Personality disorders can create a distorted self-image.
by Anne R. Allen.
Most of the truly rotten villains in fiction are what used to be called “psychopaths.” (Now clinically known as people with ASPD: Anti-Social Personality Disorder.) These are people who have no conscience and no empathy.
But psychopaths can make boring fiction. Psychopathic villains have pretty uncomplicated motives. They’re usually sexually twisted sadists or conscience-free monsters who do evil things because they’re, well…evil.
And not all people with ASPD need to be villains. Benedict Cumberbatch’s version of Sherlock Holmes has the ASPD detachment from normal human emotions like guilt and empathy. Plenty of people with the disorder lead normal, non-criminal lives. Even a conscience-free person needs a reason to commit a crime.
But you can create more interesting antagonists if you give them more relatable personality disorders. We have all experienced some PD symptoms, at least early in our lives. All healthy toddlers are narcissists. And every young child has the fear of abandonment that fuels Borderline issues. Plus we’ve all had a few paranoid moments when it feels as if somebody’s out to get us or rejection is coming at us from everywhere. Especially if you’re a writer 🙂
A basic knowledge of personality disorders can help writers create more interesting heroes and supporting characters, too. One of the most memorable detectives in recent fiction was Adrian Monk of the TV show Monk, who suffered from Obsessive Compulsive Personality Disorder.
So what are personality disorders? They’re a constellation of behaviors that are generally problematic, but not debilitating. They do cause troubling consequences for the person dealing with them—and for those around them. Generally they don’t require hospitalization (with the exception of Borderline patients.)
Diagnostic and Statistical Manual of Mental Disorders
Personality disorders are defined by the Diagnostic and Statistical Manual of Mental Disorders, a publication of the American Psychiatric Society.
First published in 1952, the DSM has been revised five times, with major revisions to criteria for personality disorders. (The manual is not without controversy. It wasn’t until 1974 and DSM-3, that it stopped defining homosexuality as a mental disorder.)
The current DSM, published in 2000, is #5. It brought some big changes in thinking about personality disorders. According to Psychology Today, now a doctor will diagnose personality disorders when the patients have “significant impairments” due to behavior caused by the disorders. They need only display “one or more pathological personality traits.”
The DSM dictates that the symptoms of personality disorders must be:
- Consistent in all situations (not something that comes and goes with different interactions.)
- Not caused by the person’s situation or age. (We’re all narcissists when we’re two.)
- Not caused by drugs or alcohol or a physical disease like a brain tumor or Alzheimer’s.
Personality Disorders
DSM-5 lists 10 personality disorders, which are divided into three clusters.
Cluster A (Eccentric)
Paranoid PD:
These people are driven by shame and are highly sensitive to rejection. People with PPD also have a strong sense of what they perceive to be their rights. They can bear fierce grudges against anyone they believe has violated their rights.
As a result, they can bear those grudges for life. (Good for antagonists or vigilante characters.)
People with this disorder are also very susceptible to projection—imagining that other people are having their own negative thoughts and feelings.
Schizoid PD:
This doesn’t have anything to do with schizophrenia, and some psychologists argue it’s not a disorder at all. They believe this behavior is simply an expression of extreme sensitivity and a rich inner life.
The name comes from a person’s detachment from reality and obsession with their own thoughts and fantasies.
Although these people are often unable to form attachments because of their oddness, they don’t reject others and often long for normal intimacy.
These people can seem strange, but they generally cause no one harm and are usually hardworking, functioning members of society. (Some of them are known as “writers.”)
Schizotypal PD:
These people don’t trust others and often imagine strangers are conspiring to harm them. Some medical professionals believe this disorder can herald schizophrenia.
They are subject to irrational beliefs and magical thinking.
These are the “tinfoil hat” people who often think that outside phenomena and events have been orchestrated to harm them personally. They may think the alien mothership is sending down signals that make the traffic lights turn red just as they arrive at the intersection. Or that a government agency has them under surveillance for murky, bizarre reasons. These people are rarely dangerous, but their irrational fears can be very trying for family members and co-workers.
