The Personality Disorder -Which One Do You Have?

Girl Interrupted, or Bucket O' Borderlines

When I went to P&S, one of the great features of its curriculum was its Psychiatry requirement which spanned a full two and a half years of our time there. It was among my favorite experiences from medical school. In that first year, among other things, we discovered how really crazy we all were, each of us, in our own special way. It was then I discovered the DSM Personality Disorders, which is kind of an “interesting personalities” index. Rather like a Zodiac sign, my pals and I immediately set about viewing those around us through the lens of their particular personality disorder. People rubbing shoulders in large cities brings out these personality disorders like rubbing oregano brings out its spicy aroma.
According to the DSM-IV-TR Axis II (the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders), the person with the personality disorder has to meet first the general criteria of having “an enduring pattern of inner experience and behavior deviating markedly from the expectations of the individual’s culture.” This is a very interesting criteria because it implies the existence of whole cultures that are crazy and where that flavor of crazy is normative (think Klingons before the Khitomer Accords). It also implies that whole families may be crazy, but within the confines of that family, one’s crazy behavior may seem “normal,” and children from such families only realize how abnormal their families are once they leave for college. This is not a personality disorder if the individual realizes that yelling their frustrations is not normative and corrects that behavior. This is an important feature of the general diagnostic criteria -that  two out of four deviations go unrecognized in terms of cognition (self perception and interpretation of others and events), affect (range, intensity, lability and appropriateness of emotional response), interpersonal functioning, and impulse control.
Also in this definition, this personality pattern is inflexible and persists along a broad range of personal and social situations, leading to distress or impairment in personal, social, and occupational functioning. This pattern is persistent and present for a long period of time, and not secondary to another primary mental disorder, substance abuse or medical condition. It means the person affected by a personality disorder may or may not be aware of their “deviation from the norm.”
The personality disorder list is then grouped into three clusters with subcategories.
Cluster A (odd or eccentric disorders)
-Paranoid personality disorder
-Schizoid personality disorder
-Schizotypal personality disorder
Cluster B (dramatic, emotional, or erratic disorders)
-Antisocial personality disorder
-Borderline personality disorder
-Histrionic personality disorder
-Narcissistic personality disorder
Cluster C (anxious or fearful disorder)
-Avoidant personality disorder
-Dependent personality disorder
-Obsessive-compulsive personality disorder
Appendix B -for further study
-Depressive personality disorder
-Passive-aggressive personality disorder
Deleted from DSM IV but present in DSM III-R
-Sadistic personality disorder
-Self-defeating (masochistic) personality disorder
The key point in personality disorders is that their conditions are considered out of the norm but not completely incapacitating. Most people have some degree of the above characteristics, and the differences in the ingredients results in the person. The PD-afflicted individual has one of the above characteristics in superabundance, resulting in flawed social interaction. Through this year, we’ll go through the personality disorders and figure out why some people behave the way they do.

I.D.D. -Irony Deficit Disorder, Unwanted Connectedness, and the Importance of Defending the Modern

The Greatest American

As a middle school student, we were assigned Jonathan Swift’s A Modest Proposal. I laughed my guts out, but soon realized that many were appalled by the idea that Irish babies should be used to feed the poor. As I grew up, I read Vonnegut with the avidity that presaged the kind of fandom that we see kids have nowadays for video games, and for it, I was a bit of an outsider. The word I learned in medical school was concrete -most of the world is concrete. They can process black and white, but are blind to shades of gray. A pie in the face is funny, but a pie made of Irish babies, not so much.

You can see this in the audience for comedy -in the 90’s, it was fans of Leno versus Letterman (and now  O’Brien), Jeff Foxworthy versus Jerry Seinfeld, and Britney Spears versus Lady Gaga. It’s the divide that separates America into Walmart and Target. There are people who take Sarah Palin seriously and those who see a cosmic joke. It is with utmost seriousness that I propose a new DSM personality disorder -the Irony Deficit Disorder or IDD.

IDD is marked by a lack of curiosity of the world beyond the experience offered by life within earshot and immediate view. People with IDD have limited affect and rarely express themselves with their hands. They hew to orthodoxy and are great believers of world views constructed by dead people. They are suspicious of the new and generally feel uncomfortable around people who don’t share their background. IDD is found across the political and socioeconomic spectrum. People with IDD are easily offended. They will likely be offended by this piece. These people find change distressful and uncomfortable. At first, new things are regarded with disdain and suspicion, and the ethical and moral dimensions are weighed from the viewpoint of their particular flavor of orthodoxy. When change threatens to intrude, they usually have been able to withdraw from it and the world, but not anymore. The internet, which back in the halcyon days of the nineties offered a utopian view of world connectedness -a New World Order, functions as both the irritant and the balm to those with IDD.

Every country now has its native Taliban fighting the bare-legged, ochre-skinned, breast implanted, spangly-pole dancing march to progress. It is the loss of tribe, social norms, and social status to barbarian invaders talking, looking, and thinking differently and dictating change while secretly sneering at the rubes, or so it seems to the bitter IDD person. They look at their internet in shock and awe – How can it be not wrong for a man to kiss a man and marry a man? How can it be not wrong for a white girl to kiss a black man? Why are they trying to get me to eat that horrible looking food? Why do I have to look at that person dressed that way? Why are those signs not in my native language? Why do I have to pronounce that name the way they want to? How can it be not wrong to assert that America is a country whose only mention of God in the Constitution is in the separation of church and state? Their fears are straightforward –They are trying to change my core values and by extension, denigrate them.

Now, having IDD in no way handicaps that individual. These people buy Toyotas and GM cars, use Windows, and wear red Christmas sweaters embroidered with reindeer. They pay taxes and abide the law. In fact, they are the majority, and their concerns have to be respected up to the point where someone else’s rights are infringed. Those of us endowed with the third eye of irony and rationalism have a difficult position because we will always be in the minority and vulnerable (see Qin Dynasty -burying of the scholars and burning of the books, Spanish Inquisition, Nazi Gleichshaltung, McCarthy Hearings, the Cultural Revolution, the Gulag, Taliban Kabul Soccer Stadium activities, the Iranian Election of 2009, The Glen Beck Show). A candle is mostly wax with a fine evanescent flame, easily blown out.

The bright lights of our world have to make a stand. Rather than retreat to Starbucks to grope out discontented tweets for a limited audience, we have to reach out and actively defend ourselves and our civilization which is the Modern Civilization. Rather than sneer behind our Kindle’s, we have to speak clearly for our Constitution and rule of law. We have to make our votes count and work with our like minded brethren in the opposing camp to come to rationale, workable solutions rather than digging trenches festooned with figures hung in effigy. The rational center must hold true to the convictions of Franklin, Washington, Jefferson, Hamilton, and Adams.

You now have the tee box.