In recent years, the concept of personality disorders is increasingly contested in the media and no longer just within the psychiatry, psychology and psychotherapy communities. This post picks up a few of the milestones from a United Kingdom perspective.
For clients reading this: as a counsellor, my approach to ‘personality disorders’ is to not be too concerned with the label itself. My interest is in what meaning that label has for you, whether or not you have been diagnosed. For me, it is more important to understand what is driving the feelings or behaviours that are of concern to you, which get called a “personality disorder”.
Personality disorders – a new media campaign in 2018
January 2018 saw the publication of – take a deep breath! – The Consensus Statement for People with Complex Mental Health Difficulties who are diagnosed with a Personality Disorder.
This document is a joint statement by agreed upon by Mind (a leading UK mental health charity), The British Psychological Society, the British Association of Social Workers, the Royal College of General Practitioners, the Royal College of Nursing and several other relevant bodies. And it has many more contributors. It is based on the premise that the label of ‘Personality Disorder’ is flawed and needs to change. It also notes that people given that label are likely to have experienced past trauma.
The significance of this is not only its collective voice. It is that it also goes beyond policy papers or reports circulated within government and the charity sector. It is a campaign document with a news launch.
In the same vein, Mind’s explanation of personality disorders (2020) makes a clear effort to de-stigmatise this diagnosis. It notes that “if you experience significant difficulties in how you relate to yourself and others and have problems coping day to day, you may receive a diagnosis of personality disorder”. It goes on to highlight the question of whether that diagnosis means there is something wrong with who I am. Their answer is: “No. We all have parts of our personality that can cause us or others difficulties.”
Personality disorders: from media to mainstream books
Also In 2018, we had the publication of Professor Peter Tyrer’s book, Taming the Beast Within. This describes a shake-up in psychiatry’s thinking on personality disorders. And it explained in broad terms the upcoming changes as to how personality disorders would be formulated in version 11 of the the World Health Organization’s International Classification of Diseases. It is an authoritative account as Professor Tyrer chaired the working group on personality disorders. At the time, I questioned whether we could wait a whole generation for change, as he suspected we might.
Only a year later came a comprehensive account of how we could rethink personality disorders entirely. In 2019, we had the publication of Drop The Disorder! Challenging The Culture Of Psychiatric Diagnosis. Its stance is clear from its title. This is probably the most prominent book challenging the establishment stance on personality disorders, in the UK at least.
The hostile treatment of people diagnosed with a personality disorder
Media visibility is not limited to attempts to re-think personality disorders as a concept. Another aspect of personality disorders in the media is highlighting a tendency among medical staff towards hostile treatment of patients with that diagnosis.
In my own experience, listening to clients accounts of their time in the health system, this seems to extend to actual exclusion of patients from services. This takes the form of say, ever extending the waiting time when other patients are being seen. And on one occasion a patient just being told they could not have any more services even though they were “mentally ill”.
A good illustration of this is one of the earliest articles to come to my attention. This was a 2016/17 Huffington Post UK article: “Borderline Personality Disorder – A Diagnosis Of Invalidation” by Dr Jay Watts, a London-based, consultant clinical psychologist and psychotherapist. I wrote a few notes on her article at the time here in my blog.
Of course, this is attitude is far from universal across the UK’s mental health system where you can find some very caring and effective practice. But it just keeps on recurring. Unfortunately, it can be seen as part of a wider picture of abuse that keeps raising its ugly head. You only have to look at the investigation into abuse at a mental hospital near Manchester by the BBC’s Panorama Team. It is all over the media as I write (30/09/2022).
Your insights please!
This post was first published on 6 March 2018 with the latest update being 30 September 2022. Please let me know what you see as the recent milestones in this debate in the media about personality disorders. It would be also interesting to get feedback on how this debate is – or isn’t – happening in other countries. Please, do let me know!
Sources : [1] Copyright Mind. The full version of this information is at mind.org.uk