Question:
My 19 year old son was recently diagnosed with depression, anxiety and personality disorder. I am trying to gather as much information as I can so I can understand his problems and be of help. Much of what I read indicate that the source of personality disorders is a personality disorder in a parent or abuse by a parent. My son was a difficult child at times growing up but I don’t think I abused him. Am I so blind to my own problems that I have harmed my son without knowing it? Is there anyway that I can be a help in his recovery? Would my son be better off without me in his life?
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Answer:
This is a great question that I think many people struggle with; thanks for asking it.
The best way to think about what personality disorders are is to think of them as a form of developmental delay within a person’s ability to cope socially and emotionally. The world is a complex place that is very demanding. People find themselves in different situations that require different responses from them at different times. It is appropriate to act one way at work, but an entirely different way while with family and close friends, for instance. Mature adults generally develop a complex understanding of what is appropriate and expected of them in different situations and are able to respond appropriately in each situation according to that situation’s needs. However, people with personality disorders do not generally develop this wide-ranging understanding of how to respond appropriately. Instead, their ability to function socially and emotionally is developmentally delayed and they generally will take a more rigid, restricted approach to social functioning. They may only know how to be one way and insist on applying that one way to all situations even when it doesn’t fit. Their one way may work fine in one setting, but may create problems in other settings. So they may not appear to have a problem in that one setting, but it becomes obvious that they do have a problem functioning in the other settings.
For instance, think of a narcissistic surgeon (to pick one stereotype out of many). That surgeon expects to be in charge and for others to do what she says without question, and generally at work, this is what happens around her as her staff coordinates themselves to her direction so as to accomplish the demands of surgery. If the surgeon brings the same demand for conformity and subordination back into her personal life, her family, who should not be subjected to that sort of treatment, will suffer.
There are a number of different personality disorders, and they occur for different reasons. Some of the personality disorders seem to have more of a genetic, inherited cause, such as schizoid and schizotypal disorders (which tend to occur in the same families who are prone to schizophrenia), while others have more of an environmental cause. With regard to most of the personality disorders, it isn’t one cause or another – a number of various causes combine to create the disorder. for instance, Borderline Personality Disorder. Though many people diagnosed with BPD have been abused in one form or another, not all of them have. There are likely to be some underlying biological factors at work which predispose certain people to develop the disorder, and when abusive situations occur, that pushes said vulnerable people over the edge. However, in some cases, the disorder occurs in the absense of abuse, and in some cases, if someone has been abused fiercely enough, they can develop the disorder in the absense of the underlying vulnerability. It’s impossible to tease apart the various contributions in most cases.
What might some of these underlying vulnerabilities look like? Being born "hard-headed" and stubborn by temperament may be a vulnerability factor for a social developmental delay. Essentially, these characteristics make it difficult to punish a child (e.g., to teach him or her that their course of action is inappropriate). Where a "softer" child might take correction more easily, a harder headed child requires more persistance and consistency on the part of a parent if they are to get the message. And the consequence of their not learning the message is that they persist in believing that their wishes are all that are important in the world past the time when other children learn about the importance of taking other people’s wishes into account. Unchecked, this sort of tendency can (if other environmental conditions are right) blossom into an antisocial personality disorder or some sort of narcissism.
Without knowing the intimate details of your family life it is impossible to say whether abuse has occurred, and whether something you have done (or failed to do) has harmed your child. That you are capable of writing this letter suggests that you are not so full of yourself as to be incapable of entertaining self-doubt, which is a good thing, as it suggests someone less prone to be abusive than might otherwise be the case. You should certainly walk away from reading this secure in the knowledge that personality disorders can occur even when there is no trauma or abuse and that it is not necessarily the case that you did anything wrong. You should also know that, while it is not the easiest work in the world to accomplish, that many personality disorders can be successfully addressed with psychotherapy and (in some cases) psychiatric medication. Many forms of personalty disorder amount to a sort of social-emotional immaturity, and with the proper quasi-parental attention, some people who have these problems are quite capable of growing out of them.
