Don E. Gibbons, Ph.D., NJ Licensed Psychologist #03513
This Blog is published for information and educational purposes only. No warranty, expressed or implied, is furnished with respect to the material contained in this Blog. The reader is urged to consult with his/her physician or a duly licensed mental health professional with respect to the treatment of any medical or psychological condition.

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The New Center for Counseling and Psychotherapy, LLC

The New Center for Counseling and Psychotherapy, LLC, is located at 675 Route 72 E, Manahawkin, NJ 08050,
Telephone (609)709-2043 and (609) 494-0009.

Driving directions: Take Mill Creek Road South, just off Route 72 E After about 400 feet, turn right into the office complex of Mill Creek Commons.Then, immedately turn right again and go past the Lyceum II Gym. Continue on to the Prudential Zack Building,which will be the only building on your right. We are the last office at the end.

We accept Medicare and most other major insurance.
We do not accept credit or debit cards.

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Wednesday, July 31, 2019

Mindful Hypnotic Meditation for Conducting a Non-Deceptive "Seance"


To borrow a line from Charles Dickens, “One thing must be clearly understood, or no good can come from this story I am about to tell.” Our brain constructs our own reality! We construct this reality out of what William James called the “buzzing, blooming confusion” of raw sensory input, which bombards us from every direction. Since no two people have exactly the same experiences, what we believe to be “out there" is actually an individually constructed parallel universe which only approximately intersects with those of others.

In accordance with the teachings of post-modern constructivism, my job as a therapist is to help clients to construct a reality that will help them to live better lives, regardless of the reality that I may construct for myself

"Maryanne" was the last of six children in a rigidly conservative Catholic family. All of her brothers and sisters had gone to Catholic school, and those who wanted to had gone to college. By the time Maryanne was born, there was no money left for private education. so she went to public grade school and graduated from high school with no prospects of going further. 

Shortly after she was married, she incurred serious spinal injuries from a fall an icy sidewalk, which resulted in her having to see a pain specialist and take medication for the resulting chronic discomfort..

Her mother wanted to keep Maryanne by her side instead of leaving to get married as her other children had done, so she encouraged her to become emotionally dependent.

Her father, on the other hand, scolded her incessantly, in the mistaken belief that he could "shock" her into being highly motivated if he nagged her intensely enough. Instead, Maryanne developed s number of stress-related physical ailments including ulcers, migraine headaches, and chronic constipation.

When she finally did go to work, her boss was bullying and sadistic. Once when she.had mistakenly ordered a shipment of several cartons of supplies delivered directly to her desk instead of the office, her boss forbade her to move them out of the way for several days, and made her climb over them in order to get to her desk.

She lived close enough to her parents to go home for lunch, and her mother would hold her and soothe her to give her courage enough to return to her job every afternoon, until she finally was fired because she could not put up with her demanding boss any longer and her work had begun to suffer.


She married a man with Crohn's disease, a chronic inflammation of the digestive tract, in the expectation that they would be able to help each other with their health problems. He had also developed a chronically sarcastic outlook which was well within her emotional comfort zone because it unconsciously reminded her of her father.

Shortly after she was married, she incurred several serious spinal injuries from a fall on icy pavement which requires her to receive ongoing medication and treatment by a pain specialist.

On her first visit to my psychology practice, four years after her mother had died, Maryanne showed me a picture she had taken on her cell phone of household clothing piled inside her bathtub because she did not have the energy to put it away. Fortunately, her new husband liked to cook, and he did most of the grocery shopping. But the matter of household chores was clearly her responsibility.


Maryanne responded very well to hypnosis and was amnesic for most of the sessions. However, no matter how much I tried, I was unable to help her to summon the energy to clean up her messy house.

One day, she was discussing her desire to go back to work in order to help with the family finances, adding that she would have to clean up her house first before she could ever consider doing that. She also mentioned how depressed she was and how much she missed her mother, who had died four years previously. Her father was also deceased.

It occurred to me that she might be unconsciously using the condition of her house as a wall to prevent her from having to look for a job. When I was about to hypnotize her, I told her confidently that this time we were going to give her all the energy she needed. "Are you going to take the place of my mother?" she asked, which tended to confirm my suspicions.

