Personality Disorders

[Darth V.]

disclaimer: I make no claim to being a psychological expert or proffessional, merely an interested layman.

Clearly characters like Xykon and Belkar are meant to be examples of anti-social personality disorder at it's wackiest, most horrifying extremes. But am I the first one to suggest that both Haley and Vaarsuvius show many traits associated with Schizoid personality disorder?
To elaborate: Schizoid personality disorder is essentially an abnormally poor ability to form emotional bonds or close relationships with others. People with this disorder can often function almost normally in casual relationships but feels extreme anxiety with any kind of emotional closeness or when called upon to open up to another person. There are two basic categories of this disorder: an overt schizoid tends to be asocial and uninterested in interacting with others, resulting in them seeming stoic and emotionally cold (like V) while a covert Schizoid is capable of being charming and sociable so long as they can emotionally divorce themselves from the persona they assume and avoid giving anything of emotional value (like Haley). Other identifying traits of schizoid individuals include:
-Susceptibility to brief reactive psychosis- in other words, a tendency to go temporarily insane (full on insanity- with hallucinations, delusions, and irrational behavior) as a result of severe psychological trauma (i.e. Haley after the loot was destroyed or V after Azure city)
-A stilted way of speaking, alternating between eloquence and terseness (i.e. V's way of talking)
-"uneven" morality- with strong moral codes they won't violate that seem to have odd holes in them (i.e. Haley will steal from those who can afford it or lie to get her way but is also brave, loyal and self-sacrificing concerning friends or people who can't defend themselves, V. is completely loyal to her friends and single-mindedly pursues the party's world saving quest with little hope of immediate reward, but is extremely ruthless in the pursuit of these goals and towards those who commit evil or threaten it's friends)
- Extreme self-reliance- (i.e. the real reason V. refused the alternative plan offered by the demons)

[Mutant Sheep]

Well, since these characters are all meant to be people, and not 2-D "I am a boring stick person, fear my stick wrath" they don't necessarily need to have a disorder. Also, thats the way D&D work's. :smalltongue: You have laid out a nice list of symptoms and who has these symptoms, but I don't think almost every magical elf in fantasy suffers from a disorder. Unless the disorder is called "Being a magical elf" in D&D-land. :smalltongue:

[Umberhulk]

You've pit quite a bit of thought into this. Its interesting, but I'd wager too far a leap. I've always imagined Haley as someone with a lot of baggage. You don't need to be mentally ill to have self esteem of trust issues. As for V, I could l draw a parallel to a brilliant mind like Nichols Tesla. Some geniuses have brains that just plain operate on a different level. Maybe he just has mild Aspergers Syndrome. :)

[Darth V.]

replying to mutant sheep: I am not saying that all characters have personality disorders or that that those personality disorders are the only thing that define them, I am merely observing that Vaarsuvius and Haley both show traits associated with Schizoid personality disorder and describing those traits. Nor does this post have anything to do with D&D rules, I'm just talking about psychology and characterization. I disagree with your statement that most fantasy elves show the personality traits that I pointed out in Vaarsuvius.

replying to umber hulk: A personality disorder is not a mental illness. Rather, all personality disorders describe behaviours that any person is capable of displaying under certain circumstances (e.g. anyone can act seemingly without empathy (anti-social personality) or in an attention-seeking manner (Histrionic personality) under certain circumstances). Where such behaviours become a disorder is when a person has undergone experiences (i.e. "baggage"), usually in childhood, that lead them to repeatedly act in that manner regardless of the situation or the results of previous behavior. Someone with a disorder doesn't know any other way to think or interact with people, though they can sometimes learn over time. I think this definition of a disorder accurately describes V and Haley's behavior. Having a personality disorder doesn't make a character insane, and it can sometimes make them more relatable and human. If in doubt, ask any fan of Neon Genesis Evangelion, the show where every character has a personality disorder.

[ThePhantasm]

If I'm reading you right, I think you might be overthinking this. I'm pretty sure Rich didn't sit down and say "Hey, I'll characterize V as having this personality disorder!"