If you’re writing one of those unreliable narrator thrillers, a Schizotypal PD character might provide a fascinating voice. They are usually careful observers, but come to bizarre conclusions about what they observe.
Cluster B (Dramatic, Erratic)
With the exception of ASPD, people with Cluster B disorders have a desperate need to be the center of attention. They often can’t sit in a theater for more than a short performance of music, film, or live theater. They will find an excuse to leave or create a disruption because they’re miserable when attention is on something other than themselves.
The same is true in social situations. If someone else has the floor, they will often pick a fight or tell the speaker they’re wrong–only to “correct” the speaker with the identical statement–in order to draw attention.
Anti-Social PD:
This is the personality disorder most commonly associated with crime. People with ASPD are the most likely to have criminal records and a history of incarceration.
They are incapable of empathy or feelings of guilt. This means you’ll only make them angry if you ask them to “have a heart” or “remember the Golden Rule” They have no “heart”, and are incapable of imagining themselves in anybody else’s shoes.
Because of this, they don’t believe social rules and obligations apply to them. They can become irritable and aggressive when someone asks them to follow the rules. They never feel ashamed, so they usually don’t learn from experience and tend to commit the same offenses over and over.
Unlike the Cluster A people, the anti-social generally form relationships easily. They can be charming, but their relationships are usually short-lived and abusive.
The classic serial killers in fiction (and real life) have the characteristics of ASPD.
Borderline PD:
These people lack a sense of self and suffer feelings of emptiness and fear of abandonment. The disorder is characterized by wildly unstable emotions and relationships.
Borderline people don’t know who they are unless they have someone to mirror them, which means they’re terrified of being alone. This can lead to substance abuse, sex addiction, depression, and eating disorders.
The designation “Borderline” came from early perceptions of the disease, when the medical profession saw the disorder as something between psychosis and neurosis—on the “borderline.” That’s not accurate, but when it was recognized as a personality disorder in 1980, the misnomer stuck.
Like the Harmoniums in Vonnegut’s Sirens of Titan, BPD people spend their lives saying, “Here I am!”—always looking for people to say, “There you are!” But if somebody says “Here I am!” instead, a BPD person can burst into rage.
They’re not able to sustain interest in other people except to boost their own self-worth. For that reason, they seek out either high-status people or “good listeners” who never express needs of their own.
Because of their inability to reciprocate friendship, they tend to “take hostages” rather than make real friends.
They often use threats of suicide to control people around them, and have a pattern of intense, highly volatile relationships. They’re prone to outbursts of violent rage, mood swings, and wildly impulsive—usually self-destructive—behavior.
The character of Alistair Milbourne in my novel The Gatsby Game was based on a real person, David Whiting, who suffered a mysterious death in a famous Hollywood scandal. I knew David and I think now that he had Borderline Personality Disorder. He was desperate to “belong” but he never could. His father was a mysterious stranger who never acknowledged him, and his mother abandoned him in boarding schools from the time he was six.
Histrionic PD:
The Histrionic person lacks a sense of self-worth and depends on the constant approval of others.
These are people who are always “on” and seem to over-dramatize every event in their lives. Every little slight or perceived show of disrespect can trigger reactions of operatic proportions.
They tend to fetishize minor events in their lives and expect others to do the same. They may expect the entire family to wear black on the anniversary of the death of their beloved parakeet, or go into a rage if everyone in the office doesn’t buy their self-published poetry chapbook.
If a HPD person loves red roses, then red roses will take on an almost religious significance. People who give her red roses will automatically be seen as trustworthy, honest and kind.
But if the lying ex of the HPD gave her white roses, even a mention of white roses will send her into high dudgeon. Or like the Queen of Hearts in Alice in Wonderland, she may expect you to paint the white roses in your garden red.