I could not take the place of her mother, of course; but if she could re-experience her mother holding and soothing her just as she had done in real life, I would not need to. In Victorian times, there was a great interest in contacting the spirits of departed loved ones by means of a "seance," in order to obtain reassurance and advice. The practice died out, however, when many of the supposed mediums who conducted these sessions we're exposed as frauds. Nevertheless, the widespread popularity of seances revealed a deep yearning on the part of many people for this.type of experience.

After hypnotically guiding her through a rainbow of pleasant emotions and coming to the pot of gold at the end of it, I suggested that this was the gateway to Paradise, where she could contact her mother and pour her heart out to her while being comforted and soothed, much as her as her mother had done while she was alive.

This type of reassurance appeared to be all that Maryanne needed in order to regain her former self confidence, clean up her house, and  begin looking for a job.

Was she really talking to her mother at the gateway to Paradise? As a post-modern constructivist, I have no right to say that the experiences I have constructed for myself are any more "real" than hers. I am perfectly content to help my clients put together a set of beliefs which enables them to lead happier and more effective lives as they themselves interpret them. Considering
 the depth of pent-up longing experienced by many grieving relatives who yearn to contact their loved ones once more, as the Victorians have amply demonstrated, the opportunity to experience a non-deceptive hypnotic seance would appear to be a potentially useful application of hypnosis. However, one must be careful not to ask leading questions, in order to insure that the hypnotic realities constructed by one's clients are truly their own, and not a projection of the hypnotist. 


Monday, July 29, 2019

Suggestibility: Exploding the Myth

A Suggestion is an Induction.
                                                                      -- Ernest. R. Hilgard

Let's perform a thought experiment. Imagine that you are giving the Harvard Group Scale of Hypnotic Suggestibility (Shor & Orne,1962), which is the most widely known scientific measure of   individual hypnotic responsiveness, to a class of introductory psychology students in a politically sensitive part of the world, when someone dressed in a police uniform bursts into the room, shouting that there is an active shooter on campus and orders everybody to take immediate cover under their desks and await further instructions. Everyone, including the instructor, promptly cowers under their desks in a high state of emotion for an indeterminate time, until it gradually becomes clear that this was a hoax, i.e., a cleverly designed suggestion on the part of a dissident student group in order to disrupt the smooth operation of the school. 

What happened to the individual differences in suggestibility that the test was supposed to measure, and what happened to the individual differences in hypnotic depth that had been achieved? They disappeared! In other words, under the right conditions everybody is totally suggestible, and in practically no time at all.

How, then, does suggestion really work? Here is Steve Lynn's excellent summary of our induction chapter in the American Psychological Association's Handbook of Clinical Hypnosis:

. . .how clients respond to suggestions depends less on the nature and success of a particular induction than on the following variables: (a) clients' prehypnotic attitudes, beliefs, intentions, and expectations about hypnosis; (b) their ability to think, fantasize, and absorb themselves in suggestions; (c) their ability to form a trusting relationship with the hypnotist; (d) their ability to interpret suggestions appropriately and view their responses as successful; (e) their ability to discern task demands and cues; (f) their ongoing interaction with the hypnotist; and (g) the appropriateness of the therapeutic methods and suggestions to treating the presenting problem. . . . Accordingly, clinicians should devise inductions and suggestions with these variables in mind and tailor their approach to the unique personal characteristics and agenda of each client they encounter" (Gibbons & Lynn, 2010, p. 289).
If a suggestion is perfectly in keeping with one's existing beliefs about the world, the self, and the future, as illustrated in  our thought experiment, dramatic changes in thinking, feeling, and behavior may easily be obtained simply by presenting it. There is no need to first suggest that a person is experiencing a "trance" in order to communicate directly with the "unconscious mind," whicn, in light of our current knowledge about brain structure and functioning, is at best a crude approximation. Although I continue to use the term hypnosis for ease of communication, I currently prefer to use the concept of multiversal meditation as a metaphor for suggested change, as illustrated by the following Blog entries. 

