Paradise Cafe Discussions - A Place For Bible Research And Christian Encouragement

I thought it might be good to start a thread on mental illness and related disorders because we're living in an age where many individuals and families are dealing with this challenge. Understanding the nature of mental and emotional problems goes a long way towards dealing appropriately with them.

We here, cannot heal mental illnesses but we can, by understanding their nature, be more effective in coping with attendant problems without needless frustration.

I'm hoping that others will kick in on this topic and it's going into the Controversy forum because of its sensitive nature.

I thought it might be good to start with one of the harder to detect forms: Dissocial personality disorder. The following material was written for mental health professionals in a hospital setting but there is a lot of universally useful material here.

The ICD-10 is the diagnostic reference book for mental and behavioral disorders and is accepted throughout Europe. It describes primary personality disorder as Dissocial personality disorder (World Health Organization – 1992) and lists the traits of this personality disorder as follows:

"( a ) callous unconcern for the feelings of others;

( b ) gross and persistent attitude of irresponsibility and disregard for social norms, rules and obligations;

( c ) incapacity to maintain enduring relationships, though having no difficulty in establishing them;

( d ) very low tolerance to frustration and a low threshold for discharge of aggression, including violence;

( e ) incapacity to experience guilt or to profit from experience, particularly punishment;

( f ) marked proneness to blame others, or to offer plausible rationalizations, for the behavior that has brought the patient into conflict with society."

In order to make the diagnosis of Dissocial Personality Disorder at least three of these traits must be present and enduring over time. Let’s look at how these personality traits interact to create the pattern of behavior typical of this disorder.

Callous unconcern for the feelings of others can be defined as lack of conscience and comes from the inability to empathize with others. This effectively removes the normal social barriers associated with respect for other people. The dissocial personality disordered person will quite literally ride roughshod over anyone in order to get what they want and will be incapable of feeling any remorse or even understanding right and wrong in the normal way. Hence the characteristic gross and persistent attitude of irresponsibility and disregard for social norms, rules and obligations. It also explains the incapacity to maintain enduring relationships although their typically charming front means that they have no difficulty in establishing them.

These people crave stimulation and are easily bored. This is why they have a very low tolerance to frustration which combined with their inability to empathize explains their low threshold for discharge of aggression, including violence.

Dissocial personality disorders are characterized by marked proneness to blame others, or to offer plausible rationalizations…. To put it another way they do not generally accept responsibility for their misconduct which is another reason why those around them tend to suffer. Their plausibility often results in innocent bystanders being blamed for offences in which they had no part and friendships can be destroyed. Dissocials are particularly dangerous with regard to vulnerable people such as the disabled or mentally ill who are often unable to recognize or withstand their behavior.

Finally their incapacity to experience guilt or to profit from experience, particularly punishment is the reason for their resistance to treatment. This is partly because they experience stimuli less intensely than other people do. Put another way they feel pain less and don’t experience any emotions as intensely either. That’s why they’re so easily bored and in part explains their need to engineer dramatic (and often extremely disruptive) situations. Such situations may be said to ‘punctuate the emptiness’ caused by their high stimuli threshold.

Many people are drawn into what has come to be known as the savior fantasy in relation to these people and will patiently endure a range of unpleasant circumstances in an attempt to put them back on ‘the right track’. An excellent source of information about the sort of strategies used by dissocials in these situations is GAMES PEOPLE PLAY (Berne E. – 1964).

So what can we do?

In any behavioral disorder it is vital to draw firm and consistent boundaries. This is very different from the usual stance people take when dealing with others. As a rule in our society 'no' tends to mean 'no - unless you can persuade me otherwise'. With psychopaths 'no' must be absolute. And it must be consistently maintained throughout the team.

Psychopaths tend to play one person off against another and will use your friends and colleagues to emotionally blackmail you by gaining their support with plausible explanations for their behavior. Typically they will explain how hard they are trying and how difficult it is to cope with their problems - particularly when that callous nurse (you) won't give them any slack. Then comes the trump card: 'How can anyone expect me to get better when the nurse (you) treats me so unfairly?' Students are vulnerable because they are not yet used to this sort of manipulation and regularly get hurt emotionally by strategies such as these.

The same is true of the patient's parents and associates, which is why they often visit the ward to verbally attack the staff. These people often complain officially about staff. Be aware that these people generally are doing precisely what they believe to be right and are only fighting against the perceived injustice the psychopathic patient has persuaded them of. Incidentally this is why nurses on psychiatric wards are so insistent that the approach is consistent and that the rationale is well documented. Psychopaths are dangerous people to the inexperienced.