For example:


Clearly characters like Xykon and Belkar are meant to be examples of anti-social personality disorder at it's wackiest, most horrifying extremes.

"Meant to be" and "are" are two different things. This would be a consequence of their characterization, not an intention of it.

[Scarlet Knight]

I believe that Rich used Haley's separate personalities as a literary device.

However, having conversations with the voices in your head (Haley's Self-Loathing, Latent Bisexuality, etc...) telling you what to do or that you're worthless is a classic "red-flag" of schizophrenia.

[Darth V.]

Haley only experienced hallucinations and hearing voices on one occasion, during a period of emotional trauma. As I mentioned above, schizoid individuals can be susceptible to Brief reactive psychoses in which they show schizophrenia-like symptoms for a brief period (days or weeks) following a period of trauma. V experienced a similar period with delusions, extreme difficulty sleeping and irrational behavior following the battle of Azure city.

The Phantasm said:
If I'm reading you right, I think you might be overthinking this. I'm pretty sure Rich didn't sit down and say "Hey, I'll characterize V as having this personality disorder!"

You think correctly- I am overthinking it, but considering that the primary discussions on this forum concern things like endless debates over the precise alignments or motivations of this or that character I'm not sure I see your point- overthinking things is what we do on this forum. Also, I'm not claiming to have deduced some pattern behind how the author designs his characters, I'm merely looking at characterization from a psychological point of view. On the last bit, considering the amount of in-comic time that has been spent examining both V and Haley's emotional issues, I consider it extremely likely that a good deal of thought went into how their emotional state would be portrayed, and that this is relevant to the story even if the author never actually consulted a psychology text.
As for the comment on Belkar and Xykon, I'm gonna stick with my original post, given how often Belkar is explicitly described as a psychopath/sociopath I consider it very likely that the Author at least considered these real-life disorders when he was writing the characters.

[veti]

I think you have accurately and insightfully described an aspect of both Haley's and Varsuuvius's characters.

But, along with just about everyone else in this thread, I think it's a leap from that to assume that the writer actually "had those disorders in mind" when writing the characters. You can apply this sort of diagnosis to all kinds of real-life and literary characters, and it will always be controversial because everyone likes to think "character" is something individual, nobody likes to see it modelled or "reduced" to a bunch of symptoms.

Even in the case of Belkar - a lot of people throw words like "sociopath" around, without really being aware of its technical meaning. It's roughly synonymous with "I hate that guy".

[Frecus]

It is common knowledge that the average PC in D&D is a murderous sociopath or otherwise shows deviant behaviour. :smallwink:

Seriously; to show an audience something in your art, be it theater or a webcomic, you have to exaggerate. And the Giant has done a heck of a job! I don't think he ever had disorders in mind, but the comic explores tough personal problems with its characters.

Frecus
The glade wanderer
Madwarrior

[RLivengood]

I've never heard of Schizoid personality disorder before, but I think you've made a pretty good case for Haley (V not so much, there are a variety of things that can make a person act aloof).

I don't get why everyone seems almost offended by attempts to psychoanalyze fictional characters. Whether or not an author even knows about a particular mental disorder, that author will attempt to make their characters behave in ways that real people do, and many people have abnormal psychology. A personality disorder or mental illness doesn't define somebody, but it can describe or explain a lot of their behavior.

[sparkyinbozo]

Well, there has to be clinical and pervasive disruption/incapacitation in everyday functioning to qualify for a personality disorder...I guess I don't really see those criteria in V or Haley. It can be coded on Axis II as having "X tendencies," though.

It's a really good theory, and I will probably put some more thought into it come morning when I can have my DSM on hand. :smallbiggrin: More to come then.

[Darth V.]

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"Well, there has to be clinical and pervasive disruption/incapacitation in everyday functioning to qualify for a personality disorder...I guess I don't really see those criteria in V or Haley. It can be coded on Axis II as having "X tendencies," though."

