I’ve talked to multiple doctors who vehemently dislike the label “personality disorder”. In their view, this type of mental illness is more like a set of maladaptive coping mechanisms. In other words, they argue that personality disorders are better described as unhealthy techniques for dealing with a world that’s hard to understand and fit into.
I’m willing to bet there’s a lot of merit to the argument that we should do away with the personality disorder label. These particular doctors, whose qualifications range from psychology PhDs to psychiatry MDs, have told me that diagnosing someone’s whole personality as “diseased” is extremely stigmatizing and often inaccurate. After all, aren’t we more than just our mental illness? Doesn’t some part of the human condition transcend faulty brain receptors and other underlying causes of “personality disorders”?
To what degree can we control who we are despite our biology?
I agree with a lot of the point of view that these disorders are better characterized as dysfunctional coping mechanisms. The people who suffer supposed personality conditions probably have more control over their character than their diagnosis would suggest. Personally, when I was told I have borderline personality disorder, I immediately felt hopeless. The name alone seemed to suggest that I have an inherently broken character, that all of the traits that make me unique are diseased. Fortunately, I did my research and realized that this initial perspective was an exaggerated oversimplification of a very complex disorder that actually allows a lot of room for improvement.
Not everyone with a PD diagnosis wants to be a doctor like I do, however, and if they don’t read books about psychiatry, they may spend the rest of their lives convinced that their whole self is irreparable just based on the name of their disease. Wouldn’t the label “maladaptive coping mechanisms” suggest more hope for recovery? Coping strategies can be mended. Entire personalities, however, feel much more set in stone.
The question of how much an individual can change their inherent traits is a very interesting one with a somewhat subjective answer. Really, the speculation over whether these diseases should have the title of “personality disorder” gets at the nature of the human condition itself. Is our consciousness powerful enough to change our biology, or are they so deeply connected that our sense of self can be broken by poorly functioning neurochemicals? Is it more accurate to label people based on how well they cope with the world instead of who they are at their core? And what about the stigma associated with telling someone their whole sense of self is sick?
For now, I’ll leave these questions open. I intend to do more research on the subject and formulate a better-educated view. However, I believe that these questions need to be asked and answered, especially by the medical community – and hopefully before the next DSM is published.