Are Cluster B Personality Disorders on the Increase?

Excellent article by a woman’s site called Shrink4Men.

Now ordinarily I would be very suspicious of any woman offering therapy for men. I flat out refuse any therapy with a woman. I have seen about 3 female therapists, and in general, it was simply a disaster. They just don’t understand men. I talk about sexual stuff a lot in therapy, and female therapists just don’t get it. They usually think I’m a “typical male asshole” or something. Not a whole lot of empathy on their end. They can’t get out of their “Sisterhood” thing enough to do good therapy with me.

Anyway, it’s a good piece on the Cluster B’s. There is evidence that Personality Disorders (Axis 2) are increasing in modern society. They’ve been on the rise for about 80 years or so, with each succeeding generation having a higher rate of them than the preceding one. There are a lot of theories who this is so, and the author outlines them in the piece.

I also have noticed this (mostly crazy women) but I just blamed it on feminism.

Some of the reasons offered are:

1. our advanced industrial society that provides most of our needs,
2. our highly litigious, get mine and screw everyone else for as much as you can take them for lawyered up culture,
3. a pop Zeitgeist full of entitled, high conflict persons celebrating belligerent, unpleasant, assholey, bitchy, selfish, high conflict behaviors,
4. the culture of radical individualism fostered by radical Ayn Rand style, screw everyone, get mine, Libertarian neoliberal economics since 1980,
5. increasing divorce, drug abuse and family instability leading to children having an unstable first six years of life when the personality is formed (instability in ages 0-6 can create Axis 2 problems as the person fails to develop an effective and adaptive personality.)

At any rate, the Cluster B disorders are some of the most abrasive PD’s of them all. These are the “conflict-prone” or “extroverted” disorders characterized by continuous conflict with others in pursuit of blatantly selfish gains, refusal to accept responsibility, lack of insight and profound selfishness.

Cluster B people cause a great deal of damage to society in various ways on the job, in school, and on the streets. They run up high costs in the health care system and often run afoul of the law too. Cluster B disorders commit much more crime and especially violent crime than the rest of the PD’s and vastly more than normals.

They are abrasive, in an aggressive, unstable, mercurial, threatening and intense way. They provoke strong reactions in others and frequently elicit aggressive and even violent defensive reactions in those they constantly attack.

The Cluster B’s are:

Antisocial PD – sociopaths, psychopaths.

Borderline PD – a hurricane or tornado like behavior syndrome, mostly women, awash with suicidal behavior, acting out, self-harm, drug abuse, dangerous behaviors, promiscuity, occupational instability, extreme, regular and violent mood swings, very high anger levels, fluctuating self-esteem that descends to intense lows, over-idealization followed by or combined with total devaluation, emptiness, no insight, constant blaming, manipulation, scheming and threats and often what looks like “multiple personalities.”

Occasionally psychotic, but more often appears “near-psychotic or quasi-psychotic.” Often shows unconscious behavior that is even poorly remembered or not remembered not all, as if one was in a fugue.

Histrionic PD – I don’t know it well. Mostly women. Most of the men who have it are gay or bisexual. Bitchy, over-dramatic, always on stage, “actor” or “actress” like histrionics, putting on shows and displays and generally acting out.

Narcissistic PD – The center of universe, brags, manipulates others, has little to no concern or love for or even interest in anyone else, extremely inflated self esteem followed by incredible lows (“brittle” or “shallow” self-esteem), jerky, assholey or bitchy behavior, is often cruel or sadistic, insults or puts down others, displays haughty or arrogant attitude, blames others, has no insight, takes no responsibility, engages fantasies of extreme accomplishment and grandeur, shows profound jealousy of rivals.

Can lead to violence or criminality in pursuit of selfish ends or revenge against the hated rivals. Has no idea how they come off to others and is stunned or mystified when told how they do. Seems “blind and deaf.”

Master manipulators, often excellent social skills, extremely competitive, associated with high achievement but unstable relationships and even occupational history as they fight with most around them.

The term narcissism is often conflated with Narcissistic PD. I have a psychodynamically oriented therapist now who tells me that I am a narcissist.

What he means is that I am vain, self-centered and conceited and can tend to think I’m better than others, though I try very hard to control that part of it.

The problem is that that only skims the surface of Narcissistic Personality Disorder. I’ve known some NPDs, and I am certain that I am noting like these folks.

I am not a high-confict person. I am a low-conflict to zero-conflict person. I go everywhere trying to be as nice as possible to most everyone all the time. If someone tells me they’re a Nazi, I am afraid to act offended because then maybe they won’t like me. So I just smile and try not to act offended. I pretend that they just told they like cherry pie or something.

What I am, in part, is the person described in the first paragraph below – a “vain individual who may overly enjoy his own reflection and is self-centered.” At worst, I am like Paris Hilton below – a “spoiled, silly, self-centered, attention seeking brat,” but even that’s pretty much of a reach for this introvert.

The following quote from the page above shows how the popular term “narcissism” has been ridiculously conflated with the extreme toxicity of the ultra-abrasive, high-conflict NPD type. He also points out that it’s just wrong to call Cluster 2 types mentally ill people who need our sympathy.

Screw that. They have a character problem. They’re people who are pretty much deliberately acting bad, and they need to knock it off. We need to aggressively confront their high-conflict bullshit, and deliver swift consequences on them every time they act up. They are like little kids who need to be “sent to their room” from time to time until they act better.

Here is the quote:

Like I think many, I always associated the term “narcissist” with vain individuals who may overly enjoy their own reflection and are self-centered, etc.

Obviously this just skims the surface in terms of NPDs.

While I can see where “narcissist” was a convenient label to attach to a particular flavor of PD for the purposes of, as Dr. T. previously mentioned, a sort of shorthand for the purposes of mental health professionals, I think the term is misleading in respect of PD’s and should be dropped by the psychoanalytic community.

The reality is that what we might see as narcissist personalities in the media, e.g., Paris Hilton, could just as easily, and likely accurately, be described as spoiled, silly, self-centered, attention seeking brats.

Obviously NPDs are something way beyond this.

When you get right down to it, PD’s seem to be, as evidenced from our almost identical experiences with them, more a personality type rather than individuals with anything I would from my layman’s perspective describe as a mental health issue or disease.

Their minds just work differently than most. If they worked differently in a beneficial way, they wouldn’t be identified as being “mentally ill,” however because they work differently in a negative way, the assumption is that this must not be from their own choice and that they would choose to be “good” if not for that infernal “mental disease” that prevents them from doing so.

Speaking of “infernal”, and calling a spade a spade, I have no doubt that PD’s were well represented in the group of those described as “possessed”, “witches”, “evil”, etc. a few hundred years back.

I have come to think that society and non-PD type people would be better served if PD’s, sociopaths, etc. were removed from the psychoanalytic realm and into the, for lack of a better word and as Dr. T. put it, the “character realm” and understood as being personality types who are best recognized and avoided or dealt with firmly when they use disruptive or dishonest, etc. tactics to achieve their ends rather than than being seen as individuals with a “mental disease” beyond their control who require understanding and forbearance.

Just my layman’s opinion.