As a Vietnam veteran who suffers from PTSD, I can say that not one therapist at the VA has ever discussed the “60%” inherited part of one’s personality. We are treated like everyone’s crazy uncle.
If one in five people are affected by a disorder, I don't understand the relevance such a diagnosis plays any longer, as that is a huge number of the populace. Also, what is society's role in the stressors involved, and environmental factors like, poverty, poor access to good nutrition, parents inability to parent due to the economic conditions of society, etc.. How does using a stigmatizing diagnosis help from furthering the growth of this disorder. I only see the numbers increasing if the underlying cause is not address and by placing the onus on the individual aren't we detracting from the real source of the problem. Also, what about gender differences and what is acceptable behavior for each. As well as how varying cultures view gender differences.
As I see it, diagnosing someone with a personality disorder is not quite in the same category as diagnosing someone with a heart condition. Diagnosing someone with heart disease, per your example, doesn't tell them that their very sense of self is pathological or "not right". That's exactly what these labels do, in my mind - they attack the person's very sense of self. No one is their label. And these labels do indeed carry a lot of stigma, as has been noted. I've heard of examples of when someone is diagnosed with a personality disorder, they end up continually self-pathologizing. Checking the contents of their minds for pathology, unsure if their behavior is pathological or not, and so on. If abuse, addictions, loneliness, debt, etc are problems for people, then for sure, they should be helped. But where does one draw the line between normal personality flaws and having a personality disorder? I guess what I'm asking, is why are some personality flaws "normal", and others "pathological"? To err is to be human. To be frank, I think these labels are more damaging than they are helpful. Not that the symptoms of various PDs don't exist, because they do. Just thinking it's better to forget the label and focus on the symptoms, so to speak.
These labels help to organize and codify any long-term efforts given to helping the person cope and normalize their behaviors. Admittedly, money is also playing a factor in this. If you can't label someone's disorder, you will find it very difficult or impossible to get funding to treat, unless it's private pay. But, I'll focus more on why labels are necessary from a treatment perspective. If those clinicians that treat these individuals don't have labels, the overall, long-term treatment that a person gets will need a literal restart, from scratch, every single time they see a new doctor or move to a new facility. If you ask me for directions to a location, would you rather get a specific address, or hear me say "somewhere in that direction, over that mountain maybe, but I don't want to really force you to be defined by that path." I'm interested by the statement that "no one is their label" since in the past 10 years, especially in the past 5 years, it is quite common for nearly everyone you encounter to label themselves as part of some group, some political agenda, some sexual orientation, some oppressed sub-group, or some socially elite group, etc. etc. all so they can immediately communicate to you who they are and who they are not. Society itself is to blame for this if you consider it a problem. In addition, it's increasingly common to hear groups demanding the definition of their chosen labels be modified so as to not offend them. By all accounts, it appears that the average first world citizen not only defines themselves by many labels, but demands control over their definitions. So how is it possible that "no one is their label?" I cannot help but chuckle at the idea that "labels do not define us" when I look over to the recommended videos on TH-cam where I could randomly click on a video and have a high probability of viewing something where a person labels themselves within the first 15 seconds. It's rampant, ergo, apparently normal. Has Psychology contributed to this? Perhaps. Getting back on track...Psychology doesn't use labels to paint people into some corner so they feel bad, it needs them as a common language to diagnose and treat. This should be obvious. Labels are only damaging when you give them negative connotations. Labels will never go away, so attempting to draw any attention to removing them is a waste of time. Humans long to be unique, and the more global contact we have with each other through the internet and media, the less unique we realize we are and therefore, the more labels we'll naturally use to try and define ourselves as unique and important to separate ourselves "from the pack." But, the delivery of those labels, as he discusses early on, is what matters. He mentions explaining a personality disorder diagnosis to someone with empathy and care instead of making them feel like a social pariah. Having worked at different treatment centers now over the past 16 years, I have noticed there is a concerted effort to focus on the person, not the label...but, not once have I ever heard any professional propose that we stop using labels. Psychology is already inherently nebulous and removing labels would make it even more difficult to codify. You asked "where does one draw the line between normal personality flaws and having a personality disorder?" He explains that in the first 5 minutes. When your personality flaws cause other people pain and you have little to no empathy or awareness for those you hurt, you are disordered. Besides, "normal personality flaws" wouldn't be flaws at all....it would just be the normal variation in human behaviors and beliefs based largely on traits (inherited attributes). As he pointed out, individuals with personality disorders are much, much more likely to engage in criminal behavior. Treatment for a personality disorder is as much about protecting and caring for the people in their lives as it is about them. Where I work, we don't even use the DSM labels to interact with our clients, but we hold them in mind to frame and guide the course of their treatment. We don't treat the label, we treat the whole person, but the labels are necessary to give everyone involved a common understanding of what is needing attention.
