A Personality Disorder Diagnosis – Helpful, or a Trap?
Dr. Sheri Jacobson
March 12, 2023
By: Neil H
by Andrea M. Darcy
Have you or a loved one been given a personality disorder diagnosis? And you aren’t sure what to think or feel?
What are personality disorders?
Personality disorders are labels created by mental health professionals to describe groups of people with ways of thinking, behaving, and seeing the world that do not fit the societal norm. A person seen as having a personality disorder has longstanding challenges with relating to other people. They can find it difficult to fit in and meet the expectations of others.
While some people find a diagnosis of a personality disorder helps them understand themselves, for others, it can feel a very unwelcome label. In fact many mental health care professionals themselves are opposed to saddling clients with a personality disorder. Why is this?
The positive side of a personality disorder diagnosis
Let’s start with what the benefits of a personality disorder diagnosis can be.
A label can be useful, working as a good shorthand and reference point for doctors and healthcare workers to communicate with. And, if you have a diagnosis, you can be saved having to tell your whole life story and personality to each practitioner you work with.
Some people find being offered a diagnosis a great relief if they have suffered for a long time with behaviour they can’t control or understand. It can feel like you finally know where you are standing, and have a platform to now work from.
A diagnosis of a personality disorder can also help others understand you. Perhaps your family really struggle trying to understand you, but now they have a reference to try. They can seek out support and information to improve their relationship with you.
And last but not least, a personality disorder diagnosis can also help sufferers to feel less alone in the world. It can be a sort of comfort to know there are others out there who suffer in the same way they do, and who might see the world like they do. It also means you can find information you need. And perhaps finally find the specialist help that can then help you move forward.
Why is a diagnosis of a personality disorder controversial?
By: cea +
Many people feel that our personalities are too complex and individual, and too composed of personal life experience. It’s not fair for that to be distilled down to a diagnosed ‘disorder’ just because someone doesn’t fit an expected pattern.
The word ‘disorder’ itself can sound limiting and negative. It’s really a word of exclusion, with a focus is only on what is different and ‘wrong’ with someone. It does not encompass a person’s strengths and resilience, but carries the implication that one’s personality is faulty.
And when our personalities are so much of what we are, who wouldn’t feel upset by that thought? Or potentially hopeless and invalidated and rejected?
An over focus on the negative
A diagnosis can also lead to a client overlooking their strengths and only identifying with their weaknesses. Or feeling they are powerless to change. It can feel harder for the person to trust their sense of self or to have self-worth. And can mean they now see all problems in their life as their fault.
A personality disorder diagnosis can provoke the habit of looking through all of one’s life experiences from the tinted lens of “I have a personality disorder”. Suddenly, experiences that might have once been seen by the person as valuable, or something they learned from? Are now seen as ways they were ‘doing things wrong’ or ‘can never really change’.
Some mental health care professionals point out that the negative focus of a personality disorder diagnosis is far from useful when it comes to treatment. It doesn’t inspire someone to learn to manage their life better.
The client can be left feeling unable to believe they can grow or change, and the therapist can waste a lot of time trying to encourage any self belief. Whereas if the diagnosis is not made, and a person is just aware their personality is just difficult? A practitioner has a better chance of helping them recognise their strengths, have a balanced view of themselves and life, and find ways to move forward.
Ordered vs disordered
A personality disorder diagnosis also raises the question of just who can say what is and isn’t right in a personality. It doesn’t help that the requirements for diagnosis are constantly being changed by the health boards that publish them.
This then raises the question of what is ‘ordered’ vs ‘disordered’? This itself is something that changes according to cultures and the present norms of society. And then what is the difference between someone who has a troublesome personality, and one who has a disorder? There are so many grey areas that it begs to question how accurate some diagnoses can really be.
The Stigma of a Personality Disorder Diagnosis
By: Ludovic Bertron
On top of all else there is the stigma that any mental health diagnosis can sadly still bring, let alone one of a personality disorder. They are some of the least understood mental health conditions. Not helped by a media that focuses only on worst case scenarios and makes movies that are far from accurate on the subject.
Some personality disorders are more understood and accepted than others. Such as obsessive compulsive disorder versus the often misunderstood (and misnamed) borderline personality disorder. Other personality disorders, such as antisocial personality disorder, can leave one completely ostracised or feared by others. What are the implications of this on the patient’s future?
Discrimination within the mental health industry
Worst is that stigma and discrimination exists towards personality disorders even in the mental health industry itself. For a long time there was the idea in the mental health community that those with personality disorders were untreatable or a waste of time. And sadly, this attitude can still be found.
There is also the idea that certain personality disorders, such as borderline personality disorder, mean someone is too difficult or manipulative to work with. It’s not uncommon even now for someone with BPD to be told by a psychotherapist they would be too difficult to work with, or that they don’t take on clients with the disorder.
Keep this in mind when it comes to personality disorders…
Perhaps the important thing to remember is that a diagnosis is not all of who you are. It cannot describe your wealth of experiences, or predict the strengths you’ll develop in the future.
And also, mental health diagnoses are by no means an exact science. A personality disorder is not really an illness that can be identified across all sufferers in a microscope, but really just a term to describe a group of people with similar behaviour patterns. And it’s a term created by another group of people, namely mental health researchers.
It’s someone else’s idea of what is wrong with you. Your life, and your viewpoint on what is right and wrong with you, and what you do and don’t struggle with, is really, at the end of the day, up to you.
