When alarm bells should ring

by Susan Schwartz Senstad MA


Introductory quotes

“[Do not] discount the need to view pathology as pathology. A situation involving pathology needs to be dealt with appropriately. And the more information you have about the particular disorder of the other person, the better. That way you know what is the illness and what is more personal. You know what to expect and what it is unrealistic to expect. You are less vulnerable and less judgmental. You can deal with a situation—and the other person—more creatively and with more understanding. You will know how—and when—you need to protect yourself and your own vulnerabilities.”

Drs. Hal & Sidra Stone

Aims of this Article

Many of us who have chosen Voice Dialogue as a method value its non- pathologizing essence. We may, however, also share what might be called ‘a tendency to project health onto people’ — to be so committed to maximizing people’s potential for growth that we risk minimizing the significance and implications of their limitations.

This article is designed to offer a short introduction to the pathologies called ‘Personality Disorders’ so that VD practitioners can:

• be better equipped to screen for appropriate candidates to facilitate and/or train to use VD with others. This is particularly important since there is no process for either certifying or de-certifying VD facilitators;

• more clearly recognize some of the people for whom the use of VD is inappropriate and thus should be referred to a qualified therapist instead;

• work better with clients/students who are the adult children of, or in relationships with people with a Personality Disorder;

• know where to learn more about a kind of pathology that is hard to recognize.

Drs. Hal and Sidra Stone make it clear that Voice Dialogue is not a tool to be used by or with everyone. They have asked me to write this paper. All of us doing this work feel the ethical weight we agree to carry when we accompany people on journeys into their inner lives. Becoming familiar with the warning signs of psychological disturbance can help us carry that weight more responsibly and with a greater sense of safety. Thus, no matter how long or short a time you have been a practitioner and/or teacher of Voice Dialogue, if you have not received education in recognizing pathology in general and Personality Disorders in particular, it will serve you and your clients/students well for you to seek it out. The aim in gathering this knowledge is not so that you can make diagnoses yourself—it takes a trained clinician to do that—but rather to help you to navigate your practice more consciously.

Obviously, no short article can teach the complex issues of recognizing subtle forms of disturbance. Nor is this paper designed to teach how to treat Personality Disordered individuals. All I hope to do here is to give some indication of when your alarm bells should ring. Also, I will recommend some useful reading to help you orient yourself.

Please note: Diagnostic categories serve a clarifying function to help choose an appropriate treatment or approach. In some growth-oriented circles, unfortunately, there still lingers the misconception that it is more compassionate and tolerant to refuse to think in diagnostic terms and that to think diagnostically is rude or arrogant. Historically, this rejection of the usage of diagnostic terms began as a highly appropriate rebellion, particularly among the holistic, Humanistic Psychologists of the 1950’s and 60’s, against the psychiatric community’s tyrannical, dehumanizing misuse of diagnoses to label people and then discriminate against them.

Diagnostic terms must be used with respect and care. I have no desire to repeat historical abuses. I ask you to remember: a Personality Disorder or any other pathological condition is something that people have. It is not something they are.

(For the sake of clarity, I will use ‘he’ for the disturbed person and ‘she’ for the person in relationship to the disturbed person. Statistically, more women are diagnosed with, for example, Borderline Personality Disorder, while more men are diagnosed with Antisocial Personality Disorder.)

Read the whole article: When_Alarm_Bells_Should_Ring