Kelsey MooMoo Borderline is one of many personality disorders. Just like "cancer" is the general category of a number of different types of cancer, "personality disorder" is the general term for borderline, antisocial, bipolar, etc. Hope that helps.
This was So informative! Thanks to Dr. Shannon and Gay Maxwell for this useful look at the various personalities that are so hard to make sense of, sometimes.
My reaction to this interview is similar to that of John Sommers-Flanagan. I found Joseph Shannon's responses to be a bit gib and without cultural context. And I take issue with "codependents" as being personality disordered--again gender differences and culture need to be considered.
Dr. Shannon seems like a good guy. However, he's so darn immersed in the medical model that he is far too confident in his overly precise statements. Never once does he talk about any uncertainty or variability. He includes an "old" personality disorder from DSM-III. He has no sense of how culture might effect personality development. He says things like Schizotypal PD is a "done deal" at birth. . . and things like people with Borderline PD never really recover. His confidence in what he's saying is overdone and unwarranted.
His medical model fits very accurately with my reality having been mauled by one of the more severe of the Cluster Bs. I could not fault his interpretation myself
Incredible interview.
As a Vietnam veteran who suffers from PTSD, I can say that not one therapist at the VA has ever discussed the “60%” inherited part of one’s personality. We are treated like everyone’s crazy uncle.
Just a note - 4% of the populations is 4 in 100 ... or 1 in 25 as the host was suggesting.
Hhw much education do psychology (phd or psy-d )undergrads get in personality disorders?
I guess they get little math.
Fascinating talk - thank you. His explanations were very clear + I also enjoyed the movie references.
If one in five people are affected by a disorder, I don't understand the relevance such a diagnosis plays any longer, as that is a huge number of the populace. Also, what is society's role in the stressors involved, and environmental factors like, poverty, poor access to good nutrition, parents inability to parent due to the economic conditions of society, etc.. How does using a stigmatizing diagnosis help from furthering the growth of this disorder. I only see the numbers increasing if the underlying cause is not address and by placing the onus on the individual aren't we detracting from the real source of the problem. Also, what about gender differences and what is acceptable behavior for each. As well as how varying cultures view gender differences.
As I see it, diagnosing someone with a personality disorder is not quite in the same category as diagnosing someone with a heart condition. Diagnosing someone with heart disease, per your example, doesn't tell them that their very sense of self is pathological or "not right". That's exactly what these labels do, in my mind - they attack the person's very sense of self.
No one is their label. And these labels do indeed carry a lot of stigma, as has been noted. I've heard of examples of when someone is diagnosed with a personality disorder, they end up continually self-pathologizing. Checking the contents of their minds for pathology, unsure if their behavior is pathological or not, and so on.
If abuse, addictions, loneliness, debt, etc are problems for people, then for sure, they should be helped. But where does one draw the line between normal personality flaws and having a personality disorder? I guess what I'm asking, is why are some personality flaws "normal", and others "pathological"?
To err is to be human. To be frank, I think these labels are more damaging than they are helpful. Not that the symptoms of various PDs don't exist, because they do. Just thinking it's better to forget the label and focus on the symptoms, so to speak.
These labels help to organize and codify any long-term efforts given to helping the person cope and normalize their behaviors. Admittedly, money is also playing a factor in this. If you can't label someone's disorder, you will find it very difficult or impossible to get funding to treat, unless it's private pay. But, I'll focus more on why labels are necessary from a treatment perspective.