So the best piece of advice, if a diagnosis has upset you, might be to not focus on the label. Focus on getting the support and help to manage your life that works for you and helps you feel better.
Need help for a personality disorder? We connect you with a team of talk therapists who can help, and psychiatrists.
Andrea M. Darcy is a mental health and wellbeing expert and personal development teacher with training in person-centred counselling and coaching, as well as a popular psychology writer.She is very passionate about fighting mental health stigma. Follow her on Instagram for encouragement and useful life tips @am_darcy
Hello. When I started therapy I didn’t know I had a personality disorder. My therapist thought that a la el would only hurt me. After 1 year un therapy I started to ask my therapist and myself where this chronic problema came from, so she told me. I don’t know if knowing that I have a personality disorder has helped or not, as I now ser my whole life through the lens of a personality disorder, but it helped me un tje way that I changed therapists and now I am seeing one who has experience un personality disorders (a schema therapist). Thank you for the article. It opened my eyes as to why I shouldn’t label my self as having avoidant personality disorder.
Thank you for this sharing I am sure it will be very helpful to others who might be going through what you are. It’s important to work with a therapist who you feel right with, as the client therapist relationship is really a big part of therapy being successful. Schema therapy is a wonderful powerful therapy that has been shown in studies to really help. But yes, you are much more than a label!
I actually wanted a diagnosis but was refused, simply because they insisted on counselling rather than CBT but I’d already tried counselling and it didn’t help. After a crisis episode which meant a stay on a psychiatric ward, I was given a diagnosis of BPD or emotionally unstable personality disorder. So getting something I wanted has bitten me on the bum because I do not see myself in some of the traits but I do in other traits. The worst are dependent and manipulative, neither of which I believe I am. I also believe diagnosing someone at a time of emotional distress when only speaking to them for a few minutes on ward round is not the best way to give a diagnosis. Having this diagnosis is doing everything you have suggested, I believe everything that has happened is my fault and I’m a bad person, unable to change so obviously my mental health has gotten worse and suicide attempts are more the norm. That obviously isn’t a positive way forward from having a diagnosis. This belief I am this personality has also meant I’ve disengaged with all mental and physical health professionals. So no, I do not believe a diagnosis is helpful at times, it depends on the diagnosis and the acceptability of that diagnosis within the wider community.
Samantha we are sorry to hear this. There are such problems with the way things are diagnosed within most medical systems, and BPD in particular can see such stigma even within mental health communities. Many if not most of all BPD sufferers are BPD because they experienced trauma, and then then the diagnosis almost seems to blame them! We feel in a way it can be re-traumatising. You are not a diagnosis. And again, mental health diagnoses themselves are not ‘sicknesses’, they are created by groups of mental health professionals to describe groups of people who differ from the norm, and there is room for argument they are not at all as cut and dried as some mental health practitioners would have one believe (how can they be when people themselves are so unique?) but should exist on a spectrum. Here’s the thing – you ARE able to change. BPD is actually the one personality disorder where it is found that symptoms lessen with age. And there are nowadays great treatments just for BPD. But it is important that that right therapy is offered, as, like it sounds you already learned, some types of therapy can make BPD worse, such as psychodynamic and general counselling. Someone with BPD will first try to impress the therapist and will second of all not have a stable enough identity to discuss themselves like that! CBT does help but dialectical behaviour therapy (DBT) is a better option, it was designed by someone who had BPD herself! We’d suggest you read our article on the types of therapy specifically for BPD. Then try to find others in places like online forums who are positive about moving through BPD instead of negative. And don’t let anyone tell you what your experience of life is and isn’t – only you can say. http://bit.ly/BPDtreatment. We wish you courage and hope you do find some good support!
I have AvPD and have found the give up direction attached to the diagnosis useful as I now no longer feel compelled to continue wasting thousands on an endless line of mental health professionals, it’s all been terribly useless and unhelpful. I’ve reached the conclusion that I’m as good as people lile me can get.
I don’t know if this is going to the writer of this article but I want to make as many people as possible know how I feel about diagnosising personality disorders and what I experience has been. I am against diagnosis of the entire category of such disorders. .I spent 10 minutes with a psychiatrist after reveling a lifetime of abuse by my Father. I had told no less than 3 different employees in the ER. The questions and shocked responses and the other staff gawking at me caused me to need to shut down and I asked the pyichitrst if we could talk about it later when I felt able to . He insisted on speaking to me right then and was not sympathetic or polite to me as I tried to explain. I did lose my temper and told him to get out and I wanted to go home resulting in a DCR needing to clear me to be released.. This Dr. had the power to label me without evidence of my background,talking to my family or a neurologist. My therapist and other providers didn’t agree but I still can’t rid myself from this Dr. I have been discriminated against and abused by treatment providers and staff for 17 years and the damage is severe. I can’t go to any kind of Dr.because of fear, I don’t trust people at all. I developed misanthropy and I am terminally depressed. I don’t know why there are no guidelines that must be followed before someone who takes an oath to do no harm is allowed to label anyone without being responsible for the damage. I also see those who treat people with diagnosis of PD as having limited empathy and I think the have a character problem. I isn’t my belief system and developed many issues that I didn’t have before seeing this Dr. I was 42 and had an identity and good solid interpersonal relationships I no longer have . Now I don’t know who I am ,hate myself and most people and want to die. Maybe if the system wants to keep diagnosing this stuff the should need evidence and put their money on it if they are wrong. Nobody should be harmed by people who are supposed to help you. It is like being abused by a parent and permanent injury for many victims of the labels given to clients..