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Blahaj admin defending a blatant transphobe
(lemmy.blahaj.zone)
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this post was submitted on 26 Aug 2023
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chapotraphouse
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As someone who used to have a personality disorder, I have a really hard time buying that they are akin to either neurodivergence or disability.
Like, personality disorders are generally defined as a set of maladaptive behaviors and symptoms that are in no way essential to a who a person is, but can be incredibly damaging to both the person and the people around them.
In my opinion, having words that precisely describe the disordered nature of these behaviors is necessary for both the person with the behaviors and the people they may have victimized. I'm highly skeptical of medicalization and strict diagnostic categories and whatnot, but words like narcissism have a tremendous amount of utility both for people raised by abusive parents trying to understand their behavior, as well as people who may exhibit these behaviors and need to realize they're toxic and should be worked on (I was both).
It's not the same as having different abilities or focus levels or whatever, the toxic behaviors should not in any way be tolerated. And they very much can be relearned given the right resources and a willingness to do so.
Personality disorders are divergences from normal patterns of thought and behaviour. In plenty of cases, they are caused by physical differences in the brain.
They are definitionally neurodivergance, and become disability when the resulting behaviours impact an individual's ability to function normally in society.
To avoid getting into a semantic debate, the essence of what I'm saying is there is systemic, oppressive otherization experienced by people who are neurodivergent or differently abled. Then there are people who (because of childhood trauma or for whatever reason) develop maladaptive behaviors and cognitive distortions that affect their ability to have healthy interpersonal relationships. The usage of certain words to describe the former can be problematic when the words serve to reassert systemic otherization or dehumanization. Whereas in my opinion words that describe toxic interpersonal behaviors aren't doing so. Thus narcissist isn't a slur and we don't need to be careful to tolerate "different" (read:toxic) behaviors like we should tolerate different capabilities and inherent, unchangeable characteristics that define people.
Well, you said that the word narcissist is useful because it helps people identify abusive parents. Which would imply you think there's some connection between being an abuser and having NPD. So the fact that you think a mental disorder is responsible for abuse is an example of that systemic, oppressive otherization that we narcissists experience. I was told by a former friend that I don't deserve to live, because narcissists don't have a shred of humanity. Is that not oppressive otherisation to you?
I see your point here. The negative stigma associated with personality disorders isn't great. And the way the disorders are viewed by some medical professionals, the way some medical professionals treat people they categorize as PD, probably qualifies as systemic otherization.
I'm gonna have to reflect on this.
I agree that it's not desirable to conflate the two in common usage, but I don't really see how that can be done while continuing to use those specific terms.
What constitutes toxic behaviour is culturally subjective. Many people in the first group would have been considered a part of the second not so long ago.
In this case narcissist is being used as a general insult for someone where we have no indication whether she's a narcissist or not.
we don't ban the word because it could have general use for someone who's actually a narcissist in the same way we don't ban the word schizophrenic except when it's used as an insult
My contest is with the idea that the medicalized category and its label takes supremacy over any behavior that uses the same label, especially when the specific behavior in question is defined by its problematic nature.
In crystalizing this issue, I can maybe agree calling someone a narcissist isn't ideal because it reasserts the existence and immutability of the category (which I and others believe is institutionally/socially constructed, not real in and of itself). But even so, the behaviors that define the word are not something I think should be tolerated or accepted, both due to their harmful nature and their ability to be relearned.
I find the claim that you used to have a personality disorder dubious, unless you're saying it like Mitch Hedburg said he used to do drugs. Personality disorders are incurable and lifelong. Symptoms are often mitigated with therapy and age, but those are the result of learning to live with a disability, not curing it.
Could you say what personality disorder you used to have?
I was diagnosed with borderline personality disorder. After years of therapy and multifaceted self-work, I no longer exhibit enough symptoms/behaviors to meet the DSM criteria. I know one person irl and multiple people online with somewhat similar experiences.
I'm agnostic about the label for various reasons, I don't care that much if someone describes me as a borderline person with coping mechanisms or a "cured" borderline person or doesn't mention it all. There's things I still have to work on, things that still are harder for me than they might be for other people. But I've gotten to the point where it doesn't define me or my interpersonal relationships very much. So I tend to say "used to" because it more accurately conveys my experience with it.
Ultimately I'm skeptical that the categories actually exist in nature. I'm more inclined to believe there's a wide array of behaviors that may be maladaptive, that the DSM categorizes largely for insurance purposes. There's certainly utility in using the words to group maladaptive behaviors that commonly go together, so that people experiencing them can find help and so that treatments can be explored. It's useful to put a name to an experience. Like, being able to search "borderline" and come up with communities of people, descriptions of patterns and distortions I wasn't aware of, theoretical treatments, etc-- that was useful. But identifying permanently as a borderline person-- unchangeable, always gonna be this way, this is who I am-- seemed like a self-fulfilling prophesy. Also ignores neuroplasticity and cognitive therapy and narrative therapy etc.
Here are the top 4 google results for "Can BPD be cured?":
bridgestorecovery.com/borderline-personality-disorder/can-bpd-be-cured/#:~:text=Borderline%20personality%20disorder%20(BPD)%20cannot,in%20intensity%2C%20or%20entirely%20eliminated.
https://www.verywellmind.com/is-there-a-cure-for-borderline-personality-disorder-425468
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4500179/
https://embarkbh.com/blog/borderline-personality-disorder/ask-a-therapist-can-bpd-be-cured/
Look at it this way: Imagine your leg was amputated and you had to get a prosthetic. With time, and physical therapy, and a leg that matches your needs, you'll eventually be able to walk, run, and jump again. But you'll always rely on the prosthetic leg, and there are some things you'll never be able to do. You might have a leg that's better for soccer and a leg that's better for sprinting, and you'll need to switch legs to keep up with two-legged athletes. And you might end up surpassing two-legged athletes at some things. It's still a disability, you're still disabled, but it's effectively treated. My NPD and your BPD are like that missing leg. We have tools to solve our problems, and we can get really good at using them, but the fact we still need them means we're still disabled. And at the end of the day, no amount of skill is going to help us if a fully abled person decides that today they hate "cripples", or they hate "borderlines", or they hate "narcs".
