Silenced, Shamed & Invalidated

L'invention de la vie by Rene Magritte, 1928

I remember a luncheon with several women who had been friends for numerous years. I was the 'newbie'. The one who was similar, though my divorce irrevocably defined me as being different from the group.

The luncheon was going as usual, each woman complaining about diets and calories and clothes that didn't fit while we justified eating Double-Fudge Brownie a' la mode together. As long as we talked about getting fat, it was okay to eat something making us fat. When the fattest woman in the group ordered dessert, the rest of us followed suit. We didn't even contemplate ordering one dessert with five forks as people tend to do these days--something my mother would have considered crude & gauche, eating off other people's plates! We wanted a whole dessert just for ourselves. Maybe we were willing to share our lives, but woe be the woman who wanted to share our dessert!

Now, I'm a very open person but even more than my willingness to self-disclose, is my willingness to listen. Being a good listener means people reveal things they may never have spoken of before. Maybe it's my older age, maybe it's my honesty, but people feel comfortable revealing innermost secrets. Secrets hidden beneath the cloak of public approval. Secrets locked inside for fear of criticism, rejection and public disapproval. After all, it's not nice to air one's dirty laundry in public.

Maybe I was invited to lunch because they noticed a clothesline attached to the end of my nose. Over the past fifty years, I've learned that nothing whitens sheets quite like exposing them to sunlight.

During this particular luncheon, one of the women admitted she'd been married before. This was a startling revelation since we assumed her current relationship was her first and only marriage. She said, "I'm ashamed to admit what happened, but twenty-five years ago my first husband left me for another woman. Just like you, CZ!"

I was relieved no one asked her why she had kept her abandonment a secret, or why she hadn't trusted her friends enough to tell them, or why her husband left. Instead, they offered her the grace of silence to compose herself. It's not polite for a woman to weep in her ice cream, after all. When she could speak without crying, she whispered, "Please don't tell anyone."

This summer, an older friend in my hometown was dumped by his new wife.

They'd been married less than a year when he returned from a business trip and discovered she'd taken his furniture, his vehicles, his lifetime savings account, and most of all: his reputation and credibility. One year of marriage and his 'beloved' felt entitled to everything he owned, which says a lot about her and nothing about him--other than the fact he'd been a dedicated saver.

When people told me about his plight, they said, "Well, I'm not one to judge! I don't know what he was like in private!"

See, this is what I'm talking about: the automatic assumption something was wrong with him for her to treat him the way she did! Why people do this is beyond me, but they do. They assume alls fair in love and war and who can say what's right and wrong when it comes to intimate relationships.

People are loath to make public judgments, yet are quick to deny private judgments about the victim. I don't suppose they'd say something like that if his business partner had robbed him blind; but hey, they were married.

Besides, everyone knows Water seeks it's own level. It takes two to tango. Birds of a feather flock together. All fine examples of ridiculous Blame-the-Victim thinking. People assume we must have done something to merit our abuse, rather than examining the facts and holding the abuser accountable for his or her crimes.

What's even more egregious is that people don't even think of the betrayed as a victim! That says a lot about people's dubious assertions of morality when they lack the guts to make a judgment call. What does it matter if he picked his nose at the dinner table or she farted in her sleep? What does it matter if their relationship was short-term, long-term, or purported to be perfect?

What matters is what happened and actions speak for themselves.

And if the shame of being replaced, robbed, or cuckolded by a trusted partner isn't crippling enough, people reinforce the shame of rejection by rejecting us, too. Imagine doubting our credibility after years of relationship with us! In a foolhardy desire to be seen as nonjudgmental, people give a free pass to the abuser. This means victims are not only mistreated by so-called 'beloveds', they are mistreated by their community, too.

It's easy to determine right from wrong, even with intimate relationships. Here's how ya do it: Look at the facts. They speak for themselves. Stop wondering why things turned out the way they did. Look at what happened. You know right from wrong, don't be afraid to say so. Because if you don't, here's what happens when abusers are not held accountable by their community:

They set the example for others.

What one narcissist gets away with, others will do likewise.

Narcissists know only too well that their victim's credibility will be in question. People are reluctant to believe anyone would hurt an innocent person. When a beloved abuses a beloved, there must be cause to the effect, or so people WANT to believe.

