Mental health articles

OF mental health care and mentally ill

Lack of ‘core identity’ about personality disorder

People with personality disorder often have difficulty understanding who they really are. Often they describe feeling like they are nothing or nobody. In a healthy personality, people develop traits and choose values in response to their experiences. They choose what aspects of society and culture are important to them. Over time, these choices become integrated into their personality, part of who they are.

A client with personality disorder is often hyper-aware of this process and interprets it as being somehow fake or unreal. This leads to excessive introspection and self-criticism, which significantly contributes to the dysfunctionality of the client with personality disorder.

Clients with these symptoms are often social chameleons, adapting who they are, their likes, dislikes and preferences to fit in with those around them. This is often an attempt to fit in and be accepted, or to disguise their sense of being ‘no one’.

However, this leads to further feelings of being a fraud. It is hard to be yourself if you have no idea of who ‘you’ are.

This process of inconsistent personal identity also makes it easy to dismiss any positive feedback from other people. If they are not seeing the real you, their positive comments are not genuinely about you but only comments regarding the person you are pretending to be. Interestingly, this does not seem to hold true for negative comments. These tend to be interpreted as insightful perceptions seeing through the attempts to appear acceptable.

One major difficulty this causes is that clients with personality disorder will often ‘become’ the client that health care professionals expect, that is anorexic, addict, psychotic, depressed. Often it is only after several failed treatment programmes that the health care professionals begin to question their original diagnosis.

This can lead to further difficulties when the client loses confidence in the health care professional’s ability to understand or help them. Some will see this as evidence that health care professionals are easily fooled; for others it only serves to strengthen their belief that they are beyond help and utterly hopeless.

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