Perhaps the greatest skill in dealing with dissocial personalities is assertiveness. See the related handout in this series. Assertiveness skills help you keep boundaries and avoid the manipulation and emotional blackmail.

Relatives find it extremely difficult to understand and deal appropriately with psychopathic family members. This is understandable and certainly not a reason to dismiss or otherwise under-value them or their experience. Just as you had no knowledge of psychopathy before you began your training - neither can they be expected to. They are generally reasonable people faced with a bewildering situation and doing the best they can. It is often possible to help them by teaching assertiveness but don't call it that - most parents and relatives prefer to think of it in the popular guise of 'tough love'. The message is the same. Essentially it's important to help them understand their personal rights and also to accept that the psychopath is an adult. However bizarre their relatives' behavior may be, however destructive or offensive it is the psychopath's own responsibility. Relatives have no need to feel responsible. Incidentally they don't need to run around after the psychopath either although that is often extremely hard for relatives to hear and the message often fails to get through at all.

Those who do take this message on board often find that the psychopathic relative will eventually learn to leave them alone but this may result in total separation. This is no different from a bereavement resulting from death of a loved on. For that reason it is inappropriate to try to 'force' the relative into an assertive position. The resulting separation may be too hard for them to cope with. It is enough to help them recognize the issues. Anything further must remain their own choice.

excerpted from: Mental Health Today

Hope this info is useful,

Rez:giverose:

Hi Resolute

Re: "Hope this info is useful,"

Yes. Very useful. Thanks.

(the link does not get through when clicked on...I think it might be the square brackets thingies....as when the link itself is copied and pasted, one arrives at the desired location...no problem...grin)

:coffeeread:

Christian love and appreciation

gogh

Sorry, bro. I didn't make it a link....shall do right away!

:clap: Awesome idea Rez :thumbsup: I give this thread two thumbs up.

In this modern world where we live in supposed understanding of so many things, Mental Illness has somehow been swept under the rug by mainstream society. In our media and literature we are shown it's something to fear or disregard, but it is neither.

Having a mental illness can be terrifying: both because of the way it affects a person's personal life, and because one never knows how it will be accepted amongst friends and family. There is a stigma there that never really died, and I am of the strong belief that it is because most people are not presented it in the proper light. And because of it there are those suffering who may not even realize what they are doing to themselves and those around them, or if they do they're frightened of being 'put away' or even of seeing a therapist for what they need most: which is help.

I hope to see more on this topic, and may do some digging myself for treasures in finding out about the world of Mental Illness to share here, because I'm sure we all know someone with some sort of illness or disorder, and we might not completely understand sometimes the things that they do or say. It's time to open the doors of ignorance, excellent job Rez and thanks again. :thumbsup:

Thanks Draka:siskiss:

So, here's a practical scenario....something that might happen right here on the Paradise Cafe. A poster comes on board and manifests some of the criteria of Dissocial personality disorder...say, for instance that they:

1. manifest a callous unconcern for the feelings of others

2. when confronted about their obnoxious posting behavior they have an attitude of irresponsibility and disregard for social norms, rules and obligations

3. They display a marked proneness to blame others, or to offer plausible rationalizations, for the behavior that has brought them into conflict with other board members.

(Remember, in order to make the diagnosis of Dissocial Personality Disorder there only needs to be at least three of those 6 traits that were listed earlier and which must be present and enduring over time.)

You come to recognize that this poster has a mental disorder -- what to do? What do you need to know in order to give a correct and effective response to their sometimes histrionic or confrontational posts. Remember -- they are seeking stimulus because they feel pain less and don’t experience any emotions as intensely either. That’s why they’re so easily bored and in part explains their need to engineer dramatic (and often extremely disruptive) situations.

How would you deal with a situation like this? Just curious.... :P

Love,
Rez:giverose:

Hmm...loaded question there Rez. :shocked:Let me think here...:scratchhead:

In such a hypothetical scenario such as this I would at first, show patience and as much support as is possible. If, as time progresses, I found that patience was wearing thin and that too much chaos was the result I would talk to the person in question, calmly see what roads he/she would consider to be logical to take. If no truly logical decision can be found (because though they may believe their logic is sound, under the influence of DPD it very well may not be) then I would suggest to them to possibly seek professional aide to improve upon their bruised social skills,:doctor: dropping subtle hints about to lead them in this path as kindly as possible. I would give them options to express themselves in less disruptive ways because the creative flow, though it might be part of the problem, may also help to lead to the answers they need.

