Emotional Revolt of the Soul, Personality Disorders

(March 2011 – URD John 16:6)

 

1. These disorders are a warning sign to believers that they are about to become psychotic and need to rebound and get back under the inculcation of Bible doctrine.

2. Whatever habits you have developed from personality disorders, these become intensified and become characteristics of your psychotic or neurotic problem.

3. E.R.S. Personality Disorders include: Antisocial personality disorder, Histrionic personality disorder, Narcissistic personality disorder, Passive-aggressive personality disorder. Personality Disorders, formerly referred to as “character disorders”, are a class of personality types and behaviors that the American Psychiatric Association (APA) defines as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it”.

Additionally, personality disorders are inflexible and pervasive across many situations, due in large part to the fact that such behavior is ego-syntonic (i.e. the patterns are consistent with the ego integrity of the individual) and are, therefore, perceived to be appropriate by that individual. This behavior can result in the believer adopting maladaptive coping skills, which may lead to personal problems that induce extreme anxiety, distress and depression. In Personality Disorders inflexible and pervasive behavioral patterns often cause serious personal and social difficulties, as well as a general functional impairment. Rigid and ongoing patterns of feeling, thinking and behavior are said to be caused by underlying belief systems and these systems are referred to as fixed fantasies or, “dysfunctional schemata”, (cognitive modules).

Personality Disorders are classified into various clusters in the “Diagnostic and Statistical Manual of Mental Disorders”, fourth edition, used by the American Psychiatric Association, (APA), the World Health Organization (WHO), and others:

Cluster A, (odd or eccentric disorders):

  • Paranoid Personality Disorder (DSM-IV code 301.0): characterized by irrational suspicions and mistrust of others.
  • Schizoid Personality Disorder (DSM-IV code 301.20): lack of interest in social relationships, seeing no point in sharing time with others, anhedonia, introspection.
  • Schizotypal Personality Disorder (DSM-IV code 301.22): characterized by odd behavior or thinking.

Cluster B, (dramatic, emotional or erratic disorders):

  • Antisocial Personality Disorder (DSM-IV code 301.7): a pervasive disregard for the law and the rights of others.
  • Borderline Personality Disorder (DSM-IV code 301.83): extreme “black and white” thinking, instability in relationships, self-image, identity and behavior often leading to self-harm and impulsivity. Borderline personality disorder occurs in 3 times as many females as males.[5]
  • Histrionic Personality Disorder (DSM-IV code 301.50): pervasive attention-seeking behavior including inappropriate sexual seductiveness and shallow or exaggerated emotions.
  • Narcissistic Personality Disorder (DSM-IV code 301.81): a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.

Cluster C, (anxious or fearful disorders):

  • Avoidant Personality Disorder (DSM-IV code 301.82): social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction.
  • Dependent Personality Disorder (DSM-IV code 301.6): pervasive psychological dependence on other people.
  • Obsessive-compulsive Personality Disorder (not the same as obsessive-compulsive disorder) (DSM-IV code 301.4): characterized by rigid conformity to rules, moral codes and excessive orderliness.

There several other disorders that are not specified including Depressive, Passive–aggressive, Sadistic and Self-defeating. In this study we will define several of these disorders including Cluster B and C, (excluding Obsessive-Compulsive Disorder) and the unclassified disorder of Passive Aggressive Personality Disorder.

a. Antisocial Personality Disorder (APD), is defined by the American Psychiatric Association’s Diagnostic and Statistical Manual as “…a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.” It is a mental health condition in which a person has a long-term pattern of manipulating, exploiting, or violating the rights of others. This behavior is often criminal. A person with antisocial personality disorder may: be able to act witty and charming, be good at flattery and manipulating other people’s emotions, break the law repeatedly, disregard the safety of self and others, have problems with substance abuse, lie, steal, and fight often, not show guilt or remorse, and often be angry or arrogant.

It includes:

1) Irresponsible and antisocial behavior, including: lying, stealing, vandalism, cruelty to animals, and cruelty to people.

2) Criminal activity.

3) Inability to be consistent academically or consistently hold a job.

4) Irritable and aggressive activity in which one feels justified in having hurt, maltreated, or stolen from others.