The victim is thus silenced, shamed and invalidated.

We know it, too. Oh, we may not be conscious of our observation that people question the victim's integrity, but we know it in our heart of hearts. Sometimes, the only way to maintain our dignity and self-respect is to hide ourselves beneath a cloak of public approval.

When we do that, when we silence ourselves, narcissists know they can get away with anything.

And so they do.

Hugs,

CZBZ

Unbelieving the Unbelievable

The Lovers by Rene Magritte, 1928

When first learning about narcissism in 2001, many other people were also searching for explanations of the Jeckyl-Hyde person causing pain and relational confusion. At this point in time, there is so much information about personality disorders, Narcissism and Psychopathy, dysfunctional systems, toxic families and abusers that I’m more confused that I was prior to reading my first book about narcissism: Denial of the True Self by Alexander Lowen.

I’m j’est kiddin’ with ya a little, but the increase in websites, books, blogs and research articles has been phenomenal. At first, any book mentioning ‘narcissism’ was piled on my nightstand. Now books are lining my office walls. I’ve resorted to scheduling a read-list that should be completed by 2050, if my self-discipline improves from what it has been. Hopefully by then, psychologists will have a better handle on what narcissism is, who’s got it, who doesn’t and what kinds of people stay in narcissistic relationships.

In review of all the books I’ve read so far: Dr. So-and-So defined NPD as 'this' while Dr. Such-and-Such disagreed and insisted it was 'that'. Then Dr. What’s-his-Name questioned existing criteria while Dr. I-have-the-Truth, didn’t. To add to the confusion, some doctors said narcissism could not only be treated, it could be cured; while others insisted there was a biological component, precluding cure. While the good doctors define and redefine the NPD diagnosis (is malignant narcissism the same as psychopathy and can it be inherited?), the rest of us are making as much sense of existing information as we can. We are the ones who live/d with these folks, after all. We have valuable information about how the narcissistic pathology manifests and how other people are affected by the narcissist’s pathological self-interest.

If accumulated studies have relied on narcissists’ self-report, well, there’s one answer as to why specificity has been complicated. Narcissists are not inclined to admit failures, divulge bad behavior, confess to using people like stepping stones, nor offer an unbiased report of their public and private relationships. They are equally unlikely to admit they’re manipulating their psychological profile---and the psychologist, too.

If narcissists willingly admitted to their misdeeds, they’d not be defined as narcissists.

This is why listening to the narcissists’ victims merits inclusion in professional studies. But that would require offering us the same credibility extended to narcissistic clients; in other words: assuming we’re normal until proved otherwise. Extending an unbiased perspective means questioning assumptions about who those N-partners and children of Ns might be. It’s as if narcissists are finally diagnosed and we, by default, are assumed to be mirror reflections of their mental disorder. "Water Seeks its Own Level", don’t ya know.

So here’s what's worrisome after seven years of daily communication about narcissism:

There is an erroneous assumption amongst lay-people (and some professionals, too), that anyone related to, partnered with, caring for, or working with a narcissist has serious defects of character. A belief that victimized folks have psychological deficits, immature narcissism, character flaws, co-dependent behaviors if not a Dependent or Borderline Personality Disorder. Besides, as common knowledge goes, children of narcissists will likely become abusers and former partners are masochists-in-waiting.

Now, I’m not sure where people are collecting their pseudoscientific data, but to everyone out there writing about your private experience with narcissists, bon courage. Don’t be swayed by people’s attempts to deny the truth, which is: anyone can meet and love a narcissist. That anyone, no matter how ‘authentic’ they believe themselves to be, can still become involved with a narcissist. That even with a Red flag checklist tattooed on the palm of their hands, people can be misled, tricked, conned and fooled into believing someone is the person they claim to be.

I can’t fault people for their self-protective assumptions, though. Most of us read a news story about a sociopath or narcissist and tell ourselves we’re too smart to fall for such trickery and deceit. But con games would never work if people realized that being normal rendered them susceptible to manipulation and belief.

