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From Neurosis to Personality Disorders

by Izzy Kalman (August 2003)

(Please excuse me for the exaggerated generality of what I am saying in this article.) In general, people with personality disorders suffer in life, readily express their anger about their problems, and have difficulty maintaining relationships. However, they blame others for their difficulties and are surprisingly satisfied with themselves. They are also considered to be extremely resistant to psychotherapeutic help. Treatment involves trying to get them to blame themselves rather than others for their problems, but for some strange reason, they don’t like this.

For much of the previous century, the most common psychiatric diagnosis was neurosis. In general, neurotics are people who suffer in life, but blame themselves for their misery. They bottle up their anger, but it seeps forth in the form of various symptoms. They are likely to stay in abusive relationships even though they are suffering because they blame themselves. For a long time, neurotics were considered difficult to treat, generally requiring years of psychoanalysis. However, the psychotherapeutic establishment ultimately made great strides, and neurosis has largely become a historical phenomenon.

How have we tackled neurosis so successfully? By teaching clients: that they are not responsible for their problems because their misery originates from abuse and neglect; that they have a right to be angry and shouldn’t bottle it up; that they should esteem themselves regardless of their difficulties and what others think of them; and that they shouldn’t tolerate abusive relationships. These philosophies of mental health have also permeated general society and popular psychology. As a result, we all know we are entitled to self-esteem, we are not to tolerate any abuse, and we should divorce partners who are cruel to us (contributing to the skyrocketing divorce rate in the country, now at 57%).

In other words, we have taught that the solution to being neurotic is to think like someone with a personality disorder!

Society has not eliminated the mental health problem once posed by neurosis; we have merely changed the nature of the people’s suffering. And we have come full circle. We have gotten rid of neurosis by getting people to STOP blaming themselves, and now we are trying to get rid of personality disorders by getting people to START blaming themselves.

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