that deviates from
> the expectations of an individual's culture, as manifested in two (or
more)
> of the following areas:
> 1. cognition (i.e., ways of perceiving and interpreting self, other
> people, and
> events)
> 2. affectivity (i.e., the range, intensity, lability, and
appropriateness
> of emotional response)
> 3. interpersonal functioning
> 4. impulse control
> B. The enduring pattern is inflexible
> C. The pattern leads to distress or impairment in social areas of
> functioning.
> D. The pattern is stable and of long duration.
> E. The patern is not better accounted for as a consequence of another
mental
> disorder.
> F. The pattern is not due to a drug of abuse, a medication, or a general
> medical condition (e.g., head trauma).
>
> [Jake] I interpreted the above as a pure ad hominem. Perhaps a somewhat
> sophisticated and intelligent sounding one, but an ad hominem regardless.
> Perhaps you could say, "Well, I was just trying to help people out by
warning
> them about Joe." But I don't really buy that. Whether Joe gives you
> headache, whether you find him full of "brutish eloquence" or something
else,
> he has been around these parts for a while now. A look through the
archives
> of the memetics list, or the Church of the Virus
> http://virus.lucifer.com/bbs/, for the last several years should give
people
> whatever warning they need. I personally avoid psychiatrically
"diagnosing"
> people over the Internet.
So do I. I'll make an exception only when two factors are in place. First,
there has to be no doubt whatsoever as to the accuracy of the diagnosis.
Second, the offending individual must keep up the bullying for a long time,
showing no signs of relenting. I spent months calmly responding to each and
every attack from Joe. I spent more months simply ignoring his attacks.
Finally, it became obvious that he was never going to stop no matter what I
did. Joe is entirely to blame for the exposure of his mental illness. He
has brought this upon himself. Not that it matters to him, of course. He
honestly believes he's a wonderful guy, and I just harbor some kind of
irrational hatred for him. So it's not as if I'm hurting his feelings or
anything. All of this goes right through him. If my comments were intended
to hurt his feelings, as is usually the case with ad hominem, I'm doing a
pretty lousy job of it.
> Speaking of diagnosing people, this is one of my favorite "What's wrong
with
> me?" fun links. http://www.4degreez.com/misc/personality_disorder_test.mv
Thanks for the reference. I'll take a look at it.
Ted Dace
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