Drastic Definitions #1: Personality Disorder

A personality disorder is a delusional way of seeing and feeling the world and the self. The person, owing to developmental failure in infancy and childhood, cannot tolerate his own reality. His reality is pain and feeling wrong in the world. “Wrong” is his immaturity and out-of-sync-ness with his chronological age and therefore with life.

Personality disorder is a new world that the person has wrapped herself in, a world of thoughts and beliefs that “read” the body’s feeling states to conform with those thoughts and beliefs. As I’ve written elsewhere,* a Narcissist doesn’t wake up in those first few seconds feeling good. He feels wrong because he never grew up (frozen in his mother’s solipsism, neediness, lovelessness along with father’s absence), but interprets his fear and contempt and need for identity as a feeling of superiority.

See the childishness in the personality disorders. A “man-baby” Narcissistic, black-and-white-thinking, rage-based oppositional-defiant crash-and-burn president. A Borderline woman rips out hair and cuts herself if a friend misses a lunch date. A Dependent thirty-five-year-old who needs and wants her mother to make decisions for her. An Antisocial man who sees all people as bad, as his victims, who never grew morals, who needs instant gratification. An Obsessive-Compulsive Personality with futile, hidebound pursuits. A Paranoid Personality with vulnerability fear oozing out of his porous mind.

While most of us “have” a so-called inner child – our adult character carries regressive parts of ourselves – the personality disordered individual is his inner child: It is his ground and structure. Since the lost child is his predominant quality, it is “ego-syntonic”: not merely in harmony with his view of himself, but one with his life. The adult is the window dressing, the outfit he wears poorly or relatively comfortably.

It can be difficult to identify a personality disorder, because defense and immaturity exist on a continuum. We know adolescents and adults who are egotistical but not Narcissistic; immature, impulsive men or women who are not Borderline; subservient, domestic violence victims who are not snugly Dependent; someone capable of transient cruelty who doesn’t qualify for Antisocial Personality. A therapist, unsure, is likely to check off criteria in the DSM-5, hoping for what seem to be enough to reach the diagnosis. We may let an arbitrary number of client behaviors decide: A psychiatrist I knew assigned Antisocial Personality if a man had a second incarceration. I often look for a feeling theme in the person, an emotional philosophy that is wide and deep, defining a whole life. A sense of self that goes beyond bragging to self-perfection. Sometimes just a facial expression and tone of voice prove it. Not merely a middle-aged woman leaning on her elderly parent, but complacence about, endorsement of leaning.

We want to know the presence of personality disorder, because it is the defense that undergirds all the others and undermines everything. It is immaturity, a forever-inchoate identity – a troubled six-year-old in an adult’s body – that can’t be fixed by time or standard therapy techniques. It may be addressed by regression, sometimes by brutal insight.

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* https://pessimisticshrink.blogspot.com/2017/08/mini-statement-don-one.html.