Archive for personality disorder

On Delusions and Accountability

Posted in health, mental health, personal with tags , , , on April 16, 2013 by theweirdphilosopher

I wrote before that I´m starting to believe my abuse obsession was a form of psychosis. It´s not the whole story, but it´s starting to look more and more likely to me. At least it feels somewhat consistent with my experience of it. It is another time of my life for which to take responsibility I can try endlessly, and yet there is never a moment when I can just say: “Yes, I did something very wrong here, but it´s long ago, I did what I could to repair the damage and I feel at peace with it now. I won´t suddenly fly into a fit of self-hatred if I encounter the subject somewhere.”

There is one thing, however, I can take responsibility for. There were times in those months of madness when I woke up and experienced a moment of normalcy. Moments when I recognized madness as madness. Naturally, those moments caused me great distress. Who likes to wake up to the realization that he´s been spewing absurd accusations over the last few weeks? In those moments of sanity, I felt massive shame. I felt like my life was over. Also, like I was trapped in some dead-end. If my ideas about the past were wrong, then what was I still supposed to believe, what was I supposed to think about myself? I had no idea that what I experienced there might have been genuine insanity. There would have been nowhere to turn to, no explanation other than that I was a terrible person, and that, too, did not correspond to what I had learned about myself and reality. Here is where madness could pick up again. Because if I couldn´t really be such a terrible person, then my mad beliefs had to be true. For all I knew, there was no third option.

When I briefly dropped back into sanity, I started to feel a sense of urgency, like something was slipping through my fingers. I wanted to be able to hear the voices of my “alters” again, or become them. Live in a different frame of mind, perceive myself and the world differently again. Of course I realized in those moments I was essentially hoping I had been abused. At least that´s how I viewed it then. Under normal circumstances I wouldn´t have hoped so, but I guess most people would experience extreme denial if I they were suddenly faced with the possibility that they had been believing and passionately defending completely unrealistic accusations over weeks and months. You could arguably say this terror and denial is a normal reaction to the disease, in which case it wouldn´t have much to do with my specific personality.

At any rate, at the time I was terrified at the notion that I desperately hoped my delusions were true. It raised the stakes, escalated the false dichotomy. Either I was so rotten that I might as well have been a rapist myself, or there had to be some explanation as to why a person who wondered if she had repressed memories of abuse could want it to be true. And in those relatively sane moments I was actively searching for such explanations, driven by the terror of what kind of person I seemed to be. I was encouraging and fostering my madness.

When I say I can take responsibility for that, I´m not talking about finding grounds for condemnation. All I´m saying is that those were things I did intentionally, and with a purpose of my own. Evaluating or judging my motives is only the next step. First and foremost, I´m trying to figure out what parts of my behavior were sanity/madness and what I can actually hold myself accountable for. And my definition of sanity here is not: healthy, well-thought out, good, functional, well-adjusted, balanced. It merely describes instances in which I felt I was acting on my own accord, intentionally, in response to what I thought was my situation. It doesn´t mean that I wasn´t driven, under massive inner pressure and misguided by believing there were only two alternatives.

 

When I later reflected on this time I always knew there had been moments when I had actively cooperated with my madness. I remembered wanting to prove I had been abused, I remembered wanting it to be true. What I was falsely convinced of for many years, though, is that these wishes were not merely a reaction to my manic belief that I had been abused, but the cause of it.

What I believed was that having abandoned Lola despite her history of having been abused threatened my self-image as a martyr and victim of everything, and so I had to make up a story that was even worse than hers. Actually, I always knew I hadn´t intentionally lied, but needing to believe in a delusion for narcissistic reasons made me just as guilty in my book. In fact, it additionally made me a ridiculous person. Even though it seems more reprehensible to lie on purpose than to go mad, I´d probably feel a whole lot better if the former had been the case.

What I think now is that by the time I developed the manic belief I was already caught up in a similar false dilemma. I couldn´t deny that my delusional fantasy world had been more important to me than Lola, but at the same time I couldn´t see myself in what this seemed to say about me. My illness had started with the “vision” I´d had two years earlier, had probably announced itself far earlier in the form of the voices, which had been with me for ages, and little, anxiety-inducing misgivings.

