Mental Health Month “Personality Disorders”

The first day I was interning in a crisis center, I heard two women talking, and one said; “Whatever you do, don’t ever see a client who has Borderline Personality, they’re the WORST”

Shamefully I had studied but didn’t know very much about BPD yet, as I was only a year into my studies. I went home that night and read up on it and subsequently read some books devoted to BPD including the well-known book “I love you / I hate you.”

Shortly afterward I found out a friend of mine was BPD (BPD often goes hand-in-hand with Bipolar, as we often see Anxiety and Depression co-morbidly). She educated me significantly in a first-person account of what it was like to suffer from a personality disorder.

The very words ‘personality disorder’ strike me wrong. It’s not really giving someone a chance is it? If we label them as being disordered in some way?

It is thought personality disorders ‘grow’ in childhood and upon reaching maturity can be responsive to treatment or not, depending on the depth and extent they were reinforced in childhood. They usually have triggers such as the link between BPD and being sexually abused in childhood.

Why this is – isn’t so hard to understand if we consider, we all have personalities that are shaped by our experiences – any wonder then that certain experiences will commonly shape certain personalities and responses/reactions. If we take this to an extreme, a ‘disorder’ is a disorder of that personality caused by something wrong and traumatic that occurs to a child.

Why then doesn’t every child who is sexually abused BPD?

Because BPD and other personality disorders must be reinforced. If you are abused as a child but someone finds out, the person is taken away, you are told it was not your fault, the trauma is made better by a rectify and love and lack of shame, then you may well be affected by that abuse but not altered by it in terms of your personality.

If however, the opposite occurs and that trauma is reinforced, then by its very nature of reinforcement, the personality ‘disorder’ forms and every bad thing that happens afterward goes to continue that reinforcement.

It can work something like this;

Child A gets raped by her step-father. Child A tells her mom. Her mom calls her a dirty little liar and beats Child A. Child A is then raped repeatedly by her step-father who threatens to kill her if she ever talks again. Child A remains silent to her abuse for years and it goes on, unpunished. At 15 Child A goes to a party, gets drunk and is raped by a friend. Child A is told by her friends she is a slut and deserved it. Child A internalized all of this and develops BPD which among other things is characterized by a profound lack of trust in others.

Phrased like this, are any of us surprised?

In other words, a personality disorder is a consequence to abuse. As such I find the use of ‘disorder’ punitive because we’re saying the person has something wrong with their personality we are focusing on that, without really considering how this occurred.

Why? Because BPD can be very destructive, both to the person with BPD and those who know them. When you are dealing with someone who is capable of throwing everything into flux, it’s hard to make time to consider the background. You are too busy putting out the fires. And that is why BPD is so feared by therapists and wrongly, stigmatized as being a personality disorder people dread. Whether people dread it or not, any health care worker should aim to help those under their care and treat everyone equally. Perhaps that is easier said than done, but this is why more time should be spent learning about the formation of personality disorders.

Later on in my training I was warned again about BPD folk and told that they can be highly manipulative and destructive, they can and will always try to bring you down. I recall thinking ‘I can’t see how anyone could do that’ but later on I saw several colleagues have to defend their licenses against false accusations by BPD patients who were ‘testing’ them or flexing their muscle.

It appalled me to think anyone, even someone mentally ill, could deliberately go after someone with the sole purpose of trying to ruin their life. I found it hard to understand and empathize with them on that. Which is why I now understand why mental health workers can fear certain diagnosis in people. But despite this, I believe, given the right training and awareness, people can find ways to help those who even lash out at them.

BPD is characterized by a pull-push approach to relationships, an intensity, followed by a rejection, both of which are extreme, due to an inability to trust people shifting from intense attraction/like, to repulsion and hate. For most of us, this extreme is not impossible to imagine, perhaps if we have fallen out with a friend who back-stabbed us or a relationship went wrong because someone cheated on us, we went from love to anger at very least. With BPD those emotions are amplified and far more aggressive, with anger as the source. BPD individuals stoke the flame and are among the most angry and vitriolic of the mental spectrum.

For this reason when befriending someone with BPD it’s important to secure firm and unwavering boundaries. Ensuring the BPD knows the ‘ground-rules’ in other words, don’t flirt one day, and be cold the next, don’t be close one day and distant the next, because by doing that, you are feeding into their fears that nobody is trustworthy, and that will only bring on an extreme response.

