What’s in a name? How personality disorders are being misunderstood and misdiagnosed
...There’s a fundamental argument going on among experts about the labels given to personality disorders. One of the leaders of the attack on the status quo is Peter Tyrer, professor of community psychiatry at Imperial College London. He and his colleagues seem to have succeeded in removing the individual names of personality disorders in the forthcoming 11th version of the International Classification of Diseases (ICD11), due out next year. Professor Tyrer claims the names are artificial and fail to acknowledge the range of personality traits found in each person.
...Professor Tyrer prefers to use the word dysfunction rather than disorder, because personality is on a continuous spectrum and we all have a little bit of everything. The evidence is that there’s enormous variation in personality traits in people and they’re not easily categorised into one label or other. When you do try to fit someone into a particular slot, you find that they fit the criteria for several others as well. ‘Very few people,’ says Professor Tyrer, ‘have one slab of personality characteristics which don’t overlap with others.’
...He has helped to pioneer a form of treatment called nidotherapy, where the environment is adapted to suit the person. For example, someone who’s a risk taker and a loner might be happiest as a cattle farmer mustering on a motorbike.
...‘One of the big negatives of current mental health practice is that we’re too obsessed with treating symptoms and if we’re not, then we go back to treating some sort of amorphous, core developmental problem. In fact it’s not a core developmental problem. It’s a personality that can be dealt with in practice quite well. There are very few people that I come across in my clinical practice that I would ever say, “Sorry, your problems are too difficult for me to deal with because they’re beyond my abilities†... most of the people who reject patients on the grounds that they’re untreatable are actually saying, “I am incompetent at dealing with personality problemsâ€. That is why you are untreatable. Not because you’re really untreatable.’