I realize that I'm probably taking my life into my own hands referencing wikipedia with someone who may actually know what he's talking about. But the DSM criteria found on wikipedia list seven diagnostic criteria with 4/7 indicating a positive diagnosis:
1.neither desires nor enjoys close relationships, including being part of a family
2.almost always chooses solitary activities
3.has little, if any, interest in having sexual experiences with another person
4.takes pleasure in few, if any, activities
5.lacks close friends or confidants other than first-degree relatives
6.appears indifferent to the praise or criticism of others
7.shows emotional coldness, detachment, or flattened affect
I'd say V definitely fills all of these criteria except 4, and arguably fills that one as well. Haley seems to fit 2 and 7, and may fit 1 and 6 as well (YMMV). As I said earlier, Haley seems to show covert traits, while V shows some overt and some covert traits.

[Chuck Peirce]

"Momma always said stupid is, stupid does."

Let's make up a condition. Call it Peirce's disorder. Peirce's disorder can be characterized with behavior patterns A, B, and C.

Now, we spot a character who has behavior patterns A, B, and C. I say, that person has Peirce's disorder!

I haven't actually said anything new with my diagnosis. By the definition I just laid out, "X has behavior patterns A, B, and C" is logically equivalent to "X has Peirce's disorder". They're just different words with the same meaning.

This is all part of the "Lumping people into categories" stage of psychological study. It's convenient to have shorthand labels; for example, "Peirce's disorder" is quicker to say than actually enumerating all the behavior patterns every time.

If this is all you do, though, you've only scratched the surface of psychology. The real interesting question is why a person exhibits behaviors A, B, and C. It's not enough to chalk it up to Peirce's disorder; as I just said, that's circular thinking. The interesting task is finding what external factors correlate with the "disorder". Model the behavior, predict it, and control it; then you truly understand it.

[Juggling Goth]

The mis-diagnosis of personality disorders is currently a massively controversial - dare I say political - issue in psychiatry. Having this happen has destroyed my sense of humour on the matter. Please don't play with this; it is not a toy.

[suszterpatt]

Correct me if I'm wrong, but a personality disorder is something that prevents the person from practicing normal social behavior. Just because someone talks funny or prefers to keep things to themselves doesn't make them a sufferer. Both Haley and V are perfectly capable of civilized, social behavior. Haley talking with her various selves was more a result of not having anyone else to talk to. (see #483 (http://www.giantitp.com/comics/oots0483.html))

[sparkyinbozo]

Okay, I've had some coffee in me now.

I'm going to stay away from X and B's antisocial bits, because I fear it'll turn into a "game-evil alignment vs mental disorder" debate.

Wikipedia might not've been clear on it, but personality disorders all have 2 sets of criteria: a general one in order to be diagnosed with ANY personality disorder and one specific to each type.

The general criteria are:

A. An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:

(1) cognition (i.e., ways of perceiving and interpreting self, other people, and events)
(2) affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response)
(3) interpersonal functioning
(4) impulse control

B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.

E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.

F. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition (e.g., head trauma).

So even if you fit all of the specific disorder's diagnostic criteria, but it doesn't cause disruption in everyday functioning, it's not diagnosable. Most mental disorders are that way; persons A and B can have the same major depression, but if A functions daily and is able to cope, it's only diagnosable in B.

Looking at the Schizoid, I have to say I don't really see it; both H and V may tend to be loners, but they do have some strong interpersonal connections (if few). Consider how nutty V got when the dragons ate H and threatened his/her family. It's not a half-bad theory, though, and definitely some good parallels.


The mis-diagnosis of personality disorders is currently a massively controversial - dare I say political - issue in psychiatry. Having this happen has destroyed my sense of humour on the matter. Please don't play with this; it is not a toy.

That...is probably true, unfortunately. Especially in the military; if a soldier with PTSD gets discharged/misdiagnosed with a personality disorder, they get no benefits nor med care because personality disorders, by definition, have to exist before they were enlisted and should've never been allowed to have done so. I had a colleague do some research into it...it's really sketchy and makes me a little sick.

Edit to address Peirce: I agree with your last paragraph wholeheartedly and find myself looking at that more and more every day.

