![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 8 of 8. This is the beginning of the thread.
Posted by socialdeviantjeff on January 16, 2004, at 3:04:26
This may be more of a thing for PB psychology, but I'm not sure.
I was talking with my pdoc, he's a very frank sort of person who takes the "drugs only, sir" approach.
I asked him about my dx, and he said he is trating my issues as a depressive disorder. My dx is psycohtic depression, GAD and OCD. He said that my case is extremely complicated because of my bizarre drug reactions. We discussed some of the overlaps between my symptoms, Bipolar II and BPD. He said that he would not rule out the possibility of BP II, but he han't seen any evidence of hypomania. He said that if drug treatments didn't work at all, after trying everything with no or partial response, he would say it was a possible personality disorder. He did say that there is no evidence of character problems so he doubts that a personality disorder would be it.
Correct me if I'm wrong, but on the cogntive-behavioral model, the pathology of personality disorders comes from maladaptive behaviors caused by external stressors. People with inherent tendancies towards these behaviors develop these disorders.
I really only buy this to a point, but where does "character" come into this? Philosophically, I see the building of character as what happens when you eat your peas, lose gracefully, get grounded, stuff like that.
So, what I don't understand is how could a personality disorder be a character deficit? it makes no sense to me.
Posted by tabitha on January 16, 2004, at 4:06:05
In reply to Personality disorder as a character issue???, posted by socialdeviantjeff on January 16, 2004, at 3:04:26
Geez.. I don't like the word 'character' much. To me it implies some kind of moral judgement that I really wouldn't want from my mental health care provider. I have no idea how a doctor would use the term. Maybe do some googling about it? Or ask him next time you see him?
Posted by Dinah on January 16, 2004, at 8:57:55
In reply to Personality disorder as a character issue???, posted by socialdeviantjeff on January 16, 2004, at 3:04:26
The term "personality disorder" is bad enough, and should be removed entirely from the diagnostic lexicon in my humble opinion. Most are based on underlying mood or anxiety disorders anyway. Avoidant and obsessive compulsive personality disorders are so clearly a response to anxiety. Borderline personality disorder is so clearly a mood regulation problem. Introversion is so much a part of many of the disorders that it really should just be listed as a diagnostic entity that bears no overtones of judgement. They could move the underlying part of the diagnosis to Axis I. "Reactive mood disorder" or "GAD" or "Social Phobia".
Then Axis II could be changed to "defensive structures" if they want a shorthand way of grouping behavioral tendencies, since those behavioral tendencies *are* characteristic defenses against the underlying feelings.
Sorry, pet peeve of mine. The whole thing seem so judgmental and antitherapuetic.
Someone get the DSM committee on the phone for me!
Posted by Karen_kay on January 16, 2004, at 14:48:54
In reply to Personality disorder as a character issue???, posted by socialdeviantjeff on January 16, 2004, at 3:04:26
You know, I don't get it either. I mean, I read about personality disorders and I swear I have every one I read about. So, I have to go to my therapist and ask him whether or not I actually do have a certain personality disorder. Last time it was Antisocial.
I've been dx with BPD (EEK!) and now I'm completely convinced it suits me. But I think the question is to what degree and how it affects your life. I think the major problem is that there is a spectrum that is often not recognized. I don't habitually threaten suicide, nor do I feel suicidal idealation. And I am constantly alone, and I prefer it. So, I'm left wondering, am I really Borderline.... No way! So, even if my chart says I am, I don't care. Maybe later, I'll have to get it changed. Not exactly sure how to yet. The thing is that many other factors come into play. I've had unstable relationships in the past, due to the fact that I don't enjoy intimate relationships.
The question of character is a good one. I suppose that personality disorders are based on negative or maladaptive traits, therfore the characterists even if they are quirks or marks of character may still be maladaptive and "need adjusting" according to therapists.....I've noticed improvements in my thinking and wouldn't say that I fit the dx anymore, so I don't necessarily think I ever was dx correctly. Maybe I'm just lying to myself. I tend to do that :)
Posted by jay on January 16, 2004, at 17:18:22
In reply to Personality disorder as a character issue???, posted by socialdeviantjeff on January 16, 2004, at 3:04:26
Jeff...let me tell you as a Social Worker (one on disability...and mentally ill...but still good at what he does..;-) that there is a whole issue of "labeling" here, and there are many school's of thought (i.e. sociology) that disagree very strongly with it's worth. Psychology is just *one* of many social sciences that have many diverse opinions on the topic. A sociologist would say there is absolutely nothing wrong with your "character', nor is it an issue, but one in which society tries to label and blame everything on *you*, and hence label you "deviant". So...I really wouldn't worry much at all about the issue...as it is only a matter of perception...academic perception at that.
Best,
Jay
Posted by justyourlaugh on January 16, 2004, at 22:00:48
In reply to Re: Personality disorder as a character issue??? » socialdeviantjeff, posted by jay on January 16, 2004, at 17:18:22
there you are jay,,
good to see you up..
j
Posted by jay on January 17, 2004, at 16:58:32
In reply to sleeping beauty..., posted by justyourlaugh on January 16, 2004, at 22:00:48
JYL...I haven't shaved in 3 days...I look like I belong on the streets. Thanx anyways. ;-)
Jay
Posted by socialdeviantjeff on January 17, 2004, at 21:37:39
In reply to Re: Personality disorder as a character issue??? » socialdeviantjeff, posted by jay on January 16, 2004, at 17:18:22
Well, thanks for the input.
I think what jay said about the issue of "Academic Perception" hits the nail on the head. I also agree that the labeling can be prejudicial.
Over the years, I've had lots of labels, some that would appear true and some so far off the mark it really makes me wonder. Since childhood: ADHD (true), Asperger's Syndrome(Maybe), Conduct Disorder (What the h***?), Depression (Fer Sher), Schitziod Personality Type (Still up in the air for me), BPD (doubt it), Bipolar non-specified (Heh?) and so on. It really makes me wonder how many doctors sleep through their classes and how many pay attention. :(
I found an old discussion here: http://www.dr-bob.org/babble/19991108/msgs/15163.html. Pretty interesting.
I also found a definion for Character Disorder.
"(character neurosis)
A personality disorder manifested by a chronic, habitual, maladaptive pattern of reaction that is relatively inflexible, limits the optimal use of potentialities, and often provokes the responses from the environment that the person wants to avoid. In contrast to symptoms of neurosis, character traits are typically ego-syntonic.
The old term for personality disorder."The consensus for the conventional spectrum of personality disorders (based on info I could find) would appear to be ego-dystonic, meaning that the person with the symptoms can recognize that behaviors or traits are maladaptive rather than normal and acceptable. Not to mention that many maladaptive behaviors are caused by an underlying biological problem.
So, I guess that is that. To me, it would seem that there is a clear difference between a "character issue" and a "personality disorder" (PD). Also, PD's do generally arise from biological complications.
A good example could be: 2 people, one is an unremourseful criminal with no conflict about his nature. He would have a character problem. The other person has a problematic background, recognizes there is a problem and battles with it on some level. Person 2 could have a personality problem.
Now I want to know all the more why my pdoc framed his opinion as he did. The info I found is what I can agree with, for now. There are sooooo many schools of thought on this, there is no obvious answer.
This is the end of the thread.
Psycho-Babble Social | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.