This was actually very similar to my original response, which I deleted. I have my own theory that personality disorders are not often diagnosed due to the rejection of psychoanalysis. Out of all mental disorders, personality disorders are the ones most explained by developmental issues, which has traditionally been the domain of psychoanalysis. I was going to write that psychiatry might in the past have been interested more in the human condition more generally, and that whether a murderer has a diagnosable mental illness or not, it seems like the question of why is not productive and happy would be of interest to a psychiatrist. I know that it's often said that people with personality disorders don't seek help or are untreatable, but in my experience, I've noticed a reluctance to diagnose or treat on the part of psychiatrists. I would guess that this has to do with the move to the biological model, which cannot account for personality disorders--which can't be treated with medicine.
I suppose it depends on each individual and the severity. The two people I know who have a diagnosis of BPD were both frustrated that they didn't get a diagnosis for many years (in one case, the psychiatrist had diagnosed it but not told the patient and the patient found out through requesting records). One I'm very close to, my aunt, has been very mindful after getting the diagnosis. Maybe the diagnosis isn't accurate and she isn't what you typically see with BPD, but for her, she appreciates being able to see the patterns. I personally think that I have a personality disorder that hasn't been diagnosed (in my case I would guess it's NPD--although again maybe not as you expect it stereotypically), and I can't say with certainty that it would hurt my rapport with my therapist but I would like to think it wouldn't. He's not big into diagnoses with anything, though (his usual question is: What would it change if you had X diagnosis?). As far as my psychiatrist, I don't think she deal with personality disorders. I can't see how she would be able to given the way she has her work set up. From an outside point of view, I think that if you could see these ingrained patterns and realize what they were, it would be very helpful especially if you could find and resolve the root cause. Or at least make some internal progress.
Not to worry—I don't take that as advice. NPD is actually something I had already been planning on asking my therapist about tomorrow. I actually came upon it after Googling "can't handle being criticized" and it was one of the first results. I have a really hard time with needing to be perfect, always have felt I have to beyond reproach, which is difficult in that obviously no one is.
I've looked this up a few times, but not since some months ago, so I'm going off of memory here. We mostly had no increase in mass murder rate until several years ago. It seemed to go up sooner mostly due to media coverage, but recently it actually went up. However, does this make a meaningful trend? Too early to tell. If it keeps going up or holds steady in this elevated rate, that would be meaningful. But it might drop back down, which would suggest this is just some random variation.
I've always had the exact same sentiment until I started considering that it is our human nature to believe there are legitimate and illegitimate forms of violence. Generally we think of governments as the only legitimate implementers of violence, and within that value system, a mass murderer is illegitimate in his use of violence. And I agree that something is off with that person--it is by definition off given a certain value framework. There's an inability to cope with the structure of society and what is acceptable. But when you consider that it is psychiatrists and psychologists who clear men and women to be healthy enough to participate in legitimate forms of violence, I think we have to consider that violence is part of our nature. It is more an issue of social rules and conditioning that dictates who has the authority to use violence, and ultimately the illegitimate use of violence is kept in check with the that of violence from a legitimate source. To some extent you could say we are violent and make many attempts to control our violence, including using violence.
If psychiatry isn't the authority on these afflictions, who is?
Somebody being violent and aggressive is not a mental illness. Calling it an affliction sounds like a complete abdication of personal responsibility. I work with the victims of violent people every day and I have also met the perpetrators both when I worked in a jail and a few times when I was a resident of these institutions. The violent offenders are very clear and calculating in their appraisals of what they at doing. In fact, to survive in that world, you damn well better be able to regulate your emotions, deal with high amounts of stress, and have effective problem solving strategies. All things which my patients struggle wih doing on a day to day basis.
I feel like there must be a path forward for the villain in any story. I believe every person should have a place in society.
So those examples go back to legitimate vs illegitimate uses of violence. If we're talking about a mafia-like organization that has clear, rational goals and uses violence to further their interests, it's not terribly different than a state that invades another state for its resources. In that sense, the people are bad in that their interests don't align with the majority's, and possibly their values of attaining their interests don't either. The people committing violence may not even be able to see themselves as committing violence. They may even see themselves as heroes as colonists have throughout history. Or they may be conflicted, just as people have been who have served in state militaries.
I thought he was saying that some people are bad and I tend to agree. They aren't usually the ones that are making the news recently, but most violence is not carried out by people with disorganized thought processes. There will probably always be this based on my own observations of how cruel we can be even at a very young age. Just step onto any middle school playground and you will see it every day.