Many BPD’s confess that the hardest part of the illness is the social disapprobation and isolation. They do not maintain long-term friendships or relationships, they are at high risk for suicide and self-harm, they vacillate between self-incrimination and feelings of persecution. In short, it’s an instability of their psyche due to being fractured in childhood.

This is among the myriad reasons I condemn child-abusers unreservedly. It is not just rape and abuse, it is messing a child’s life forever when you take someone and you fracture them. If we can take child abuse more seriously and catch more of them before they go on to ruin more people’s lives, this will have the knock-on effect of reducing the numbers of people who grow up to develop BPD and save them from difficult and unfair experiences in life. The one positive of a personality disorder is you can prevent it from happening, we cannot do that with all mental illness but when we can, we have no excuse but to try our hardest.

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Mental Health Month “Narcissism”

Social Media has spates of trending headlines and buzz-words. Periodically, ‘Narcissism’ will be among them. We know the basic meaning, the mythological story and how a modern narcissist can hurt relationships be they friendships or otherwise. But if we were asked to clearly define the process it might be tricky. That’s because the issue with a buzz-world is we gloss over the deeper meaning, we stereotype it, until we’re using it out of context and it loses the potency of its original meaning.

Thus, you will hear many people calling out narcissists, and in truth, fewer people are true clinical definitions of narcissists than we would imagine. Equally, some of those who labor the point regarding narcissism, are in fact guilty of the very thing they decry.

A narcissist as their core, is someone with low empathy for others, high self-regard, an inflated and delusional sense of self, an entitlement and sense of superiority to others. They can be charming and appear popular and ‘normal’ in some settings, only to be a down-low narcissist, or they can be an overt example. typically a narcissist is considered to have some sociopathy and inability to care for others meaningfully, as well as a belief they deserve more than others and others should act accordingly. Likewise, a narcissist will seek adoration and forms of worship over say, maintaining a give-and-take relationship. If they do something that appears giving it is with the knowledge they will get something in return, thus it is insincere.

Narcissists can also be very successful because they have less quam about their actions, they are confident, bullish, determined and strive for what they believe they are ‘owed’ as well as not being perturbed about the cost of achieving this or the damage inflicted upon others. Some narcissists will play games with people to manipulate them, in this sense they can be also described as sadistic and cruel.

As with any mental disorder, narcissism is on the spectrum and varies a great deal. It is a personality disorder manifested often early in life, and can be controlled, hidden or overt, depending upon its specific characterization within an individual. In other words, one size does not fit all. Typically with any personality disorder, it cannot be completely ameliorated but you can lessen its outcome if you are open to that, which many narcissists will not be because they suffer the delusion of self-aggrandizement.

Most of the time if someone hurts us, and we call them a narcissist they are not. Sometimes when someone calls out narcissistic behavior they are enabling it by their reactions to it. An example would be, if you call someone narcissistic but you do much the same in your own interpersonal relationships with people. It is possible to be  narcissist and not be aware of it.

With varying degrees of personality disorders, it is very hard to definitively say someone is a narcissist because many times you can display narcissistic behavior but not have enough to qualify for the actual personality disorder. With any mental illness it is dependent upon frequency, duration and extent of (symptoms).

If you are in a relationship of any kind with someone who is a narcissist you will expect to experience some of the following;  A sense that you are not entirely worthy of the individual and they feel you are lucky to be with them, difficulty in expressing successfully your perspective and that being understood. It is not as simple as being vain, confident, or even arrogant, narcissism is at the very core of a person’s nature and decision-making process.

Likewise, those subject to the natural manipulations of a narcissist will become versed in how to respond ‘correctly’ to their needs and thus, alter their behavior accordingly. It can take years to re-train yourself out of responding this way to a figure-head such as a narcissistic parent, or lover, and the beating it gives a person’s self-worth and confidence can require a lot of work to re-balance. This is because a narcissist is so confident they convince others they are right, even in the face of common sense. A narcissist parent will rear a child who is always considering the parents needs rather than the other way around, and thus, does not develop fully because they are attuned to the needs of another and not so much, their own.