b. Borderline Personality Disorder, (BPD), or “emotionally unstable personality disorder” is characterized by extreme “black and white” thinking, or splitting, chaos and instability in relationships, self-image, identity and behavior often leading to self-harm and impulsivity. Borderline personality disorder occurs in 3 times as many females as males. BPD is prolonged disturbance of personality function in a person (generally over the age of eighteen years, although it is also found in adolescents), characterized by depth and variability of moods. The disorder often manifests itself in idealization and devaluation episodes, as well as a disturbance in the individual’s sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation. BPD is closely related to traumatic events during childhood and to Post-Traumatic Stress Disorder (PTSD). Individuals with BPD tend to experience frequent, strong and long-lasting states of aversive tension, often triggered by perceived rejection, being alone or perceived failure. Individuals with BPD may show lability (changeability) between anger and anxiety or between depression and anxiety and temperamental sensitivity to emotive stimuli. Individuals with BPD can be very sensitive to the way others treat them, reacting strongly to perceived criticism or hurtfulness. Their feelings about others often shift from positive to negative, generally after a disappointment or perceived threat of losing someone. Self-image can also change rapidly from extremely positive to extremely negative. Impulsive behaviors are common, including alcohol or drug abuse, unsafe sex, gambling and recklessness in general. They can be hyper-alert to signs of rejection or not being valued and tend toward insecure, avoidant or ambivalent, or fearfully preoccupied patterns in relationships. They tend to view the world generally as dangerous and malevolent, and tend to view themselves as powerless, vulnerable, unacceptable and unsure in self-identity. These behaviors are traced to inner pain and turmoil, powerlessness and defensive reactions, or limited coping and communication skills. BPD is identified as a pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts.

It is characterized by five (or more) of the following:

1) Frantic efforts to avoid real or imagined abandonment.

2) Identity disturbance: markedly and persistently unstable self-image or sense of self.

3) A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.

4) Impulsivity in at least two areas that are potentially self-damaging (e.g., promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving).

5) Recurrent suicidal behavior, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself.

6) Affective instability due to a marked reactivity of mood, (e.g., intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days).

7) Chronic feelings of emptiness.

8) Inappropriate anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).

9) Transient, stress-related paranoid ideation, delusions or severe dissociative symptoms.

c. Histrionic Personality Disorder (HPD), is a condition in which people act in a very emotional and dramatic way that draws attention to themselves. It is defined by the American Psychiatric Association as a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood. These individuals are lively, dramatic, enthusiastic, and flirtatious. They may be inappropriately sexually provocative, express strong emotions with an impressionistic style, and be easily influenced by others. Associated features may include egocentrism, self-indulgence, continuous longing for appreciation, and persistent manipulative behavior to achieve their own needs. This is also classified as hysterical personality disorder. People with this disorder constantly seek or demand reassurance, approval, or praise from others and are uncomfortable in situations where they are not the center of attention. Histrionic personality disorder is characterized by rapidly shifting and shallow expressions of emotions.

These believers crave novelty, stimulation, excitement, and quickly become bored with normal routine. Such believers are quick to form friendships, but once the relationship is established, they become egocentric and inconsiderate. These believers show little interest in intellectual achievement and are indifferent to analytical thinking.

Believers in this status are impressionable and easily influenced by other people and suckers for the latest fad. Such believers show an initial positive response to any strong authority figure who they think can provide a magical solution to their problems. Such believers are easily disillusioned. Their behavior is overly reactive and intensively expressed. Minor stimuli give rise to emotional excitement. They are very self-centered with very little or no tolerance for frustration or delayed gratification; they want immediate gratification.

There are seven general characteristics of HPD:

1) Constantly seeking or demanding reassurance, approval, or praise.

2) Inappropriately sexually seductive in appearance and behavior.

3) Overly concerned with physical attractiveness.

4) Displaying rapidly shifting and shallow emotional expression.

5) Expressing emotion with inappropriate exaggeration.

6) Temper tantrums.

7) Frequent flights into romantic fantasy.

d. Narcissistic Personality Disorder (NPD), is described as being excessively preoccupied with issues of personal adequacy, power, prestige and vanity. It is closely linked to self-centeredness. It is a condition in which people have an inflated sense of self-importance and an extreme preoccupation with themselves. This person has an extreme interest in their own life and problems that prevent them from caring about other people. They are hypersensitive about self and insensitive about others. They have an extreme or obsessive interest in their own appearance.

In narcissistic personality disorders, the Christian believes that his or her problems are unique and can only be understood by special persons whom they idolize. They also use “splitting” as a central defense mechanism. They do this to preserve their self-esteem, by seeing the self as purely good and the others as purely bad. The use of splitting also implies the use of other defense mechanisms, namely devaluation, shame, idealization and denial.

The pattern of this disorder includes:

1) They are hypersensitive to evaluation by others.

2) They fall apart and get angry when criticized by others.

3) They lack empathy or inability to recognize how others feel.

4) They react to criticism from others with rage, humiliation, shame, even if it is not expressed.

5) They take advantage of others to achieve their own ends.

6) They have a grandiose sense of self-importance and expect or even demand to be noticed as special or to be treated as special.

7) They Exaggerate achievements and talents.

8)  They are preoccupied with fantasies of success, power, beauty, intelligence, or ideal love.

9) They have a sense of entitlement (they think they are entitled to something) and unrealistic expectation.

