Meeting-The-Challenge-Making-a-Difference-Practitioner-Guide

THE TERM ‘PERSONALITY DISORDER’ HAS BEEN CRITICISED
FOR THE FOLLOWING:
• There is no clear cut-off between someone who has an unusual
or troublesome personality, and someone with a ‘disorder’.
• Individuals labelled as having a ‘personality disorder’
might feel that this marks them out in a way that is
stigmatising or unhelpful.
to harm herself. Kelly finds it
very difficult to be alone;
when alone she feels empty
and frighteningly unsure of
who she is. When feeling
desperate she sometimes
cuts herself, and she took two
overdoses in the last 2 years.
Susan has been suffering from
anxiety and panic for over 20
years. She relies heavily on her
teenage children, expecting
them to accompany her
whenever she leaves the
house, and calling them on
their mobile phones if she
panics when alone. She also
often calls the emergency
services, imagining that she is
having a heart attack when
she has anxiety symptoms.
She has been repeatedly
referred to mental health, IAPT
and psychology services for
treatment of her anxiety and
agoraphobia, but has difficulty
getting to appointments and
has never stuck with any
treatment programme. Her
older daughter has recently
been missing a lot of school
because she has been staying
at home to care for her mother.
Do you recognize anyone with
similar, longstanding difficulties
amongst the people that you
work with? If so, reading this
guide may help you in your work.
When working with people who
have personality problems, we
do not want them to feel
labelled, put down, or squeezed
into diagnostic boxes. They are
fellow human beings, many of
whom have suffered greatly as
they were growing up, and
now struggle in adult life.
We want to help people on the
road to recovery by working
alongside them in a respectful
way, working together, helping
to build their sense of trust
and confidence. The language
that we use is therefore very
important. Service users
sometimes say that they do
not like the abbreviation
‘PD’, or to be seen as nothing
but a disorder.
A number of different phrases
have been used to describe these
difficulties or people with these
kinds of difficulties, including:
• ‘Complex and severe
psychological difficulties’.
• ‘Complex needs’ (this is
sometimes also used to
refer to people with severe
mental illness).
• ‘People diagnosable with
personality disorder’.
• ‘People who identify with
the problems associated
with the diagnosis of
personality disorder’.
In this guide we are going
to stick to using the phrases
‘personality disorder’ or
‘personality difficulties’
though we will describe
some of the problems with
these terms.
We all have personalities,
and we all have aspects of
our personalities that are
troublesome at times. People
with personality disorder are
not fundamentally different
from anyone else, but might,
at times, need extra help.
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