References

Gibbons, D. E., & Lynn, S. J. (2010). Hypnotic inductions: A primer. In Ruhe, J. W., Lynn, S. J., & Kirsch, I. (Eds.) Handbook of Clinical Hypnosis, 2nd ed. Washington, DC: American Psychological Assn.

Shor, R. E. & Orne, E. C. (1962) Harvard group scale of hypnotic susceptibility, Form A. Palo Alto, CA: Consulting Psychologists Press.

How to Learn Self-Hypnosis at Home

You can easily  learn the basics of self-hypnosis at home and free of charge by reading this instructional article on WikiHow. It describes the use of the BEST ME Technique to combine Beliefs, Emotions, Sensations and perceptions, Thoughts and images, Motives, and Expectations, in order to more fully involve oneself in the content of a suggested experience. I use it with the clients in my psychology practice, both as an introduction to the experience of self-hypnosis and for use between therapy sessions as a training and practice aid. According to the statistics available at the site, with the help of several co-authors, it has been viewed almost 1-1/2 miillion times since I first wrote and posted it.

Thursday, July 25, 2019

"Covert Hypnosis" and "Ambush Hypnosis:" It's Mostly a Hoax, Folks!


In spite of the numerous advertisements encouraging you to learn how to do just that, don't just sidle up to someone at the mall, or someone who is asleep, and try to hypnotize them on the sly!

Though not impossible, it is extremely difficult to hypnotize someone without their prior knowledge and consent. Although covert hypnosis (sometimes referred to as "ambush hypnosis") can work occasionally with an unsuspecting person who is caught by surprise, much more often than not, people will catch on to what you are trying to do. They will either laugh at you, or become angry for insulting their intelligence, and/or suspect that you have an ulterior motive and report you as a suspicious person -- that is, if they don't decide to take the matter into their own hands.



Monday, July 22, 2019

The "Law of Attraction" is FATALLY FLAWED!

The central theme of the book, "The Secret," is that we create our own reality by "the law of attraction." If we send forth positive thoughts, then we attract positive events to us; and if we send forth negative thoughts, then we attract negative events.

Whatever an individual's thoughts can attract, a group's thoughts should be able to attract too. If we really do create our own reality by sending forth positive or negative thoughts, then this effect should be apparent not only in individuals, but also in groups, in historical trends, and in society as a whole. But it isn't!

I have listed below some comments which my friend Roy Hunter reports as being made to individuals who are suffering from cancer and other maladies which should also operate according to "the law of attraction," and taken the liberty of constructing a reply to them. 
  • What did you do to attract cancer in the first place? What about all those people who get cancer because they are living in an area where there is a high level of carcinogens in the environment?
  • You have a disease consciousness. The Black Death killed between 75 and 200 million people, between 1348 and 1350. What could all those people have been thinking that caused such a plague to so suddenly descend upon them?
  • You must have a karmic debt to pay off.  If you have read The Diary of Anne Frank, you will have a good idea of the kind of person she was. Now consider the fate of Ann and others like her as they lay covered with lice and dying of hypothermia in a Nazi concentration camp during World War II. What did they do to bring this upon  themselves?
  • Why can’t you create enough faith to be healed? Age is a wasting disease. And the survival rate for this particular disease is zero. Has anybody crated enough faith to get out of that one?
  • Don’t you know smoking will kill you? With 99% of the same genes as our closest simian cousins, the chimpanzees, and over a century of experimental research to back them up, most psychologists agree that short-term pleasure is often more important than long-term consequences in determining our behavior, particularly when it comes to matters of addiction.
  • Fat people are out of control. An African journalist recently stated that her greatest surprise in coming to the United States was to discover that in America, thin people are rich and fat people are poor, since in her own country the reverse is true. If this is the case, how can weight be a function of one's personal discipline rather than one's culture?
  • You have a poverty consciousness. The CIA World Factbook lists the United States as twelfth in per capita income, behind such nations as Norway and Hong Kong, yet most Americans are inclined to think of themselves as the richest nation in the world. If we create our own reality, why are we not in first place?
  • "Get out of the victim trap!" Try telling the survivors of Stalinist tyranny who were imprisoned in Siberia that they shouldn't have been thinking so negatively about their situation that it caused them to end up there.
  • Why did you create this problem? The CIA World Factbook lists the United States as fifteehth from the top in infant mortality compared with other nations. Explain to the parents of the babies who died because they were not given better medical care what they or their children did to create this problem.
  • What is God punishing you for?  If God is keeping quiet about His reasons, then what is the point of punishment?
  • If “The Secret” is not working for you, then you must be doing something wrong.  Maybe so!  On a recent radio interview show featuring a leading theoretical physicist who was commenting upon the latest discoveries in his field, a questioner asked him about the "law of attraction." He forcefully criticized the promulgators of this belief for misleading people, and assured the caller that the universe simply does not work that way. Perhaps what people who subscribe to this false doctrine are "doing wrong" is believing in "The Secret" in the first place!
Of course there can be negative and self-destructive attitudes within the personality which interfere with the successful accomplishment of a goal, and which contribute to the development of psychosomatic conditions. But their causes and effects are well-documented in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, and have nothing to do with "The Secret!"