We have been discussing how judging any mental health manifestation is wrong, and should be avoided at all cost. With Narcissism it is somewhat different. Narcissism, along with Sociopathy, Psychopathy, and other extreme personality disorders and mental disorders, has a poor cure or treatment rate, it often causes a great deal of harm and pain to others, and many who are ultimately imprisoned share these traits. While no good comes from judging, it is worthwhile considering whether becoming close to someone who is unable to treat these symptoms is a good idea, given the likely outcome.

Obviously someone who is a sociopath or narcissist shouldn’t be precluded from having a relationship or a life, but unfortunately in some ways, the damage of their personality can be so bad that it does come to that. Of course I feel some compassion for this, but it is tempered by the fact that someone who is a sociopath or narcissistic does not experience compassion or empathy and simply goes through life feeling they deserve what they want at any cost. Some milder forms that are say, manifested by trauma, can be treatable, but if they are entrenched, it is often a poor prognosis.

I have met some people who repeatedly are attracted to narcissistic types, this is because they learn patterns and unconsciously respond and repeat them without meaning to, because of early exposure to that kind of behavior. You could almost say it was masochistic and it is, though not consciously. It is a little like ‘better the devil you know’ because the familiar patterns of treatment become instilled and it is hard to break the cycle. In this regard, the victims of narcissists are more likely to be seen by mental health professionals than the perpetrators.

Ultimately then when we talk of narcissists we usually refer to the damage they wrought upon others and how best to help those people.

Learning to spot the signs of a narcissistic personality as well as increasing self-worth are the keys to overcoming the damaging cycle. This can include watching for people who only know how to talk of themselves, rarely show interest in others, and if they do it’s very much crafted toward gaining trust to get what you want. This is of course hard to gauge as it can be subtle and most of us have been on the losing end of a friendship with a narcissist.

There is no cure-all but the more self-respect we have, and the greater awareness of being taken advantage of, as well as looking out for people who are self-obsessed, will help us circumvent typical narcissists. This can include setting boundaries, ensuring that friendships are relatively equal (give-and-take) watching for obvious signs such as being self-obsessed, lack of empathy, lack of interest in anything but self, self-aggrandizing behavior, a need to be worshipped and/or continually praised and excessive vanity.

Just as those who are raped as children, can sometimes go on to rape children when they are adults because they are subverted into a twisted parody of their own abuse, and act it out, the same is true with narcissists. The victim of a narcissist will often exhibit narcissistic behaviors also. They will assist without knowing, the antagonism with the narcissist by responding/reacting in such a way that feeds the ego of that narcissist, they will also expect some of the same things their narcissist expects such as attention and adoration. It’s almost as if they learn from their oppressor and take on some of the traits.

This can be ‘fixed’ and is highly receptive to therapy, the first step being, admitting you have done this and wanting to stop doing it.

Breaking the cycle including your own reaction/response to narcissists is key. In some ways if you do not do this, you will aid and abet the narcissist and even attract others to treat you this way, just as you would any addiction. The behaviors are learned and highly addictive as all extreme forms of behavior are, especially if learned in childhood which they often are, such as in the case of a narcissist father and their children. The kids are literally trained into subservience, into blaming themselves as a narcissist will not take blame on themselves and are very good at displacing blame onto their victims.

Learning to be attracted to non-narcissistic people can be challenging when you are taught to be drawn to the magnetic inflated personality of a narcissist. Other people may appear ‘boring’ and ‘bland’ and not push your buttons including your sexual-desire, attraction buttons. It may seem ‘sick’ to be attracted to a narcissist but they are very adroit at becoming attractive enough to gain many followers. this is why narcissists are often in positions of power and/or lead others. They do have a magnetism and charisma that superficially impresses others. Sadly in some cases they are revered and never held to task for their less desirable traits.

It could be said our society is sick for our worship of certain narcissistic figure-heads and we should question the message we are sending by glamorizing narcissistic people in the media en mass. In many ways it is our society that creates a narcissist and certainly, we perpetuate them. What this also means is, we can change that.

 

Mental Health Month “Friends without benefits”

Friendship.

Watching TV shows, reading books, the influence of an ideal, ‘friends forever’ the friends who are there when you need them, friends for life, friends through thick and thin.

Probably should preface this with “unless you are mentally ill”

Why?

Mentally ill people struggle to maintain life-long friendships and connections. An unkind soul may say “can you blame anyone for not being able to put up with THAT?”

