The line between mental illness and personality

[Blagsta]

Really. I wasn't aware of that to be honest. I thought it was pretty much untreatable, hence psychiatrists being very wary of pressure to lump personality disorders in with mental illness.

PD's used to be thought to be untreatable. However, anti-psychotics are sometimes prescribed for it. There has been some success treating some pd's using the therapeutic community model (Henderson Hospital in Sutton, for example, before it was closed down ). Dialectical Behavioral Therapy is currently in vogue for treating bpd.

 

[goldenecitrone]

PD's used to be thought to be untreatable. However, anti-psychotics are sometimes prescribed for it. There has been some success treating some pd's using the therapeutic community model (Henderson Hospital in Sutton, for example, before it was closed down ). Dialectical Behavioral Therapy is currently in vogue for treating bpd.

All of this stuff is pretty much in it's infancy really. Psychiatry and psychology have come a hell of a long way in the last hundred years but they really are only just scratching the surface, I would say. The science of mind has a long, long way to go.

 

[Meltingpot]

This sounds like the answer to the OP.

It probably reflects the difference between a metabolic and a developmental issue.

How about neuroses then? They can be treated or at least alleviated with drugs, but most of them have their roots in developmental problems such as one's parents having conflicting views of the world (Robyn Skynner in the books he wrote with John Cleese calls neurotics "two map people").

 

[Meltingpot]

All of this stuff is pretty much in it's infancy really. Psychiatry and psychology have come a hell of a long way in the last hundred years but they really are only just scratching the surface, I would say. The science of mind has a long, long way to go.

Agreed, but maybe it's not possible to know everything about the mind. There was an Asian psychiatrist (not Raj Persaud) who wrote a letter to one of the broadsheets a while back which contained this sentence; "If the mind were simple enough that we could understand it, we would be so simple that we couldn't."

 

[CJohn]

There is no line. They are different, but related, concepts.

Personality is a relatively stable and enduring set of attributes, ways of understanding and interpreting the world/self/other, and patterns of behaviour. Mental illness refers to psychological wellbeing, usualy an enduring state of mental distress or suffering.

Ones mental health cannot be understood in isolation from ones personality. The personality is the structure giving rise to (via its ongoing reciprocal interaction with the environment) certain forms of mental suffering.

The current psychiatric manuals typically diagnose on the basis of phenomenology, without reference to underlying personality structure. However - and this is missing from diagnostic conceptualisations (though sneaked back in via Axis2) - this ignores the role of the personality as both a predisposing and maintaining factor in mental health.

e2a: basically mental suffering (or mental illness, if you want to call it that) arises out of the conflict between the personality and the current environment.

 

[Jonti]

How about neuroses then? They can be treated or at least alleviated with drugs, but most of them have their roots in developmental problems such as one's parents having conflicting views of the world (Robyn Skynner in the books he wrote with John Cleese calls them "two map people").

What a strange notion!

I'd've thought everyone has different ('conflicting') views of the world to everyone else

 

[Meltingpot]

Yeah, and everyone's neurotic to some degree. It depends how fundamental those differences in outlook (between the parents) are I guess.

Parents who are overprotective of their children and teach them that the outside world is something to be feared probably create neurotic children too.

@CJohn: excellent post.

 

[Agent Sparrow]

What is it? Is someone obsessive because they are mentally ill or because that's their personality? When does an antisocial trait become illness?

Traditionally it was seen as a distinction of treatability, although with the rise in treatments of "personality disorders", that's probably not necessarily the case anymore.

Interesting question - haven't got time to read the thread now, but will hopefully have time to come back to this.

 

[Idaho]

Ok - here's an example. Say a husband is controlling, possessive and violent. He controls his wife and children - where they can go, who they can speak to, and is a real tyrant.

Is he, by that definition, mentally ill?

 

[Blagsta]

No, but he certainly has some emotional issues.

 

[panpete]

Ok - here's an example. Say a husband is controlling, possessive and violent. He controls his wife and children - where they can go, who they can speak to, and is a real tyrant.

Is he, by that definition, mentally ill?

I would say he is definitely showing strong symptoms of something.
His symptoms are affecting others in a negative way, too.

This society would probably wait until someone in his sphere is actually harmed or killed, before they acknowledge him, though, as that's how it works.
Not agreeing with it, but that's the way I see it as it is, here.

 

[panpete]

This is a ridiculous statement.

The symptoms can be masked with drugs
In cases where the mental illness was caused by emotional disturbance, however, this can only make mental illness worse.
This is because the patient is not getting chance to see and heal their unconscious mind.
It therefore, floods over into the conscious mind, creating psychosis (a symptom of mental illness, and not mental illness itself)

I say, humans, as a species, are so removed from nature, we are collectively psychotic to a degree, and I feel, definitely collectively neurotic.

