The Dirty Diagnosis

It really does feel like the dirty diagnosis.  The label some are scared to give, and many are scared to own.  The one that immediately flags up words such as 'manipulative,' 'awkward,' and 'incurable.'  If the people that bandied around these connotations sat and thought for a minute, about the origins of the illness (the biosocial model) and tried to... wait for it.. empathise, they might see that some of these 'awkward' traits have roots in the past messages and feedback given at an early age, and that the person really is doing the best they can, with what they know, and what they have learnt from life thus far. 

Manipulation, for example, may well be borne of a person's feelings of worthlessness in so much that they do not feel they have the right to ask for something, or that they deserve the outcome they need and so go about plotting to get it instead. 

Equally, self destructive tendancies, whilst frustrating for those working with them, are usually a result of 'learned truths' for example, that 'things always go wrong' or 'I am useless at everything' or 'nothing I do is good enough' and so anything that doesn't fit into this accepted pattern is considered as an anomaly.  It takes a good deal of courage to risk standing the other side of the line - the hope side.  It means leaving everything the person knows, to stand with the single, or few things that have gone well.  If something threatens this new 'hope' idea, it is much easier to screw it up and go back to the 'everything is shit' mindset as it is familiar and comfortable.  A love hate relationship with failure - Failing leads to feeling like shit, but if everything is already shit, nothing bad can happen.  It's safe.  In a way.

Behaviours, whilst maladaptive, are coping mechanisms, and may very well be the only reason the person is still alive and fighting.  Whilst it may not be apparant, it is likely that the person is fighting it for the majority of moments every day, therefore, to go days at a time without enagaging in such behaviours is a major achievement.

Of course, most of these behaviours are there to endure emotions, or avoid them altogether.  Often feelings are intolerable in their own right, or which stem from other initial feelings that were learnt to be dismissed as 'wrong.'  The mere idea of 'being sad' or 'feeling guilty' are inconceivable; a harmful behaviour is much eaiser to bear, and has the added bonus of being a 'real' and tangible pain.  One that it is acceptable to hurt over.

The phrase 'born without an emotional skin' is used to describe the biological aspect.  The social aspect, however, is all linked to growing up in an invalidating environment.  Learning that one's feelings/views are wrong, and that they should be a certain way instead.  Learning that there is always a right way to feel and to look to others for verification of what that might be.  ...it destroys interpersonal relationships, leads to interpersonal dependancy and therefore opens up an increased liklihood of abusive relationships.   It also washes away self esteem and a sense of identity as there is a perceived ideal of what the person should be and how they should act, which over time takes them further and further away from who they are and what they want from life.  This ideal is often unattainable and leads to feelings of weakness, failure, and permanent ineptitude at not being able to achieve it.  It's being set up to fail at the very beginning of life.