EP4: What Psychiatrists Get Wrong About Personality Disorders

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Are psychiatrists getting it wrong when it comes to personality disorders? We break down the biggest misconceptions about personality disorders, and reveal what the field of psychiatry often overlooks.
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What Psychiatrists Get Wrong About Personality and Personality Disorders
In this video, we expose the common mistakes and misconceptions that psychiatrists often make when diagnosing and treating personality disorders. Whether you’re a clinician, mental health professional, or someone interested in understanding personality pathology, this discussion offers a fresh perspective on how personality disorders are diagnosed, the shortcomings of current psychiatric approaches, and what we can do to improve treatment outcomes.
Personality disorders-like borderline personality disorder (BPD), narcissistic personality disorder (NPD), antisocial personality disorder (ASPD), and obsessive-compulsive personality disorder (OCPD)-are often misunderstood and misdiagnosed. In this episode, we discuss why this happens and the flaws in how psychiatry currently conceptualizes personality and personality disorders. Dr. Fu and Dr. Malzberg argue that personality pathology is more complex than the DSM-5 criteria suggest, and they dive into the nuances of diagnosing, treating, and understanding personality issues.
Key topics covered include:
The role of maturation and integration in treating personality disorders
Why psychiatrists often misdiagnose or overlook key signs of personality disorders
How personality traits like narcissism and borderline tendencies can manifest differently in different patients
The limitations of the DSM-5 in diagnosing complex personality pathology
How trauma, temperament, and childhood experiences contribute to personality development
The difference between normal personality and personality pathology
The challenges in treating personality disorders effectively with medication alone
Why some clinicians might favor diagnoses like complex PTSD over traditional personality disorder labels
How to improve the understanding and treatment of personality disorders in clinical practice
If you’ve ever wondered why psychiatrists sometimes get personality disorders wrong, or if you’re interested in a deeper look at how we can rethink personality pathology, this episode is for you!
personality disorders, psychiatry, mental health, personality pathology, borderline personality disorder, BPD, narcissistic personality disorder, NPD, antisocial personality disorder, ASPD, obsessive compulsive personality disorder, OCPD, DSM-5, personality disorder diagnosis, complex PTSD, trauma and personality, maturation and integration, Dr. Greg Malzberg, Dr. Eric Fu, psychotherapy, forensic psychiatry, mental health podcast, personality development, psychiatric misdiagnosis, understanding personality disorders, personality disorder treatment, psychiatry podcast, personality traits, psychiatry and mental health, treating personality disorders, narcissism, mental health awareness, mental illness, psychiatric practice, psychology podcast, psychodynamic therapy, trauma-informed care, psychiatrist mistakes, mental health stigma, mental health tips
#PersonalityDisorders #Psychiatry #MentalHealth #BPD #Narcissism #Psychotherapy #MentalHealthPodcast ##MentalHealthAwarenes

Опубликовано:

14 окт 2024

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Комментарии : 17

@Goodpsychiatry День назад

So when will we get Dr. Fu's course on personality, attachment, dynamics, etc., on the website? Loving the content, guys! Also, we all know that even though Dr. Fu wants to keep their identity secret, they are secretly Nancy McW with an AI voice changer.

@PsychoFarm День назад

@@Goodpsychiatry lol Dr. Fu is a lot meaner than Nancy

@Goodpsychiatry День назад

@@PsychoFarm 😂

@jpie78 14 часов назад

great episode! thank you for humanizing this so beautifully with personal examples of how we all exist on this spectrum. Can't wait for part two!!

@jamiesmith9943 День назад

Love this discussion. Perfect level of wonkyness says I

@PsychoFarm День назад

@@jamiesmith9943 thanks!

@fricklesoup2350 День назад

Dang I missed it by 14 minutes. My favorite psych channel

@PsychoFarm День назад

@@fricklesoup2350 better late than never

@sunnygem123 День назад

Such great content, thank you for spending the time to share your knowledge!

@PsychoFarm День назад

Thanks sunnygem! Friend of the podcast

@kenhaze5230 День назад

Personality is just so highly abstracted, or really, I'd rather say, emergent, that it, like so many analogously emergent traits, characteristics, or properties, is really best defined in whatever way yields the most clinical utility. Is writing highly compound sentences personality? Plausibly. If it helps solve the problems of someone who does so by defining it that way, a putatively reasonable one, and more so than by defining it any other way, then yes.

@kenhaze5230 День назад

This is a mere proposition. I have no idea what I'm talking about.

@kenhaze5230 День назад

On PDs being petite versions of REAL MH disorders, ADPD when? ASPD*? DIPD? Reminds of discussions of nonepileptic seizures. But not as hopeless. Lots of fun terminology has come from clinicians and researchers trying to figure out what to call them, or what they even are. *Edit: I realized during sleep paralysis ASPD already exists, but I mean autism spectrum personality disorder.

@savannah_schrader День назад

Wondering if you have one of these on ADHD? Gonna look now but if not it’d be interesting to hear your thoughts on that

@savannah_schrader День назад

I found it haha, last video

@user-kp6ne8gt3y 16 часов назад

Hello I noticed that Dr Fu seemed to dismiss cluster A personality disorders and I had a question/comment... me and my therapist have found Zachary Wheeler's dissertation on the treatment of schizoid personality disorder from a psychodynamic perspective to be helpful in understanding me and outlining my treatment, but looking at the literature on schizoid personality seems extremely mixed and to describe a pretty diverse group of people. One type is conceptualized as an extreme introverted/avoidant type of borderline personality organization, another as a prodromal/lesser psychotic disorder, and another as autistic people who weren't diagnosed in childhood and aren't very friendly. It seems like a major problem is that clinicians can't really get past the flat affect and other possible defenses. I guess my question was about whether the first type has any merit and if it does, would recognizing it as such be too much of a tall order for clinicians who have such high acting-out standards for considering personality pathology anyway.

@PsychoFarm 15 часов назад

Your question raises some important points about the varied conceptualizations of schizoid personality disorder, which is exactly why it's so difficult to come to a consensus on it. Dr. Fu's comment on cluster A reflects a broader challenge in psychiatry-it's an area where opinions can vary widely, as much of the theory is abstract and not yet fully supported by empirical research. In response to your concern about clinicians struggling to see beyond flat affect and defenses, I agree with your observation. Schizoid personality can often be misunderstood due to these surface-level characteristics, leading to an oversimplified view that may miss the underlying complexity. That said, I think there's value in recognizing that schizoid presentations can range from avoidant-borderline overlap to a subsyndromal psychosis to undiagnosed autism spectrum condition, to something totally different. I recommend checking out Nancy McWilliams' work (i'll link an essay below) that offers a deeply empathetic and nuanced view of schizoid personality, and her insights have resonated with many individuals who feel "seen" by her formulation. This is why I continue to find schizoid personality a useful category, not just as a lesser form of schizophrenia, but as its own unique and complex experience. While formal research has yet to fully capture these subtleties, I don't think we should dismiss conceptualizations that resonate deeply with patients, even if they're not universally accepted in the literature. So, if you or your therapist have found something helpful, such as Zachary Wheeler's dissertation, that’s what matters. As long as it aids in understanding and treatment, it’s valid, even in the absence of widespread agreement. Recognizing the diversity within schizoid presentations is essential, and though it's challenging for clinicians who often lean on clear criteria, this kind of thoughtful, individualized perspective can lead to more meaningful care. Nancy's paper: www.researchgate.net/publication/7142775_Some_Thoughts_about_Schizoid_Dynamics