Given the chasm between us and nature, it's no surprise we have, manifestations of aberrance in the behaviour of, individual members of our species.

 

[panpete]

dysfunction and pathology is because we dont take responsiblity

That's a heck of broad and overly defensive brush you're wielding there. Surely the degree of 'blame' (a terrible way to start looking at it, btw) depends on the 'mental illness' in question.

With autism, for eg, AFAIK it has entirely genetic causes, so there can be no question of blame (unless someone wanted to start blaming people for having a child in the first place).

Then again, with say schizophrenia, AFAIK has a lot to do with nurture. But then can you 'blame the parents'? I'm not sure that's a practically helpful - and is probably a very damaging - way to look at it.

Almost all the characteristics of personality passed on by carers seems to be done less than fully self-consciously, so while it is possible to apportion blame to parents, gaining insight to break damaging patterns of behaviour would seem to be the way to deal with it.

Maybe blame is a bollocks concept, because, who do the parents blame for their dysfunction?
Maybe its about responsibility.
By that, I don't mean, people should feel responsilble for another individual, but I do mean, they should be responsible for themselves.
Each and every one of us.
If I had a kid who was a bully, sitting blaming myself would be futile.
If I thought about it responsibility, I would perceive my part in the whole thing, non self judgementally, but objectively.
I would act in any way I could to improve or help the situation.
My child, if responsible, would see their role in the situation and be responsible for taking action to correct the pathology.

Pathology is part of life, but as individuals, we must be responsible for not giving ourselves or others dysfunctional behaviour/pathology.
Sometimes, in ignorance, we do give others pathology, but it is our responsibility to become aware of any dysfunctional behaviour/pathology and correct it.
Its all a part of learning, which is another personal responsiblity.

Pathology, of which Mr Wee and Poo man, is deeply immersed, grows when people fail to take responsibility for themselves.
That is, fail to respond, in the right way, to life, for the greater good.

I stress, responsibility is not another word for blame.
Responsiblity is not about guilt.
It is about our response.
It is about responding to, rather than dumping responsiblity on, or feeling guilt.

 

[Meltingpot]

Yeah, but before responsibility comes awareness IMO.

I can only speak for myself here, but when I was younger (particularly in my teens) I acted sometimes without knowing why and later regretted it. Now I'm older I can see many of the same impulses to act in the same ways I did then, but I've got more "space" to stop and consider whether or not I should do this or that. Doesn't always happen (I can still be impulsive etc.), but more often than it used to.

 

[Idaho]

No, but he certainly has some emotional issues.

What's the difference between emotional issues and mental illness? What about the man who jumped out the window holding his children last year - emotional issues or mental illness?

Is it just social dysfunction? Is it the scale of laws broken?

 

[inflatable jesus]

Ok - here's an example. Say a husband is controlling, possessive and violent. He controls his wife and children - where they can go, who they can speak to, and is a real tyrant.

Is he, by that definition, mentally ill?

http://en.wikipedia.org/wiki/Paranoid_personality_disorder

He would probably have a good shot at being diagnosed with Paranoid personality disorder. However, that depends on a few things.

 

[Blagsta]

What's the difference between emotional issues and mental illness? What about the man who jumped out the window holding his children last year - emotional issues or mental illness?

Is it just social dysfunction? Is it the scale of laws broken?

Back to diagnostic criteria again...

 

[Idaho]

Back to diagnostic criteria again...

So there is no overall philosophical distinction sitting behind that criteria, just a case-by-case approach per theoretical disorder?

 

[Agent Sparrow]

What's the difference between emotional issues and mental illness? What about the man who jumped out the window holding his children last year - emotional issues or mental illness?

Is it just social dysfunction? Is it the scale of laws broken?

I guess one possibility would be to the extent to whether the symptoms come and go. Mental illnesses are clusters of symptoms that come and go, personality traits are more stable. Could emotional issues be framed in a similar way as personality traits?

But then the power of emotional issues, or our emotional vulnerabilities, is more when they've been triggered by certain things, or we're feeling more vulnerable in general. So maybe emotional issues fulfil a space somewhere inbetween the two - they are fairly constant at some level, but that level increases and decreases depending on the person's life experiences and circumstances.

That would suggest however that whilst you can learn to deal with stuff, you can never truly get over things, which I'm not entirely sure I agree with :hmmm:

Edit: another way of framing it is that emotional issues cause mental illness or a lesser level of difficulty/difficulties we haven't defined as mental illess. It is worth at least being somewhat critical of the idea that the psychiatrists who defined mental illnesses got it right.