The Queen of Hearts is a great example of a histrionic character. In fact, most of the characters in the Alice books could represent some kind of personality disorder.
“Histrionic” is derived from the Latin word histrionicus, meaning “pertaining to the actor.” No, it doesn’t come from the Greek word hystera, meaning “uterus” as you may have read. And histrionic people are not considered “hysterical”—a misogynist word that does come from the Greek “hystera”.
But lots of HPDs find a home in the theater, or in sales positions where putting on a dramatic persona is useful..
They can live in a vicious circle where the more rejected they feel, the more histrionic they become — and the more histrionic they become, the more rejected they feel.
Narcissistic PD:
This is the personality disorder we hear most about. These people have an extreme sense of entitlement and a pathological need to be admired and control others.
They are fiercely envious and expect other people to envy them.
Like people with Anti-Social Personality Disorder, they lack empathy. They lie and cheat and exploit others to achieve their aims and are prone to irrational rages.
But unlike people with ASPD, they do feel shame and guilt, and will go to great lengths to cover up things that embarrass them. They are highly critical of others but can tolerate no criticism of themselves.
There are only two people in the life of a person with NPD: Me and Not-Me. So if Mr. NPD tells something to his secretary, he expects his wife to know what he said—even if she wasn’t there—because both people are “Not-Me.” This is why narcissists go into rages when people can’t “read their minds.”
They can also be very charming and charismatic as they draw potential minions into their web. Narcissism is dangerous—but it’s less dangerous to the narcissist than it is to the people around them–so they are the least likely to seek help.
Narcissists make recognizable villains for your fiction, because everybody has had to deal with one at some point in their lives. Most of us still carry the wounds if we’ve ever run into a Malignant Narcissist (a combination of ASPD and NPD.)
But narcissists can be endearingly childlike. And funny. Many sitcom characters are classic narcissists. Frasier Crane, Karen Walker in Will and Grace and Titus Andromedon in the Unbreakable Kimmy Schmidt are all endearing narcissists.
Cluster C (Anxious, Fearful)
Avoidant PD:
People with avoidant personality disorders believe that they are unappealing, inferior, and socially incompetent. The constant fear of being embarrassed, criticized, or rejected drives all their actions.
Because this can make them socially awkward, they can go to great lengths to avoid social situations. They also may self-sabotage to avoid any kind of success that might put them in the spotlight.
They often reject people who are kind to them in order to reject before it happens to them.
An abusive level of criticism in childhood may be one of the causes of the disorder
Dependent PD:
These people lack self-confidence and have an inability to make mature decisions. They demand that other people—-sometimes complete strangers—make decisions for them.
But they will turn on those people if the decisions have negative consequences. They can’t take responsibility for their actions so they need to have somebody to blame for their failures.
This means they can’t learn or grow. We all learn from our failures, so people who can’t allow themselves to fail can’t grow up.
Dependent issues can lead to the personality disorders of Cluster B. People with DPD crave attention the way a small child does. So their symptoms can mimic the childish behaviors of NPD or BPD.
Obsessive-compulsive (Anankastic) PD:
These people suffer from extreme perfectionism, which can be paralyzing. They’re obsessed with details, rules, lists, organization, or schedules. They often need to repeat ritualistic actions.
Sometimes they’re germphobic and obsessed with cleanliness. They can also be hoarders and very stingy with money. The classic miser character sitting alone and counting his money is typical of someone with OCPD.
All of this comes from a need to control a universe that feels disordered and chaotic to them.
OCPD is not the same as Obsessive-Compulsive Disorder (OCD) although the two have many similar characteristics. OCD is an anxiety disorder, not a personality disorder. People with OCPD don’t repeat ritualistic acts. Also, they usually enjoy their actions, rather than feel guilty, like people with OCD.
OCPD also mimics some symptoms of Asperger’s syndrome, and people on the autism spectrum are more likely to have OCPD than the general population.
