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WHEN ALARM BELLS SHOULD RING:
Recognizing Personality Disorders
By
Susan Schwartz Senstad, M.A., M.F.T., M.F.A.
Aims of this article
Many of us who have chosen Voice Dialogue as a method value its
non-pathologizing essence. We may, however, also share what might
be called ‘a tendency to project health onto people’
– to be so committed to maximizing people’s potential
for growth that we risk minimizing the significance and implications
of their limitations.
This article is designed to offer a short introduction to the pathologies
called ‘Personality Disorders’ so that VD practitioners
can:
• be better equipped to screen for appropriate candidates
to facilitate and/or train to use VD with others. This is particularly
important since there is no process for either certifying or de-certifying
VD facilitators;
• more clearly recognize some of the people for whom the use
of VD is inappropriate and thus should be referred to a qualified
therapist instead;
• work better with clients/students who are the adult children
of, or in relationships with people with a Personality Disorder;
• know where to learn more about a kind of pathology that
is hard to recognize.
Drs. Hal and Sidra Stone make it clear that Voice Dialogue is not
a tool to be used by or with everyone. They have asked me to write
this paper.
All of us doing this work feel the ethical weight we agree to carry
when we accompany people on journeys into their inner lives. Becoming
familiar with the warning signs of psychological disturbance can
help us carry that weight more responsibly and with a greater sense
of safety. Thus, no matter how long or short a time you have been
a practitioner and/or teacher of Voice Dialogue, if you have not
received education in recognizing pathology in general and Personality
Disorders in particular, it will serve you and your clients/students
well for you to seek it out. The aim in gathering this knowledge
is not so that you can make diagnoses yourself – it takes
a trained clinician to do that – but rather to help you to
navigate your practice more consciously.
Obviously, no short article can teach the complex issues of recognizing
subtle forms of disturbance. Nor is this paper designed to teach
how to treat Personality Disordered individuals. All I hope to do
here is to give some indication of when your alarm bells should
ring. Also, I will recommend some useful reading to help you orient
yourself.
Please note: Diagnostic categories serve a clarifying function
to help choose an appropriate treatment or approach. In some growth-oriented
circles, unfortunately, there still lingers the misconception that
it is more compassionate and tolerant to refuse to think in diagnostic
terms and that to think diagnostically is rude or arrogant. Historically,
this rejection of the usage of diagnostic terms began as a highly
appropriate rebellion, particularly among the holistic, Humanistic
Psychologists of the 1950’s and 60’s, against the psychiatric
community’s tyrannical, dehumanizing misuse of diagnoses to
label people and then discriminate against them.
Diagnostic terms must be used with respect and care. I have no
desire to repeat historical abuses. I ask you to remember: a Personality
Disorder or any other pathological condition is something that people
have. It is not something they are.
(For the sake of clarity, I will use ‘he’ for the disturbed
person and ‘she’ for the person in relationship to the
disturbed person. Statistically, more women are diagnosed with,
for example, Borderline Personality Disorder, while more men are
diagnosed with Antisocial Personality Disorder.)
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Table of Contents
Aims of this article
What is ‘normal’?
What is ‘abnormal’
Warning signs that a potential client/student
may suffer from a Personality Disorder
What to do – but first, what NOT to
do
Working with a client/student whose parent
and/or partner suffers from a Personality Disorder
Doing Bonding Pattern work with a client/student
with a Personality Disordered parent and/or partner
About the author
Appendix 1: References and Useful Books
& Websites
Appendix 2: DSM IV – Personality
Disorders
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