 

[Idaho]

I guess one possibility would be to the extent to whether the symptoms come and go. Mental illnesses are clusters of symptoms that come and go, personality traits are more stable. Could emotional issues be framed in a similar way as personality traits?

But then the power of emotional issues, or our emotional vulnerabilities, is more when they've been triggered by certain things, or we're feeling more vulnerable in general. So maybe emotional issues fulfil a space somewhere inbetween the two - they are fairly constant at some level, but that level increases and decreases depending on the person's life experiences and circumstances.

That would suggest however that whilst you can learn to deal with stuff, you can never truly get over things, which I'm not entirely sure I agree with :hmmm:

Edit: another way of framing it is that emotional issues cause mental illness or a lesser level of difficulty/difficulties we haven't defined as mental illess. It is worth at least being somewhat critical of the idea that the psychiatrists who defined mental illnesses got it right.

What if the symptoms are constant despite being akin to known mental illness - are they therefore personality traits?

All this is leading me to believe that psychology is a pseudo science - that it is more to do with established definitions and rule-of-thumb than being built on a robust scientific framework.

 

[Agent Sparrow]

What if the symptoms are constant despite being akin to known mental illness - are they therefore personality traits?

I think it would depend on the person and circumstances. But possibly, yes (depending on what the symptoms in question were and whether they could not be accounted for by other long term conditions).

For example, with depression there is acute clinical depression, then recurrent depression, and dysthymic depression (long standing but relatively milder depression). All are considered mental illnesses. However, there is a (controversal) diagnosis of depressive personality disorder for individuals who it seems have a perpetual depressive thinking style. At the less extreme level, we all know people who are really very pessimistic across their life span.

All this is leading me to believe that psychology is a pseudo science - that it is more to do with established definitions and rule-of-thumb than being built on a robust scientific framework.

For a start, I'd consider this debate to be more about psychiatry specifically than psychology. There's a large group within clinical psychology who criticise the assumed validity of these diagnostic categories. On the other hand, they do map clusters of symptoms and can be useful.

Secondly, psychology is a social science, not a proper hard science. Its constructs are intangible and will in essence be somewhat socially constructed, due to the complexity of the mind and the impossibility of studying parts in isolation you can never control all the possible variables, and there is a massive degree of individual difference. Tbh, I think the problems come when psychology claims that it is a science comparable to chemistry or physics. However, I don't think that makes it a "pseudo" science, as long as claims of hard science are not being made. There is a place for the scientific method (as long as the problems of using it within this field are acknowledged) alongside more context rich qualitative research.

After all, is the alternative that such an important area as the mind and mental health just don't get studied, because the methodology isn't perfect?

 

[inflatable jesus]

All this is leading me to believe that psychology is a pseudo science - that it is more to do with established definitions and rule-of-thumb than being built on a robust scientific framework.

That's a thoroughly stupid conclusion. Much of psychology is built on a great scientific foundation. There are reasonable criticisms you can make about some aspects of the psych-world, but you're not even doing that. You're posting a couple of sentences describing behaviors, expecting that somehow a some people with no relevant training can make a diagnosis on the basis of those couple of sentences and then writing the whole thing off on the basis of whatever vagueness arise from that ridiculous approach.

If you're genuinely interested in this, why don't you do some research? Then maybe you can make a reasonable conclusion backed up with good evidence.

 

[Meltingpot]

I think it would depend on the person and circumstances. But possibly, yes (depending on what the symptoms in question were and whether they could not be accounted for by other long term conditions).

For example, with depression there is acute clinical depression, then recurrent depression, and dysthymic depression (long standing but relatively milder depression). All are considered mental illnesses. However, there is a (controversal) diagnosis of depressive personality disorder for individuals who it seems have a perpetual depressive thinking style. At the less extreme level, we all know people who are really very pessimistic across their life span.


For a start, I'd consider this debate to be more about psychiatry specifically than psychology. There's a large group within clinical psychology who criticise the assumed validity of these diagnostic categories. On the other hand, they do map clusters of symptoms and can be useful.

Secondly, psychology is a social science, not a proper hard science. Its constructs are intangible and will in essence be somewhat socially constructed, due to the complexity of the mind and the impossibility of studying parts in isolation you can never control all the possible variables, and there is a massive degree of individual difference. Tbh, I think the problems come when psychology claims that it is a science comparable to chemistry or physics. However, I don't think that makes it a "pseudo" science, as long as claims of hard science are not being made. There is a place for the scientific method (as long as the problems of using it within this field are acknowledged) alongside more context rich qualitative research.

After all, is the alternative that such an important area as the mind and mental health just don't get studied, because the methodology isn't perfect?

