Victim Personality Disorder

I have recently had six clients who would not, I believe, be diagnosed with a personality disorder by any rule-following therapist, yet I believe they would qualify for an unspecified one. Some of them have paranoid-like assumptions. Some meet criteria for the once-proposed Depressive Personality (DSM-IV axes for further study). Some meld both syndromes in a thick soup of negativity.

They could be called Victim Personality Disorder.

D, 43, is enmeshed in his family of origin. They are the constant headline in his life. There is a bitterness and rage against them for deprioritizing him. It is the subject of every session. E, 23, is similarly fused to her parents and older sibling. She has been the recipient of bullying and malign intent at every job she’s had. This includes conspiracies among coworkers. T, 52, with chronic baseline anger and vengeance intent, feels condescended to and harassed at work and has an EEO case in the works. Same with N, age 41, except that her discrimination case ended in defeat. K, 31, suffers extreme dysphoria, is constantly miserable, passively endures bullying by coworkers. He has a girlfriend but she doesn’t seem to bring him any happiness beyond the moment. L, 24, has lost five jobs in a row, has been bullied and made fun of at each one.

None of them has a capacity for stable happiness or even calm, though most of them are in a relationship they would call positive. This is the Depressive Personality component.

What in these clients equals or approximates a personality disorder? What differentiates them from people who have a “bad attitude”? I think you have to go geological here, down through the layers of their character history to some early place in childhood where there was either a proton or an electron, a positive kernel or a flame. Those still simmering will see only smoke in their landscape and will probably have no insight: “I am being harassed, disliked, mocked every place I work. It’s not me, it’s them.” It’s this seamless certainty without relenting that begins the diagnosis of a character disorder.

Next step is the cognitive escape from feeling. Each of them lives in thought, pessimistic thought beneath which they cannot go that covers their volcanic, childhood-origin emotional pain. Their thinking insists and argues like a cornered rat to prevent their vulnerability to the tears that belong to their youth.

A supplemental feature that I've seen in some of these clients is a blind childishness. They believe with rock-solid certainty that their fellow adults are disliking and bullying and ganging up on them, persecuting them as only immature children would do. They don't realize they are still children forlorn in their elementary and middle school classrooms.

I don’t doubt that some of these individuals have both flame and calm at their core. These are the ones who can grudgingly accept that there may be reason for hope, the sun may come out, but they can’t live in that place.

Therapists know (or should know) that personality disorders are next-to-impossible to dispel. Dialectical Behavior Therapy and other Cognitive approaches do not attempt to get to the root of Borderline Personality in Masterson's "abandonment depression." A Narcissist would disintegrate were he to somehow lose his sense of special perfection. We can’t make a Dependent Personality want to have initiative, be independent and alone. We can't give a sociopath a conscience. And my lesser afflicted clients? Is there a way to break through their suffering and thinking and victim-mind that protect their pain from exiting?