[Juggling Goth]

That...is probably true, unfortunately. Especially in the military; if a soldier with PTSD gets discharged/misdiagnosed with a personality disorder, they get no benefits nor med care because personality disorders, by definition, have to exist before they were enlisted and should've never been allowed to have done so. I had a colleague do some research into it...it's really sketchy and makes me a little sick.

I got mis-diagnosed with Borderline, which in a way was hilarious, because BPD people are supposed to be incredibly impulsive and get through friends and partners like socks. And, well, entire tectonic plates move faster than me, and I'm mostly hanging out with the same people I was ten years ago. My girlfriend's a newbie. We've only been together seven years; only known each other about nine. We're thinking about moving in together, but well, it's only been seven years, and we don't want to rush things.

But it was also incredibly annoying, because BPD means "you're a young, self-harming woman, and your shrink hates you, because you're not doing what he says and getting all better now and being suitably grateful." And he knew that if he could get me labelled untreatable, attention-seeking (I just want to be left alone) and manipulative (I'm very straightforward and find it frustrating when people can't communicate plainly like grown-ups), he wouldn't have to bother with me any more.

BPD in women and Anti-Social Personality Disorder in men have a long history of being diagnosed by psychiatrists who are just sick of this patient they don't like very much, who is annoying them by not getting better (how do they think the patient feels?).

The personality disorders are incredibly controversial in terms of power and who's wielding it, because flippant diagnosis of them can really screw up a patient's credibility and chance of getting appropriate treatment ever again. More so even than the standard mental illnesses. So seeing them used as a tool to explain dramatic character traits... it's a bit too close to home.

If it helps, I was at least this cranky about psychoanalysis in historiography at uni. My dissertation supervisor was a huge fan. I thought it was imaginary at best and offensive at worst. Oops.

[ResplendentFire]

I got mis-diagnosed with Borderline, which in a way was hilarious, because BPD people are supposed to be incredibly impulsive and get through friends and partners like socks. And, well, entire tectonic plates move faster than me, and I'm mostly hanging out with the same people I was ten years ago. My girlfriend's a newbie. We've only been together seven years; only known each other about nine. We're thinking about moving in together, but well, it's only been seven years, and we don't want to rush things.

But it was also incredibly annoying, because BPD means "you're a young, self-harming woman, and your shrink hates you, because you're not doing what he says and getting all better now and being suitably grateful." And he knew that if he could get me labelled untreatable, attention-seeking (I just want to be left alone) and manipulative (I'm very straightforward and find it frustrating when people can't communicate plainly like grown-ups), he wouldn't have to bother with me any more.

Oh, sympathies on that - I was misdiagnosed with BPD also, although I am certainly not young. It was really frustrating when it happened, but no one who has seen me professionally since the diagnosis believes it.


BPD in women and Anti-Social Personality Disorder in men have a long history of being diagnosed by psychiatrists who are just sick of this patient they don't like very much, who is annoying them by not getting better (how do they think the patient feels?).

The personality disorders are incredibly controversial in terms of power and who's wielding it, because flippant diagnosis of them can really screw up a patient's credibility and chance of getting appropriate treatment ever again. More so even than the standard mental illnesses. So seeing them used as a tool to explain dramatic character traits... it's a bit too close to home.

Also, people diagnosed with BPD are treated as incredibly manipulative even when they're behaving in much the same way as other clients. Once a couple of acquaintances found out about my misdiagnosis, everything I did was interpreted through the lens of "diagnosed with BPD" and previously reasonable behavior on my part was perceived as attention seeking and manipulative. This left me extremely confused in social interactions when people would respond to perceived ulterior motives and I was just speaking my mind.

Annoying. Fortunately, that's about 90% behind me now.

Oh, and also how Simon Baron-Cohen's recent book explicitly marks ASPD and BPD as "zero negative empathy," or basically, "evil." It's called The Science of Cruelty.

[El_Dictator]

Edit: A more careful reading showed that Sparky covered Haley and V.