Yes.

One reason mentally ill people struggle is the sense of isolation, loss, abandonment, and judgement, all discussed before. Friendship and ties to the community is the basis for survival for most people. Isolation and rejection can lead to suicide and worsening illness. It is not the duty of anyone to befriend a mentally ill person but equally as a society if we put our rapid judgement aside and turned from only seeking ‘fun happy people’ to socialize with, and gave a little thought to those suffering, our empathy would go a long way.

We are selfish on the whole when it comes to friendships. We don’t want to ‘bother’ too much, we don’t want to make an effort. We want something easy and fun. If it’s not we’re likely to drop it.

But the effort we put into our children, our families, our marriages, should equally be considered when looking at friends in need. If we cannot be a good friend are we even a friend? Or are we just a fair-weather friend?

Many people I have spoken with have talked about how much it hurt to be ‘friend dumped’ and how often this occurs when they are going through a hard time. The worst being, it can compound the already existing feelings of worthlessness and self-blame.

It is not the responsibility of others to take care of mentally ill people but it begs the question … if you are only friends with someone when the going is good, are you really friends? If you only want to be friends with someone without any strings attached and no difficult times, how invested are you? In short, are you even a friend?

Friendship is perhaps an art that is lost on us these days, with our increasingly ‘busy’ lives and selfish preoccupations. But remember, society functions well when all of us care about those in our society. If we simply live for ourselves and give no regard to others and their well-being, are we really the good and giving people we envision ourselves to be?

If we are Christian is this the Christian way? If we are Buddhist is this the way of the Buddha? If we are aiming for empathy and treating others as we would hope we would be treated, are we acting accordingly? What would happen if we suffered from a mental illness? What would we expect?

It is worthwhile considering this. A close friend of mine became incredibly ill with a brain tumor and she observed that she lost many friends, including those who went to her church. It showed her the time observed adage that you know who your friends are in your moments of crisis and need. This is where physical and mental health share something in common, in both instances, people flee the individual like rats from a sinking ship.

Finally we can say this is something both mentally ill and physically ill people experience. But why?

People are afraid of illness. They see someone with a brain tumor and act like it’s contagious. They know it’s not logically but this is an instinctive fear. They want to avoid sadness at any cost, they want to avoid reality at any cost, nobody wants to dwell on the possibility of death. It takes a very strong soul to want to go there.

Consequently at your time of need, the very hour you really need people there, you are deserted. Before I began visiting the hospital regularly I was completely unaware of this, I had no idea how many hospital rooms were emptied of visitors and support systems, how many go without any friends to comfort them in their hour of need.

I recall as a kid going to see a friend who was diagnosed with schizophrenia in the state hospital and how he talked about losing all of his friends. It seems like not much has changed.

And ask yourself this … how much would it take to care?

Recently another acquaintance developed Terminal Stage 4 Ovarian Cancer, when asked, her colleagues, who had worked with her for TWENTY YEARS put off going to visit, until someone posted on Facebook ‘she’s going to die! Go see her before she does!’ and then, the herd mentality took over and everyone went to visit. It was ingenuous and false, and I came to see, these people who had worked with this woman for two decades, really didn’t care, they wanted it over with.

I understand the knee jerk response to death and all things unpleasant, but we’re all going to die, is this how we would wish others to react to us? Empathy means, consideration of how we treat others, as much as how others treat us, and the two are connected by an understanding that it cannot be a one way street. As painful as it may be, supporting those in their hour of need is what makes the world a better place. If we are too busy to attend to that, what does it say about our priorities?

The same applies to the mentally ill. This can literally be a life saver, a life line, a much-needed support network. Suicide often occurs because of isolation and a feeling that the world would be a better place if I were not in it. Surely losing friends and being ignored, adds to that feeling and thus, the reverse is true if loyalty and constancy exist.

Obviously some friendships have an expiry date and that’s okay, that’s the nature of the beast, but if you’ve stopped calling someone because you are fed-up with their mental illness and it’s not ‘fun anymore’ consider this, what would you want if you were going through the same thing? Should friendship simply be about benefits?

