Sunday, October 31, 2010

Living with a personality disorder diagnosis

One of the hardest parts of living with my mental health problems is accepting the personality disorder diagnoses that I have been given.  When asked what these diagnoses are, I generally respond somewhat cynically "depends oon the psychiatrist."  This is true.  However, the two most popular diagnoses are Narcissistic Personality Disorder and Histrionic Personality Disorder.  In layman's terms this means that I am a self-centred drama queen.  Not exactly the most popular person at the party...

I've done enough group work to begin to recognize the traits within me that prompted these diagnoses and to begin to get a handle on muting them (at least a bit.)  While not all of the descriptors in either profile fit me, enough do.

The trouble is trying to live with this while not hating myself.  Often enough, I can manage it, but some days are worse than others.   A therapist once asked me why I hated myself so much.  I asked her if she had ever tried reading about narcissistic mothers and taking it personally.  She asked what I had been reading and I admitted that some of it was a couple of decades old and perhaps out of date.  She confidently promised to find me a more supportive description of personality disorders.  When she returned, she had a wonderful book : "I hate you, Don't Leave Me" by Kreisman and Strauss.  The only problem is that it discusses primarily borderline personality disorder...which I don't have.  It turns out that she couldn't find anyone with anything positive to say about narcissists either.

When I talk to mental health professionals myself about myself, they waver and discuss difficulties with diagnoses in the personality areas; they emphasize how these are just traits on the extreme end of a spectrum that everyone is on; they point out that I learned these behaviours trying to live with a chaotic disfunctional family and that it's not my fault.

But when mental health professionals discuss narcissists in general, a different picture comes out.  Narcissistic mothers are blamed for troubles in their childrens' lives (I am terrified to think about what I am doing to my children simply by existing).  Many psychiatrists refuse outright to treat people with personality disorders.  It seems that we are too difficult to deal with.  Now, therapist burn-out is a very real problem and anyone willing to put themselves on the frontlines in mental health is a person too valuable to be allowed to burn-out, but it leaves me in a bit of a position.  Those therapists who do take on people with personality disorders either do so only to monitor meds or in very limited numbers (wisely).

For me, the end result is that I have literally lost count of the number of therapists who have refused to treat me.  I'm not sure which is worse: the ones who do so without even meeting me, or the ones who do so knowing full well who I am.  Either way, the rejection is excrutiating.  I was advised at one point that I should stick to group therapy specifically to avoid burning out anyone who took me one-on-one.  I did for several years.  The problem with group therapy is that groups are encouraged to point out to one another the behavioural traits that grate.  This is essential since it is the only way that someone can know what to change.  But in the long-term when it is the only feed-back that I get, it gets very hard for me not to conclude that everyone would be better off if I weren't around.  It's not as if I'm not trying to change.

A few years ago, I took part in a day-treatment program.  This is a very intensive program in which you get group therapy all day long most days of the week for a period of months.  Throughout the program, I repeatedly got told that the "melodramatic pauses" that I put in my sentences were very annoying.  I had heard this before and wasn't surprised.  The problem that I had was that I couldn't understand what they were referring to.  Close to the end of the program, I finally got it.  The times in which I paused to gather the courage to say something intensely personal (where I was terrified of rejection and literally had to force myself to speak) were being interpreted as simple melodrama.  And this was by a group of people who, at the end of four months on intense group therapy, ought to know me as well as any person can know any other.  Well, I'm sorry, those pauses are here to stay.  Getting past terror is hard and sometimes takes a bit of time.  How to make them look less like melodrama, I have no idea.

So how do you live with these diagnoses without hating yourself?  Frankly, I sometimes have no idea.  Other days, I am able to remind myself that a diagnosis is not the whole of who I am.  Yes, I do automatically act to try to be the centre of attention.  Yes, I overdramatize myself at times.  But I am also a kind, empathic, honourable person (I'm not supposed to be empathic while being narcissistic but that's one of those traits that don't fit).  Some of what I do in the world has helped the people around me.  And I believe (or at least desperately hope) that my children are better off given that I have managed to choose not to suicide any time within the last eight years.  Anybody have any ideas to add to mine?

1 comment:

  1. Dear Jinxed,
    I just caught your comment on the Emotional Vampires article. Your pain came through like a punch in the solar plexus, so I wanted to reach out to you. Frankly though, I am not a public person and avoid public exchanges. If you would like to email me, you can reach me at I am a 47 year old married female.