This has interested me enough for me to register. As a professional, this topic interests me greatly (personality pathology is my area of research), but I also realize it can be a very sensitive one, so I shall try to tread carefully. Also, I don't think the APA ethics code prohibits me from assessing fictional characters (even without the use of objectively-measured instruments such as the Structured Clinical Interview for DSM-IV!).

The OP brings up a very interesting topic. The language certainly looks a lot like V, and parts of it (particularly language about avoiding emotional attachment) sound a lot like a big part of Haley's character/development. That said, I don't think Haley fits the intended meaning of the DSM-IV classification at all really. She enjoys her relationship with Elan, she enjoys her friendship with Roy, she definitely seems to react to criticism (Celia and her rival), etc. I agree with those who said she has a lot of baggage to work through, but she appears to have worked through it.

V is more difficult (assuming we assess V as we would a human). I would say that V does lean in that direction, but I would not diagnose V primarily due to V's concern for V's family and mate.

Belkar is totally antisocial personality disorder. He's also a classic case of a related construct-psychopathy (Type 2--the impulsive, non-planning type). Interestingly, his character development has led him to have more Type 1 traits--namely being more planful and less impulsive. He's not charming like Type 1's tend to be though (though you could argue he is "charming" in that he presents himself in a much better light than what he actually is).

Nale is obvious narcicistic personality disorder. Enough said.

Tarquin is a full-blown, terrifying, textbook Type 1 psychopath. Not at all impulsive, very charming, yet fully dastardly.

Xykon plays at Type 2 a lot, but his plan makes him look more like Type 1. The two factors of psychopathy are highly correlated, so being both is no issue.

None of the other characters that I can think of have PDs. Note that PDs exist on a continuum. They describe clusters of behavior, and the data show that DSM-IV PD constructs frankly aren't very good. They are far too comorbid (occurring together in the same person) and yet too variable (two narcisists can look very different). The characters I've faux-diagnosed above are at the extreme ends.

As an aside, there are many psychoanalytic (which is a school of thought within clinical psychology--psychoanalyst does NOT mean clinical psychologist) who are far too fast to diagnose PDs, and BPD, along with bipolar, unfortunately anecdotally gets too many diagnoses. It is my experience that clinicians in general are a little too fast to hand out PD diagnoses, which is very unfortunate. However, the model is changing, and pressure is slowly (too slowly) mounting for more evidence-based assessment (which is available and peachy).

[Prowl]

Professional psychology is the practice of finding - or inventing, if necessary - chronic conditions that require the patient function as a recurring revenue stream. The more lucrative the revenue stream, the better the diagnosis.

[El_Dictator]

As I believe has been pointed out, dramatic characters tend toward extremes. Elan is in the extreme of a personality characteristic called Openness to Experience, for example. Extremeness is normal in storytelling and webcomics (look at all of the personality pathology in 8-bit theater...). And in a sense it can be said to mirror real life--major events can often involve statistically rare personalities (e.g. many politicians and CEOs rank relatively high in Type 1 psychopathy--they manipulate, charm, and lack empathy/concern for the well being of others). But it doesn't represent the average population. Belkar, Xykon, Tarquin, and Nale are memborable because of their extremeness--they happen to fit into personality disorder categories quite well, but it's not because these categories are easy to fit into; it's because these characters are intense.

Clinical psychology has its share of quacks. I might even myself claim that many in the (practicing, not academic) field practice snake oil. And I'm very sorry if you've had encounters with such...

Practiced properly, however, it is very effective and helpful. A huge number of people experience clinical depression, for example. The average course is about 9 months. During this time, life is often miserable for the person, and he/she often wears out whatever social support system is available while faltering in school or work. Alternatively, 8-12 sessions of an empirically-supported treatment can often bring people back to normal levels of functioning, and perhaps more importantly, greatly reduce the risk of relapse (~50% of people who were depressed once become depressed again, and it jumps to ~80% after two bouts; relapse is a very big deal). These treatments are much cheaper than psychotrpic meds, and meds have side effects and don't help relapse at all (but they can still be quite useful; they just shouldn't be the first line, and that they are is a problem with the system and a failure to apply the scientific literature when implementing national guidelines).

