Not everyone buys into the idea that people have “personalities”. Sure, you may think that your friend acts in predictable ways. But you’ve also seen your friend change their behavior in different settings. In front of their parents they become someone else.
Heck, let’s not talk about your friend. Let’s talk about you. Do you adjust your behavior when you’re at work? (Have you ever peeled off your socks at the workplace and left them bunched on the floor?) Do you use different words when you’re with your parents versus when you’re with your friends? (If you text your parents, look at the emojis you use with them versus the emojis you use with your friends. Are they the same set?)
Maybe not so consistent and predictable, huh.
But for those who do believe in the concept of a personality—”a set of distinctive traits and characteristics“—then the idea of a “personality disorder” seems reasonable. It makes sense that people with personality disorders would have a set of “abnormal” traits and characteristics.
Over the past year(s) and maybe in response to the yesterday’s news, some have wondered if people in positions of power have personality disorders. Their rhetoric, policy decisions, and implementation of regime change via kidnapping—their emotional and behavioral characteristics—all seem abnormal. Our frowns do not turn upside down. They deepen with ongoing and worsening misbehavior.
It is imprudent to diagnose public figures with physical or psychological conditions. I don’t know these people; I will never be in a position to assess them. As an academic exercise, though, let’s look at what it means to have a “personality disorder”. This is how the most recent version of the Diagnostic and Statistical Manual defines a general personality disorder:
A. An enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individual’s culture. This pattern is manifested in two (or more) of the following areas:
- Cognition (i.e., ways of perceiving and interpreting self, other people, and events).
- Affectivity (i.e., the range, intensity, lability, and appropriateness of emotional response).
- Interpersonal functioning.
- Impulse control.
B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.
E. The enduring pattern is not better explained as a manifestation or consequence of another mental disorder.
F. The enduring pattern is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition (e.g., head trauma).
It is hard to argue that the elected leader of a nation has “impairment in social, occupational, or other important areas of functioning”. To achieve that level of power one must be able to navigate (nay, dominate!) social relationships and occupational duties. Maybe the methods they use seem “abnormal”, but “abnormal” and “impaired” don’t mean the same thing.
Consider the history of the United States. It includes ugly events—both distant and recent—of dehumanization, oppression, and exclusion. Aren’t these “expectations of the individual’s culture”? Are we witnessing any actual deviation from these expectations?
It’s true: We don’t know if these Very Important People experience “clinically significant distress”, even as they induce that in others. Maybe they have other medical, mental, or substance use disorders. We just don’t know.
“Personality disorders” are actual clinical conditions. They are not slurs. It’s okay to dislike the totality of someone’s emotional and behavioral characteristics. That doesn’t automatically mean, though, that they have a personality disorder. We can have low approval of someone with high status. They might simply be “a stupid, annoying, or detestable person“.
Maria Yang, MD 