Portraiture

f801918ca3883a4898de8530a0e88a98It is true if I could I would claim you through time

circle your coiled hair and patent smile

did the photographer pose

or you just know

how to swan your neck and hide your pain

in thrice mended sweater a size too small

our boiled wool and best kept stockings

sweating out youth

if now you lived I’d show you what came after

austerity and lit eyes of hazel

wishing into the future

is it better now? or then when

the greatest harm an unmarried pin

sticking your freedom to the quick

you laced yourself in and breathed out

coal dust and fisherman’s hands

chaffed and reddened by toil

ancestors enriching highland soil

would we have been friends?

my lack of Godhead your penchant

for John Bunion and his sermon

who can say? only the field mouse’

small and mauve in death

brought in by cat laid carefully by farm-house mat

beyond a sewing room where you cobbled looks from Paris

on muslin form, breathing life

I was clumsy and wide waisted in compare

climbing trees watching for the worm

as magpie attracted to beauty

is not capable of wearing his fine theft

he is a creature of the outdoors

looking in from cleft of oak

like I summon you through time

spend a moment here

lend me strength

show me how

you endured the fallow path and

hard winter of turning twenty

as light leaches from heathered hills

and tired men return for their supper

only the fair-headed girl lingers

until last golden arc presses against

violet hour and she too must

return her gaze to humbler pasture

Quiet sincerity

575d3e8450d2b93d9ae583716b569a05I learned

long after I should

friendship comes not

in fizz and pour

nor the brightness of

shower and radiance

nor promise and its papery craft of bows

but more often unexpected slow

hesitant over years

water leaving her tears on

marble rock

stalwart and less demonstrative

a cat who watches food put out

does not immediately approach

I fell for the fireworks

the hot kiss on lost ego

glittering words

feathered protests to believe

those party animals in their tinsel crowns

pushing me toward celebration

in those days I did not mind

the quiet soul who hung back

someone you could call upon

when deserters ran out of festivity

turned their backs on former animation

I was suckered by their demands to believe

their loudest call was truth, hear me!

now I know quiet love is the steadiest

those who may seem cold or aloof

often outlast town crier

hawking themselves for fancy

I’m sorry it took me so long to

understand silence and softness

are more often truth

much like the piper who

sung children through the mountain

bewitching their longing for loud

merriment

before they grew and knew

the sweetness of sincerity

whispered

Cast in open mouth

Fickle her words

imprecise

imperfect

slices of lemon

squeezed on cuts

cast in open mouth

let the plaster envelop

emotion

I suppose it’s her need

to inflict harm

when her own heart devours

when lust points compass

and mercy

mercy does not show

for role count

instead choosing

to sit out turn

bashing heels against

old radiators

trying to keep warm

this is the danger of

sore hearts

seeking solace

in the unknown

corridor of others

tempered souls

watchful against

storm

Flat hands pushing

They predicted

she would write down

the scar

since healing

was slow

words conveying

that breakage

They predicted

she would condemn

the ones who made the thirteen turns

in hangman’s noose

and pushing lightly

watched her fall like dandelion seed

catching heavy air

she was predictable

and not the one they knew

but some amalgam of all they had hated

in their little boxes of life

laid without opening on red shelf

she who carried her shoes

when stepping through

knew there were times words

could not save

could not banish

the cruelty of flat hands

pushing

Winding a clock

Whom ever first penned

the idea coldness was strength

and weakness came when we

trusted and let others in

must have known the curve of the knife

those disposed to violence

carry in their mouth

just incase a moment

should present itself

and licking their lips

wide

they conquer and divide

our feeble entreaty

just leave us be

on the wet coil

perhaps our world measures

guts and glory

on how much blood

remains

when after battle they come

to count the fallen

and it is always your dearest

the one who came closest

the one who said I will never

remove you from warmth

who sharpens that knife

and turns it like

winding a clock

makes it tick

reluctantly

ahead

Death

Strange faced girl sits in her pew

itching wool tights with Bible corner

whilst Mormon’s console Jehovah’s

witnessing their profit in the funeral

business

all along she hadn’t believed

people could turn to wax effigy

the poor man in his pine coffin knew

formaldehyde truths

his children driving home

instead of toys throw words

of anger and resentment

she had always wanted siblings but now

in her black faux expensive dress

less couture than ransacked bargain store

she wasn’t so sure

how the language of the world made sense

if God laughed at those who pretended

to repent

or God was a lizard drinking from brown bottles

one block down from the mockery

of death