0.19 Personality disorders  (Page 3/6)

Discussion Question: What sort of impression do you have of people with personality disorders (it’s OK to consider things you have seen on television and in movies)? Is this what you think of when you typically think of mental illness or psychological disorders?

An Alternative Perspective on Categorizing Personality Disorders

Theodore Millon has presented a different perspective on the categorization of personality disorders based upon an evolutionary model of personality development. In this model, personality is seen within the same context as any other factor contributing to the evolutionary survival of a species (and, therefore, individuals representing that species). As with other species, humans need to succeed in four areas: existence (a person must continue to live as an individual), adaptation (if the species cannot adapt it will become extinct), replication (individuals can “survive” over time by having offspring), and abstraction (the ability to plan and make good choices). According to Millon, we can now describe four polarities on which the personality develops to accommodate these evolutionary needs: the pleasure-pain polarity (existence), the active-passive polarity (adaptation), the self-other polarity (replication), and the thinking-feeling polarity (abstraction). Personality disorders can be viewed as adaptive forms of development under abnormal conditions, and they can be classified in accordance with these four dimensions (as opposed to the three clusters proposed in the DSM system). Millon cautions, however, that the complexity of individual personality and the developmental processes involved make it difficult to define in any simple terms how the development of anyone’s individual personality might have occurred (Millon, 1996; Millon&Grossman, 2005).

The first category in this schema describes the pleasure-deficient personalities , individuals who lack the ability to experience the joys, rewards, and positive experiences of life. Individuals with schizoid personality disorder appear to lack the intrinsic capacity to experience the pleasurable aspects of life. Those with avoidant personality disorder show an excessive preoccupation with, and an oversensitivity to, life’s stresses. And finally, people with depressive personality disorders have a pervasive sense of hopelessness and futility in their lives. So although these disorders arise for different reasons, they all arrive at a common point at which individuals suffering from these disorders do not find pleasure in their lives.

The second category includes those disorders that are characterized as interpersonally-imbalanced personalities , a condition in which disordered individuals are either overly disposed to orient themselves toward fulfilling the needs of others or overly inclined to meet their own selfish needs. The first two disorders in this group, dependent and histrionic personality disorders, are characterized by their need for social approval and affection, and by their willingness to live according to the desires of others. Individuals with dependent personality disorder do so by taking a passive stance, whereas those with histrionic personality disorder take an active stance. Those with narcissistic and antisocial personality disorders turn inward for gratification. For narcissistic types, their self-esteem is based on an inflated assumption of their own personal worth and superiority, and they expect others to behave accordingly. Antisocial types are fundamentally distrusting of others, and use aggressive self-determination as a protective maneuver.