Personality Disorder……

I, like many colleagues find this an extremely difficult but fascinating area. I am not happy with the word’disorder’ as the very meaning of the word means ‘a disturbance or a derangement’- this has a demeaning implication and harps back to 50s style mental health labels.

Working as a therapist with many people over several years, I notice how, in relationships, when drawn into another’s world, an attraction above and beyond our conscious awareness, may be present. A desire to mend the ‘bird with the broken wing’ ; their need in turn, to find ‘ a rock’.

The universal laws of attraction? Or simply our own personality traits, tending to guide us towards others issues. So a situation where one is the ‘doer’, the ‘rescuer’, the ‘problem-solver’ might evolve. A mutual meeting of needs, a dynamic may begin to form- each with a subconscious part to play.

In a loving,equal ,healthy relationship this ebbs and flows and difficulties can be resolved. Compromise is made by each in order to remain in a generally harmonious and supportive place. Time passes and each gets to know the others ways, including negative traits, but these are ok as the firm foundation has been set and obstacles are far more likely to be overcome because of this.

Where one of the partners does not have a stable personality and is unable to develop trust for instance, the smallest of triggers can create mayhem. An emotional hurricane is created by over-reaction to the other. Feeling out of control is frightening and a need to take back control is natural when feeling insecure, but I notice how this taking back of control often has to be absolute. e.g. ‘If you leave the house now, ( even after I have told you to leave) , it proves beyond all doubt that you don’t love me , in fact you never did’ ( because I am unloveable, hateful, rotten to the core, ugly, fat -and any other negative I can conjure up). Trust rears its head, ‘ You will cheat on me at every opportunity'( even though there is no evidence you have or will do this). Cue the arrival of the dreaded jealousy, ‘ I must also protect myself by suffocating you and knowing your every movement and by isolating you from all others so you are just with me. If you aren’t prepared to do this then you must leave!'( This will prove how right I am that you never loved me). ‘ BUT if you leave I might hurt myself, or worse.’ This inner double-bind is created and the partner is damned if they do and damned if they don’t. Emotional blackmail has entered the relationship. Patterns begin to form.

There is little or no logical rational thinking , the motivation comes straight from the emotional core. Anxiety, low mood, anger, pain, frustration and more may then all be transferred onto the partner; why wouldn’t someone with this lifelong burden want to share or ‘dump’ the load? Projection is a habitual tool and the other person often becomes the ‘whipping boy’ or scapegoat.

Calmer moments are sublime, but even these become tinged with doubt and the stable other, starts too, to feel unstable and seeks to reduce any triggers ( book ‘Stop Walking on Eggshells’ , Mason.P& Kreger.R, 2010).

I have noticed too, how sometimes the taking on of the other’s desirable traits and characteristics begins, whilst the stable other themselves starts to crumble. Projection and denial abound. One seeks therapy in desperation, often in love and attached to their damaged other, but the other can’t know, it has to be a secret or there will be another emotional Tsunami- or worse.

Violence is often appears; usually to the Self. ‘I get so frustrated with him I smash plates, throw plants- always my own and then regret the loss and the mess’ or worse ‘ I punch myself, hit myself off the wall- it’s a relief for a while’. But this can also escalate , ‘ She gets in my space , won’t stop talking and I push her away’, ‘I hit him because he tries to control me- I won’t be controlled. It’s not my fault- (it never is). ‘ No one understands me, least of all him!’. These are all statements I have heard over the years and people tend to seek help later rather than sooner.

What can you do? Speaking to your GP is always a first port of call. Visiting http://www.mind.org.uk or http://www.helpguide.org
Can provide a wealth of information about signs symptoms and where help can be sourced.

Advertisements

‘Disorder’

i really wish we could find another word to replace this within the mh world. Having a disorder must be very disheartening- there you go : anything with ‘dis’ at the beginning is really not so great. There are plenty of debates on the topic of labelling. Some are relieved to have a diagnosis, to be able to name the distress, to know , at least some of what is going on. For others it is stigmatising, a source of shame and embarrassment: best kept under wraps. Distressed is the opposite of Eustress( the OK healthy kind of stress)- so worth knowing which you have in order to make some changes or get some help. So maybe some ‘Dis’ can be useful?

When a client/patient says ‘ I have personality disorder’ almost always the personality bit doesn’t bother them, after all our personalities are multi- faceted, but the ‘disorder’ bit does . ‘ I have a disorder of the mind!’ Who can blame them. Rather like the word ‘disease’ and all the Victorian horror this conjures in our minds. A physical disorder seems less stigmatising than a disorder of the mind/ personality somehow. Controversial,but if it can be seen it can be understood somewhat

So ,yet again, we need a review of mh language. Not out of political correctness , but out of kindness.

Feathers or Dark Matter-Burnout

It seems to come from nowhere, yet with hindsight, when we examine what was happening in our lives we can the signsburnout were there; an initial euphoria that led to taking on yet more tasks and projects. A ‘can-do’ attitude, exuding willingness to one and all. Those broad shoulders, a keeness to excel, to show all around that we are almost super-human, capable of so much. Our energy reserves are not infinite- we know this so why oh why do we ignore? The re-charging of our resilience  involves fun, rest, healthy nourishment of the body and soul. It is a bit like being in love – we focus on nothing else. It is actually unhealthy, ok for a while, but out of necessity it wanes and we then find a happy medium- a balance of activities. The things we HAVE to do, the things we like to do and all the in -betweens!

I see too, the desire in individuals to portray an image of being invincible- so prevalent amongst health professionals. ‘Anything else is weakness’. I would once have agreed- that is before my own burnout a few decades ago. I struggled on the brink and pushed myself to a point where there seemed only one way out. Thankfully (eventually) I found the right support, rested for a rather long time, and reinvented myself. So the idea of weakness was replaced with an insight into how I had become vulnerable and how I could reconnect with my strength again. So I know it can be done, and I see it every day through the privilege of working with people suffering and struggling and eventually coming through.

Burnout happens because the balance in our life is all wrong. If it were a set of scales we would see feathers on the side where our joy, happiness and contentment sits, and on the other, sacks of heavy  dark matter in the form of stress, anxiety, depression, insomnia, even paranoia. Of course we do not see this then, so we falter, and try and work even harder to distract (the worse thing we could do at that point); we may self medicate with alcohol (a depressant in this instance). We may engage in risky or harmful behaviours( another distraction to take us away from feeling trapped by our emotions). Those around us become concerned but often back away because we are angry, out of character, alien and projecting all the negativity at them in an effort to distract from our own reality and in order to carry on.

As soon as you feel the balance is out of kilter- do something: take a break (‘I can’t I am needed’- ‘well you wont be wanted at all if it carries on this way….’). Speak to someone who you trust or someone outside your circle, a professional. ( ‘I don’t have time, they’ll think I’m weak’- ”well if you carry on like this you will have all the time in the world from your hospital bed, and you will regret ignoring your inner alarm bells’). Burnout can be prevented; we must learn at points to put ourselves first for a change. To notice what is going on before it becomes debillitating.