I agree, as long as it's recognised that there are always going to be social-value based biases in diagnosis and interpretation and those need to be accepted and made explicit. For example, a child who prefers his own company and doesn't want to mix much with other children may be an extreme introvert and not actually have anything much wrong with him, and yet in the US (according to Martin Seligman, originator of the "learned helplessness" theory of depression) there are psychologists who will diagnose a social disorder in this case and try to get him or her to mix more.

Other examples; is it OK for people to lose their interest in sex as they get older (i.e. past 50) or is this a disorder requiring investigation and treatment? How about children who are diagnosed with ADD (and I'm not saying there isn't in fact such a disorder) who in the past would have been given ample outlets for their abundant physical energy? These are not easy questions.

 

[Idaho]

After all, is the alternative that such an important area as the mind and mental health just don't get studied, because the methodology isn't perfect?

I am not clear on the difference between psychiatry and psychology philisophically speaking. I know for the former you need to be a medical doctor. Do they have different rational and criteria when talking about personality and mental illness?

It's a massive leap from saying something isn't purely based on scientific methodology to saying it should not be studied. I am merely interested in exploring whether in psychology personality and mental illenss are based on some measureable and robust criteria and what is establishment consensus and broadly accepted definition. So far I haven't seen anything concrete to distinguish the two.

That's a thoroughly stupid conclusion. Much of psychology is built on a great scientific foundation. There are reasonable criticisms you can make about some aspects of the psych-world, but you're not even doing that. You're posting a couple of sentences describing behaviors, expecting that somehow a some people with no relevant training can make a diagnosis on the basis of those couple of sentences and then writing the whole thing off on the basis of whatever vagueness arise from that ridiculous approach.

If you're genuinely interested in this, why don't you do some research? Then maybe you can make a reasonable conclusion backed up with good evidence.

I'm genuinely interested in a discussion on a message board I frequent. I have absolutely no idea why you are getting your knickers in such a twist

 

[inflatable jesus]

I'm annoyed because I thought you were interested in a serious discussion about a serious subject. If I had known you were just stirring the pot I wouldn't have bothered contributing.

I'm thinking about pursuing a career in the mental health world, I have friends who do great work in it. I'm all for debate about it's role and it's problems, but it's dissapointing to hear somebody make such dumb disparaging remarks about it, especially using such poor evidence.

But I suppose what you do with your time is your own business.

 

[Idaho]

What has prompted all that? I haven't made any dumb disparaging remarks. What are you talking about? I am interested in a serious discussion and thought I was having one...

 

[Spion]

All this is leading me to believe that psychology is a pseudo science - that it is more to do with established definitions and rule-of-thumb than being built on a robust scientific framework.

TBH, this did strike me as a contender for one of the wrongest statements in the history of the internet. As such it came across a teensy bit trolly.

Not only is it an error to not see socially-derived knowledge as unscientific, but it also neglects the huge amount of rigorous scientific method employed in the study of the mind, from such as Bowlby's attachment tests to the work being done now that is starting to find the links between socialisation and parts of the brain such as the orbitofrontal cortex.

You and IJ clearly have different expectations of the discussion

 

[Agent Sparrow]

Idaho, perhaps the term "psuedo science" is a bit more loaded than you reckoned?

On the flip side, if you swear blind too much that psychology is a science, you don't notice how socially contructed a lot of the constructs of interest are. In subtle and less subtle ways, psychology has been guilty of maintaining oppressive social attitudes. I think the scientific method is fine in psychology, as long as you keep that critical eye open at all times.

As for the question about the different criteria for personality disorder and mental illness, it's a long subject and I'm feeling a little foggy headed atm. A brief search found this paper that you may find interesting (I've only read the abstract so far, but I think it's accessible without an athens account). http://bjp.rcpsych.org/cgi/content/short/180/2/110

 

[Idaho]

I suppose some may see the term 'psuedo-science' as provocative

I was really just trying to prompt discussion rather than get anyone cross

I think 'What Constitutes a Science?' would be a good discussion that could certainly see sociology and other related social sciences in the dock being cross-examined. Not saying I have an answer or an opinion on the topic as yet. However it sort of sprawls away from the original topic of this thread.

 

[bhamgeezer]

Truth is the world is not neatly split into compartmental states and types but constantly changing, there is no true distinction between mental illness and strange personalites but it is necessary for us to create one in order judge whether the individual can be considered a moral agent. We can do this to the best of our abilty but the system will never be full proof and people always slip through the cracks on either side of the imaginary fence. We certainly can get better at distinguishing whether a individual constitutes a morally culpritable agent but we will never know for 100%.