Personality disorder

“ His personality also changes markedly; he becomes deceitful, self-retired, cowardly, and grouchy. His physical appearance reflects well the internal conflict and the slow sapping of his physical and mental strength ”

“ By this mental bondage morbid sympathy is clearly and definitely distinguished from all subordinate degrees of this instinct, however closely allied the imitation of a disorder may seem to be to that of a mere folly, of an absurd fashion, of an awkward habit in speech and manner, or even of a confusion of ideas. Even these latter imitations, however, directed as they are to foolish and pernicious objects, place the self-independence of the greater portion of mankind in a very doubtful light, and account for their union into a social whole. ”

“ The natural consequence is restlessness, agitation, anger, indecision, etc. The dissociation of personality, with the outcropping of the “b mood,” follows—a conflict due to the excitation of certain childhood complexes, conserved in the unconscious and embracing sentiments in which are incorporated the instinct of self-subjection or abasement. This “b mood” is a study in itself. ”

“ Amongst other things they tend to determine the points of view, the attitudes of mind, the individual and social conscience, judgment, etc., and, as large systems, may become “sides to one’s character.” When such complexes have strong emotional tones they may set up conflicts leading to the inhibition of antagonistic sentiments, and sometimes to the contraction and even disruption of the personality. All these phenomena can be induced by the artificial creation and organization of complexes and this principle becomes an important one in therapeutics. ”

“ The type of behavior disorder, the social reactions, the trends of interests, etc., which psychopathic personalities may show give special features to many cases, e.g., criminal traits, moral deficiency, tramp life, sexual perversions and various temperamental peculiarities. ”

“ But, after all, it is not necessary to insist on such extreme instances in order to demonstrate the essential instability and divisibility of that which we commonly have in mind when we speak of the “self.” Dissociation of personality is in evidence every day in the pathetic symptomatology of the various insanities, and in the chronic, if often masked and unrecognized, memory lapses universal among sufferers from the manifold affections of hysteria, such as we dealt with in the chapter on “Dissociation and Disease.” ”

“ The course of the disorder appears to be that the rationalisations, developed by the subject to explain his inferiority, become so intimately connected with the affective basis of his trouble that they attain a reality and effectiveness which greatly relieve, or even wholly remove, the painfulness of the conflict. ”

“ The absurd irritability of his system, which makes a crisis out of every one of his experiences, and sees dramatic elements in the most insignificant occurrences of life, deprives him of all calm reflection; he ceases from being a personality, at most he is a rendezvous of personalities of which first one and then the other asserts itself with barefaced assurance. ”

“ Events that threaten the impulse of self-preservation of the individual, such as misfortunes, shocks, losses, tend to bring about psychopathic states, on account of the aroused fear instinct, on account of the impulse of self-preservation, and sudden inhibition [356] of the stores of reserve energy. Events that may lead to dissolution of personality are, hence, attended with intense anxiety. ”

“ He had talked to me a good deal concerning "subliminal selves," of the theory of "successive planes of consciousness" and of "isolated personalities," ending with the statement that, so far as any definite knowledge of the psychology of multiple or dissociated personality was concerned, even doctors were the merest laymen. Of its actual rationale they knew virtually nothing, though in some cases the disintegrated personalities had been synthesized into a normal self by means of hypnotic treatment. ”

“ This state is characterised psychologically by an extraordinary loss of orientation about one's personality, about what one really is, or else the individual has a positive but mistaken idea of that which he has just become. Intolerance, dogmatism, self-conceit, self-depreciation, contempt and belittling of "not analysed" fellow-beings, and also of their opinions and activities, all very frequently occur. An increased disposition to physical disorders may also occasionally be observed, but this occurs only if pleasure be taken therein, thus prolonging this stage unduly. ”

“ As Clark expresses it, "The nucleus of this personality defect is a temperament of extreme hypersensitiveness and egotism and all that these two main characteristics entail ... a personality defect which makes its possessor incapable of social adaptation in its best setting and which, if it remains uncorrected, renders the individual inadequate to make a normal adult life." ”

“ The acute panic of the personality is due to the perverse sexual cravings which threaten to overcome the ego, and disestablish the individual's self-control. At the same time, the affections for winning social esteem are pushed into an eccentric adjustment. The weakness of the ego may be attributed to fatigue, debilitating illness, loss of the love object, homesickness, misfortunes, imposition on the part of a superior, or erotic companions. As the individual shows his eccentricities and irritability, he is often teased and tormented by his fellows. ”

“ Toward the process of adjustment and adaptation, of the environment to the individual, as well as of the individual to the environment, attitudes will change from hopeless acquiescence in the inevitable to a complete self-determination of the self and its surroundings. The adventures of the personality, strung along as the episodes of his career, his friendships and sex reactions, his mishaps and diseases, and the final fate or fortune that overtakes him, be he normal, subnormal, supernormal, or abnormal, begin to become comprehensible, and hence controllable. ”

“ He cannot think, he becomes less and less original in his thoughts, he becomes even incapable of thinking. The patient’s whole mind becomes limited to himself and to the symptoms of his disease.
Along with it the fear instinct grows in power, inhibiting all other activities. There is a limitation of the patient’s personal self. The personality becomes reduced to the lowest levels of existence, caring for his own selfish pains and small pleasures, which are exaggerated and magnified to an extraordinary degree. ”