***
All of these disorders exist on a spectrum, and people can have a mild version of a disorder and function normally. But substance abuse, trauma, or disease can intensify the disorder.
For instance, Adrian Monk’s OCPD increased exponentially after his wife was murdered in front of him in a seemingly senseless act—increasing his dread of chaos.
People with one personality disorder will often show characteristics of another—especially in the same cluster.
There’s disagreement in the mental health field about how many people have personality disorders. For a number of years some psychologists argued it could be as many as 1 in 5. But a 2006 UK study put the number more at 1 in 20.
Personality disorders can’t be cured, but they can be controlled with medication and talk therapy. They also usually improve with age. (Except for the people with schizotypal PD who later develop schizophrenia. )
Mental health experts don’t agree on the causes of personality disorders. Some disorders appear to be genetic, and others seem more likely caused by childhood abuse or trauma. Many are cases of arrested development, where people’s personalities simply didn’t mature along with their bodies.
But I think we can agree that studying up on them will help us understand our fellow humans—and write about them more effectively.
by Anne R. Allen (@annerallen) August 5, 2018
Those of us who studied psych. in college several decades ago didn’t learn this stuff because a lot of these definitions are relatively new. Did you know all the kinds of personality disorders? Have you written about characters who have any of these disorders?
BOOK OF THE WEEK
99C/99p Countdown Sale!!
COUNTDOWN!!
HOW TO BE A WRITER IN THE E-AGE: A SELF-HELP GUIDE
co-authored with Amazon superstar and NYT Bestseller,
only 99c/99P in the US and UK for five days
August 3rd–August 9th
***
OPPORTUNITY ALERTS
UNO PRESS PUBLISHING LAB PRIZE for book-length fiction. Any genre. $18 ENTRY FEE. The University of New Orleans Press is looking for full-length fiction manuscripts, either novels or short story collections. This is the fourth annual Publishing Lab Prize. There’s a $1,000 advance on royalties and a contract to publish the winning manuscript with UNO Press. Deadline August 15, 2018.
Stories That Need to be Told Contest from Tulip Tree press. $20 entry fee. $1,000 prize for a poem, a short story, or an essay that “tells a story.” And an anthology anthology, Stories That Need to Be Told will include winners. Up to 10,000 words. Categories: Passion, Depth, Humor, Love. Deadline August 26.
Glimmer Train Fiction Open. Glimmer Train prizes carry a lot of prestige. Also, they award a $3000 prize for a winning short story. Second prize is $1000. Entry fee $21. Any subject or theme. From 3000 to 20,000 words Deadline August 31.
WOW-WOMEN ON WRITING FLASH FICTION CONTEST$10 ENTRY FEE They are open to all styles and genres of flash fiction. Between 250 and 750 words. You can write about anything, as long as it’s fiction within the word count. Deadline August 31.
SERVICESCAPE SHORT STORY AWARD NO ENTRY FEE. They’re looking for any genre of short fiction. Maximum 5,000 words. Prize is $1000 in addition to publication in SERVICESCAPE. Deadline November 30, 2018.
13 Imprints of Big 5 publishers who take unagented submissions. From the good people at Authors Publish Magazine.
48 Small Presses looking for children’s books. Also collated and vetted by Authors Publish magazine.
The DSM IV-TR puts NPD (Narcissistic personality Disorder) at between 2-15% of the population in clinical cases and less in the wild, which is quite worrying. But, as you say, most of us have had a run-in with at least one personality-disordered person in our lives at some time. I think the trick when writing about characters suffering from PDs is to not exaggerate. I always feel a little disappointed when I’m reading a great book and the ending falls flat because the loveable guy/gal you’d never think did whatever’s been done reveals him/herself to be out-of-control at the end (and weirdly out of character). Manipulation is a subtle thing, maybe only identifiable by the knot in your tummy, and is difficult to pinpoint in real-life. I’m always impressed by someone who gets in right in writing – makes me put the book down and go “Aaaah, now that’s what I call talent!”