"The default is trust until there's a reason not to," says Robyn Dawes, a psychologist at Carnegie Mellon University. ~Article Link

Most people go through life without questioning their extension of trust, until it’s misplaced that is. In fact, I don't think most of us consider how much trust we extend every day of our lives. Because we don’t question our assumption that we're relatively safe in a not-so-safe world, each time a victim speaks about his or her experience, they threaten everyone’s self-protective defenses. Perhaps this is why 'threatened' people are quick to reify their Just World Assumptions by blaming the victim---making us feel worse than we already do. Suggesting there's something wrong with us and oh-so-right with them:

“Why’d you trust that person so much? Are ya gullible? I’d never do that!”

It’s easier to be a critic than it is to empathize and identify with the victim.

“We size up someone's trustworthiness within milliseconds of meeting them, and while we can revise our first impression, there are powerful psychological tendencies that often prevent us from doing so - tendencies that apply even more strongly if we've grown close.” ~Article Link

TRUST is a normal behavior. Imagine what our world would be like if we could not trust drivers to stop at stop signs. Imagine the chaos if we had to see proof of their safe driving records before we agreed to get on the road with them. We basically trust people to be conscientious, honest and responsible. It’s very hard to disbelieve our assumptions about life, especially since most of us don’t even know we have them.

It’s the same way with choosing a partner. We trust them to be committed to the relationship in the same way as ourselves. Once incongruent behavior causes us to question our perceptions, we’ll wrestle with Unbelieving the Unbelievable (Gilbert, 1990) by rationalizing our partner’s behavior.

Our society is on a steep learning curve about personality disorders (cluster B specifically) now that people are breaking the silence about psychopathy and narcissism. We are discovering that not everyone is trustworthy, nor of mutual good will. There are people in our world for which self-interest will always trump altruism. But rather than accusing victims of gullibility in a false sense of protection against a similar fate, we can learn about human behaviors in which trust is preliminary to a healthy society.

"Trust is the baseline," says Susan Fiske, a social psychologist at Princeton University. "Trustworthiness is the very first thing that we decide about a person, and once we've decided, we do all kinds of elaborate gymnastics to believe in people." ~Article Link

It’s important to give victims the benefit of the doubt and listen to their experience. They are doing everyone a service in their courage to face public criticism, speak of things most people prefer we silence, confront personal insults and the discrediting of their credibility. It takes a powerful confidence in one’s self-worth to insist on being heard, to admit to making mistakes, to being nothing less or more, than human.

Hugs,

CZBZ

Resources

Daniel Gilbert. Unbelieving the Unbelievable: Some Problems in the Rejection of False Information. 1990. "...This method of initially representing ideas as true may be economical and it may be adaptive, but any system that uses it will err on the side of belief more often than doubt. That human beings are, in fact, more gullible than they are suspicious should probably "be counted among the first and most common notions that are innate in us.""

Drake Bennett. The Confidence Game. 2008. "...The art of the con is based on a variation of this idea: that trust is more reflexive than skepticism. And research has suggested that, once people form an initial impression of someone or something, they seem to have a hard time convincing themselves that what they once believed is actually untrue..."

Ego-dystonic and Ego-syntonic

Breakfast in Bed by Mary Cassatt

Ego-dystonic: "is a sign, symptom or experience which the patient finds uncomfortable or doesn't want."

Ego-syntonic: "is a sign, symptom, or experience which the patient finds acceptable and consistent with his personality." ~Nicholas G. Ward

Mothering is a life-altering experience. We're challenged to face our emotional immaturity, consider the long-term impact of our behavior, to become as reliable as reliant children need us to be. I hadn't given much thought to the power a mother has over powerless children, until watching my impatient self react to their demands. It occurred to me in a flash of self-observation: I was acting out of character and didn't like myself very much.

If Mary Cassatt were commissioning portraits today, she'd never ask me to pose for a painting. Who'd buy an all-too-real portrait of an exhausted mother murmuring complaints when her child woke up early in the morning?

Mothering cuts through youthful narcissism if we accept responsibility for our impact on children. If that means going to bed early ourselves so we don't mind snuggling next to a stinky child at 6:00 a.m., so be it. Children can't be expected to accommodate their mother's...ahem...lack of self-discipline. Rather than blaming my kids for being kids, I knew impatience was my problem to fix.