“ These illustrate the dangers of affectional wound,—the sensitivity of personality to emotional shock. A conflict may make or break an individual.
Just what is it which differentiates between two lives of similar asocial behavior or suffering affectional wounds, one becoming disorganized, the other attaining higher levels of mental and social integration? Certain psychoanalytic biographies show struggles of eminent men and women who passed through periods of mental strain or moral failure, yet rose superior to and even strengthened by their wrestling with life. ”

“ When the mind undergoes degeneration, the moral feeling is the first to show it, as it is the last to be restored when the disorder passes away; the latest and highest gain of mental evolution, it is the first to witness by its impairment to mental dissolution.... ”

“ But, as we have also seen, they are potentially capable of being awakened and determining mental and bodily behavior. Furthermore, evidence has been adduced to show that the various units of personality do not always coöperate and function harmoniously with one another, as no doubt they ought to do, but sometimes are incited to conflicts and then they play the deuce with the individual and he fails to be able to adapt himself to the realities of life. ”

“ We lose no opportunity of preaching against them as unwholesome and 101misleading; because they mostly deal with conditions of physical excitement, and study of the abnormal and diseased, including problems of disintegrated personality which present such close analogy to those of insanity. We have the deepest distrust in, and distaste for, stories of abnormal appearances and conditions. ”

“ For statistical purposes the differentiation of the psychopathic personalities has been described by the Association's committee as follows:—
"Under the designation of psychopathic personality is brought together a large group of pathological personalities whose abnormality of makeup is expressed mainly in the character and intensity of their emotional and volitional reactions. To meet the demands of current usage, the term for this group has been shortened from the older one "psychoses with constitutional psychopathic inferiority" with which it is synonymous. ”

“ Although he receives nothing more from outside, and his personality is completely isolated from the surroundings in which he is placed, he may be seen to go, come, do, act, as if he had his senses and intelligence in full exercise.’ This, it is true, is the description of a patient, but what he says of the latter applies equally, with a difference of degree only, to the ego-maniac. ”

“ The narcissistic personality is especially vulnerable to regression to damaged or defective self-concepts on the occasions of loss of those who have functioned as self-objects. When the individual is faced with such stress events as criticism, withdrawal of praise, or humiliation, the information involved may be denied, disavowed, negated, or shifted in meaning to prevent a reactive state of rage, depression, or shame. ”

“ In the degenerate with disturbed equilibrium consciousness has to play the part of an ape-like mother finding excuses for the stupid and naughty tricks of a spoiled child. The unconscious personality commits follies and evil deeds, and the conscious, standing powerless by, and unable to hinder it, seeks to palliate them by all sorts of pretexts. ”

“ These attributes are not applicable to a human personality; being as a rule judgments of character intuitively and not critically approved, which are projected upon our fellow-beings, inevitably doing serious injury to human relations. ”

“ In any given case the {263} possibility of the occurrence of an attack of what is really the assumption of a secondary personality must be judged from the circumstances, from the previous history of the individual, from the family traits, and from certain stigmata as narrowing of the field of vision and the like, which go to show the existence of a highly neurotic constitution. ”

“ By this mechanism we can explain the dissociation of large systems of sentiments leaving a contracted personality—a mere extract of its former self—dissociated and distinguished from what it was by different sentiments, instincts and other innate dispositions. [248] The facts seem to show that the awakening of the emotional impulses of certain sentiments inhibits, not only those particular antagonistic sentiments with which the former are incompatible, but large systems of sentiments, and many instincts and other innate dispositions with which the inhibited sentiments are systematized. ”

“ So much attention has recently been directed to the subject of secondary personality by the startling phenomena described in numerous books and articles on the subject, that a certain class of "nervous" patients have permitted themselves to be influenced by the auto-suggestion, flattering the vanity, that they, too, have a secondary personality. ”

“ Whenever an emotion quite out of keeping with conscious desire is allowed to become habitual, we may know that it is being chosen by a part of the personality which needs to be uncovered and squarely faced. Nervous symptoms and exaggerated emotionalism are alike evidence of the fact that the wrong part of us is doing the choosing and that the will needs to be enlightened on what is taking place in the outer edge of its domain. ”

“ In judging of our own powers we are just as likely to under- as to over-estimate them, and the results are equally painful.
How acute are the sufferings of a diffident, shy, self-distrustful, over-sensitive disposition! Such a temperament is a sad make-weight in the struggle of life. ”

“ The most common of the resurrected psychic trends is the general tendency to dissociation or disruption of the personality with the reanimification, in varying degrees, of certain mental deficiencies and inferior types of reaction which are indicative of the relative failure of the patient to measure up to and efficiently deal with and adapt to the struggles of life as he must face and meet them. ”

“ If you could but get the fumes of this evil feeling out of yourself, you would see, as we see, what a common thing it is, and you would recognise, as we recognise, that your very expression of it is just such as is given to it by every hysterical man or woman that has ever experienced it. It is a physical condition caused by contact, and kept up by your own perverse pleasure in it—nothing more. Every one grows out of it in time, and any one with proper self-control could conquer it. ”

“ At the same time an inborn instinct of self-control, accompanied, doubtless, by a refined unwillingness to intrude his personal feelings upon the notice of other people, led him into such habits of self-repression that his friends sometimes felicitated him on "having no nerves." ”

“ With them the will-power is oftentimes an element in the recovery, throwing off disease by the determination not to yield to its influence. There is no doubt but that this temperament is more liable to mental derangement than any other; the great emotional intensity and the difficulty of moral control laying the mind open to causes that tend to produce insanity. ”