Like, I know how certain institutions want to categorize and pathologize and medicalize things, I've spent years reading about it. But there's a lot of good criticism of these institutions too, particularly against the DSM (is homosexuality a disorder?)
The whole idea that our behaviors exist as a specific disorder, like there's an NPD gene or a BPD gene and we just "have" it, to me is much more harmful/offensive/stigmatizing than anything. Human consciousness and behavior is infinitely more complex and dynamic than that.
Part of the problem is the restrictive (and usually false) assumption that emotional/cognitive/behavioral pathology can be categorized and treated like medical disorders. Like, "I have appendicitis so I need an appendectomy" is supposedly equivalent to "I'm experiencing depression so I need an SSRI."
But appendicitis or a missing limb or whatever is itself observable-- we can actually measure the cause. Mental, emotional, behavioral, personality disorders-- by and large, we can only observe the symptoms, then try to make educated guesses as to the categories and causes. Pharmaceutical/insurance based psychology seems unable to understand or explain many of these categories that they've constructed and thus write them off as incurable.
But even within the four sites you linked:
Which then would no longer be categorized as BPD
They haven't discovered a wonder drug that passes double blind tests to 100% of the time "cure" BPD, which, of course not. It's a behavioral disorder, not a bacterial infection. It has to be treated at the source.
Again a limitation of the empiricist fixation in US psychology. The replicability crisis is happening because a lot of things are hard to definitively prove using the methods commonly accepted for simpler medicine. Cognition and behaviors are too complex to easily model in a test with a control group.
Yeah this is a great example of the medicalization and stigma coming from overconfident generalists happy to make broad sweeping statements that are impossible to actually prove (and which anecdotal evidence suggests aren't universally true).
Now that we've exhausted the subject of "Is NPD curable", let's focus on your original claims You said you didn't buy that personality disorders are neurodivergence, because they're curable. The two most commonly discussed neurodivergences are ADHD and ASD. Can ADHD and ASD people learn coping mechanisms the same as personality disorders that reduce the symptoms and make them harder to diagnose? Yes, 100%. I have seen testimony after testimony from autistic adults whose psychiatrists said it was hard to diagnose them because they learned masking. Narcissists and borderlines learn masking too, and that's how we're "cured". So what's the difference making NPD not neurodiverse to you?
In the process of dealing with my own problems and identity, I've spent a lot of time reading various theories, talking with other PD sufferers, and trying different treatments around PDs, which is why I feel confident speaking on them. I can't say the same for ADHD (have it but haven't extensively researched it) or ASD.
The way I see it, our disagreement comes down to this:
Are personality disorders immutable characteristics or patterns of behavior, and then following that should they be tolerated and accepted or treated and relearned? Or more in line with the original topic, should words that are commonly used to describe either the behaviors or the categories be avoided?
My own experience of my PD is that it was comprised of learned behaviors, maladaptive coping mechanisms, and cognitive distortions, all of which were relearned or are in the process of being relearned, to the degree that I no longer identify with the label "borderline". This experience, coupled with multiple examples of people with similar experiences, as well as a wide array of criticism of static models of psychology and institutional pathologization, makes me lean in the direction of PDs being a social construction that describe a variety of behaviors, which can be relearned.
Onto the next question, I don't see the symptoms as a different way of thinking-- a matter of diversity-- but as patterns that are generally harmful to both the disordered person and the people around them. This isn't to say that the disordered person is harmful-- that we're essentializing toxicity to someone's fundamental identity because they've been assigned a label-- but that the behaviors used to characterize the label are harmful, by definition (otherwise it wouldn't be viewed as a disorder). As such, I don't advocate tolerance of toxic behaviors, whether they've been categorized or not. What I actually hope for is that people around me draw attention to these patterns and behaviors so that I can work on them.
And finally, should words used to name these categories be avoided in common usage to describe behaviors? To be honest I have a much bigger problem with the institutional categorization than anything. Especially with how controversial and inconsistent the diagnostic criteria and definitions are. The idea that because someone exhibits disordered behaviors means that they are a disordered person (and always will be) is the source of the stigma and the source of the institutional otherizing, not the other way around. I only have a problem with common usage of the terms inasmuch as they essentialize behaviors as inherent characteristics to a supposed "type" of person, a type that is institutionally defined and may or may not actually exist.
Well, since you don't know much about autism, I'll tell you about mine:
As an autistic person with NPD, I can tell you from direct experience they're very similar in terms of how they influence my relationship with society. Autistic people struggle to understand my narcissism, narcissistic people struggle to understand my autism, neurotypical people struggle to understand everything about me, and I get along great with other autistic narcissists, of which there are not many.
I appreciate your perspective and this discussion, even if we can't see eye to eye. I'll probably continue to dwell on this over the next few days.
I'm glad I managed to inspire a bit of change. Thank you for your open mindendess
I find your faith in DSM categorizations misplaced. There are lots of places where the DSM fails to have any sort of mechanistic idea of what it labels a disorder (just a diagnostic one) and thereby no real ability to say whether it is curable or not.
don't do this comrade.