Personality vs. Personality Disorders

Last week I wrote about the difference between personality or temperament preferences according to one’s type and moral choices. There’s no personality preference that excuses a person from moral, sane behavior. While working on this series, I was reminded of a family therapy group I co-led with a colleague some years ago. One of the indispensable tools in our tool box was the MBTI, which we used to help couples understand why they often didn’t see eye-to-eye, and what they could do to gain insight and change the way they related to one another.

An interesting byproduct of our work on personality types was a question raised by one of the group’s participants, Ned: what’s the difference between a personality type and a personality disorder? How do I know which is which when I’m dealing with problematic interpersonal relationships?

ned’s story

Ned was a single dad who attended the group because he was trying to heal a broken relationships with his son. After taking the MBTI and learning about personality preferences, he expressed concerns that his own preferences for introverted, intuitive thinking ran so far counter to his son’s extraverted, sensing personality that maybe he had alienated his son needlessly. Perhaps, he suggested, his son took after his ex-wife, the young man’s mother. They hadn’t gotten along very well, either. Were the problems and the falling out they’d had Ned’s fault, after all?

We found that as people learned about type and how it can affect one’s marriage and especially one’s child-rearing experiences, they often became concerned about whether they’d done their children a disservice by not fully accepting or understanding their personality preferences. Decent parents are always concerned about screwing their kids up. Unfortunately, screwed up parents are also concerned about screwing their kids up; they just can’t or won’t do what it takes to produce a healthy child, which primarily involves becoming a healthy parent first. Our work in the group was to try to separate one sort of parent from another, give the able parents the tools they needed, and get the screwed up folks into individual therapy.

I couldn’t answer Ned’s question about the estrangement with his son without knowing more details of the circumstances. Ned came in for several sessions of individual counseling so that we could try to sort things out. Ned was the adult child of an alcoholic whose early childhood was spent in a tense household occupied by an intelligent alcoholic father and dependent mother. After his parents divorced, he’d had to grow up quickly, becoming the “little man” around the house and juggling life between two households, as children of divorce must do. When he grew up, he fell in love with and married another adult child of an alcoholic, Allison, whose childhood had been chaotic and full of abuse and abandonment.

Ned and Allison believed that their love would pull them through any difficulty, and their love worked for them until Allison’s first pregnancy, which ended in a stillbirth. Ned recalled that she had never seemed to recover from the loss of their first child, and gradually developed a wine habit over the next few years. By the time their second child, Gabe, was born, Allison was drinking a bottle of wine every night. One evening while Ned worked late, Allison had passed out on the couch and Gabe had wandered out into the neighborhood. A concerned neighbor had taken the child home and notified Ned.

Ned had given Allison an ultimatum: either she got sober, or he would leave with Gabe. Allison agreed to stop drinking, and they attended AA and Al-Anon, where they learned about the addictive process, recovery, and mental and moral health. Allison had a year’s sobriety under her belt by the time Gabe was four years old.

Over time, however, Ned realized that sober Allison wasn’t much improvement over drunk Allison. She was intensely self-centered, had mood swings, and was also clingy and demanding of his time. She called Ned’s office several times a day “just to talk,” and regularly called him home for one emergency or another. She expressed many fears, including fear of strangers, fear of intruders, and suspicions about friends and family members. She was hyper-vigilant, observing and commenting on everything. Though always busy and occupied with a great many tasks that involved Gabe spending a substantial part of his time with her strapped into a car seat, stroller, or shopping cart, she was deeply lonely. She had no close friends and had alienated the few recovered family members they had. She was obsessive, driven, and tightly wound. Ned began to feel he was being choked.

In an effort to help his wife, Ned suggested she try yoga, which might calm her down, give her something to do, and expose her to other women who might befriend her. Allison loved yoga and began to practice religiously. “Emphasize ‘religiously,’” Ned had smiled wryly. Allison seemed to need an obsession to keep her from being in the present with Ned and Gabe. Though the principles taught in yoga included being present, attending to one’s breathing, and learning to be peaceful, Allison merely talked about her intentions to be present, be peaceful, and be available to others, too. No one who knew her could say that she had improved and could actually manifest her intentions, though Allison sang her own praises to heaven.

