Remember when psychiatry was all about neurotics and psychotics? Now personality disorders are the big thing. People used to be “normal” or be suffering from “mental illness.” Now disorder has replaced illness or disease. But just what does it mean when someone is said to have a personality disorder?
The word “disorder” has a number of meanings. If a machine breaks down, it is out of order. So what is this order that the machine is out of? Order exists when things are arranged in a rational manner. When they are randomly placed, it’s disorder, otherwise known as chaos. The Free Dictionary defines it “In a state of disorder and confusion; higgledy-piggledy; unable to agree, at odds.” Another meaning of the word “order” is command. The person in charge tells everyone what they are supposed to do. Order is rationally and meaningfully structured.
The medical world has it’s own definition of disorder which it sees as “a derangement or abnormality of function; a morbid physical or mental state. For specific disorders, such as the psychiatric disorders, see under the name, such as anxiety disorders and personality disorders.”
Then what is a disease? All Nurses says, “Disorder and disease are used interchangeably in clinical settings, but as what i(sic) have observed, disease is used more on the physical while disorder is very frequent in psychiatric/psychologic. Syndrome- characterized by the consortium of a group of signs and symptoms that occur together in a disease. You may also check out med dictionaries so you can confirm.” Disease can be broken up into “dis” and “ease,” lack of ease. Disorder is lack of order. The nurses define disorder as “a disturbance of function, structure, or both, resulting from a genetic or embryonic failure in development or from exogenous factors such as poison, trauma, or disease.”
So what is this “personality” that can become disordered? Gordon W. Allport defines personality as “The dynamic organization within the individual of those psychophysical systems that determine his characteristic behavior and thought.” So personality is organized, a system having order. Therefore, a personality disorder must be a disruption of that organization. Wikipedia defines personality disorders as “a class of mental disorders characterized by enduring maladaptive patterns of behavior, cognition, and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual’s culture.” It doesn’t seem to mean a lack of order so much as a clash with what the “individual’s culture” expects. The very fact that these “disorders” can be arranged into groups, called “clusters” and given names and descriptions of characteristic behavior and inner experience for each “disorder” suggest that there is order in each of these phenomena.
Of course, it’s the human mind that seeks order everywhere. Even disordered things are made orderly in the minds of those who define them. One could say that all order is a product of our minds. As Kant showed in his Critique of Pure Knowledge,
Things as they are “in themselves”—the thing in itself or das Ding an sich—are unknowable. Wikipedia
If people with personality disorders were really so lacking in order or structure as to confirm to the original meaning of the word “disorder,” could they function as well as they do? Could they be classified as rationally as they are in the DSM-5 (although there is still much room for criticism of that structure)? I think “disorder” in the context of personality means something society disapproves of. Or maybe this only applies to Cluster B. People in Cluster C certainly seem to be suffering. They fit the criterion for dis-ease. I don’t know if people in Cluster A are suffering. Their cluster is the “weird” one. They live in their own alternate universe (although not enough to be considered psychotic). Whatever the situation, society, as represented by the committee of the American Psychiatric Association that wrote the DSM, has declared people in the ten designated groups of the disordered to be considered abnormal.
Since Psychopathy is not named in the DSM, room is left for the possibility that it isn’t even a disorder and, therefore, not abnormal. Cleckley wrote The Mask of Sanity. But that the DSM allows us to suggest we are sane and normal, after all, and still be consistent with the cannons of the DSM. Of course, most of us are still antisocial as defined by the DSM so we can still be called disordered anyway.
Whatever. All personality disorders have their own structures, all are ways of coping with the situations people with those disorders are in. Therefore, all are kinds of order. I call them alternate orders. Some work better than others. That’s the most one can say about them. As alternate orders, they are ways of distancing oneself from Society as a whole. And I think this is a good thing.