10) They require constant attention, live for admiration, and are preoccupied with feelings of bitterness, vindictiveness, implacability, and sometimes jealousy.

e. Avoidant Personality Disorder (AvPD), or “anxious personality disorder” is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation, and avoidance of social interaction. People with AvPD often consider themselves to be socially inept or personally unappealing, and avoid social interaction for fear of being ridiculed, humiliated, rejected, or disliked. Believers with AvPD are preoccupied with their own shortcomings and form relationships with others only if they believe they will not be rejected. Loss and rejection are so painful that these individuals will choose to be lonely rather than risk trying to connect with others. AvPD includes: Hypersensitivity to criticism or rejection, self-imposed social isolation, extreme shyness or anxiety in social situations, though feels a strong desire for close relationships, avoidance of physical contact because it has been associated with an unpleasant or painful stimulus, avoidance of interpersonal relationships, feelings of inadequacy, severe low self-esteem, self-loathing, mistrust of others, emotional distancing related to intimacy, highly self-conscious, self-critical about their problems relating to others, has problems in occupational functioning, lonely self-perception, although others may find the relationship with them meaningful, feeling inferior to others. In some more extreme cases like agoraphobia, they utilize fantasy as a form of escapism and to interrupt painful thoughts.

AvPD is characterized by at least four of the following:

1) Persistent and pervasive feelings of tension and apprehension.

2) Belief that one is socially inept, personally unappealing, or inferior to others.

3) Excessive preoccupation with being criticized or rejected in social situations.

4) Unwillingness to become involved with people unless certain of being liked.

5) Restrictions in lifestyle because of need to have physical security.

6) Avoidance of social or occupational activities that involve significant interpersonal contact because of fear of criticism, disapproval, or rejection.

f. Dependent Personality Disorder (DPD), is a long-term (chronic) condition in which people depend too much on others to meet their emotional and physical needs. People with this disorder do not trust their own ability to make decisions. They may be very upset by separation and loss. They may go to great lengths, even suffering abuse, to stay in a relationship. These individuals are fixated in the past. They maintain youthful impressions; they retain unsophisticated ideas and childlike views of the people toward whom they remain totally submissive. Individuals with DPD see relationships with significant others as necessary for survival. They do not define themselves as able to function independently; they have to be in supportive relationships to be able to manage their lives. In order to establish and maintain these life-sustaining relationships, people with DPD will avoid even covert expressions of anger. They will be more than meek and docile; they will be admiring, loving, and willing to give their all. They will be loyal, unquestioning, and affectionate. They will be tender and considerate toward those upon whom they depend. Individuals with DPD see themselves as inadequate and helpless; they believe they are in a cold and dangerous world and are unable to cope on their own. They define themselves as inept and abdicate self-responsibility; they turn their fate over to others. These individuals will decline to be ambitious and believe that they lack abilities, virtues and attractiveness.

It includes seven characteristics:

1) They are unable to make everyday decisions without an excessive amount of advice.

2) They allow others to make most of his or her important decisions.

3) This believer agrees with people even when he or she believes that they are wrong because they fear rejection.

4) This believer feels uncomfortable or helpless when alone; hence, goes to great lengths to avoid being alone.

5) This believer feels devastated when close relationships end to the point of excessive emotion being out of control. They always blame the   other person and never see their own flaws; projection.

6) Preoccupation with fears of being abandoned or rejected and having to care for themselves.

7) Is devastated by criticism or disapproval.

g. Passive-aggressive Personality Disorder (PAPD), is characterized by covert obstructionism, procrastination, stubbornness, and inefficiency.  Such behavior is a manifestation of passively expressed underlying aggression. It is a pervasive pattern of negative attitudes and passive, sometimes obstructionist, resistance to following through with expectations in interpersonal or occupational situations. It can manifest itself as learned helplessness, procrastination, stubbornness, resentment, sullenness, or deliberate/repeated failure to accomplish requested tasks for which one is, often explicitly, responsible. It is a pervasive pattern of negativistic attitudes and passive resistance to demands for adequate performance, beginning by early adulthood and present in a variety of contexts, as indicted by four, or more, of the following: Passively resists fulfilling routine social and occupational tasks, complains of being misunderstood and unappreciated by others, is sullen and argumentative, unreasonably criticizes and scorns authority, expresses envy and resentment toward those apparently more fortunate, voices exaggerated and persistent complaints of personal misfortune, or alternates between hostile defiance and contrition.

This person often makes a good first impression, yet they:

1) Procrastinate, putting things off that need to be done, so that deadlines are not met.

2) Become sulky, irritable, or argumentative when asked to do something he or she does not want to do.

3) Protest without justification that others are making unreasonable demands on him or her.

4) Avoid obligations by claiming to have forgotten.

5) Believe that they are doing a better job than others think they are doing.

6) Resent useful suggestions from others on how to be more productive.

7) Obstruct the efforts of others by failing to do his or her share of the work.

8) Unreasonably criticize or scorn people in a position of authority.