And then, if after all this they still create the disruption and chaos :computerpunch: I would, unfortunately remove their option to post, for the greater good, though it certainly wouldn't be my first choice. Chances are they wouldn't believe that they had an issue (who ever wants to admit that, after all?) and would leave with feelings bruised, as there would be little to physically do for them as we're dealing with a digital group rather than one that sees each other face to face. I would pray for them every day that they found the help they needed and if ever given the chance be ready to help them should they realize they had an issue. :pray:

But things always sound easier than they really are, don't they? :cry:

Not sure if this helps, but I tried my best.

:heartbeat: -Mia

Very good, Draka!

Now you've offered the suggestion that they seek professional help and you've received in return a stern rebuke that "they're just fine, thank you very much, dear!" (remember "their incapacity to experience guilt or to profit from experience, particularly punishment is the reason for their resistance to treatment.") Oh dear, and are you a mental health professional to be offering a diagnosis of mental disorder? For shame! And there is nothing wrong with their posting...it is YOU that is the problem!

Now what?

(and to make it more challenging, you don't have the option of removing their posting privileges. Ha!):whistle:

I know what you are saying Rez. Don't want to make light of this subject, but in my case, I had to divorce him; and yet he is still giving me problems, because in my familly I was conditioned to accept these behaviours.

And tablets are not the answer.



vicky

Yes Vic,, that is the root of the problem.
We are taught to except bad behavior. that is the part of being PC that i just cannot do.
We need to have mercy yet we need to know when to run and run fast. and maybe hide. Cuase trying to stand up to certain problems is a waste of time.

Some problem just follow us in this life. I am thinking only GOD can give of the way out and the peace we seek.

I have just come to the conclusion that sometimes things may actually have to fall apart "from our perspective" for us to Get the peace that God can give us. IT may put us in a very uncofortable place but the outcome might be just what is needed. I am thinking that the struggle to hold it together out of responsibility might also be something he wants us to all together let go of.

I will let you know in a few months... if this new approach works for me.

Peace and May GOD bless you Vicky:happyheart:

Ahhhh...Vicars! You were wed to one. But you were able to free yourself somewhat....although that is no doubt ongoing.

But just for the sake of this little scenario, on a day-to-day basis, how would you respond and what pitfalls would you have to watch out for with a person who had this disorder?

For instance....does persuasion work? :argue:

Well, like I said, they probably wouldn't admit they had an issue. I doubt that persuasion would work unless you were face to face and they could see the concern in your eyes, and even then given the nature of this disease that may not work either.

And no vicky tablets are NOT the answers. Pills = bad in my opinion.

If they don't want to believe it, then that's their choice, and one doesn't have to be a mental health professional to see it: how is it that most people end up going to see a mental health professional in the first place? Surely a therapist doesn't walk up to people on the street and say "You have the look of someone who desperately needs my help. Come, make an appointment with me and we'll discuss this further" :doctor:

Of course not, and I'd be wary of such doctors. :shocked: Chances are in such a case you're a young blonde with "assets". :whistle: It's the people around them without mental health training that will spot it and help the most. And if they have real world experience with such matters, even better! But...chances are, they won't see it that way.

You can't push them to seek aide, but you planted the seed. I'd personally carry through with the rest and let God do the rest.

Yep, I was a blond assette who attracted an ass.


More to the point there are many with mental problems that need to find help, and not be embarrassed that someone messed with their head in their early years.

No persuasion does not work. Short-term flattery works, but that is all, short term.

True that.

Not easy, is it!:(

I have a little saying that I've found to be true: "When the pain of the problem becomes greater than the pain of the solution....people will change."

Until then you are only able to use coping techniques to save your own sanity. At least, becoming aware of what is going on will spare you somewhat and you can often avoid being manipulated.

Mental disorders are no fun for the victims or for those who care for them. We can hope and pray that God's time of restoration is near and work to that end with love and patience.

But we have a little practical example to learn from.

So, you been working your hardest to convince the person that he/she needs to look at things honestly...to confront themselves. Have you fallen victim to the "savior fantasy"? How would you know if you have?

When despite too much heartache, and too many chances given you're pushing yourself to make the blind see. :( Once you've asked yourself the question, you should know the answer.

You can't save them all...