Friday, July 12, 2019

Poetry: Sending Words nto Battle

Anxiety and depression are tlike a flat tire. If you don't fix it you aren't going anywhere. However, they are he most common psychological problems which most people have to contend with in everyday life. Inspirational poetry, as illustrated by the following examples, can often provide the battle cry which enables us to continue the fight when all seems lost. More information can be found at the Websites of the National Association for Poetry Therapy and the Institute for Poetic Medicine

If

If you can keep your head when all about you
Are losing theirs and blaming it on you;
If you can trust yourself when all men doubt you,
But make allowance for their doubting too:
If you can wait and not be tired by waiting,
Or being lied about, don’t deal in lies,
Or being hated, don’t give way to hating,
And yet don’t look too good, nor talk too wise;
If you can dream—and not make dreams your master;
If you can think—and not make thought your aim,
If you can meet with Triumph and Disaster
And treat those two imposters just the same:
If you can bear to hear the truth you’ve spoken
Twisted by knaves to make a trap for fools,
Or watch the things you gave your life to, broken,
And stoop and build ‘em up with worn-out tools:
If you can make one heap of all your winnings:
And risk it on one turn of pitch-and-toss,
And lose, and start again at your beginnings
And never breathe a word about your loss:
If you can force your heart and nerve and sinew
To serve your turn long after they are gone,
And so hold on when there is nothing in you
Except the Will which says to them: “Hold on!”
If you can talk with crowds and keep your virtue,
Or walk with Kings—nor lose the common touch,
If neither foes nor loving friends can hurt you,
If all men count with you, but none too much:
If you can fill the unforgiving minute
With sixty seconds’ worth of distance run,
Yours is the Earth and everything that’s in it. . . .

                                                    --Rudyard Kipling

Invictus

Out of the night that covers me,
Black as the Pit from pole to pole,
I thank whatever gods may be
For my unconquerable soul.

In the fell clutch of circumstance
I have not winced nor cried aloud.
Under the bludgeonings of chance
My head is bloody, but unbowed.

Beyond this place of wrath and tears
Looms but the Horror of the shade,
And yet the menace of the years
Finds, and shall find, me unafraid.

It matters not how strait the gate,
How charged with punishments the scroll.
I am the master of my fate:
I am the captain of my soul. 

Wednesday, July 10, 2019

PERSONALITY DISORDERS: Ten Toxic People who can Wreck Your Life

  

Toxic, or personality-disordered people, can wreck your life when they are bosses, friends, or family members, As clients,they can cause you to doubt yourself because of their abrasive nature and the fact that they are often resistant to treatment.

If you search on Facebook or the Internet for "toxic people," you're going to get all kiinds of lists, but the following descriptions of personality disorders is based on the Diagnostic and Statistical Manual of the American Psychiatric Association. They have been compiled by some of the best minds in the field of mental health, drawing upon years of clinical observation and literally hundreds of research studies to find patterns which “clump together” in present-day culture. Of course, actual diagnosis and treatment should only be undertaken by a mental health professional, and many people can have the traits of one or more personality disorders without qualifying for a full diagnosis -- but, there is an old saying, "If it walks like a duck, and quacks like a duck, and looks like a duck -- it's a duck!"  If you know someone who appears to fit one or more of these descriptions, it might be worth your while to examine the reasons why you maintain a relationship with such a toxic person, with professional  help if necessary

Borderline Personality Disorder.