Better yet, computer and web-administered modules have shown similar efficacy to standard therapy with a much lower cost. I've recently read a study about a form of treatment that involved one initial session with a therapist and 7 or so of self-administered treatment that had an effect size on par with antidepressant medications. The future (and the academic present) of treatment for mental illness and mental hygiene is cheap and effective.

How can you tell if a therapist is offering good therapy? Ask if it's evidence-based practice, and ask about what that even means. If they give a good answer, hurray! If not, or if they look confused or make excuses, go elsewhere.

Note: The same should go for assessment (which should not involve ink blots). It should be evidence-based assessment.

[KingofMadCows]

The important thing to remember is that these disorders are descriptions of a certain set of behaviors or attitudes, they are not the causes of these behaviors.

For example, when you say that someone has anti-social personality, you are describing a certain set of behaviors and attitudes that the person displays. However, it would be in error to say that the reason why the person displays those behaviors and attitudes is because s/he has anti-social personality disorder as that would be using circular reasoning.

[derfenrirwolv]

People with this disorder can often function almost normally in casual relationships but feels extreme anxiety with any kind of emotional closeness or when called upon to open up to another person.


Well they've finally gone and made "male" a disease then...

[Juggling Goth]

Professional psychology is the practice of finding - or inventing, if necessary - chronic conditions that require the patient function as a recurring revenue stream. The more lucrative the revenue stream, the better the diagnosis.

See, I've found the exact opposite: nobody will acknowledge that my depression is going to be chronic and lifelong. I've seen the graphs and looked at the studies. Most people relapse, and after a few episodes, you're probably stuck with it. The more episodes you have, the more and worse you're gonna have. I've been like this for ten years, so we can safely say the future is not bright. And yet I keep having to deal with professionals who say "well, you've been on the meds for a year now, I think we should take you off them". Or who think that six-to-eight sessions of cognitive behavioural therapy has any effect whatsoever on the long-term relapse rates (it doesn't). And when I point out the facts and the studies, they get all "don't be so negative! Don't you want to get better?"

Maybe it's different in the USA, but in Britain, the vogue is for very short-term therapy at the moment. Mind, you'll have to wait a year to get the therapy, by which time your depression is either gone or permanent.

I promise I'm not a dupe of Big Pharma or greedy shrinks, either. I have actually felt like crap for ten years, and work incredibly hard to function, and the jury is still out on whether it's worth the effort. I try not to think about that.

I am in that odd and infuriating position where I am highly critical of how mental health care works, but I also know that I'm dependent on it to function. Yes, living with this contradiction does make me crazier. I've sat there wondering why this guy who is clearly an idiot gets to have power over my brain chemistry, and I've been ridiculously grateful when I get a good one. I've told psychiatric med students "don't be evil", and doubted they noticed.

My incredibly long and rambling and navel-gazing point? It's serious business, with people in pain at the centre of it, and it's a lot more complicated than most people think. Treat it with appropriate respect.


Alternatively, 8-12 sessions of an empirically-supported treatment can often bring people back to normal levels of functioning, and perhaps more importantly, greatly reduce the risk of relapse (~50% of people who were depressed once become depressed again, and it jumps to ~80% after two bouts; relapse is a very big deal). These treatments are much cheaper than psychotrpic meds, and meds have side effects and don't help relapse at all (but they can still be quite useful; they just shouldn't be the first line, and that they are is a problem with the system and a failure to apply the scientific literature when implementing national guidelines).


*Raises an inconvenient hand* Meaning cognitive behavioural therapy, right? That actually makes me worse. Seriously, it's happened twice now. (The second time was extra-fun because the guy did it anyway after I told him not to, and then got all defensive when I called him on it.) Therapy is not harmless; medication is not alone in having unwanted effects that may or may not be worth it.