The first step towards eliminating guilt for behaving in a very un-Cassat-like manner, was talking with other mothers like myself. Did they get frustrated? Did they yell? And if so, what did they do to change?

Now this was back in the 1970's when running to a therapist was NOT the typical and norm. We didn't even like therapists back then. The only people who needed therapy were people who were so messed up, they couldn't help themselves. Most likely, we didn't even have a counselor in our local community though I never checked the yellow pages to find out. My friends and I relied on self-help books, tapes and group discussions. One of my friends suggested listening to a ten-tape program on self-defeating behaviors which of course, I was eager to do.

This was the beginning of a long process uncovering the root of my frustrations which had nothing to do with my children---but everything to do with myself.

It's fair to say that for me, yelling at toddlers was ego-dystonic. I knew it was nutz to blame my kids for being----kids. Yelling made me feel guilty and fortunately for me, this guilt motivated changed behavior rather than defining myself as a Bad Mommy. At the time of course, I had no idea how mentally healthy it was to question my sanity, rather than rationalizing or projecting the guilt that was mine to bear and mine alone.

A ten-tape session with Dr. Sterling Sills (I think that was the psychotherapist's name...this was a long time ago!), offered insight into why we act the way we do if underlying issues remain hidden from our conscious awareness. I did the grown-up thing and took healthy steps towards positive change by changing 'me'; thus becoming more congruent with myself. I believe I was 26 at the time and yes, that was a long, long time ago. ha!

If I had been comfortable with my behavior (or unwilling to question my sanity), then yelling would be ego-syntonic. There would be no need to ask for help, listen to tapes, talk openly with mothers like myself. I'd view my temper tantrums as perfectly sane considering the annoying toddlers I had to live with! In other words, the problem was them, not me.

I'm guessing most therapists are loath to deal with people who see no fault in themselves, nor question the validity of their perceptions. "Of course I scream at my children!" they might say. "That's how kids are supposed to be treated, so don't try and lay a guilt trip on me!" That would be an example of ego-syntonic behavior. There is no problem with her, you see; the problem is her selfish children.

Thanks to anonymous eyes for encouraging me to examine the meaning of dsystonic verus syntonic behavior. Unfortunately, we're prone to psychoanalyzing ourselves to pieces in an effort to understand our relationship with a narcissistic partner. When we scrutinize ourselves through biased lenses however, we overlook courageous steps we took to confront ourselves: to overcome our past; to take responsibility for the future; to stop the inter-generational transmission of unhealthy parenting.

Though my life did not turn out as expected, my relationship with my children is deeply interconnected and loving. That was no accident. I earned their respect and love because I was willing to face myself.

Hugs,

CZBZ

Resources

Nicholas G. Ward. Essential Psychopathology and Its Treatment, page 485

The DSM, Axis II & Cluster B

La Primavera by Sandro Botticelli 

“15% of Americans have one or more personality disorders.” ~Mayo Clinic 

“Up to 30 percent of people who require mental health services have at least one personality disorder (PD)--characterized by abnormal and maladaptive inner experience and behavior.”~Sadie Dingfelder

“PDs are present in 10 to 15 percent of the adult population, with Cluster B accounting for approximately 9 percent based on research…a failure to identify them may create significant risk.” ~Joe Carver

The DSM, Axis II and Cluster B

The Diagnostic and Statistical Manual of Mental Disorders (DSM) categorizes psychological disorders on a multiaxial system comprised of five levels: Axis I, Axis II, Axis III, IV & V.

If you've been learning about Narcissistic Personality Disorder, it's highly likely you've heard NPD referred to as an Axis II disorder.

Now most likely, you're wondering why personality disorders are not grouped in with Axis I disorders like depression, schizophrenia, and substance dependence. Well, that’s because a personality disorder is a long-standing condition preceding a psychological crisis. A crisis big enough to force someone with a personality disorder into a psychologist's office. As most of us know however, it's usually the narcissist's family and friends who insist he or she get help.

It's important to know that insurance covers treatment for Axis I disorders since intervening treatments are considered to be cost-effective. Axis I disorders can be ameliorated with medical & psychological intervention, unlike personality disorders requiring intensive, long-term treatment.

