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Personality Disorders:  Analogies to “Think With”

Dr. Brian Campbell

 

Analogies are often very powerful tools to use with clients in counseling.  They are also powerful in terms of conceptualizing disorders in the therapist’s mind.

Sensitive People:  A General Analogy

Marshmallows, M&Ms and Jawbreakers:  Let me start with an analogy I often use in counseling.  I tell my clients that people come in three varieties:  Marshmallows; M&M’s and Jawbreakers.  (By the way, I tell them that this conceptualization is not scientific).

                                 Marshmallows:  Very sensitive; no outer shell or coating
                                 M&M’s:  Sweet on the inside, but with an outer hard coating.
                                 Jawbreakers:  Pretty much “hard guys.”  Nothing much bothers them.

I usually draw the “normal bell curve.”  I show them that some people are way at the extreme of sensitivity.  At the other end, some people are “hard” and don’t let many things bother them.  I then tell them that I was a Marshmallow when young, but I have been working hard most of my life to become an M&M.  My wife, who is British, is a Jawbreaker.  Not much bothers her. (By the way, Marshmallows often marry Jawbreakers; the opposites seem to attract each other).

In my experience, people with mental health issues are often the Marshmallows.  They are very sensitive people, who respond to, and react to, the world.  Now lets’ look at some personality disorders with respect to this model.

Avoidant Personality Disorder

 When I trace this disorder back to its roots, I usually end up at middle school.  Children are sheltered until they get to middle school.  Then they are “thrown to the wolves.”  The number of children physically or emotionally bullied/abused in middle school is very high. 

Turtles in a Glass Bowl:  When I think of middle school, I think of a bunch of turtles in a glass fish bowl.  Each of the turtles is trying to escape and “get higher up” than the other turtles.  They don’t care who they step on…they just want to be a little higher than the other turtles in the bowl.

The Star Trek Shield:  When individuals (who later develop APD) are bullied or made fun of, they put up a “protective shield,” to keep from hurting.  (Remember, deep down, these people are often very sensitive Marshmallows).  When describing the shield, I give the analogy of Star Trek. 

The APD individual puts up a protective shield (remember the star ship Enterprise) in order to shut out the hurts from name-calling, bullying, etc.  Once the shield goes up, APD individuals start to “live behind the shield.”  They find comfort and protection there.  Emotionally, they withdraw from others and avoid interactions. 

Unfortunately, although they feel safer with their “shield up,” because the shield keeps information from coming in and hurting them, the same invisible shield also prevents information from “going out.”  Individuals become isolated in their own little worlds.  They walk around, and interact to some extent, but they are mostly hiding behind their protective shields.

People with APD would like to let the shield down and be like others.  However, they have learned through experience that they can get hurt if they “lower the shields.”

Schizoid Personality Disorder

People with Schizoid Personality Disorder (SPD), also have their “shields up,” but they have given up on trying to “let their shields down,” and join the world of others.  The shield becomes almost permanent. 

SPD individuals have “given up” on others.  They have “switched off” their emotions.  They may be married, but they are emotionally aloof and detached.  They do not want or desire close relationship.  By the way, in my experience, the overwhelming majority of SPD individuals I have worked with have been MEN.

One of the notable symptoms of men with SPD is that they are almost totally devoid of sexual drive.  This is very rare in men.  In fact, the wives of men with SPD often complain that their husbands never want to have sex.  Now, that is certainly a switch!  By the way, this low sexual desire typically occurs in the absence of low testosterone or erectile dysfunction.

Schizotypal Personality Disorder

Now, turning back the analogy of Star Trek shield, let’s have a look at Schizotypal Personality Disorder.  To some extent, this disorder can be thought of as an “extension” or “continuation” of Schizoid Personality Disorder.  People with this disorder drift out of society and into peripheral roles and jobs (like night watchmen) that require little, if any, social interaction

The Lonely Island:  Returning to the Star Trek analogy, what do you think would happen if you kept the invisible shield up for too long?  To help understand what happens, imagine Tom Hanks on the island in the movie “Castaway.”  Do you remember when he started talking to “Wilson,” the volleyball?  Well, you might imagine that if you stay withdrawn from others (as in Schizotypal Personality Disorder) too long, you might start to develop some odd and eccentric personality features.

In my opinion, this is what starts to happen to individuals with Schizotypal Personality Disorder.  Since no one else is around on their island, they start to become pretty odd.  They talk to themselves and start to make up things in their own little worlds.  Since “no one else is around on their island,” their minds start to develop “odd beliefs and magical thinking.”  They may become paranoid or suspicious of others (people who might want to attack their island).  They are socially anxious, and don’t really want to be around other people.  Not surprisingly, their appearance starts to look “odd, eccentric, or unusual.” Their affect is typically constricted; they don’t show the normal range of emotions (joy, happiness, sadness).  To a great extent, they have “switched off” their emotional worlds. 

Unfortunately, as you might imagine, people with Schizotypal Personality Disorder rarely make it into treatment.  They have few close friends; even if you get to know them, they remain emotionally distant.  As with other psychological disorders, deep down, these individual are “Marshmallows.”  In my opinion, the nidus of their withdrawal from society can be traced to their underlying sensitivity. 


Borderline Personality Disorder

Individuals with BPD are highly unstable.  They are difficult to work with because of this instability.  They may exhibit extremes in behavior (spending, sex, etc.), dramatically attempt to hurt themselves (e.g., “cutting”), or even threaten suicide.  They do not have a clear sense of who they are (identity issues) and often feel empty inside.  Most of all, individuals with BPD fear abandonment.  As a result, their relationships tend to be characterized by “over-idealization” or “devaluation.”  Let’s look at an analogy.

Lifeguard Analogy:  When I talk about this disorder with my clients, or their loved ones, I often use the analogy of drowning at sea.  Individuals with BPD often feel abandoned in the ocean of life.  They are desperate and feel the need for someone to save them.

Then they see a lifeguard swimming by.  In desperation, they throw their arms around the lifeguard and hold on for dear life.  However, their grasp is so tight that the lifeguard finds their grip uncomfortable and may try to pull away.  If he shows any signs of “looking away” or “pulling away” individuals with BPD may suddenly push the lifeguard away.  They see even the slightest lack of total/absolute commitment to be extremely threatening.  They push away and “reject before they are rejected.”  They would rather be drowning again rather than to trust someone and risk being abandoned.

Unfortunately, for individuals with BPD, therapists may serve in the role of the Lifeguard.  As a result, BPD individuals may “grab onto” the therapist and “over-idealize” him/her, only to reject the therapist if they sense the slightest feeling of possible abandonment.  For the therapist, one week you may think that things are “going great,” only to find that the next week the client has cancelled the appointment in an effort to “test the loyalty” of the therapist. 

 

Dependent Personality Disorder

Individuals with Dependent Personality Disorder see themselves as helpless, incompetent, needy, and week.  They feel devastated when close relationships end.  They find it difficult to make decisions and feel helpless when on their own.

The Boat Analogy:  People with DPD feel that they need someone in their boat with them—preferably, a strong Captain who can take care of them and keep them safe. They don’t like to be alone in the “boat of life,” and feel desperate and devastated if the Captain leaves the boat or abandons them.   The “Captain” can be a person, or an institution (such as the church).  Because people with DPD feel they need strength and guidance, they tend to be submissive and depend upon others to help them make decisions and “navigate” through life.