Therapists too quick to assume someone has a personality disorder
Alexandra Shimo is right to highlight the travesty of people who have lived through traumatic experiences being labelled as having disordered personalities (Opinion, 27 March). Aaron Beck, the father of cognitive behavioural therapy, describes two therapists talking: “I’m having trouble with my patient with personality disorder.” “How do you know they have personality disorder?” “Because I’m having trouble with them.”
This gut-feeling approach to diagnosis happens all too often in the UK. But things are changing. Next week is the 20th British and Irish Group for the Study of “Personality Disorder” annual conference in Durham. The inverted commas are indicative of the scepticism that members hold of the value of the personality disorder label. The conference is being launched by poet Clare Shaw, a staunch critic of the borderline personality disorder diagnosis, while other keynote sessions look at the impact of deprivation and trauma. We are moving away from “what is wrong with you?” and looking closer at “what happened to you?”.
Perhaps most importantly, 10% of those attending will be people with lived experience of the diagnosis. This level of user involvement is rare in services but at BIGSPD it is seen as essential to ensure that those who receive services shape how they evolve. The stigma around personality disorder leads to shut doors and closed minds. Those who have lived through trauma deserve better. People can join in the debate at #BIGSPD19.Keir Harding Clinical lead, Beam Consultancy
• Hadley Freeman writes: “It is a well-established tragic truth that one of the biggest predictors for an adult becoming an abuser is if they have been abused themselves” (Michael Jackson’s life showed us the journey from abused to abuser, 26 March).
No, it is a well-established prejudice.
The majority of abused children are little girls, and hardly any of them grow up to be abusers. Some abused boys may do, but even then the evidence shows that a climate of sexism and degradation is a stronger contributory factor than the actual abuse. If no such climate exists in the family, an abused boy is no more likely to abuse others than any other child.
It is a comforting thought that the abused do the abusing, and the rest of the world is full of “good” people, but it’s no more than that. Anyone can abuse in the right circumstances – like bullying, you don’t have to have it done to you to work out how to do it to others.
Survivors of abuse have enough to deal with without coping with prejudice of this kind. Isn’t it bad enough to have come through this without everyone you meet thinking you’re likely to become an abuser? No wonder abuse survivors have such a high suicide rate – stuff like this helps convince them they will never be normal.
Why do only abuse survivors come in for this? Are people who’ve had their car stolen thought more likely to steal cars? Are adult rape victims suspected of being more likely to rape? These are horrible things to say, and yet they can be glibly stated about the victims of abuse, that they are tainted, and cursed to repeat the abuse in a mythical “cycle of abuse”, which, if it were true, would mean the world would be full of female abusers.Ash CharltonLondon
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