We are talking about schizophrenic disorders and we stopped off
right there at the end where I reiterated that the DSM-5, the current
version,
does not recognize these types anymore but, I think it's worth it.
I'll probably continue to teach these types down the road because historically
speaking they've been with us
for many, many decades and they do speak to the kinds of presentations
that you might see with schizophrenia. Because it's a wide array of people
who have schizophrenia and even when you say it's paranoid type,
I've known quite a few paranoid type people, paranoid type schizophrenia
and they're all different. They all have different delusions. They all have different
issues. They all
present in very different ways. They're all pretty much
interesting and relatively cool people depending on the situation that there
in.
That's a very, very difficult disorder to be beset with.
Another very difficult disorder to be beset with
is personality disorder because it is so pervasive in effect every aspect of
somebody's life.
Now these personality disorders we'll see are
conditions are chronic. Right?
It doesn't go away, it's your personality
is the issue. Extreme, maladaptive,
inflexible character traits which caused distress
and which cause impaired functioning. And
I would note also in the sense that
these things are not realized by the person with the disorder often.
It often will cause pain for other people.
This pain is experienced to oneself, but they don't often recognize
their own personality is causing the situations that bring that pain.
The pain they experience oftentimes is experienced by other people because
when your personality is the problem it is a very severe issue.
In DSM-4 all the way up to DSM-4 we used to have these things call 5
Axis. You have Axis 1 which is all the clinical disorders.
Like everything you can think of. Everything we've been talking about mood disorders,
which are now divided again. Anxiety disorders which have been divided again
and into traumatic issues and other kinds of things.
Substance abuse, ADHD, autism,
you name it. It was there. Axis 2
it was mental retardation and personality disorder.
Now those can be subtle issues. You know a little bit about the assessment of
intelligence
and how tricky that is. You can't just take a number and think you know all
about a person because of their performance
at one time on one task. You have to be very careful
to assess for intelligence when it might be a clinical issue.
And the other argument was that personality issues can be very subtle too.
That people don't always exhibit the problems
in a one on one interaction of short term and short duration,
but that they do come out. So what
interested me though was also this. Theoretically,
on Axis 1, almost all of those disorders are treatable.
They're treatable by either talk therapy or medication or combination thereof.
Schizophrenia is treatable. Bipolar
is treatable. ADHD is treatable. Substance abuse
theoretically is treatable. But when you got to the Axis 2,
mental retardation is not treatable. You can
detect it early and put in some
interventions to help a person maximize what abilities they have.
In terms of their intellectual gains and knowledge gains, but you can't take
somebody with say a
a 60 IQ and raise that IQ to 110 or anything like that.
There's no medication to take for it. There's no talk therapy for it. It's just a
condition
of the person that they have to live with. It is a chronic issue.
There's no treatment for personality disorder that
works really, really well either, There's no medication to take
for your personality and while we have treatment
it's a very treatment-resistant disorder.
Who you are is core to what you are.
Think about it for just a second. Now all of us as I've said,
we all got our issues. Right? We all gotta hang ups, we all got eccentricities,
we all got our proclivities and all that thing make us,
us. Our individual selves. And we got problems
with our personalities and sometimes make it harder for us that might otherwise be
if we get over those hang ups
or might cause issues with other people. Everybody has that.
That's a shared thing. These are much worse than
normal because we already know statistically speaking
these would be unusual. Usually less than two percent of the population
would qualify for anyone of these. Some people qualify of multiple of these.
Right? But then think to yourself, if you had this issue
and some - somebody in here might. Quite frankly.
It's not that uncommon. If you've got a hundred people you'd expect
two or three on average to meet criteria. Try to be somebody different tomorrow.
Don't be you. Be somebody else tomorrow.
All day long in every single situation. Have a wholly different personality
tomorrow if you can.
And then maintain that for the rest of your life.
That's what we're talking about here. You don't just change personalities. You don't
just
become somebody else. In fact, you wouldn't want to become somebody else.
You just want to tame what would otherwise be a problem with
the degree of personality traits that you have.
It's not that people with personality disorders have personality types
unseen in other people. The traits that we talked about in the
personality chapter
are still applicable. But what we have is most peoples personality, you saw that
complemented by social psychology chapter.
They go well together because all of us have these characteristics that make us, us.
But the social chapter showed us that there are situations in which
we won't necessarily behave characteristically. Novel situations,
unusual situations, high-pressure situations,
that we will engage in impression management or we will just wholly act in ways
that aren't
really you know consistent with how other people define us.
In other words most of us are flexible
with our personality traits. They're not so dominate
that they control every aspect of our lives.
But when you have the personality disorder that's what you're looking at,
an extreme exaggeration of otherwise
normal personality traits and I'll give you some examples.
Personality disorders are classified into three clusters and we're going to
break them down in a second.
The first cluster is cluster A. Odd and eccentric.
Very unusual, but not schizophrenic.
Right? Schizophrenia I think you probably picked up on is a very bizarre and
unusual way
for people to interact with the world and other people are usually
put off by those interactions because they're so unusual they don't know how
to relate to the person
and the person themselves are not relating in a
consensus reality basis anyway. So they don't share
the perceptions necessarily other people are having.
Cluster B is dramatic and emotional.
So everybody can be drama sometimes. right air by the emotional sometimes but
again here we're looking at some extreme characteristics.
And then Cluster C is anxious and fearfulness.
So we can all be anxious and we can all be fearful, but it doesn't dominate
most of our lives. Because it's not a function of our personality
but usually a function of our response to situations.
So you look at these things and you'll see that they're not that
far off from what most people experience. And I'm just going to give you the most basic
of descriptions for these. You should be able on your test to
read a description and go, oh yeah, that's paranoid personality disorder not
Bipolar or, excuse me, borderline personality disorder.
You should know them well enough to distinguish them and their distinguishable
almost by their names alone.