I just wondered if this is some kind of personality disorder after all, since I must have had it for such a long time, and since it seems to be interacting with my sane mind so tightly. And yet it seems unfair to ascribe sudden, manic ideas and the fantasies that develop in my head to my personality. They do not reflect who I am. I will not be held accountable for the content of my delusions. Where I don´t try to shake them or even let myself slip into them, you can call me passive or lazy and I will consider how I myself judge my behavior, but being sucked into the manic belief that I will have to save mankind from a future dictator does not make me a person who is greedy for fame, attention and a grandiose self-image. If you absolutely want to, go ahead and judge how I dealt with my madness. I´m actually interested in re-evaluating my sense of who I am that way. My deliberate actions and conscious attitudes are what makes me who I am. My delusional thoughts and manic ideas are something that happens to me.

 

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I don´t even know how to title this

Posted in health, mental health, personal, rants with tags , , , , on August 6, 2012 by theweirdphilosopher

A while before I started this blog I was a member at a major Internet forum that deals with mental health issues. In fact I still am a member, but I hardly ever write anymore. I got my blog for that; at least here I don´t have to worry about writing too much.

On that forum, there were various subforums for all kinds of illnesses. There was one subforum for each major personality disorder, there were forums for dissociative disorders, for depression, for trauma, for sexual issues and for anxiety. There was more, but for the purpose of this entry those examples should be enough.

I was never quite sure in which subforums I belonged. I read many of them trying to figure it out, but I found I could identify with some elements of each of them. I noticed certain characteristics in style and content in each or at least many respective subforums and, to be honest, after a while this was starting to look like a great stage show at the theatre.

I cannot help but feel a certain disdain, even ridicule which will probably show through in my description of the various styles. Like: Everybody looks for the label that suits him best and then he starts to talk/write in a way and about topics which support the label. The folks in the Schizoid PD subforum make short, distanced, blasé posts because they don´t like social occasions. The folks in the Schizotypal PD sub-subforum talk gibberish because hey, they are almost psychotic. Those with BPD constantly talk about emptiness and what it really means, or about their fear of abandonment. They keep on saying they have trouble with empathy even though they constantly prove the opposite is true as they all excellently understand each other. This is where I feel the diagnostic criteria really distort peoples´perception of themselves. I have BPD, so I must lack empathy. I hereby dutifully accuse myself of that, even though it doesn´t feel true, but my perception must be distorted because I´m ill.

Then there is the subforum for those with Antisocial PD. The conversations are a mixture of one-upmanship and weird camaraderie. Typical thread title: “Thoughts of homicide?” Then they play a subtle game about who is more hardcore; those who enjoy killing or those who do it with complete indifference. I didn´t know the death row has Internet access lately…but maybe their chronic bragging is just totally in character with their (alleged?) AsPD diagnosis?

Enter the forum for Histrionic PD. It is filled with men who accuse their ex of suffering from the condition because she cheated on them. From a woman´s perspective it sort of sickens me. If a guy cheats on a girl, it is almost normal because, hey, they have a greater sex drive, right? But a woman who cheats must definitely be ill in some way. I found it almost intimidating.

Then the narcissists. Similar to the AsPD forum, just that the subject is not homicide but causing emotional devastation. This is alternated with musings about the complete inner deadness of narcissists, such as: “Do they have hobbies because they like them or in order to show off?”

Then there are other forums, like anxiety, self-esteem and so on. In those forums people tend to speak more freely, but what is stereotypical is the replies: “Have you thought about xyz, consult a therapist, I know it is hard but you can do it!” And be damned if that doesn´t do it for you. Because that is as much as anyone will offer. It is the zero risk reply. Telling someone to see a therapist is “the right thing to do”. Ordinary users have no right to act as psychologists after all. They cannot give their unqualified opinion on their fellow users´problems. That would be totally irresponsible.

Oh, and while we´re at it: Responsibility. Almost everybody in those forums is constantly busy “taking responsibility” for their problems. To this day I´m not entirely sure what is meant by that. I only know the conversational style it entails. “I will…I have to….Now I must…” and all kinds of prospects for the future. “Taking responsibility” in those forums is the public display of making a firm decision to do what the majority thinks is good. “I will no longer hide from my problems!” (Whatever that means.) “I will consult a therapist.” (At least that´s a concrete thing you can know you have or haven´t done.) Or, of course: “I guess I´m still in denial about…” I´m pretty sure there is a real, relevant mental state which people try to capture by using this phrase. But the phrase itself is highly illogical. And when I analyze the power structure behind that phrase I come to the conclusion that it means: “My gut feeling says you´re wrong, but you must be right so apparently I just don´t want to see it.”