There wasn’t a single problem that led to Ned and Allison’s divorce. Rather, he explained, it was “a thousand little things, and the feeling that she was always just acting like a wife and mother but was never really in it.” She created chaos and tension out of thin air, particularly causing conflict with other women. She couldn’t seem to get along with her female bosses or with Ned’s mother or sisters, and regularly seemed to fabricate division in the workplace and family. I told Ned that she had probably been unable to confront her inner “bad mother” and so had to manifest it outwardly, demanding division, fractures, and abandonment in every intimate relationship because she had to externalize her ongoing self-abandonment.

I told Ned about research done by sociologist Jan Yager, who writes that healthy interpersonal relationships are unlikely to be had with people who grew up abused, neglected, or intensely criticized, for they are likely to act out the negative patterns of childhood and adolescence in all their subsequent relationships. People thus treated in childhood must get and act on good therapy or everyone around them will suffer the consequences, consequences the bewildered personality disordered never fully appreciate.

The courts gave Ned and Allison joint custody of Gabe, who hadn’t been well served by the traditional custodial arrangement of seeing his father only four days a month and on summer vacations. Steeped in Allisons’s chaotic, intense environment, Gabe had problems of his own.

We could see why estrangement was the nearly inevitable outcome of Ned’s relationship with his son. The question was, what (if anything) could we do about it?

Post Game

Though it’s taken a good two months to do it, I’m finished with Patricia’s case study; this post may be considered a sort of post-game wrap-up, a terminal staffing of Patricia’s case. Although Patricia is a composite, she is a reliable composite of real clients. I never worked with a birth mother who surrendered her child who wasn’t devastated afterward, who didn’t regret it, and who didn’t long for her lost baby every day thereafter. Though some turned to addictions to numb their pain and thus mask it, the pain was always there. Though Patricia runs, she can never run far enough away from what she has done.

I had several clients like Patricia, clients who would never have given their children up for adoption had they been healthy people, for when they gave up their babies they sealed themselves in a special kind of purgatory reserved for birth mothers. They made sure that they would be punished for the rest of their lives for being who they were, for the choices they had made.

By this, I don’t mean to say that no mother should ever outsource her parenting to another couple or that a birth mother’s pain must be eternal and unending. I am all in favor of adoption when parents won’t get their acts together. Babies and small children get one childhood, and that childhood is short. If they don’t have healthy parents, children will be psychologically, spiritually, and emotionally maimed. All of us will pay the price. This is why, I think, the Old Testament states that the father’s sins are revisited by the third and fourth generations. In family therapy, when we do a genogram, we can see how patterns are, in fact, continued through three or four generations. Absent a healing, wounds are transmitted as surely as DNA. And I know for certain that every person alive is able to receive healing, able to be saved, eminently redeemable. I don’t mean to say that adoption is bad, that it causes an incurable wound.

What I do mean to say is that adoption and having one’s children removed to foster care occur as the result of a terrible fracture in the bones of a family. Breaks in relationship are symptoms. What caused the adoption or state intervention cannot possibly be a good thing. After having children themselves, even adult adoptees raised by the best possible adoptive parents will say that they can’t imagine giving their own child away. They say they would do whatever it takes to keep their children, and they do.

it’s not about adoption

But Patricia’s story is not merely about adoption. It would be easy to dismiss her study because adoption isn’t part of our lives. We’re not so wounded that we’ve cast away our own flesh and blood, we’ll say. We’re better off than that.

I think we should not be so hasty to pat ourselves on the back, because to whatever extent you or I were wounded, complexed, tied up in knots (as  Zen master Thich Nhat Hanh would put it), to that extent we too need healing and we too have passed on our wounds to our children. You will always see it when your children grow up, find partners, marry, have children and careers. You’ll see it in their friendships or lack of them, their mishaps, the conflicts they have with others, in what they do with their success.

