Disorders of Personality: Kink?

I am not a psych nurse, despite the fact that more than half of the patients on my caseload have a psychiatric diagnosis.  My folks with Traumatic Brain Injury (TBI) are all quite psychiatrically involved in fact, and time spent around them can be quite lively.  There was a time when I did not deal well with ‘the headgames’ as I called them… but as my clinical expertise grew I’ve become more comfortable and even enjoy certain aspects of the therapeutic dynamic I share with those in my caseload.  I might even admit to being fascinated by some of the theory concerning altered thought processes and how they manifest themselves in behaviour.  But… just bear in mind that I am far more of an expert in therapeutic/medical areas other than psych, and so my observations on things psychiatric are just mine personally rather than those of a seasoned clinician.

That said, last weekend at my national specialty conference I attended a two-part session on Personality Disorders to gain some insight, as several of my patients have that diagnosis and it’s rather frustrating to deal with.  However, my kinky li’l brain could not help but be struck on how much similarity a couple of the disorders held to some Dominants I have run across and the Dominant personality in general as I understand it.

Now, before y’all come after me with whips, canes, and nine irons, I am not labelling anyone here… I am simply pointing out something I found interesting.  I’m only too aware of my own issues to wish anyone else to feel stigmatised.  But if it hits the nail on the head for someone… well, it’s just food for thought.

Whilst personality traits appear to be genetic, personality disorders are fixed patterns of behaviour theoretically brought about when a susceptible individual is exposed to abuse, neglect, or shame at a particular developmental level within the first five years of life; the emotional system is changed by the ego (unconscious) awareness for self-protection.  The patterns are observed in communication (impaired), general affect (may be incongruous with actions), impulse control (or lack thereof), compliance (or lack thereof) and relationships.  The need to be in control greatly affects how they interact with others as an automatic defence mechanism; emotional boundaries have been damaged and so control is used instead of trust to deal with others.  Perspective is altered and they see others, the world, and themselves differently.

There are several different types of personality disorders; the person presenting the material had them grouped in three clusters based on developmental level (she went by the first three of Erik Erikson’s Developmental Stages).  Therefore, if the abuse/neglect/shame happened at the Trust vs. Mistrust stage it could generate the paranoid, the schizoid, or the schizotypal personality disorders; if it happened at the Autonomy vs. Shame stage the victim could become histrionic, narcissistic, antisocial, or borderline; and if it happened at the Initiative vs. Guilt stage the personality disorders could be either avoidant, dependent, co-dependent, or obsessive-compulsive.

Two of the personality disorders rather rang a bell for me.  Narcissistic personality disorder is characterised by a grandiose sense of self-importance and fantasies of power, requiring constant attention; response to criticism evokes either indifference or rage; there are disturbances in interpersonal relationships due to exploitation and lack of empathy.  Obsessive-Compulsive personality disorder is defined by the exhibition of at least four of the following: inability to express warm emotion, perfectionism, submission of others, excessive devotion to work, indecisiveness.

Again, not pigeon-holing anyone… but in my travels and my reading I have run across several Doms who would fall into one or the other description.  My understanding of the Dominant personality is one who requires respect and often specific protocol as the interaction dynamic, requires submission and control be yielded to Him/Her, is often seen as cool/distant, is a perfectionist, and often treats the submissive as an object rather than a feeling person.

Of course, I invite debate/discussion on this.  Recently, I saw something in one of the FetLife discussion threads to the effect that men are hard-wired to be dominant and women are hard-wired to be submissive; I vehemently disagree.  Dominant/submissive may indeed be simply personality traits that are genetic (but not gender-linked!) in nature, much like sexuality itself.  I submit that they may also be the go-to dynamic for those who have weathered abuse, neglect, or shame, whether it be a full-blown personality disorder or not.

Interestingly enough, I did not consider the dependent personality disorder to be sufficient explanation for submission, likely because we submissives are usually quite competent and self-sufficient in the day-to-day; we only relinquish control under certain conditions. I do hear story after story of past trauma in reading the FetLife discussion threads, and maybe that history combined with a personality trait can be responsible for generating a submissive tendency.  I’ve often heard it said that we are actually the ones with all of the control… ;)