Louanne–That’s why I wrote this post. Personality disorders don’t make people “evil” and it’s easy to exaggerate the symptoms for dramatic effect. But unless you’re writing a farcical comedy like Unbreakable Kimmy Schmidt, it’s best to keep the characters within the realm of reality.
Anne—Thanks for the excellent run down and such a useful guide. From “Yon Cassius” to Lady MacBeth, from Hannibal Lector to Mrs. Danvers, the writers who created these unforgettable characters were way ahead of psychologists in their recognition of personality disorders!
Ruth–You’re right. Writers have always observed disorders in people and used them to create unforgettable characters like these.
Excellent post. I was in college ages ago (when DOS was king), and this was a quick refresher on personality disorders. As a mother of a high-functioning teenager on the autism spectrum, this was thoughtfully presented. Recently, we introduced him to Monk and Sherlock. I’m glad there are positive role models in his neighborhood of quirky.
Dominique–Definitions of personality disorders have changed over the years and the DSM-5 had some info I hadn’t seen before. Personality disorders aren’t the same as anxiety disorders or people on the autism spectrum, but oddness of any kind is so often misunderstood. How great for your son that he can relate to Monk and Sherlock!
Thank you, thank you. I so appreciate writing-related posts that cover information writers may not consider to be “in the writer’s toolbag”. I have a friend who uses the Myer-Briggs to solidify her characters, & another who offers workshops on various psychological models to help authors better understand their own characters. Like your very own “Poisoning for Fun & Profit” posts at https://annerallensbooks.blogspot.com, this post gives us great writing fodder from outside the writerly ivory tower. Thanks again.
CS–Myer-Briggs categories do indeed give a lot of insight into characters and what they “would” or “wouldn’t” do.
Thanks for the shout-out for my poison series!
Great stuff, Anne! You really explained the major DSM classifications in an easy to understand manner – much better than the book itself. This is a great article/resource for characterization. I read the narcissist profile with a smile. Makes me think of a character with a major personality disorder who often trumps the news. 🙂 Thanks so much!
Garry–The people at the APA aren’t known for their clear writing skills. 🙂 It took some studying to figure out what the DSM is really saying. And yes, personality disorders don’t keep people from rising to the highest levels of business and government. 🙂
Wow, what a rundown.
It was not hard to think I didn’t have a few when I first read them. lol
Thanks.
Ann–Haha. Probably not. But as I said, we’ve all had symptoms at some time in our lives, because they’re normal stages of early childhood development. Some people with disorders simply haven’t grown up..
Fascinating topic and a wonderful, useful post (which I am of course stealing-via-sharing. I’ve been horrible to my villains over the years- they just don’t interest me! And while epic fantasy may have some room to forgive that (a liche is pretty much a liche), I would say this information is terrific for thinking about and worth the time. Of course, unless your MC is a detective with a degree in psychology, it’s going to need to be deep background- or else it’s another tell-not-show problem dampening the tension when the game is supposed to be afoot.
That being said, I’m most likely some kind of Diet Histrionic myself, so don’t take my word for it.
Will–Okay, I’ll admit I had to look up Liche. Sort of like an epic fantasy version of a zombie but it has less flesh on it? Yeah, zombies probably don’t have personality disorders.
I’m not saying that you have to tell the reader that you;’re up on this stuff. But it helps with motivations and personal interactions when you know what’s going on behind the scenes in a character’s make-up.
A Diet Histrionic? I don’t think that’s in the DSM. But I have been known to get dramatic when I’m not fed at regular intervals. 🙂
Fabulous post, Anne!
I began my compilation of mental illness about 36 years ago, and not from my psych classes previously slugged through in college, but when my husband was diagnosed as manic depressive. Only one drug for that in those days. Five years later, he was diagnosed again, still m/d, but now showing also as paranoid-schizo-affective.