One of the best examples of applied case history I’ve written was in “Talisman,” where I showed how Amanda’s wound, “Trailer Trash,” manifested itself in her life despite her extensive efforts to do other than what her parents had done. In middle age, she is very much like her parents were. The addictions have been cleaned up and are socially acceptable, and the chaos she creates in her life is chaos in the name of Good (work, helping others, etc.), but the effects are the same. There is no peace, no place of security or safety in her household, no order, very little nurture, no time to slow down, no insight or wisdom, no true spirituality.

I could give you a hundred examples, for I’ve seen it in every life of every walking wounded I know, including in my own life. We do it until we’re free, as I wrote in “Talisman.” It can be as obvious as the adult child of the alcoholic marrying an alcoholic. It can be as subtle as the survivor of sexual abuse growing up and appearing to be the picture of mental health, yet choosing to raise her own children in a neighborhood where the highest number of registered sex offenders live within a square mile of her home. It can be as subtle as the social worker who rationalizes her inhuman work schedule by saying she’s doing necessary work, helping the needy, while ignoring the fact that her own children see her no more often than she saw her own parents, and are no more known by her as a mother than she was by her own largely emotionally (if not physically) absent mother.

the good enough family

Sometimes people whose families looked good enough from the outside, and who had average or above-average opportunities but impoverished relationships fare the worst. Stan and Anita grew up in such families. Each had a high-functioning addict or personality-disordered parent; each parent divorced and remarried one or more times, using all the energy that should have been given to the children for the new romance. Each went to summer camp, lived in nice homes. They attended private schools and good universities, were members of fraternal societies and religious clubs. They were the pictures of success and ripe potential until they married. Then, though each continued to exhibit outward success–good careers, nice home, good cars–they and their marriage fell apart.

Like many upwardly mobile, intelligent young people, they sought good help and received it, spending thousands of hours and dollars on therapy. They improved and became better. But as soon as they decided to have children, they each compulsively began to re-create the very picture of disonnectedness and relational poverty with which they were raised. Like the sexual abuse survivor who moved to the nice town house in the midst of an area rife with sex offenders, they moved to a neighborhood surrounded by ghetto. In their one square mile radius were three halfway houses for addicts, nine bars, and numerous prostitutes and drug dealers. Their historic neighborhood was beautiful, but it was surrounded by a virtual war zone. They had chosen for their children a picture that was, in effect, exactly what had been given them by their own parents: the appearance of plenty surrounded by constant threats, impoverishment, and disconnectedness from intimate, supportive, and nurturing family relationships. They scorned the typical suburban neighborhoods their peers and family members chose because “normal” and “typical” had no appeal for their deepest, still impoverished selves. That part of themselves had not yet been called from the tomb; its stink was inevitable.

unless a grain of wheat falls into the ground and dies

This is what we do. We get enough health to feel better, look better, and function better. But we do not heal the wound, because the wound is never healed until we die. We can die metaphorically, as Jesus and Buddha said we must, or we can die physically after living an entire lifetime unhealed and unwhole. But die we must. We know we’re not dead when we fight for our lives over things, when we cannot yield, when we just know we’re right and the other person is wrong, when we must have our own way.

I don’t believe in trying to stop people who are in the throes of a compulsion. Just as Liz tried to help Patricia become conscious to what she was doing to herself, and to how she was re-creating patterns, we can warn people. In fact, I believe that when we see others endangering themselves we’re spiritually obliged to try to warn them off. This is not easy to do in friendships or family relationships, and it’s not easy to do even when you’re a healer being paid to help others heal. But warn we must, with fear and trembling, looking to ourselves first lest we throw our own garbage onto our neighbor’s lawn. We must stop short of complusion in our insistence.

