Diagnosis and Compassion

By Celia Coates

After the January 5th post aboutThe Distracter,” I realized I had to say something more because I’d written about disordered communication but hadn’t said enough about the possible disordered nature of the communicators. When a person produces frequent messages that are dramatic, chaotic, manipulative, and disruptive or destructive it may call for a psychiatric diagnosis. To understand what might be going on with them we have to look at character or personality disorders. This is an unusual subject for WINN but it’s a necessary one to explore now.

“The idea of personality traits dates back to at least Aristotle, who taught that internal dispositions determine moral or immoral behaviors. …  His dispositions, or personality characteristics, included vanity, modesty, and cowardice.” *  

Our understanding of human personality has expanded far beyond Aristotle’s dispositions and there is a thick Twentieth Century guidebook for psychiatric problems called the Diagnostic and Statistical Manual. There have now been five editions. In the book about treating serious mental disorders quoted above, the author, Edward Taylor, went on to write,
“DSM-IV and DSM-5 define personality disorders as a pattern of stable or persistent internal experiences and observable behaviors that diverge from a person’s culture, and partially begin in adolescence or late childhood. To qualify as a disorder, the internal abnormalities and behavior must also endure over time, lack flexibility across a number of settings, and create distress or difficulties in relationships, work, school, or other areas of functioning.” *

I turned to the 2nd edition of the DSM (1968) because its simplicity is almost charming compared to the detailed elaborations of the DSM-5. It said that personality disorders are, “… characterized by deeply ingrained maladaptive patterns of behavior that … are life-long patterns.” Twelve of them were listed, some of which no longer appear and some of which have new names. Most character disorders – such as the avoidant and obsessive-compulsive ones – do not hurt other people but there are three that can cause serious problems. They are the narcissistic, paranoid, and sociopathic character disorders and when they appear together in one person they are called the dark triad.

“… people who suffer with these disorders pose a grave threat to society when they act together and when the circumstances are such that they can influence a substantial proportion of the psychologically normal population to support them.” **

Here’s what is involved in the three disorders,
Narcissistic character disorder– involves a pattern of grandiosity, and this person needs admiration, has a sense of superiority and entitlement, lacks empathy, and is self-centered, exploitative and arrogant.
Paranoid character disorder– involves a pervasive distrust of other people, believing their motives are malevolent and this person suspects without basis that others are deceptive, exploitative, and disloyal. They bear grudges, are unforgiving, and are quick to attack when they perceive a threat to their character or reputation.
Sociopathic character disorder is also called antisocial personality disorder. This person is ruthless and grossly selfish, irresponsible, impulsive, does not feel guilt or remorse, is unable to learn from experience or punishment, has a low frustration tolerance, and gives plausible rationalizations for their behavior. They are often bullies and thrive on an imbalance of power.

We are seeing this dark triad of callous and manipulative behaviors in our world more openly now although it’s been present throughout history.  There are some similarities in all three disorders: they involve a serious lack of empathy, a need to dominate or control their world, and severe egotism. Most importantly, it is unlikely that these people will ever change. Those who are diagnosed with the triple dark character disorders are set for a lifetime of being troubled and destructive. They are likely to remain cynical, amoral, unprincipled, self-centered, extraverted, impulsive, and power-seeking. It’s a hard way to be human.

Why is compassion in the title of this post? The Ageless Wisdom that is frequently mentioned in WINN, teaches us to deal with each other with compassion, with generosity. But it is not helpful to deal with dark triad people with ordinary kindness. It is vitally important to assess (diagnose) them accurately and to give up the wish that they learn, grow, and become different since that’s not likely to happen. We must be careful not to allow our helplessness in the face of their unsettling behavior to make us either ignore what’s going on or try to find explanations that would “normal-ize” it. It is not normal. Although we are all capable of really bad behavior, that’s not the primary way of being for most of us as it is for people living with these three character disorders.

It also does not work to respond to them with anger, or fear, or attempts at punishment. It’s not up to us to judge and condemn them, but rather to try to understand how they function. Becoming wise about their capacity for destructiveness and finding compassion for the people caught up in their distorted ways of being are necessary. We must protect ourselves and what we value through action that is principled and powerful and that provides an antidote to their behavior. The disordered few must not be allowed to take over.

To go back to something Michelle Obama said, “When they go low, we go high.” We must see clearly that people with character disorders are going low and figure out – in a variety of circumstances – what going high would look like. When we ourselves don’t share these personality distortions we can get blind-sided and intimidated, but we can inform ourselves, see clearly, and refuse either to be manipulated or to retaliate. There is an urgent need for us to understand that the source of our current crisis in democracy begins with psychological distortions, that later become political problems.

*   *   *   *   *

* ASSESSING, DIAGNOSING, AND TREATING SERIOUS MENTAL DISORDERS: A Bioecological Approach, by Edward H. Taylor, Oxford University Press, 2015, pages 313 and 317.

** DISORDERED MINDS: How Dangerous Personalities Are Destroying Democracy, by Ian Hughes, Zero Books, 2017, page 4.

You might also like to read: THE DANGEROUS CASE OF DONALD TRUMP (Although he is NOT the only national or international leader we might assess as struggling with the dark triad.) by Bandy Lee, M.D., Thomas Dunne Books – An Imprint of St. Martin’s Press, 2017  or,  ON TYRANNY: Twenty Lessons from the Twentieth Century, by Timothy Snyder, Tim Duggan Books, 2017.


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2 Comments Add yours

  1. Trudy Summers says:

    Excellent. Thanks, Celia!

  2. Judith Sellers says:

    If only everyone would read this, something might be done. You have written with great clarity and more kindness than most of us could ever muster, while leaving no doubt about the source of our mammoth problem.

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