Personality disorders are a tricky thing, and often
controversial diagnoses because they involve evaluation and judgment of an individual's overall behavior patterns that manifest as an exaggeration of traits that are inherent in us all and that many of us can relate to on some level, like the exaggerated
fear of abandonment found in Borderline Personalities.
According to the DSM-IV, a key (though not the only) definitional feature of a personality disorder is "
an enduring pattern of inner experience and behavior that differs markedly from the expectations of the individual's culture". What happens, then, with cultural expectations change? What are we to make of a "disorder" that is defined by the expectations of those around you? Perhaps that your ability to "get well" might depend on the ability of those around you to accept your experience and behavior.
As the
U.K.'s Mental Health Foundation astutely observes, "What is regarded as 'normal, of course varies from culture to culture and the diagnosis has to be made within the context of the rules, obligations and social expectations held within a particular community. For example, behaviours valued in a battleground are not seen as appropriate during peace time."
Homosexuality obviously remains a controversial topic in Western culture (and elsewhere). Depending on where you look,
some would say there has been "progress" in increasingly positive attitudes toward gay people, others retain a strong stance that it is aberrant (I won't put a link there, because that evidence can be found right here in this thread
). Opposition to homosexuality is
particularly strong where that behavior is equated with "badness" or "sin," like with fundamentalist Christians. Other religious groups,
like reconciling Methodists, on the other hand, are pushing for inclusion and acceptance of gay people in the church community. And, as I'm sure you all know, and whether you agree or not, there are
groups of Christians out there who don't believe the Bible condemns homosexuality at all.
You won't ever find me lobbying for normalization of patterns of behavior found in
paranoid personality disorder, because I agree that it is a problem to be "preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates," "read hidden demeaning or threatening meanings into benign remarks or events," and have "recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner."
But hey, that's me. The rhetoric, labelling, and policy behind these diagnoses is clearly political. What can be more political than a group of disorders who has, as one of its defining features, a diagnostic criteria that includes societal norms? Whose society are we talking about here? The fundamentalist Christian society? The San Francisco Castro District society? But this is what's tricky about all mental illness (and even, to some extent, physical "problems") -- the idea of what is "normal". I don't see the problem with being attracted to my same-sex partner. And I have found myself surrounded in my daily life with people who agree. The medical community has in the past agreed with those of you who think homosexuality may be a disorder . . . as many of you probably know,
the DSM used to include homosexuality, but that was deleted in the most recent edition, the DSM-IV (which, btw,
still includes "the diagnosis of 'Sexual Disorder Not Otherwise Specified' for someone with '...persistent and marked distress about sexual orientation'".)