The appropriate first-line treatment is going to vary between individuals. I know for most people, a combination of meds and therapy gets the job done, but you're always going to have the freaky ones, and trying to force them into a treatment that doesn't work just leaves them feeling like there's something really wrong with them and they've failed again. I like better living through chemistry and being left alone. I know I'm abnormal in this, but it doesn't mean my wishes should be ignored.

[Prowl]

{SCRUBBED for giving psychological advice]

[sparkyinbozo]

See, I've found the exact opposite: nobody will acknowledge that my depression is going to be chronic and lifelong.


I'm sorry to hear you're having such a negative experience. There's actually a big push right now for more "consumer-oriented" perspectives on therapists. And yes, the vogue right now is also to push for shorter and shorter treatment periods. In general, if you don't like the one you have, find a new one. If you don't like therapists, I'd recommend looking at other support structures (religious, social, biblio, psychiatric, etc.)

It's interesting that you say CBT makes things worse, because that's usually a very effective, front-line sort of treatment for depression. Do you mind if I ask what made it non-effective, and what, if any, strategies you have seen that did help? Feel free to PM me, too.

Edit for Prowl: I work mainly with kids and there is a big emphasis now on teaching adaptive skills (i.e., emotional regulation, frustration tolerance, empathy, social skills, etc.) under the theory of "kids want to do well, but lack the skills to do so," because they've never learned them. It's based, in part, on the theory that acting dysfunctionally is far more draining and difficult than acting adaptively. It seems to fit really well in with what you're talking about. Google "Collaborative Problem Solving" if you are curious about it.

[Juggling Goth]

In general, if you don't like the one you have, find a new one. If you don't like therapists, I'd recommend looking at other support structures (religious, social, biblio, psychiatric, etc.)

Oh, I ditched therapy a while back. Therapy is the hell I put myself through every couple of years or so because it makes other people feel better.


It's interesting that you say CBT makes things worse, because that's usually a very effective, front-line sort of treatment for depression. Do you mind if I ask what made it non-effective, and what, if any, strategies you have seen that did help? Feel free to PM me, too.

For one, I was never that impressed by its insights. I mean, the stuff it gets right? Well yes, obviously, though it's usually a bit more complicated than that. Perhaps it would have worked better on the scared seventeen-year-old going through all this for the first time. The irritated twenty-seven-year-old is harder to please. And it's so short-term, when I can live with the short-term. I have lived with the short term. I dove into the murky depths of specialist care two or three years ago because I wanted someone to help me live with the long term. Still haven't found them.

Plus it's so... victim-blamey. The patient must be wrong about her own experiences, and if she's not better, it's because she's thinking the wrong thoughts and not trying hard enough. Ugh. From a disabled-activism point of view, it's terrible, and common sense and humanity should tell you that people don't get less crazy when they're told nothing happened the way they think it did or meant what it meant to them. And the way everyone tells you "this is what works! This is proven to work!" just makes you feel worse if it doesn't. Failed again, freak.

Also it needs to decide if it's going for positivity or evidence-based, because sometimes, it can't have both. Sometimes, true is not nice. And if it said, "OK, this is probably not true, but if you believe that it is, you'll be happier", I could respect that, but it doesn't.

What does work? Define 'work'. What gets me through each day is taking my meds, sheer bloody-mindedness, and knowing as much as possible about my illness and its triggers and symptoms. Not doing stupid things - not getting drunk, and if I know I'm in a bad mood, not putting that Joy Division CD on. Realising that if I don't get enough sleep, my head splits open to reveal my demon self, and acting accordingly. In the long term, I don't know. That's kind of what I was looking for in therapy.

In my experience. Which I know is weird.

[Chuck Peirce]

I have actually felt like crap for ten years, and work incredibly hard to function...

:smallconfused: Wait, is that not the norm? I always figured everyone else was faking a sense of well-being, too.

[VanBuren]

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[Chuck Peirce]

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Speaking of, I need to run in to town to pick up some things before my brain turns to mush. Later!

[VanBuren]

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[Prowl]

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[The Giant]

One, this thread is way, WAY off-topic. And two, this thread is violating our new rules against dispensing psychological advice. Some scrubbing will occur.

Thread locked.