Personality Disorders Are Not Illnesses

by Phil Hickey on May 5, 2010

The central theme of this blog is that there are no mental illnesses. The concept of mental illness is a spurious invention of psychiatrists and other mental health professionals for the purpose of medicalizing normal human problems and selling drugs.

The central tenet of the mental health system is that unusual, bizarre, and disturbing behaviors are caused by mental disorders (or illnesses). But their definition of a mental disorder is: a serious behavioral problem. So problem behavior is caused by problem behavior. This is the facile logic behind the widespread peddling of drugs in which psychiatry and the mental health system engage.

Within the mental health system a personality disorder is conceptualized as a specific kind of mental illness and is defined as follows:

“an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment.” (DSM-IV-TR, p. 685)

DSM lists eleven different kinds of personality disorder. These are: paranoid; schizoid; schizotypal; antisocial; borderline; histrionic; narcissistic; avoidant; dependent; obsessive-compulsive; and of course, personality disorder not otherwise specified.

Let us examine schizoid personality disorder. The APA lists the following criteria:

A. A pervasive pattern of detachment from social relationships and a restricted range of
expression of emotions in interpersonal settings, beginning by early adulthood and
present in a variety of contexts, as indicated by four (or more) of the following:

(1) neither desires nor enjoys close relationships, including being part of a family
(2) almost always chooses solitary activities
(3) has little if any, interest in having sexual experiences with another person
(4) takes pleasure in few, if any, activities
(5) lacks close friends or confidants other than first-degree relatives
(6) appears indifferent to the praise or criticism of others
(7) shows emotional coldness, detachment, or flattened affectivity

B. Does not occur exclusively during the course of Schizophrenia, a Mood Disorder
With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental
Disorder and is not due to the direct physiological effects of a general medical
condition. (DSM-IV-TR, p 697)

It is clear from even a cursory examination of these criteria that what’s involved here are the qualities of solitariness, introspection, and stoicism. Note in particular that the criteria do not require that the individual be troubled by these qualities. Even if a person is perfectly contented with his habitual state of quiet isolation, he nevertheless has a mental illness and swells the ranks of the “untreated sufferers.” The so-called schizoid personality disorder is one of the more blatant examples of the APA’s pathologizing of normal human differences. Even their selection of the word “schizoid” serves to impart connotations of danger and hidden pathology.

The fact is that each of the criterion qualities listed above is present in the human population to a varied degree. And it is indeed the case that some individuals are introspective and isolative to an extreme degree. Assuming, however, that this necessarily constitutes a problem is unwarranted and dangerous. Most of the introspective individuals I have known are contented productive people who would be truly appalled to learn that in reality they are suffering from a mental illness and that they need treatment (i.e. drugs). The drugs, of course, will be prescribed by a psychiatrist and manufactured by a pharmaceutical company. It is little wonder that a former surgeon general could state that one fifth of the US population is suffering from a mental disorder in any given year. As has been stressed many times in this blog, the primary purpose of DSM is not to advance our knowledge of ourselves as a species, or help us become more resilient and adaptive, but rather to generate income for psychiatrists and pharmaceutical companies.

The reader who is not particularly isolative or introspective might be thinking “Oh, well – but it doesn’t apply to me.” Read on.

Here are the DSM criteria for dependent personality disorder:

A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:
(1) has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
(2) needs others to assume responsibility for most major areas of his or her life
(3) has difficulty expressing disagreement with others because of fear of loss of support or approval. Note: Do not include realistic fears of retribution.
(4) has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
(5) goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
(6) feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
(7) urgently seeks another relationship as a source of care and support when a close relationship ends
(8) is unrealistically preoccupied with fears of being left to take care of himself or herself

Two generations ago probably half the women in our culture would have met these criteria. (Note that only five of the items have to be met.) Even today a substantial percentage of the women in our society are raised to think of themselves as essentially dependent and as having little or no personal identity until they have become “hitched” to a man. By calling this a mental disorder, the APA is pathologizing what for many individuals is a normal state. It is also critical to note that the only reason that this particular lifestyle is a mental disorder is that the APA say so. The APA attempts to promote the idea that their so-called diagnoses are based on science. This is simply not the case, and is certainly not true of the so-called personality disorders. The APA and its various committees have simply decided that certain lifestyles and mindsets are to be considered pathological. They pretend that this reflects some kind of reality, i.e. that in fact these individuals are truly damaged in some way. But in fact the determination that certain mindsets constitute disorders while others do not is entirely arbitrary.

Why, for instance, is there not an independent personality disorder? After all, if people who are extremely dependent are to be considered pathologized, why not the individuals at the other end of the continuum? Individuals who never ask for help; who conceptualize asking for help as shameful; who are driven to succeed by their own efforts; who never see themselves as part of a team, etc., etc.. One could easily draft eight or ten criteria, arbitrarily require that 3 or 4 or 5 of these be met, and voila! A new diagnosis. Frighteningly, there are probably individuals within the APA who would take this suggestion seriously. The APA’s objective is to pathologize as much normal behavior as possible, and this has been demonstrated clearly by each successive revision of the DSM.

Next Post: Sexual Disorders Are Not Illnesses

  • all too easy

    “With specific regard to the so-called personality disorders, there is an additional issue, in that many of the behaviors listed are not actually problems for the individuals concerned.” A. H.