To understand the person who qualifies for a diagnosis of borderline personality disorder, think back to some of the stormiest days of your adolescence, or the adolescence of someone you know well. With an incompletely developed sense of self, borderlines have no firm idea of who they are and where they are going. Their lives are often erratic, with frequent job changes and alterations in long term goals, and intense and unstable friendships and romantic involvements.

Because of their poorly developed sense of self, borderlines often have difficulty with so-called “boundary issues,” or the ability to distinguish between what is appropriate and what is inappropriate in a given situation. Some borderlines, in fact, may find it difficult to even talk to a person of the opposite sex for very long without acting as if they are falling in love with them. As would be expected, the romantic lives of borderlines tend to be especially tumultuous. The manipulative abilities of people with borderline personality disorder often enable them to deceive those who do not understand the inner storms which produce such behavior, which frequently causes their sudden bouts of passion to be mistaken for genuine love.

Borderlines often engage in “splitting,” with either extremely positive or extremely negative feelings towards others, sometimes suddenly reversing from extreme friendliness to extreme rejection and vice-versa. This changeability frequently leads them to engage in behavior that is highly manipulative. This splitting may also be the reason why the interpersonal relationships of borderlines are often centered around real of imagined fears of abandonment. (One book on borderline personality disorder is entitled, I Hate You - Don’t Leave Me!) These tendencies to engage in splitting may also explain why borderlines also seem to have a strong ability to divide those around them into separate camps of friends and enemies.  

Borderlines usually have very low self-esteem, and suicidal gestures, genuine attempts,and successful suicides are not uncommon. Many borderlines have a history of cutting themselves, or other forms of self-injurious behavior as a result of low self-esteem. 

The following video ex[lains how to spot the nine traits of a borderline personality disorder.




Narcissistic Personality Disorder.

The ancient Greeks used to tell the story of Narcissus -- a lad who was so good-looking that he fell in love with his own reflection in a pool of water, and spent so much time gazing at it that he eventually fell into the pool and drowned. People who are given a diagnosis of narcissistic personality disorder are often perceived as being selfish or conceited. They may often spend a great deal of time telling you how great they are, or boasting of their achievements or accomplishments.

Some people think of a person with a narcissistic personality disorder as having a superiority complex to cover up for an inferiority complex. When you get to know such people well, it soon becomes apparent that the reason they spend so much time “tooting their own horn” is that deep down inside, they really feel afraid, inadequate, and unlovable.

Narcissists do not always act selfishly in the short term. They are often highly motivated to pursue long-term goals in order to prove their worth both to themselves and others. For this reason, narcissists often tend to gravitate to positions of leadership in business, government, education -- and yes, even churches.

Narcissists often cause a great deal of suffering, particularly when they happen to be employers, family members,  or romantic partners. Yet there are ways of dealing with them. (Since no two personalities are exactly identical, however, you cannot stereotype them and treat them all exactly the same way.)

Histrionic Personality Disorder.

People who have been diagnosed with histrionic personality disorder may often be compared to an adult version of the “spoiled child” who will do anything to remain the center of attention. If histrionics are able to “show off” and remain the center of attention by doing a good job, they often accomplish a great deal. But if they feel that they are being ignored, or that the attention which they crave so deeply is denied them, they may become angry and disruptive in order to get it back again -- even if it’s unfavorable attention this time! ("I don't care what you say about me," one publicity-hungry histrionic is reported to have said to a reporter for a scandal magazine. "Just be sure you spell my name right.!")

Antisocial Personality Disorder.

People with a diagnosis of antisocial personality disorder did not incorporate our society’s standards of right and wrong into their personalities as well as the rest of us have. They begin getting into trouble with the authorities by the time they are adolescents, and don’t grow out of it. As you might suppose, this pattern is much more common in men than in women.