In writing, I finally decided that everyone with a significant mental illness (of the type you’ve discussed here) had to validate their existence — just like every person constantly validates their existence. If you operate from a position of an ill mind though, you must validate that view — and vehemently reject any attempt to deny that view is ‘real’. You may need to create situations that you know will confirm your world. Again, I don’t think you have to be mind ill at all to create situations that fit your world view — we all do it, just a bit…
The evil characters we need should be within what you’re directing and suggesting: they aren’t ‘always’ evil. If a cruelty won’t confirm or validate their views, they see no reason to be cruel.
At the same time, the reactions to these characters needs to be sensible. My work with a police department quickly showed me that a well-trained officer handles an unknown person exhibiting mental illness (no drugs, drunk, etc) will work to establish the most neutral position possible so the disturbed person can absorb what is a threat and what isn’t.
Anyway – I love that you’ve done this article! It’s something that all writers should think about — and maybe start a compilation of characters based on certain illnesses. The ‘right’ bad guy can make the whole premise of the story more believable.
Thanks for this!!!
Maria D’Marco
Maria–And sometimes the troubled person can be the good guy. I think Monk and the new Sherlock do a great job showing that.
What I’ve listed here are personality disorders, not full-fledged mental illnesses like bipolar disorder or schizophrenia which can require hospitalization. It must have been very difficult to deal with spouse with unmedicated bipolar disorder.
Personality disorders can make a person merely “odd” and are generally not dangerous. But as you say, their need to make others see their distorted view of the world can make for some very difficult interactions.
I know that people in law enforcement (and other first responders) need to have a lot of training in dealing with the mentally ill. Sounds as if you’ve got some good training from working with the police.
Hi Anne, thanks for this post. Helpful to see Frazer, Monk and Sherlock given as models. It clarifies it more when attached to a name you know. Lots to catch up on. Just started reading the “big five personality traits,” a link from CS-Myer-Briggs, who I must admit, I never knew before.
Jacqueline–Studying Myer-Briggs is fascinating, isn’t it? So many combinations of characteristics–all of them a little different from our own. It helps with creating believable characters and real life interactions, too.
Wow. What a terrific column. I’m bookmarking this one. May I recommend a book: The Sociopath Next Door. Well worth reading (easy to read, with examples that come to life). I spotted several people in that book who I had come across in my working life.
In my fiction, I find serial killer books ho-hum. For me, the kicker of a book is the ‘why’. WHY would someone similar to me step over the line, when I didn’t? What motivated them?
Again – terrific column, Anne! To me right back to third year uni, Abnormal Psych.
Melodie–I have the Sociopath Next Door in my library and I’ve read it several times. Dr. Stout has a wealth of information on ASPD and NPD characters. It really helped me realize I had to remove certain people from my life. Thanks for giving it a shout-out. Great book.
I agree with you 100% about most serial killer books. They’re always the same. People do evil things because they’re evil. I’m much more interested in why an otherwise perfectly nice person would commit murder.
You know you read a great blog post when it gives you lots and lots of ideas for creating characters with interesting quirks.
Thanks Anne for the inspiration.
Ingmar–That’s what I was hoping this post would do. Great to know it got the creativity flowing!
I’ve heard of them although not all in such detail.
I remember one reviewer saying the main character in my trilogy was borderline something, but I don’t remember what the issue or disorder was or if it was more of an obsession.
Alex–Your hero is probably not “Borderline” –unless the reviewer was a psych major being snarky. But knowing these terms can help you defend yourself against psych-major snark. 🙂
Fabulous info presented in your usual clear and understandable fashion! Thank you, Anne! I’m printing it out and saving it in my references. These examples are invaluable in creating multi-dimensional characters with good and bad intentions.
My current series hero is a woman with dyslexia. She lacks book-learnin’ but is a keen observer of personalities. She would never use DSM 5 terminology but she can still recognize traits in the characters who cause grief to others. I try to use her observations to show behavior w/o boring readers by lecturing about PDs.
