Is This Really a Crisis? People with personality disorders often see internal crises as external crises.
By Bill Eddy LCSW, ESQ.
As I wrote in my latest article in Psychology Today, people with personality disorders often see their own internal crises as external crises caused by someone else. Since I began working with clients with borderline and narcissistic personality disorders over thirty years ago, it has been clear that these individuals spend a great deal of time reacting to situations they perceive as crises that are really internal upsets projected onto others. In fact, one of the first things I learned to teach them was to regularly ask themselves: “Is this really a crisis?” This article briefly reviews some of what I have learned as a therapist and lawyer.
Personality disorders are characterized by the DSM-5 as including “significant distress or impairment in social, occupational, or other important areas of functioning.”1 This internal distress may be triggered by a wide variety of outside events, or even the person’s own internal ruminations. In addition, this pattern is unchanging over time, as it “is inflexible and pervasive across a broad range of personal and social situations.”2 Lastly, what is important in this discussion is that this includes “ways of perceiving and interpreting self, other people, and events.”3 This is not all that the DSM-5 says about personality disorders, but the theme of misperceptions of crises is what will be discussed in this article.
Targets of Blame
Because of these misperceptions of other people, those with personality disorders often have what I call Targets of Blame, who they believe are responsible for causing their feelings of distress. I have seen this many times in legal disputes, when one person is convinced that another person (husband, wife, neighbor, co-worker, supervisor, or even a stranger) is out to harm them, when they really are not. This could be someone almost at random, but it is most commonly someone close to the person or in a position of power over the person. I have observed many people lose a legal case because it was based on such misperceptions about a fantasy Target of Blame. (This is not to say that people with personality disorders don't also have valid claims some of the time.) Two brief examples help demonstrate this.
Borderline Personality Example
Many years ago, I represented a young woman in her divorce as her lawyer. She had numerous problems, including a drug addiction, an incident of violence against her soon-to-be ex-husband, a brief hospitalization for danger to self and others, and two young children who were the subject of a custody dispute. Fortunately, we were able to put together an excellent treatment team including a hospital psychiatrist, a clinical social worker as therapist, daily involvement in a 12-step program, and I was her lawyer with a background as a therapist.
The team agreed that she had borderline personality disorder, as well as substance use disorder, and she became motivated for treatment—especially because the issue of care of her children depended on her sobriety and a significant improvement in her mental health. Since her case was active in family court, we needed to discuss strategy and her progress on a regular basis. One day she told me that a key part of her recovery (from substances and her personality disorder) was to ask herself these two questions every day: “Is this really a crisis?” And: “What is my part in this problem?”
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She realized that the incident of violence by her against her husband was an over-reaction to fears that he was taking the children away from her forever, when he was really just driving away with them for his routine parenting time. It was not really a crisis, but she misperceived that it was and thereby created a real crisis for herself and everyone else around her.
Over the next months and years, she stuck with her recovery from drugs and also her symptoms as someone with borderline personality disorder. She was a good example to me of someone who out-grew the diagnosis of borderline over the next few years. And the other good news is that she was able to become a much better parent and the custody battle in court turned into an out-of-court agreement for shared parenting which both parents handled quite well (he also was in recovery from a substance abuse problem).
Narcissistic Personality Example
In another case I worked on as a divorce lawyer, my client was a husband who was also a recovering alcoholic for about ten years before I met him. In his case he was falsely accused of child sexual abuse of his young son by his soon-to-be ex-wife. (I have worked on many true cases of child sexual abuse, as well as many false cases—some honestly believed but false and others knowingly false to the extent of court sanctions being imposed. So I make no assumptions about each case.)
After a thorough investigation determine that the accusations were completely untrue, it was not surprising that he was on the defensive and understandably angry. At first he wanted sole physical custody to punish her for her allegations, especially because she told the world about them, including people at his son’s preschool and their church. It became clear that she had a problem, possibly a personality disorder, which may have explained her misperceptions about him. For various reasons, the case eventually evolved into an shared physical custody plan, which endured for several years. They were both able to let go of blaming each other enough to co-parent successfully.
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But during his family court case he had regular crises or near-crises, which is understandable given the above facts. At one point, he raised the issue of whether he had a narcissistic personality disorder. (He had read one of my books on this subject in divorce.) He was in therapy and he raised it with his therapist. He said they agreed that he may have had some traits, but not the disorder. I said that made sense to me.
Soon after this discussion, he left me a voicemail message, as he had many times before, stating in a panic that his ex-wife had just done something-or-other with the children. “You have to call me right away!” he insisted in his message. But then his voice suddenly changed. “Wait! Wait. It’s not a crisis. You don’t have to call me right away. You can call me tomorrow. (Then a pause.) In fact, you don’t even need to call me at all. You know, I can deal with this myself. It’ll be okay. Thanks.” We later discussed this call and agreed that this may be why at most he may have had some traits, but not the disorder.
Over the past year I have been writing a book which comes out this year: Why We Elect Narcissists and Sociopaths—And How We Can Stop! I have been studying history and current events to understand why there appears to be an increase in politicians worldwide with traits of narcissistic and/or antisocial (sociopathic) personality disorders. In dozens of cases, they repeatedly have what I call “fantasy crises” involving fantasy Targets of Blame. Wars are started, famines are caused, whole groups of people are wiped out. Then, afterwards, everyone wonders why people believed them in the first place. And it often comes down to accepting the leader’s false perceptions of a terrible crisis. In several cases, this was the first step toward gaining unlimited power, as I describe in this new book.
Whether the leader truly believes in this crisis or knowingly lies to the population varies by case. But it is becoming clear that we need to keep an eye on the presence of personality disorders or traits in our leaders nowadays, whether its our community leaders, business leaders or national political leaders. We need to become more educated on this subject—and develop a healthy skepticism. Our future may depend on understanding the mental health of our leaders' personalities.
1. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA, American Psychiatric Association, 2013, at 646.
Previously published version appeared on Psychology Today February 15, 2019.