Since personality disorders are so difficult to change, many such people keep going back and forth to jail from their teen years until middle age, when they seem to mellow out of their own accord. They make up the bulk of most prison populations, and often have a history of substance abuse or substance dependency. However, people with antisocial personality traits (I like to call them stealth anti socials) may be encountered almost anywhere, even at the highest levels of many organizations; and they may not be found out until their behavior gets them into trouble. (The discovery and apprehension of stealth anti socials in high-profile positions is the basis of many of the news stories we read about every day.)

Obsessive-Compulsive Personality Disorder.

People who have been diagnosed with an obsessive-compulsive personality disorder may be popularly known as a “nit-picker” or “neat freak.” They may become so involved with orderliness, perfectionism, and control that efficiency suffers as a result. This culture tends to place a high value on preoccupation with detail in certain jobs. With proper training, people who have milder forms of obsessive-compulsive personality disorder may become excellent law clerks, college registrars, bank auditors, or personal physicians -- in which case, it may not be a personality disorder any more, unless it interferes with their functioning off the job!

Obsessive-compulsive personality disorder is closely related to another disorder with a similar name, obsessive-compulsive disorder, or OCD for short, which is similar in nature but more limited in scope. Obsessive-compulsive disorder refers to a pattern of continually recurring thoughts (obsessions), or behaviors which one is compelled to continually repeat, such as checking a door several times in a row to be sure that it is locked.

Avoidant Personality Disorder.

People who carry a diagnosis of avoidant personality disorder have had such unpleasant social interactions in the past that with the possible exception of one or two close relatives or special friends, they have come to fear all human contact. Avoidants are frequently not merely shy about most social situations, they are genuinely phobic about them. Their avoidance is often centered around a core belief that if people really got to know them, it would immediately become obvious how incompetent and worthless they really are, and the immediate result would be scorn, rejection, and loss of employment. People with an avoidant personality disorder often tend to gravitate to solitary occupations -- researchers, librarians, or forest rangers, for example; and they may be attracted by certain monastic orders. (Of course, not everyone in these types of occupations could be diagnosed with an avoidant personality disorder!)

Dependent Personality Disorder.

A central theme in the life of people who have been diagnosed with a dependent personality disorder is a need to be looked after and taken care of, often accompanied by excessive fears of real or imagined abandonment. Ironically, some people who qualify for a diagnosis of DPD may behave in exactly opposite fashion. Those with milder forms of this disorder may attempt to satisfy their underlying dependency needs by becoming so efficient and thorough that they make themselves indispensable. Others, whose disorder is more severe, become highly dependent on instructions from above, and are reluctant to show any initiative in carrying out their responsibilities for fear that they will have made the wrong decision.

Paranoid Personality Disorder.

People who have been diagnosed with paranoid personality disorder tend to see the activities of other people as ill-intentioned -- even when the opposite is true. Compliments may be seen as attempts to gain undue influence through flattery, and offers of help may be seen as evidence that the person to whom the help is offered is viewed as incompetent. The resulting suspiciousness and hostility may tend to bring about the negative attitudes and behaviors which the person with a paranoid personality disorder believes were always there. (The saying goes, “Just because you’re paranoid, it doesn’t mean they aren’t out to get you!”)

Schizoid Personality Disorder.

The person who has been diagnosed with schizoid personality disorder is an extreme loner or a “cold fish” who just isn’t interested in being around people. Such people are often found in the most solitary jobs which others might tend to shy away from. Because of their extreme lack of social skills, they should not be expected to change simply by inviting them to parties or by introducing them to a wide circle of people.

Schizotypal Personality Disorder.

People who have been diagnosed with schizotypal personality disorder typically have bizarre notions of cause and effect, and may practice unusual rituals of their own devising, either to make things happen or to prevent them from happening, similar to those who have been diagnosed with schizophrenia. Their everyday speech patterns and favorite topics of conversation are usually regarded by those around them as being somewhat bizarre, although not totally “crazy” in the popular sense of the term. They may also take a keen interest in cults and in the paranormal. Although certainly not everyone who is interested in such topics has a schizotypal personality disorder, the true schizotypal still tends to stand out because of bizarre thought patterns.

Passive-Aggressive Personality Disorder.