My sarcasm has me wonder if I´m seeing something the authors of such posts don´t see (or maybe they do and they don´t know how else to express themselves; it sure has happened to me as well), or if I´m so cold and deranged that I simply don´t know what “not hiding from one´s problems anymore” means. I feel like it should be obvious, like everybody else knows what is meant by this, but I don´t. Well…sometimes I feel like I know it, but I find the expression “hiding” pretty unfair. It sounds like unless I yell at myself in the mirror each afternoon: “You´ve been sleeping till noon and your room is in a mess, you complete wreck! Look at yourself! LOOK at yourself! Your life is going down the drain!” I must be somehow in denial. I often feel like this so-called “taking responsibility” is just an exercise in drill and mercilessness towards oneself. You´re already on the ground, but you constantly remind yourself of your complete fucked-up-ness because that´s the responsible thing to do.

This publicly displayed taking of responsibility looks like an act of appeasement to me. “I know I have no right to whine and have problems, but I´ll pay your listening to me with a commitment to taking responsibility for myself and changing, okay? Now please don´t be too harsh on me!” I´ve noticed that whenever I´m tempted to assure my readers that I´m working oh so hard on myself I´m simply scared of their response. I´m scared they will tell me, “weeeeell, if you don´t like the place your in, you will have to make some changes! You alone are responsible for your happiness!” Yeah, alright, but I really just wanted to rant, okay? Share with the rest of the world how much life sucks?

The above-described mental health forum is not the place for that. There is only one way to escape the demand to take responsibility: Portraying yourself as a narcissist or as a psychopath.

I´m not sure how many of the people in those forums are what they pretend to be. Some may well  just be your garden variety full-of-shit-teenagers. At least those in the psychopath subforum. But by claiming those diagnoses for themselves they have a great advantage: They can behave however they like and nobody will say anything about it because this is part of their illness, right? It is a very convenient way of claiming a label for themselves without having to do anything about their real or alleged condition. Nobody expects them to take responsibility. They are stronger than the “helpers” who always know exactly what the ill person must do.

Thing is: I could easily copy that attitude. I´d know what to say and do. Just as easily as I can copy the “repentant mentally ill person” attitude. Or present myself as a “helper”. I could probably copy most conversational styles I find in those forums. I could work with traits and experiences of my own to present myself as a schizoid, narcissist, psychopath or compulsive stove checker. I could start with posting this paragraph in the histrionics subforum.

I don´t because I´d feel fairly guilty. I feel guilty even thinking about it. The mods are volunteering to create a place where people can talk about their issues, other people might be reading what I write looking for help while I´m bullshitting them – neither of them deserves that.

And yet somehow there is this desire to just slip into another role, be somebody else; maybe present myself as a more colorful person (BPD, HPD), or as a total badass, or as an innocent victim. Experience what that is like, and what it is like to be talked to in an entirely different fashion. Be interpreted in ways different from how I´m interpreted now. Be seen as a person who is/has this or that. Allow myself the luxury of being a cliché, of belonging into a certain group of people.

Maybe this desire isn´t such a negative, evil thing. Part of it is the triumph of proving how easily reality can be imitated, how much I could look like the original. But part of it is also the wish to explore new, paradoxical sides of me. Test several identities, find space for little experiences which seem to be out of character. Find new narratives of my life.

Who knows, maybe it would turn out that I´d completely fail. Maybe people would tell me: “No, you´re definitely not a…” But I doubt so. The typical conversation goes like: “OMGZ, I THINK I MIGHT HAVE…”, followed by list of symptoms. “Do you think I might have…?” Reply: “Maybe, some symptoms point into that direction, only a therapist can diagnose you.” I´ve never seen anyone say: “You know what kid, I think you are completely sane.”

If you post on that forum, it is already understood that you have issues which are not normal. And if you ask whether or not you might have a specific illness and list symptoms in medical jargon, is it really much of a surprise if people confirm that you might have that illness?

What happens on that forum, no matter who all these people are in reality, is incredibly constructed. It is, in some ways, a show. People find themselves in certain roles and they start to behave differently. I find myself doing this. I once posted in the AsPD forum and immediately I was trying to sound indifferent and cold. Then I replied to someone´s post in the self-esteem section and I started to sound like I was terribly wise and far ahead in my “healing process” (healing from what?) – simply because now I was the one replying to someone else´s “rants”. It is creeping me out. So much for being oneself.