Because of a poor prognosis for curing personality disorders, insurance companies have refused to pay for long-term treatment. Curing Narcissistic Personality Disorder is still uncertain which is why insurance companies are reluctant to throw money at treatment if treatment is not cost-effective.

The perception that personality disorders are untreatable is changing as results from intervening treatments like DBT, are proving to be successful. Particularly for people with Borderline Personality Disorder.

The following list will hopefully help you understand how personality disorders are categorized in the DSM-IV, sometimes called a psychologist's bible.

Axis I: Clinical disorders and conditions requiring clinical attention

Axis I mental disorders of significant impairment include: Depression, schizophrenia, social phobia, learning disorders, anxiety disorders, bipolar, ADHD, eating disorders, cognitive disorders, substance-related disorders, dissociative disorders, autism, etc. Just about everything someone sees a psychologist for goes on Axis I---with the exception of personality disorders and mental retardation.

People with Axis I disorders are most generally ego-dystonic; in other words, they see their mental problem as being separate from themselves. Their condition is not consistent with self-perceptions. This short list illustrates how disorders are categorized in the DSM:

296.80 Bipolar disorder

303.90 Alcohol Dependence

309.81 Posttraumatic stress disorder

Axis II: Personality disorders and mental retardation

Axis II refers to Personality Disorders for the most part, manifesting significant impairment in how someone relates to the world. Only those with long-term rigid, inflexible, pervasive and exaggerated traits can be diagnosed with a personality disorder.

Another important distinction is that people with personality disorders do not perceive their problems to be related to themselves. In other words, they are ego-syntonic: They say, “There’s nothing wrong with me. Everyone else is the problem!”

People with Personality Disorders frequently present with Axis I disorders. Axis I disorders are more likely to cause a crisis requiring psychological intervention. Depression and substance abuse, for example, might be the only reason a narcissist would seek psychological help. So the psychologist treats the Axis I disorder(s) but generally does not treat the underlying personality disorder.

Also, people can be diagnosed with more than one personality disorder, sometimes crossing over into another ‘cluster’. These are the three groups, or ‘clusters’ of Axis II personality disorders: Cluster A, Cluster B, and Cluster C.

Cluster A: ‘Suspicious’. Odd, eccentric behavior.

301.00 Paranoid personality disorder

301.20 Schizoid personality disorder

301.22 Schizotypal personality disorder

Cluster B: “Emotional/Impulsive". Dramatic behavior.

301.50 Histrionic personality disorder

301.81 Narcissistic personality disorder

301.70 Antisocial personality disorder

301.83 Borderline personality disorder

Cluster C: ‘Anxious’. Fearful behavior.

301.40 Obsessive-Compulsive personality disorder

301.82 Avoidant personality disorder

301.6 Dependent personality disorder

Note: Dissociative Identity Disorder, DID, (formerly called 'multiple personality disorder') is not an Axis II disorder. DID is an Axis I diagnosis.

Note: Clinicians may refer to Mental retardation and Developmental Disabilities as MR/DD. 

Axis III: General Medical Conditions

Medical conditions may influence management of Axis I and II disorders, such as: acute medical conditions, physical disorders, brain injuries aggravating disease or symptoms, and HIV/Aids, for example.

Axis IV: psychosocial and environmental problems contributing to the disorder

Axis IV problems also impact Axis I and II disorders, such as: unemployment, divorce, relocation, death, retirement, illiteracy, economic problems, lack of health care/insurance, victim of crime, births, academic problems, job dissatisfaction, homelessness, poverty, unsafe neighborhood, etc.

Axis V: Global Assessment of Functioning Scale (GAF)

The GAF is used by mental health clinicians and doctors to rate an individual’s overall social, occupational and psychological functioning.

The GAF is factored on a scale of 1-100 based on the psychologist’s judgment as to how well a client is managing his or her life. This scale ranges from harming the self or others (1-10) to no symptoms at all (91-100).

Low functioning range, 1-10: Persistent danger of severely hurting self or others OR persistent inability to maintain minimum personal hygiene OR serious suicidal act with clear expectation of death.