Yep, there are certain people you must avoid or otherwise risk the consequences when you’re sucked into their destructive vortex. That’s an especially hard lesson to learn for people of compassion who always hope they can help the troubled soul.
Debbie–A hero with dyslexia is brilliant! Very creative.
This knowledge I have presented here is NOT something you want your characters to spout. It’s knowledge for the artist to use in creating three-dimensional characters.
People with personality disorders can be dangerous for the people around them, but often if we have understanding of their issues, we can benefit from the insights of a differently-abled brain.
This is very helpful. I don’t recognize many of these although I was a psych major “back in the day”. Thank you. I love this for creating new characters.
Patricia–Most of these ideas have entered psychology since the 1980s. The whole idea of personality disorders is fairly new. That’s why I thought I’d share my research here with other writers. I’m glad if it gets the creative wheels rolling.
Wow! The whole DSM in one blog article! Impressive, Anne. I have an MA in counseling and found psychopathology one of the best courses I’ve ever taken, as a writer and certainly for illuminating the world around me. Look at Washington DC now: a child’s garden of psychopathology.
Here’s an article I wrote on Jungian Type and writers. Another way of slicing the human pie. I also talk about how writers can pitch their works to their audiences if they know what type that audience might be.
http://visionaryfictionalliance.com/personality-type-for-writers-what-writers-must-know/
Sandy–A child’s garden of psychopathology indeed. If more people read the DSM, maybe fewer people would vote for the unwell. Sigh.
Thanks for the link to your article. I remember the “Ah-ha” feeling I had the first time I read about Jungian archetypes. Yes! His work addressed the human condition better than almost anything else I read in college.
Thanks, Anne. I worked as a psychiatrist for a number of years, and in forensic psychiatry for the last 8 of those, and although we wouldn’t usually admit somebody with a personality disorders as their main diagnosis (as you say, treatment is disputed and managing some types of personality disorders is very difficult and challenging. Just imagine putting several together in the same place and you will know what I mean), many of the patients showed traits for several PDs. I worked at Rampton special hospital for a while (a hight security facility in the UK, mostly for people with mental illnesses who had committed serious crimes) and they were trying a new unit for people with complex PDs and very dangerous and patients had to be diagnoses with two PDs at least to quality for the unit (I did meet some pretty scary people there, I must say, and I don’t scare easy). Many people will have traits of several PDs although they might not fulfil criteria for any given one, and that might be handy to remember when writing characters. There are other systems of classification for illnesses, like ICD-10 (they are working on ICD-11 but revisions normally take forever, it stands for International Classification of Diseases), and I see people mention other sources. If somebody is really interested in ASPD (antisocial PD), reading the Hare Psychopathy checklist might be useful. Oh, and, of course, what they call hystrionic now was good all hysterical before (that come from uterus, womb), so, classifications go round and round but people don’t always fit neatly into any categories. Great post!
Olga–There are differences in the way the UK and US doctors define personality disorders. I chose to use the US definitions (from the DSM) for clarity, but I realize the field can be pretty murky. So many people have clusters of the disorders and that’s when they can become so dangerous (Like ASPD and NPD when combined with Borderline.)
You repeat a common confusion between “Histrionic’ and “Hysteria”. They have different meanings and different roots in Latin.
“Histrionic” comes from the Latin ‘histrio” meaning “actor” –& it’s a disorder involving drama.
“Hysteria” comes from Latin ‘hystericus” meaning “of the womb” (Same root as “hysterectomy.” ) It’s no longer a medical term.
“Histrionic” with an “i” has nothing to do with women. In fact in ancient Rome, only men were actors.
I grew up with a father who was a professor of Latin at Yale, which occasionally comes in handy.. 🙂
Thanks, Anne. I only studied a year of Latin and it was a very long time ago.
This article explains the relationship between histrionic and hysterical disorders and diagnosis.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4585318/
All the best and thanks for such useful information.