I guess my desire to go on an “undercover mission” or two might also be a way of wanting to play with those roles and free myself from them. No longer mistaking myself for them. “Give a man a mask and he will be honest.”, or however the saying goes in English. Who knows what I could do if I was wearing a mask. What I would learn about myself.

It is tempting. If I didn´t invent any facts or experiences and simply said I “wonder if I might have this or that disorder” I wouldn´t even be lying since there´s hardly any disorder I haven´t been wondering about. There wouldn´t be so much of a risk that I´d confuse people who are seeking help.

What else is this temptation about? The allure of bad behavior and having points of view that run contrary to ordinary ideas of what is right while refusing to justify them? Refusing to justify my feelings, because if I´m mad then I don´t have to justify myself for being irrational? Embracing the demon; identifying with diagnoses which would scare or upset me in real life?

Plenty of possibilities. The odd thing is: It felt like liberation – until I actually took a look at these forums a moment ago. One quick glance at the board rules and immediately my authority issues kicked in again. When all I wanted to do was learn to contradict, eh? Maybe I should aim to be kicked out? Maybe that would be a practice in self-esteem?

I feel extremely stressed out when I get into arguments. On my German blog a guy once got into an argument about homosexuality with me. He wasn´t the run-of-the-mill religious fundamentalist, but he had a psychoanalytic approach which somehow stated that homosexuals are ill and immature. I stood my ground during the discussion, refused to justify myself (and my lifestyle) and eventually said we´d better agree to disagree because we would never find a common ground. And that was it.

Sometimes I´m still scared he might return.

But this sure is something I have to learn, isn´t it? Saying my own opinion instead of using appeasement techniques and telling everybody for the umpteenth time that of course this is just my own personal view and everything is total different for everybody yada yada? I´m so tired of relativizing everything I say just so everybody will like me. It feels so dishonest to do so when in fact I have very strong feelings about a subject. Isn´t that part of establishing boundaries? Daring to have an opinion and taking one´s feelings about something seriously? Refusing to constantly justify oneself?

Given that I´m in the mood for experiments: What would it feel like to write about myself without a trace of masochism? Without the constant self-criticism? Writing while taking my feelings for granted and assuming they are legitimate and normal?

I don´t want to become a jerk who is not open for any opinions that differ from his own. I´d just like to become a jerk who dares utter an opinion. Vagueness actually helps nobody, or does it? I´m not even sure it is possible to not have an opinion on something, ambivalent as it might be. So neutrality is mere pretense. My mother is great at that, and what´s the result? I am! And my coach wouldn´t have helped me for shit if she hadn´t been a person who says what she thinks.

Maybe this is what is so tempting about the “undercover mission”. Writing about myself (and everything else) in a different way.

Treating narcissism?

Posted in health, mental health, personal, rants with tags , , on December 1, 2011 by theweirdphilosopher

I have read an article on the treatment of Narcissistic Personality Disorder today, and while it provided a lot of insights into what happened between me and my therapist a few years back (I don´t know for sure, but I suspect he diagnosed me with NPD. It´s like this: the ICD-10 code on my health insurance bill covered various personality disorders, but the most likely I found among them was NPD) – well, while that article was not entirely unhelpful, some parts of it also upset me.

The first part I would like to talk about deals with the possibility of brief therapy:

“Patients with narcissistic personality disorder who are troubled by limited neurotic symptoms and maintain apparent satisfactory adaptation in other areas of their lives are unlikely to be sufficiently motivated to tolerate the demands of psychoanalysis or psychoanalytic psychotherapy. Short-term psychotherapy is probably the best treatment in such cases. The goal of such treatment is generally to improve adaptation rather than to alter character. These patients, who are generally young and whose narcissism is often well compensated by their life circumstances, may return for treatment later in life as their narcissistic pathology makes further inroads into their interpersonal relationships, their professional endeavors, or their general sense of pleasure. At these later times, they may be capable of greater insight into their need for more intensive psychotherapy.

Okay, allow me to rant for a moment? Good. What I conclude from this paragraph is that it is a moral, medical or at least some kind of imperative that people with NPD must undergo character-altering intensive psychotherapy. Unfortunately, though, one cannot force them to do so, so one must wait until they are so deep in crisis that they are ready to hear it is all their own fault! Their moments of happiness and success are their greatest enemy! It would be good for them if they hit rock bottom as early as possible!

