This post brought to you by a pair of sisters.
In the shadowy corners of the internet lives a subset of breakup listicles designed to help you diagnose your ex-partners’ psychopathology. Oh, you didn’t know this was a thing? It totally is a thing. According to several recent pieces on sites like the Huffington Post and Thought Catalog, almost everyone who ever dumped you had a personality disorder. These articles will walk you through the process of deciding just how “crazy” your ex was. Borderline Personality Disorder is used to label someone who seems too emotional, OCPD is assigned to those who can’t compromise, and Narcissistic Personality Disorder and Antisocial Personality Disorder explain the behavior of someone who doesn’t care about you anymore. “I dated someone just like this!” flood the comment sections of these articles as readers recount their ex’s symptoms.
Having any sort of relationship with an individual who struggles with a personality disorder can bring unique interpersonal challenges. That can be a tough row to hoe, and this article is not for the people who turn to articles about psychopathology as a source of support, community and information. This article is for the type of person that diagnostic pop psychology articles prey on; those who have a habit of labeling their exes as “crazy” once the relationship is over. There is an entirely different motive for seeking out information to help diagnose an ex. Slapping mental illness labels on people who treated us badly can be the real-life equivalent of Robin Williams embracing us with whispers of “it’s not your fault.”
“But!” you might say. “You don’t understand. I looked at the DSM-V and my ex TOTALLY fits this list of bullet points! Are you telling me the DSM-V is wrong?! It has science in it. SCIENCE.” I’m not going to get into the DMS-V debate, but I will explain how you can be staring straight at an “objective” list of criteria and make anyone fit a personality disorder diagnosis.
First, it’s actually fairly easy to find a personality disorder that fits any individual to some degree. This is because personality disorders are designed to describe extremes across a broad range of maladaptive interpersonal styles (Millon, 1999). Everyone has some traits or tendencies that align with a disordered interpersonal style because we’ve all got our own special quirks. When we are in a happy relationship with someone, these quirks are endearing at best and mildly frustrating at worst. When a relationship hits the skids, the trouble starts. Many classic theories of psychopathology acknowledge that stressful life event can heighten maladaptive traits for a period of time (Prochaska & Norcross, 2009). Breakups are typically stressful, therefore if you go through a breakup with someone it’s likely that their (and your) more challenging traits will magnify.
Second, emotion impacts how we process and interpret information. There is a term to describe this called “confirmation bias” (Fiske, 2010). Confirmation bias means that how we attend to, interpret and remember information supports our preconceived beliefs. When we are faced with information that contradicts our beliefs, we experience discomfort. This discomfort is a powerful motivator to see what we already believe. This isn’t a conscious process, and in a way it’s protective of our cognitive resources. It takes time, energy, and effort to change our beliefs. The world runs much more smoothly when we all have the inherent tendency to see what we already believe. But sometimes a trade-off for cognitive simplicity is accuracy. This means that once we decide “this person is acting crazy,” we will actively work to make the “facts” fit our thoughts. So if you believe your ex must be a narcissistic jerk, it’s extremely easy to selectively remember all the information that supports your hypothesis.
Third. it’s easy to twist memories about how a person acted in a relationship to fit a personality disorder if you don’t think about two aspects that are crucial to the diagnosis a personality disorder; to what extent and to what degree symptoms are occurring. Check out this sweet noise from the APA’s DMS-V committee:
“Personality disorders are associated with ways of thinking and feeling about oneself and others that significantly and adversely affect how an individual functions in many aspects of life.” (APA, 2013).
Extent means a person with a personality disorder will have the same relationship issues with you, as with their mom, as with their boss, as with their best friend, as with grocery store Pete who gives out free samples in the deli section. Pop psychology diagnostic articles rarely mention the importance of consistency across context.
“But, Elise! I told you I was using the DS-goddamn-M-V!”
Even if you are using the DSM-V, it’s easy to forget that the criteria listed needs to apply across multiple situations. This creates a susceptibility to a confirmation bias because the reader only has to apply a list of criteria to how their ex treated them.
Degree is the next important piece. Let’s use this article as an example. It was written by a woman who identifies as having dated someone with narcissism. The signs she lists are:
1. Do they, at first, shower you with attention?
2. Do they retract when you pay positive attention to someone else at a party or social gathering?
3. Do they seek to criticize or reduce others?
4. Do they never seem satisfied with positive feedback, and are always angling for more specific affirmations?
5. Do they lack empathy towards others, and you?
6. Do they have an unrealistic belief in their own abilities?
7. Do they use you and others purely for their own gain?
At first glance this may seem like an okay list. She’s got the superiority complex, the need for attention, and lack of empathy all represented. She even acknowledges that how this person treats others (that’s the extent part!) is an important piece. A few pieces are missing such as the expectation of special treatment, but overall it seems like a fair representation of a portion of the diagnostic criteria for Narcissistic Personality Disorder… except when you think about degree. Take item 5 for example, to what degree does someone need to lack empathy? Would someone staring blankly at you while you cry count as a lack of empathy? Would someone burning all of your shoes, waiting for you to buy new shoes, burning the new shoes, and then laughing about it count? What about someone who tries to listen when you vent about work, but can only stand 5 minutes before needing to be on the internet again? My point is, there can be a wide range of how we define acceptable behavior.
The factors listed above could impact anyone’s ability to make an accurate diagnosis. Mental health professionals take this into account and try to avoid using personality disorder diagnosis until there is a clear indication of pervasive interpersonal patterns that interfere with life functioning. We also use standardized assessments to help in the diagnostic process, because it can be so difficult to objectively determine what’s going on based on observation alone. This is one of the many reasons why it is unethical for a mental health professional to diagnose or treat someone they have a preexisting relationship with. The idea is that having professional distance will make an unbiased assessment more likely. Whether this actually happens is a discussion for another day. In short, it’s difficult enough to make an accurate assessment with training, relative objectivity, and the use of standardized psychometric tools, and super difficult if it’s your ex.
The diagnostic labels that come from this process facilitate communication between researchers and practitioners, providing language to describe a common experience of suffering for a subset of individuals. But mental illness labels can also be used as a way to dismiss or degrade. It’s unnervingly easy to write someone off as not mattering in our society if they’re “crazy.” This is especially true with diagnosis that have extra stigma attached, like personality disorders. So sometimes I worry when I hear someone flippantly diagnosing their ex-partner as a sociopath, borderline or narcissistic. Those are powerful labels that mean so much more than what I think the person using them is trying to convey which I suspect might be; “this person behaved in a way I dislike, do not understand and it hurt me.”
References
Fisk, S. T. (2010). Social beings: Core motives in social psychology, 2nd ed. Hoboken, NJ: Wiley.
Millon, T. (1999). Personality-guided therapy. Hoboken, NJ: Wiley.
Prochaska, J. O. & Norcross, J. C. (2009). Systems of psychotherapy: A transtheoretical analysis, 7th ed. Belmont, CA: Brooks/Cole.
http://www.dsm5.org/Documents/Personality%20Disorders%20Fact%20Sheet.pdf
