walkitout (walkitout) wrote,

_Understanding Personality Disorders_, Duane Dobbert

Another library selection. I was looking for a book about narcissism, because a friend of mine has had problems with narcissists, then there is the obvious election thing. The book I found in the library was unsatisfying, so I thought I would pick up a book about personality disorders in general, since I have not too long ago had a strong interest in better understanding Borderline Personality Disorder and found learning more about it to be really rewarding in terms of better understanding, better ideas for how to be around people with this particular issue without making things worse (and possibly helping to support them emotionally), and in general feel more compassion.

During the lead up to the DSM V, there was talk that perhaps personality disorders would be reworked entirely, to be one true personality disorder list of criteria, and then a more detailed coding/listing of how it manifests. Dobbert's book was written before that debate occurred. In the event, the new approach is listed as an alternative. I was hoping that reading Dobbert might give me a sense of what is shared across personality disorders. Instead I wound up coming to a very different set of ideas.

I really liked this book, and I think it is generally very useful. The author is not mean spirited, nor does he engage in obvious name calling (you might go, well, duh, but you might read some books about personality disorder to get a sense of how rampant that is before you conclude that this bar is too low). He intends his book for a general audience; he himself comes from a forensic/criminal justice background, which shows up a lot in his discussion of antisocial personality disorder, and his inclination to think that conduct disorder should be rolled in to the personality disorders (I don't disagree with him). I particularly liked the section on Histrionic Personality Disorder, because I had no idea what that was (I'd heard of it, but didn't have any sense of it); once I read through it and told a friend, she immediately said, I know someone like that!

And that's perhaps the best thing about this. It is like a bird spotting guide or a nature book that you can take on a hike, only it is for people who make us all scratch our head and go, what the heck is that all about anyway? We can't figure out where the win is, they cause all kinds of problems in groups, are difficult to work around and sometime force us to quit participating in organizations or change jobs just to get away from them. Well, if you've ever wondered what was going on, maybe you'll find the same sort of value in this book that I did.

The set of ideas I came to after reading this was as follows. I knew that some of the schizo* personality disorders were confusing and difficult to tell apart (I don't have that problem any more!), and I had reason to believe (mostly because of reading people's posts on Wrong Planet) that they were either "cousins" of autism spectrum, or autism spectrum in its higher functioning forms compounded with other problems. Here's my first cut at that:

schizoid personality disorder = mainstreamed, HFA person with depression, who has not yet/ever found people of like minds. I think if you treated the depression, and then helped them Find Their People, they would wind up just looking like other autism spectrum people. Pretty varied, still gonna need a lot of alone time, and still reduced affect, but not NO affect. Might also have an asexual component; wouldn't know for sure until the depression was addressed and Their People were found

schizotypal personality disorder = HFA person, possibly from a spectrum family, weird ideas. Might think they are psychic. Might have a lot of odd ideas about UFOs, occult, etc. The spectrum component means they don't have any perspective taking ability so they don't realize that they shouldn't talk about this stuff around mundanes. Work on the perspective taking issues, walk them back from any paranoia they have developed, get them into a social skills program. Once they "get" that they need to be a little selective, and if you can help them find some flavor of Their People which isn't too terrifying, further descent into paranoia and delusions will probably halt/reverse.

obsessive compulsive personality disorder. Best BEST thing about this book: I can now actually keep track of the difference between OCD and OCPD. Never thought that would happen! I have some issues with his description of OCPD, in that his scenario has someone who weight cycles, which just makes very little sense to me. My sense is that OCPD tends to be more associated with anorexia type eating disorders than bulimic type eating disorders. But who knows. People are exploring the possibility that OCPD has autism spectrum components, but there is a tremendous amount of resistance, because if it turns out that is true, then a lot of the received wisdom in eating disorders, hoarding, etc. is going to turn out to have been entirely wrong headed. Also, it may turn out to be the case that there is a fraction of OCPD which is autism or autism like, but another chunk which has a very different etiology.

Don't blame Dobbert for any of that rambling mess! He's a very reasonable person and I am engaging in early stage, uninformed speculation. But his book is concise, clear, well cited and easy to read. It'll help you understand confusing people, I can almost guarantee it. At the end, he has a neat appendix of various psychologists/psychoanalysts/etc. contribution to the ideas in the book; it was there that I learned about (possibly again) Karen Horney, who I am going to try to read some of because I think a lot of her ideas about how people deal with (or don't) fears and anxieties might be quite fruitful to contemplate.
Tags: autism, book review, psychology
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