Wow. What a compassionate attitude, really. It is said that people with NPD have no real empathy, but I can empathize enough with people who are in crisis to feel ashamed for even thinking it might be their own fault.  I really see a problem here: A person might show up for therapy after the failure of an important relationship, or whatever. I did. The guy who evaluated me first diagnosed me with adjustment disorder. The therapist I worked with then (Dr. Stoneface) diagnosed me with some type of personality disorder which might or might not be NPD.  Now, if a person comes to me and seeks help because she is in crisis after a break-up, and I think: “Oh great, that´s a window of opportunity for treating her against being a flawed, horrible person!” – then I´m not exactly empathic, I´m not exactly compassionate, and I´m a pretty horrible person myself. It´s like a little boy falling down, crying, and his mum telling him: “See, that´s what you get for running so fast! Now I do hope you learn your lesson  this  time!” It´s not helpful. It´s just cruel.

Another thing that sickens me is the prognosis that the patients might return for treatment later in their life when their pathology has thoroughly fucked things up for them. I mean – is this really a prognosis? Or is it a threat? Isn´t it a way of saying: “Alright, maybe right now you believe that you are awesome and that your life is going great, but in a few years you will be in pieces if you don´t clean up the mess that is your inner world, I can promise you that much! But, of course, it is all your own choice! I might be wrong! I don´t pretend to be omniscient, after all!”

Okay. Next paragraph. This one deals with a patient who actually entered treatment when his life was in shambles, and made first successes:

“The treatment ended with the patient asking to be able to return at a future date to touch base with the therapist. Highlighting the masochistic side of the narcissistic coin, Oldham concluded that “the narcissistic patient whose pathology leads to dismantling his own success may be highly receptive to treatment at such a critical point.” “

To be honest, whatever Oldham says there doesn´t make much sense to me. What I am interested in is “the masochistic side of the narcissistic coin”. I fully believe that such a thing exists. What worries me, though, is that some people might believe it should be used as a motivation for treatment. First of all, it might lead therapists to encourage that masochism in order to keep patients in treatment, and second, whisper it quietly: It doesn´t work.

I entered my last attempt at therapy (Dr. Stoneface) with the most masochistic of intentions: I wanted to be made fully and pain-fully aware of  1) what a flawed, inadequate person I was, 2) how pathetically my rotten core contrasted with  my delusions of grandeur, and 3) how much I had hurt and damaged others upon trying to maintain these delusions and therefore deserved each and every break-up and rejection.

I believed that only this kind of pain could create enough motivation for change. Of course, this idea is highly narcissistic in itself: “If only you could feel with each fiber of your body what a failure you are; then you might at last get up and improve and become a great, wonderful, awesome person, the kind you always wanted to be!” Being a little more self-aware than the average therapist likes to assume, that thought occurred to me even back then. And it crushed my motivation. It crushed my hopes. It convinced me that true healing would be all about recognizing that I was shit – and accepting it and saying “that´s all there is to me”. Resisting the urge to improve and become great and admirable. Instead lead a humble life, not draw any attention to myself, rather watch others become famous and admired and successful and tell myself why I don´t deserve to be in their position: Because I am such a sick, emotionally deranged person. Fame or even praise might endanger my recovery. It might stop me from seeing how flawed and horrible I am. I must stay away from it like a sober ex-addict must stay away from his drug. Now – try to create motivation for that one! Who wants a life like that? Who wants to be healed just so he can spend the rest of his life in purgatory?

Another problem about using masochism for therapeutic purposes, of course,  is another one of my diagnoses. Sexual deviation. Writing down, and, of course, imagining the prospects above gives me a severe adrenaline rush.  It so rapes the wishful fantasies and ambitions I have, the image I tend to have of myself (proud, clever, unbreakable); and it triggers so much shame and outrage in me, that, when faced with such prospects I will either lash out against anybody who I believe suggests them (in this case: a therapist), or I will, in an act of inverted sadism, comply in the most perverted way possible. Bring it on! Hurt me, break me, make me feel as miserable as it gets! It is good for meThe entire therapeutic process gets an obscene touch if you allow masochism to enter into it. That, of course, just increases my overall shame, which, in turn, increases my defense mechanisms: 1. Rage. 2. Masochism.

I´m going to stop here, before this post gets too long and too out of hand. I´m pretty sure I will return to the subject of narcissism, though. It is something that affects and actually even triggers me in many ways. Whether or not I myself have NPD, the disorder seems to play some kind of role in my emotional life.