PERSONALITY DISORDERS CONTROVERSY

Controversies Associated with Personality Disorder

From the onset, it would be prudent to note that as per the Diagnostic and Statistical Manual on Mental Disorders, Fifth Edition (DSM-5), personality disorders could be defined as an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the individuals culture (National Institute of Mental Health NIMH, 2017). There are various personality disorders recognized under the DSM-5 Manual. These are inclusive of, but they are not limited to; schizoid personality disorder, paranoid personality disorder, obsessive-compulsive personality disorder, narcissistic personality disorder, borderline personality disorder, avoidant personality disorder, antisocial personality disorder, etc. It would be prudent to note that a significant number of persons are at some point diagnosed with a personality disorder. Over time, various diagnostic mechanisms have been suggested and treatment approaches formulated. However, there are various controversial elements that have in the past emerged in relation to not only the diagnosis, but also the treatment of personality disorders. This text explores the said issues. In so doing, it will largely focus on narcissistic personality disorder.

Narcissistic personality disorder happens to be a condition whereby a person has what could be described as an unrealistic and largely inflated perception of self-relevance. To begin with, there are those who argue that the diagnostic definitions of this particular disorder does not capture the true nature and essence of the disease. For instance, according to Ronningstam (2016), the diagnostic meaning assigned to narcissistic personality disorder does not focus on the internal as well as underlying struggles of the patient as it should. Instead, the author is of the opinion that the said definition is largely inclined towards what could be deemed attitudes and behaviors meant to secure clinicians attention. As a consequence, Ronningstam (2016) further observes that diagnosis for narcissistic personality disorder has taken a less informative and judgmental perspective. There are also those who are of the opinion that the diagnosis and treatment of the...…to deviate from informal banter that could derail the therapeutic engagement.

One ethical/legal consideration that I would bring to my practice is confidentiality. Confidentiality happens to be crucial so as to ensure that the client develops meaningful level of trust necessary for a therapeutic engagement of this nature. Confidentiality is also crucial in this case owing to the need to protect the client from ridicule and/or adverse outcomes at the workplace if his condition is disclosed. However, confidentiality does have its limits. For instance, if a person with narcissist tendencies is concerned that their glory is being stolen by someone else, and they indicate an intention to harm the said person, then disclosure to the relevant third parties could be made. There is also the issue of autonomy. This is more so the case given that the client could in this case refuse some of the treatment strategies suggested. The client would be within their right to deny any intervention proposed. I would resolve such an issue by…