High-functioning range, 91-100: Superior functioning in a wide range of activities, life's problems never seem to get out of hand, is sought out by others because of his or her many qualities. No symptoms.

The following is an example of a typical diagnostic assessment :

Axis I:

296.21 Major Depressive Disorder , Single Episode

303.90 Alcohol Dependence

Axis II:

301.6 Dependent Personality Disorder

Axis III:

None

Axis IV:

Recent Divorce, unemployment

Axis V:

58

 I hope this helps explain what psychologists mean by Axis II disorders and Cluster B personality disorders. Because it's difficult for the layperson to distinguish between NPD and BPD, for example, it's useful to look at all the personality disorders grouped in the Cluster B category.

I'd also like to recommend reading Joe Carver's article linked below. He writes, "...individuals who create the most damage to social and personal relationships, the abusers, manipulators, “players”, controllers, and losers are found in Cluster B."

 Hugs all,
CZBZ

P.S. I've also written about: Ego-dystonic versus Ego-syntonic behavior

Resources

DSM-IV Codes. 
Joseph M. Carver, PhD. Personality disorders: The Controllers, Abusers, Manipulators, and Users in Relationships 

Sadie Dingfelder. Treatment for the 'Untreatable' 

One of These Folks is Not Like the Others

The Bus by Frida Kahlo, 1929

This past week, I've been talking with a friend who has a friend who has been talking to a friend that no one can hear but herself. My friend hadn't noticed the decline in Tammy’s mental health until finding her on her bed---unconscious from a drug overdose. Did Tammy take a bottle of pills to end her back pain…or herself?

Over the past decade, Tammy managed to alienate nearly everyone in her community while increasing her dependence on a select few who could handle her occasional whacky-doo. Ordinary people with extraordinary compassion became tangled in a web of obligation and guilt over their inability to save a friend from self-destructing. As some of us learned after reaching the end of our proverbial ropes: empathy & compassion cannot cure mental illness, even if we'd like to believe love is all-powerful.

NOTE: Befriending troubled people is not a task for the faint of heart, nor is it advisable for those who might be tripping the light fantastic themselves.

At the hospital, the psyche nurse said Tammy had a personality disorder along with her mood disorder. When she heard that, my friend’s jaw nearly hit the floor. How she could have known Tammy for years and never have seen a personality disorder? I asked her, "How could you see a personality disorder if you didn’t know what to look for?"

“Well, I’ve heard you talk about Narcissistic Personality Disorder,” she said, “but it seemed so complicated to me. Besides, I thought I’d always be able to tell if someone wasn’t, well, you know---normal. Now I don’t know what to think about my ability to define normal from not normal. Tell me, what exactly is a personality disorder?”

I repeated from memory, "A personality disorder is an enduring pattern of inner experience and behavior that differs markedly from the expectations of the individual's culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to distress or impairment. Personality disorders are a long-standing and maladaptive pattern of perceiving and responding…”

She interrrupted, “Ya lost me. How about talking in English?”

Is it any wonder people are overwhelmed by psychological definitions? If I hadn’t cared so much, I’d never have devoted myself to learning about mental illness. My interest in NPD, albeit questionable to some, has been a labor of love. Not only for the narcissistic, but also for people wondering-and-wandering in the dark, blaming them selves for not being able to ‘create’ a healthy relationship---or not being able to spot unhealthy friendships.

She said, “I felt terrible about what happened in your life but people with personality disorders didn’t impact my life. It wasn't as if I was living with someone who had a mental illness, so it wasn’t any of my business. Like, who are we to judge? That’s how I thought---before now. Now I’m not so sure it’s none of my business.”

I replied, “Did you know that personality disorders may also be the root cause of addictions and depression? Medical doctors treat a patient’s immediate problems but they generally don’t treat the underlying personality disorder. That means tender-hearted people like yourself will suffer, if you’re ignorant about a disorder that is not being treated! Let me ask you a few questions just to see if we can make sense of psychological parameters defining a personality disorder, not a personality trait.”

Question One: emotions

“Did your friend rage? Maybe she wasn’t angry all the time, but when she was, her reactions were out of proportion to the situation?”

