There’s an article in the current (May/June) issue of The National Psychologist called Compulsive pleasing is deceptive and dangerous. It’s written by Les Barbanell, EdD. (The National Psychologist is a newspaper-type publication for psychologists. It’s published in Ohio, in the US. Some of their material is posted online, but this article is not.)
The article is about “the Caretaker Personality Disorder (CPD),” which apparently Dr. Barbanell invented in 2006 and has been promoting since.
The essential point of the article is that there are certain individuals who devote themselves to the welfare of others to a degree that is detrimental to their own welfare. Logically CPD is on a par with the assertion that children who are disruptive in school have ADHD. Consider the following hypothetical conversation.
Why do I neglect myself for others?
Because you have Caretaker Personality Disorder.
How do you know I have Caretaker Personality Disorder?
Because you neglect yourself for others.
Here are some quotes from the article, with my comments interspersed:
“Pursuant to the formulation of the disorder in 2006 one of my colleagues said, ‘I have always had patients like that as part of my caseload and now I know what to call it.'”
Some practitioners are attracted to the illusory certainty that a “diagnosis” provides. But in matters of behavior and feelings, a “diagnosis” is a distorting lens.
“Their diagnosis has eluded us in the past perhaps because chronic pleasers give the appearance of being capable, strong, and well adjusted.”
This is a perfect example of the destructive power of a “diagnosis.” People who seem “capable, strong and well adjusted” are pathologized and disempowered.
“If left undiagnosed their tendency to give with the minimum of receiving creates an emotional imbalance that wreaks havoc upon relationships and in more cases than many practitioners might suspect, leads to depression and suicide.”
This has been standard pharma-psychiatric fare for decades. How tragic to see a psychologist embracing this kind of nonsense. Where’s the evidence for this prognosis?
“Most patients with this illness do not recognize the cause of their suffering.”
“Patients” and “illness”!
“The personality disorders listed in the DSM rarely escape detection by the practitioner. By contrast, CPD has gone undetected and undiagnosed by the mental health community.”
I suggest that the last thing the mental health system needs right now is another so-called diagnosis.
I was prompted to write this post firstly, by reading Dr. Barbanell’s article, but secondly by a comment I received from David Steven Twist. Here’s the comment:
“A social paradigm needs balance, context and coherence as well or we will all be labelling one another with personality disorders. Omnia sane ratio omnibus: A reason for all things and all things within reason”
In my reply, I mentioned Dr. Barbanell’s article and continued:
I had been debating what – if anything – to do with Dr. Barbanell’s article, but prompted by your comment, I’ve decided to write a post on the matter.
On the more general point, I think the critical issue is to get away from “diagnoses” and “disorders” altogether. In a recent post on his blog site, Dr. Peter Kinderman, former chairperson of the BPS’s Division of Clinical Psychology, (the same DCP that recently criticized psychiatric diagnoses and called for a paradigm shift) has proposed a system whereby the “diagnosis” is replaced by a simple problem list, generated collaboratively by the therapist and the client. So, for instance, if the client says that he stays indoors all the time because he’s afraid to come out of the house, then that’s it. The therapist doesn’t try to reword this as an illness or a disorder.
Thanks again for coming in. You managed to put into words concisely and incisively something that is a very serious concern to those of us who are opposed to the psychiatric model. I strongly encourage you to develop this concept further and promote it in other venues, if you have an interest in this matter.
The present system is bedeviled with wooly thinking, and we certainly don’t want to replace it with something equally vague and invalid.
Such as, Caretaker Personality Disorder!