    Adolf believes leprosy doesn’t constitute an illness.

  • all too easy

    Dear Phil,

    Are you relegating the best, most incisive comments to the dump heap? This revealing post was found buried deep in the chronological bowels of your blog. Unintentional, I’m sure, right Adolf?

    Tell us Phil, this money making hoax of big pharma, recommends which one of their profitable drugs to treat schizoid disorder? Hmm? Since Phil doesn’t like to acknowledge his deceptive ways, he won’t answer. So, I’ll fill you in on a little secret: nothing. No drugs are recommended to treat it. Thanks Phil for one more example of big deceivers attempts at harming the public with misinformation.

    Plus, let me recommend marrying a schizoid before pretending there is no such disturbance. That will get you to hush up real quickly.

    I see that big deceivers are falling like rain. Everywhere you go, you see these bird-brains sent packing for their absurd arguments and lack of understanding. They have become a laughing stock and are largely ignored by the vast majority of scientists and educated people.

    One such creepy loud mouth announced to the world- through her incessant love and craving for public recognition and adoration- that her beloved son’s death was the result of a non-diagnosed, diagnosed mental illness by particularly heinous psychiatrists from years prior– because he was hit by a train! She actually expects her audience to buy that and some do. Psychiatry killed her son! He was hit by a train and she has parlayed that fact into all of psychiatry is to blame. When anyone challenges her opinion, she reveals just how deeply she is grieving over her loss, not of her son’s death, but of her credibility. She flies off into a rage, utterly appalled and disgusted that anyone could be so devious, so depraved as to question her interpretation of the facts. One moment she is humbly thanking those who sympathize with her and the next she explodes in bitter, sarcastic, vengeful rages that others have the gall to challenge her.

    I would say that is a typical response of these thoroughly obnoxious, self-righteous, holier-than-thou, Pharisaical experts on only what they choose to see. Whitaker, their god, conveniently conned a horde of conspirator prone pseudo-intellectuals into buying his discredited books and conference presentations. But, even our own precious “cledioaus-the-self-pitying masochist and boob”, who insists that once you claim drugs help assuage symptoms of mental illness, that must mean they cure disease; even our dear, beloved claudapuss is smart enough to know he’s a victim of zealotry.

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  • dan

    What causes these “disorders”(i do not see them as such), is being made to believe their is something wrong with them as children, when their wasn’t. Normally through bad parenting, either having abusive parents/carers, or just aloof parents etc, the child develops a shame and guilt complex, and self-hate. Obviously the child has no tools to deal with this suitably, and no external help, so they will suppress this feelings. But it doesn’t change the fact that throughout the rest of their lives, they are constantly acting out of these feelings of being wrong, their core being believes itself to be just, wrong.
    This is why someone considered a narcissist (a horrible term to label anyone), lives their whole life not accepting blame, and acting like they are holier than hou, because they are trying to escape their true feelings. They may not even be aware of these feelings, through suppressed memory, but they are there. This person will do anything to escape these feelings, this shows the extent of suffering they must have gone through.
    And then we have psychiatrists labeling them as mentally ill or having a disorder.
    What causes their problems is feeling like their wrong deep-down, so they need help counselling those feelings of self hate and low esteem which should not have been put their in the first place, and once their healed within, they wont act in a dysfunctional way, as they wont be acting out of bad feelings, but good ones.
    Whats wrong with this society is everyone telling each other they have something wrong with them, through religion, the media, social networking, and now even in the mental health professions. The only thing wrong with people is that they feel wrong deep down when their not, and that’s actually what causes them to do immoral or ‘wrong’ things.
    People suffering these symptoms shouldnt be treated like they have a disorder, or treated like they are wrong as people. They should be treated as humans who have suffered a lot, and thats whats driven them to behave in the ways they do.
    But often, lots of these traits are perfectly acceptable, e.g. preferring solitary tasks to social ones. So what if someone wants to be alone, they like their own company, let them be!

    And i know people who suffer with these ‘symptoms’ do hurt people, often in cruel sadistic emotional ways. And im not trying to downplay that, or ignore that. But labelling them as mentally ill is counter-productive. It says “You do bad things, we dont understand why… ah you must have a disorder of some kind”

    I also feel like this idea of personality disorders gives a feeling of closure or peace to people who suffer at the hands of emotionally abusive people, as they can say “Oh thats why, he was a narcissist”. This can be helpful to someone trying to recover from emotional abuse, but at the same time it shrouds the truth. And thats that these people have suffered intolerable amounts also, and thats what cause them to hurt others. This does not make them innocent, it just means their not mentally ill.
    We as a collective society need to understand that people arent wrong, or just bad, or just mentally ill. People do bad things, after bad things are done to them. And throwing the term “Mental illness” over this does nothing but give a false explanation to people who lack the intelligence to see what the real problem is

  • Phil_Hickey

    Dan,

    Thanks for coming in and for your profound comments. I agree – the notion of “mental illness” explains nothing at all. If we want to understand another person, we have to be willing to reach out and spend a lot of time and energy getting to know him and getting an understanding of where he’s coming from.

    Again, thanks for coming in, and best wishes.

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