I’ve known at least four narcissists and while on one hand, I feel like that would equip me to write one, on the other hand it’s difficult enough getting them out of your life without spending time with a fictional one for a book! I do wish people would get the names of disorders right though. So often I see people confusing schizophrenia and multiple personality disorder. I’ve known schizophrenics and it goes so much deeper than just hearing voices.
Icy–As I said, I think we’ve all had encounters with malignant narcissists and most of us still carry the wounds. They can destroy lives. But as I wrote here, there are many other personality disorders we can write about.
Not that we always have to write about unwell people. Not all fiction has to deal with pathologies, of course.
I didn’t tackle the really debilitating diseases like schizophrenia, bipolar or dissociative Identity disorder (multiple personality disorder) because they are much more complex. But you’re right that popular culture gets them very wrong and often mixes them up. Maybe that’s a topic for another post.
I think my tone might have come across wrong – I wasn’t complaining, I think this is a really valuable post! And hopefully it’ll help people to use more than just continual hand-washing to denote OCD 😉
I do think a post on the debilitating one would be super useful too. So many people think things like anxiety are just worrying a lot…and there’s so much more to it than that!
Yes. Telling somebody with anxiety to “just count your blessings and stop worrying” is like telling somebody with cancer to “just stop being sick.” Not helpful.
Amazing – one of my favorite things you’ve posted on this blog! I’ve definitely bookmarked this and emailed my friends about it to begin discussing characters who fit these. Thank you for this, because I find this stuff interesting, but most writing about psych is way too dense to wade into.
Irvin–That’s exactly why I wrote this. I don’t know why medical people don’t learn to write better, but most medical writing is dense and jargon-ridden. You can spend hours reading and re-reading before you can wring the meaning from their murky prose.
I’m glad you found this useful! I thought I’d try something different.
A writer not only needs to study they need to become. Find that switch and be that person. For a little while, that is. 🙂
Bryan–It’s sounds like you’re a “Method” writer–like a Method actor. 🙂
Probably and that’s not always a good thing. Exhausting.
Bryan–I’m sure it makes for fully-realized characters. Worth the work if you can do it without getting stuck inside a rotten character’s brain too long. 🙂
Anne, thank you for this post! I’m a retired nurse practitioner and worked in psychiatry. A few of my book characters show personality disorders and I used the word narcissistic once in dialogue between two nurses to describe a resident doctor,“he’s narcissistic and tall, dark & handsome. He could charm the pants off any nurse like he tried to do with you.”I think about the psychological aspect in scenes and how the emotion comes through to the reader. Just realized reading your post how much I do this.
Phew!????Good to know! ????Christine
Christine–As a retired psychiatric medical professional, I’m sure you’ve seen all these disorders and then some. I have no doubt your expert experience helps you create rich and layered characters. Great background for a writer!
Yes, great article! I studied mental illness, so I know a bit about personality disorders. The problem is that we must study these disorders, because many authors get it wrong, or confuse different personality disorders. As an advocate for mental health, I wouldn’t want to see people with these disorders be misrepresented.
studying psychology really does help “authors to be.”
Debbie–That’s why I wrote this post. Psych articles and the DSM are hard to read. I wanted to outline the major symptoms of each disorder so authors can get them right. And also to see that having a disorder doesn’t mean that a person is a villain or a creep. Lots of people with these disorders are very productive members of society. They also make for fascinating fiction.
As someone with a neurodiversity one of my goals is to build bridges of understanding. For me the scariest villians are the ones from the camp of “we” not from the camp of “they”. The monster isn’t the “other”. The monster is ourselves, the “normal” people, given the Very Wrong set of circumstances.
Leanne–You have a point. I enjoy those British mysteries like Midsomer Murders where the villain turns out to be the nice little old lady next door. But often that nice little old lady has some of her mental wires crossed. I find that narcissists make the best villains. But I’m not writing about the neurodiverse here, but people who genuinely see all other people as their enemies. I certainly wouldn’t equate ADHD or autism with sociopathy.