Understanding and Addressing the Challenges of Treating Personality Disorders The Controversy Surrounding Personality Disorder
The controversy surrounding this disorder is based on the general understanding of the disorder as a mental illness, the classification of the disorder, and the nature of the disorder. For starters, there are controversies over the understanding of this personality disorder. Some people argue that disorders like borderline personality disorder are not mental disorders but normal human behavior and reactions toward daily stress (Connors, 2023). As such, these people believe that classifying their response to stress as a mental illness causes unnecessary stigma. On the other hand, some accept that personality disorders are a form of mental disorders, and the diagnosis process serves to help them understand their feelings and manage them effectively. They also use this understanding to explain themselves to others.
Paraphiliac disorders also create controversy. Some claim that paraphiliac disorders are simply vices and crimes in society. Such claims, when used, mean that society is encouraged to look at these individuals not as mentally ill people but as criminals (Assumpção et al., 2014). Moreover, such perspectives also lead to prejudice and discrimination against such individuals in society. On the other hand, some professionals, especially mental disorder experts, consider paraphiliacs as disorders and thus treat such individuals as mentally ill people (Assumpção et al., 2014). This perspective means that these individuals are not considered criminals but are considered to be mentally ill people. This approach to such mental illnesses also creates controversy on how sexual crimes should be handled by society and the criminal justice system in general.
The second level of controversy is in the expert classification of these disorders. A section of mental health experts argue that both personality disorders and paraphiliac disorders have several overlapping symptoms, even in the DSM-5. Unlike other conditions that have direct symptoms, making them clearly defined in a certain way, personality disorders like borderline personality disorder (BPD) do not fit any specific category of diseases. Connors (2023) supports this observation by noting that patients who are diagnosed with BPD do not fit a specific class of mental disorders. In many cases, they are also diagnosed with other disorders. Other experts believe that the focus should not be on categorizing the patient but on understanding the special needs of each patient with personality and paraphiliac disorders and helping them cope. This is a controversy since the larger society considers paraphiliac disorders to be criminal offenses and vices.
The third source of controversy when focusing on personality disorders is the nature of these disorders. Some argue that many things make a person feel stressed and overwhelmed with unbearable emotions (Connors, 2023). For instance, childhood trauma, situations, and environments like poverty, as well as stigma and discrimination, can all be challenges to deal with. Therefore, it is not enough to use the social context to conclude that one has a personality disorder. The opposing group, on the other hand, classifies BPD by examining how the patient reacts in a social setting or socializes with others around them. Similarly, some experts argue that paraphiliac behaviors are caused by childhood trauma and other events in life that are outside the control of the person. This is controversial since society argues that people can control their urges, especially sexual urges.
Professional Belief about Personality Disorders and Paraphiliac Disorders
Professionally, personality and paraphiliac disorders are believed to be disorders that are manifested through a person’s inability to control their emotions. The lack of control can result in impulsive conduct and further affect how a person feels about themselves and responds to others in society (Goes, 2023). This lack of control also affects the way a person with these disorders relates to others. Psychiatric professionals believe that people with such disorders experience intense mood swings, have uncertainty about their self-image, and respond to others based on their mental and emotional challenges. According to Nierenberg et al. (2023), a person with personality and paraphiliac disorder will often look at things from extremes. Bobo (2017) also argues that these individuals quickly change their values and interests and may act recklessly based on impulse.
Maintaining a Therapeutic Relationship
When dealing with a patient with such disorders, one must consider maintaining a therapeutic relationship that is characterized by five components. The strategy involves creating rapport, cultivating empathy, building effective communication, encouraging collaboration, and keeping to the professional boundaries. According