In discussion today with one of my very good psychologist supervisees I was discussing this topic and more explanation came to light. In the previous post I made the distinction between personality disorders and personality types. One of the key factors in the distinction is that those with what is called a personality disorder have a characterological problem.
This person has a disturbance in their basic character or sense of self. They feel wrong, bad, not right, empty or simply Not OK in their basic sense of self. As mentioned before this is only a small group of people, say around 5%. These people will report that this sense of badness is in their very bones or the cells of their body. The feeling has a somatic quality about it. They will also report that they have always felt like this, that there was never a time where they felt OK about self. In Transactional Analysis theory they feel this badness in their C1 or C0 part of the personality. Thus one can say that this persons sense of badness is experienced as ego syntonic.
Most others do not have this basic sense of badness about self. They feel a sense of basic OKness in self. Later in their development they may suffer various trauma. These can lead to painful feelings like depression and anxiety but these are not experienced as being part of their character or who they are. In this sense they are felt as ego dystonic.
One way to diagnose this is with a relatively easy therapeutic technique. A two chair situation is set up with the client in one chair as the Adult and Parent ego states and they are asked to see the young Child part of self out there in front of them. Most do this relatively easily and will see that small child part of self there.
The client is then asked what is their reaction to the Child? What do they think and feel about the Child part? The vast majority of people will have some kind of positive reaction to the Child. It will be sympathetic in some way and be wanting to help or assist the Child part.
There is a small group where one does not get this reaction. The person will state that there is nothing good or positive about the child and they may indeed state that the child is worthless, disgusting, just full of needs and so forth. The therapist will then hunt around a bit for any positive responses but none are found. This indicates a character problem where the person has a basic sense of dislike or worthlessness. It is this type of person who is most often diagnosed with a personality disorder. It should be noted that a person with a personality disorder may not have such a third degree impasse or character problem but if someone does then a diagnosis of personality disorder should be strongly considered.
Harriet has provided a possible example of the sort of comments one would get in such a two chair exercise as described above. She states:
" I was telling my therapist a couple of months ago that if I ran into myself as a child I would throw her under a bus. I don't like her at all. She was weird, embarrassing, had no social skills, not good at making friends, etc. "
The therapist would need to make further enquires to make sure this was the dominant attitude of the person to the Child part of their personality. If one did not find contrary attitudes of liking or sympathy for the Child then it would be tending to signifiy a third degree impasse.