She answered, "You know that poem we learned as kids? When she was good, she was very, very good, but when she was bad she was horrid? That’s how people described her. She took a couple of days to cool off and then she acted as if nothing had happened. Some people refused to reconcile with her. I was cautious after the first rage attack but as long as I didn’t say anything to set her off, we got along pretty well. It did mean I was a little nervous around her though. I couldn't predict what I might say that she would interpret as being wrong.”

Question Two: impulses

“Did she rage again? I mean, after you had made up? Maybe you could call it a cycle because she couldn’t stop herself from acting out?”

She replied, “Well, she never could stop herself! That really confused me and it made me angry, too! Why couldn’t she stop herself when the last time she got mad at people, she said she was going to kill herself because she felt so bad about it. And then of course, there’s her prescription drug addiction. No matter how many times she promised to control herself, she couldn’t! I felt miserable about that too, but what could I do? Live with her? I even thought about turning my home into a pharmacy and handing out her pills once a day. Then I realized she’d just get her pills somewhere else. She’s done that before, too. ”

Question Three: relationships

“How about her family? Does anyone stay in contact with her?”

“No. No one. Her son shows up once in a blue moon. He’s also an addict so all he wants from her is money. Come to think of it, she doesn’t have a close relationship with anyone, so I see what you’re getting at. The least little thing someone might say would send her skyrocketing to the moon and she’d dump a friend overnight. Absolutely throw her friend away on a whim. I felt sorry for her, so very sorry that she was alienating people because they couldn’t trust her anymore!”

I interjected, “Did she idealize people after deciding her former friends were worthless rubbish? Like yourself, maybe. Did she see you as an angel of mercy because YOU understood and no one else did?”

She thought about my comment without saying anything.

Question Four: empathy

“Is she oblivious to other people’s feelings? In other words, does she connect her relationship problems with her behavior, or is it always their fault?”

She said, “It was always about her, what she felt, wanted, needed and never about the other person’s feelings. I guess my answer is that she couldn't understand people’s reactions to her at all. That’s really weird now that you bring it up. I never could figure that out. She seemed to be a sympathetic person but if she were able to put herself in other people’s shoes, she’d never treat them the way she did!”

Question Five: thoughts

“Would you say her thinking was ‘off’, maybe even disordered, especially when she was stressed?”

“I remember when she got all into this book called The Secret," she said. "Tammy believed she could move mountains with her thoughts and when I’d reason with her, she’d get mad at me for having negative energy. She said everything in her life was under her control, even stuff she could never have caused or prevented, like her mood disorder. She decided she could control her depression by changing her thinking, so she quit taking her meds. That’s when things got really bad. I almost swore off our friendship at that point. But instead, I called her doctor who made her get back on her medication.”

I said, “So we can say there are four areas in which your friend had exaggerated behaviors, beyond what most of us recognize as personality traits everyone shares. In other words: her thoughts were noticeably distorted; her emotions were erratic and unpredictable; her relationships basically sucked eggs; and she had zero control over her impulses. If she had a thought, she acted on it regardless of the consequences, including the pain she inflicted on her friends. Would you say that’s a fair way to describe Tammy?”

“Yes. The basic things people didn’t like about her, never changed no matter how much we talked. She wanted me to do everything for her, she couldn’t stand being alone, she expected me to put her life in the center of mine and it was hard sometimes. Like when I drove her to work twice a day for weeks because she wouldn’t drive her car. Even after the doctor had given his permission after her back surgery. I scheduled my whole day around taking care of her and she never thought about the impact she had on my family.”

I told her, “Well, you’re a lot like myself. You’re a good-hearted person who wants to help people if you can. Have you heard of a group called Al-anon? That’s where I started learning how to be responsible to myself and how to grant someone the freedom to be responsible for their life, too.”

I ended our conversation by reminding her she owed it to herself to learn about mental illness, i.e.: mental and personality disorders. “You can’t change your friend,” I told her, “but you can change yourself by getting smart about who you need to be compassionate to first: YOU. How about we meet for lunch and talk about prioritizing healthy self-care when someone we care for has a personality disorder?”

Hugs,
CZ


Resources

Personality Disorders. AllPsyche Online: the Virtual Psychology Classroom 

Al-anon Organization.