Although the American Psychiatric Association no longer officially lists this as a separate personality disorder, people with passive aggressive tendencies try to disrupt things by sabotaging the success of their employers, their family, or their friends without appearing do so deliberately, because they feel that their own needs for recognition, status, or achievement are not being met, or that other people are more successful than they are. Passive aggressive people may risk an occasional confrontation if it helps them to get their frustrations out, but they can usually gauge their actions carefully enough to avoid losing their jobs or their families.

If they are not frankly and firmly confronted about their behavior, their passive-aggressive patterns may become worse over time as they continue to follow their own “hidden agendas” and they feel that their actions are being accepted or condoned. They may single out for special treatment vulnerable individuals or groups who will not or cannot “fight back,” and their behavior may degenerate into outright bullying. Then, when the inevitable day of reckoning does arrive, the consequences may be much more serious -- both for the victims and for the organization -- than if the problem had been immediately and forcefully dealt with.

Limitations of a Personality Disorder Diagnosis.

In order to qualify for any of the foregoing diagnoses of personality disorder, the disorder must be seen to cause people significant distress in their social, intellectual, or occupational functioning, regardless of whether or not they are aware of this fact. Temperamental but highly successful movie stars, for example, whose demanding and self-centered behavior would interfere with their adjustment in another setting, would probably not qualify for a diagnosis of narcissistic personality disorder as long as they can "get away with it." Similarly, people who live alone in a remote location miles from the nearest neighbor would not qualify for a diagnosis of avoidant personality disorder as long as they are able to function well their current situation, regardless of how intensely they may dislike having social contact with their fellow human beings.

It's easy to see how more than one personality disorder, or the traits of several, can work together in the same individual. Most of us are familiar with, or have heard stories about, the narcissistic borderline who sleeps her way into an executive position and then proceeds to systematically eliminate all those who are familiar with how she got to where she is, while tyrannizing over the ones who have been hired as their replacements. We are also not surprised to learn about a narcissistic antisocial convict (sometimes referred to as a psychopath), who immediately commits another crime upon his release from prison, which entitles him to several more years of "three hots and a cot," plus free medical and dental care. Many of us have also witnessed instances of a passive-aggressive histrionic, who regularly disrupts public meetings with their oft-repeated tales of woe, to the extent that it becomes next to impossible to get any business done. 

People with personality disorders are not likely to seek professional assistance, because they are frequently inclined to blame their troubles on everyone but themselves. When they do seek help, it is usually because they are forced to do so (often in conjunction with an assault or a suicide attempt, or because a family member insists on it). They tend to remain as long as they are "hurting," or as long as they are forced to stay. When they are no longer hurting and are in a position to stop, they discontinue treatment.

Instead of seeing the personality-disordered individual directly,a therapist is much more likely to see a family member, romantic partner, or employee who presents with anxiety or depression as a result of their interaction with someone who has a personality disorder (whom they may refer to as a "toxic person" or an "energy vampire").

A final word of caution: as stated previously, an actual diagnosis of a personality disorder should only be made by an appropriately trained mental health professional. One of the easiest and most powerful ways to insult people is to let them know that you suspect them of having a personality disorder! While avoiding making such a diagnosis yourself unless you are properly trained to do so, and not communicating your suspicions to the individuals concerned, knowing how to recognize the major symptoms of a personality disorder will place you in a much better position to deal with such people on a daily basis, and to seek professional assistance in order to better cope with them if you need to do so. 

Of course, I am: not talking about people with just any mental illness. I am talking about the comparatively few people with a personality disorder, which is the subject of this post.

I often say to my clients that' the one who comes to therapy is frequently not really the one who needs it, and they agree. Family systems theorists refer to these clients as the "identified patient" who is usually the healthiest one in a sick family But in the majority of cases, they are unable  to leave, and they come to learn coping skills. 

We'd love to get personality disordered peoplle  into therapy, but most of the time they just won't go. (In fact, many of my colleagues now agree that we've got one in the Whte House!)


Print Sources

Cavaiola, A. C., & Lavender, N. J. (2000). Toxic co-workers: How to deal with dysfunctional people on the job. Oakland, CA: New Harbinger Publications.

American Psychiatric Association (2013). Diagnostic and statistical manual, DSM-V. Washington, DC: American Psychiatric Association.