“If the unbelieving one wants to leave, let him leave,” Saint Paul wrote. If others must give in to their compulsions, then we must let them do it wholeheartedly until they are finished living their wounds. This is what Patricia did, and it’s what nearly every client does, at first. They do it at major milestones in the most reliable ways. Only a fortunate and stubborn few come back for more healing and eventually make it through to wholeness. This may be what Jesus meant when He said that the road to life was narrow, and few, very few, are those who are on it. The way to destruction is broad, and very, very many are on it. That’s what He said. He said we are statistically unlikely to avoid the wrong road.

love yields

I believe that one reason why Christians–and indeed all who live in religious communities–are taught to live in community and to avoid schisms is because it’s impossible to avoid schisms without dying to oneself. We all want our own way. We must have it. We cannot yield when under compulsion, when controlled by forces bigger to us than God. Even God yields. So it was that Saint Paul said, “All things are lawful to me, but I will not be controlled by anything.” When we see our children, our friends, ourselves compulsively enter marriages that others warn against, compulsively move away, compulsively insist that they will do this, do that, buy this, take that risk, and have their way, this is when we know that it is no longer love at work, but law. Love yields, suffers long, is patient and kind. Love can give the other person his turn first. There is no substitute for real love. Once you know it, you can never be fooled by a forgery.

The problem is that all too many people have never seen real love. They don’t know it, so they are fooled by forgeries. I’ve heard that when law enforcement agents are taught how to recognize counterfeit bills, they are given real bills to handle and smell first. Sadly, though, to the person who was raised with counterfeits, the counterfeit always feels right. Counterfeits feel more comfortable after you’ve lived with them for over 20 years. If even Satan disguises himself as an angel of light, we can be pretty sure that lesser compulsions will disguise themselves in pretty packages, too. They may seem and feel right; we may be able to get others to agree with us that what’s wrong is, in fact, right.

Before going ahead, though, we should ask what our healers, our shamans, our priests and confessors advise. Are peace and joy leading us forth, as the Prophet Isaiah said they would?  Or are we like Patricia, determined to do what we must?

Patricia: Part 7

Several weeks passed, but Liz didn’t hear from Patricia again. Troubled by the lack of contact, Liz tried calling Patricia. Her number had been disconnected. Finally, Liz called Jeanette Sizemore, the social worker who had first referred Patricia’s case to her.

“Oh, yes,” Jeanette said, “Patricia had the baby and placed him with a wonderful young couple from out of state. Everything is fine with the adoption.”

“I’m more concerned about how Patricia is doing,” Liz replied, “Do you have a current contact number?”

“I’m afraid I don’t,” Jeanette replied. “But I need to do a follow up visit myself. If you like, I’ll get her new number and call you later.” The two professionals agreed on this plan. Even so, Liz felt troubled as she slowly replaced the phone.

Patricia had never really wavered from her plan to give her baby up. Though at times she expressed typical motherly feelings toward her unborn son, more often she appeared indifferent or closed to the possibility of bonding with the baby. It was as if she was already carrying someone else’s child. Patricia had often said that she didn’t ever want to see her father again; Liz suspected that she harbored similar feelings for her baby. Liz had worried that Patricia would give birth and never even hold her son, so eager was she to distance herself from the child.

Was Patricia symbolically distancing herself from her weak mother as she separated her weak and dependent baby from herself? Or did she identify the little boy with her own father somehow? Babies could be awfully unpredictable and chaotic—maybe on some level the little boy would dredge up archaic feelings of helplessness in Patricia.

“In any case,” Liz murmured to herself, “it’s done now. Now all you can do is wait.”

A few days later, Liz received a call from Jeanette. “Liz, I have surprising news about Patricia,” she began. “When I got out to the trailer, it was empty. Her neighbor said that as soon as Patricia felt better, she packed her things, withdrew the girls from school, and moved to Kansas to be near her mom and sister.”

Liz leaned back in her chair, dumbfounded. “Are you sure?” she asked.

“As sure as I can be,” Jeanette replied. “I was just as surprised as you, because she had a follow-up appointment with us, too. I’m going to have to try to contact her by mail, but I don’t even have a forwarding address that’s current. She put an old address for her mother on her original paperwork, so we’re pretty much up a creek without a paddle on this one.”

Liz thanked Jeanette and disconnected the call, sighing deeply. The clock ticked.

Patricia’s file was open before her on the desk. Liz charted her call with Jeanette Sizemore, then closed the file and locked it in her file cabinet. A few minutes later, she heard a soft knock at the door; time for her next client.

Tucking her hair behind her ear, Liz took a cleansing breath and opened the door, smiling as she ushered him into the room.