If those clinicians that treat these individuals don't have labels, the overall, long-term treatment that a person gets will need a literal restart, from scratch, every single time they see a new doctor or move to a new facility. If you ask me for directions to a location, would you rather get a specific address, or hear me say "somewhere in that direction, over that mountain maybe, but I don't want to really force you to be defined by that path."
I'm interested by the statement that "no one is their label" since in the past 10 years, especially in the past 5 years, it is quite common for nearly everyone you encounter to label themselves as part of some group, some political agenda, some sexual orientation, some oppressed sub-group, or some socially elite group, etc. etc. all so they can immediately communicate to you who they are and who they are not. Society itself is to blame for this if you consider it a problem. In addition, it's increasingly common to hear groups demanding the definition of their chosen labels be modified so as to not offend them. By all accounts, it appears that the average first world citizen not only defines themselves by many labels, but demands control over their definitions. So how is it possible that "no one is their label?"
I cannot help but chuckle at the idea that "labels do not define us" when I look over to the recommended videos on TH-cam where I could randomly click on a video and have a high probability of viewing something where a person labels themselves within the first 15 seconds. It's rampant, ergo, apparently normal. Has Psychology contributed to this? Perhaps.
Getting back on track...Psychology doesn't use labels to paint people into some corner so they feel bad, it needs them as a common language to diagnose and treat. This should be obvious. Labels are only damaging when you give them negative connotations. Labels will never go away, so attempting to draw any attention to removing them is a waste of time. Humans long to be unique, and the more global contact we have with each other through the internet and media, the less unique we realize we are and therefore, the more labels we'll naturally use to try and define ourselves as unique and important to separate ourselves "from the pack." But, the delivery of those labels, as he discusses early on, is what matters. He mentions explaining a personality disorder diagnosis to someone with empathy and care instead of making them feel like a social pariah. Having worked at different treatment centers now over the past 16 years, I have noticed there is a concerted effort to focus on the person, not the label...but, not once have I ever heard any professional propose that we stop using labels. Psychology is already inherently nebulous and removing labels would make it even more difficult to codify.
You asked "where does one draw the line between normal personality flaws and having a personality disorder?" He explains that in the first 5 minutes. When your personality flaws cause other people pain and you have little to no empathy or awareness for those you hurt, you are disordered. Besides, "normal personality flaws" wouldn't be flaws at all....it would just be the normal variation in human behaviors and beliefs based largely on traits (inherited attributes). As he pointed out, individuals with personality disorders are much, much more likely to engage in criminal behavior. Treatment for a personality disorder is as much about protecting and caring for the people in their lives as it is about them.
Where I work, we don't even use the DSM labels to interact with our clients, but we hold them in mind to frame and guide the course of their treatment. We don't treat the label, we treat the whole person, but the labels are necessary to give everyone involved a common understanding of what is needing attention.
What is the difference between Borderline personality disorder and just a personality disorder?
Kelsey MooMoo Borderline is one of many personality disorders. Just like "cancer" is the general category of a number of different types of cancer, "personality disorder" is the general term for borderline, antisocial, bipolar, etc. Hope that helps.
She is right. 1 in 25
he is amazing. Wonderful explanation of PDs.
This was So informative! Thanks to Dr. Shannon and Gay Maxwell for this useful look at the various personalities that are so hard to make sense of, sometimes.
My reaction to this interview is similar to that of John Sommers-Flanagan. I found Joseph Shannon's responses
to be a bit gib and without cultural context. And I take issue with "codependents" as being personality disordered--again gender differences and culture need to be considered.
Excellent questions and excellent answers!
Dr. Shannon seems like a good guy. However, he's so darn immersed in the medical model that he is far too confident in his overly precise statements. Never once does he talk about any uncertainty or variability. He includes an "old" personality disorder from DSM-III. He has no sense of how culture might effect personality development. He says things like Schizotypal PD is a "done deal" at birth. . . and things like people with Borderline PD never really recover. His confidence in what he's saying is overdone and unwarranted.
His medical model fits very accurately with my reality having been mauled by one of the more severe of the Cluster Bs. I could not fault his interpretation myself