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Title: DSM V: identity Post by: ciel on October 18, 2014, 12:51:06 PM The thread on empathy got me thinking about another DSM-V criteria for personality disorders: identity. I think this might have been a critical stumbling block for some of us who aren't personality disordered, but who ended up intimately intwined with those who are.
Excerpt Identity 0—Little or No Impairment Has ongoing awareness of a unique self; maintains role-appropriate boundaries. Has consistent and self- regulated positive self- esteem, with accurate self-appraisal. Is capable of experiencing, tolerating, and regulating a full range of emotions. 1—Some Impairment Has relatively intact sense of self, with some decrease in clarity of boundaries when strong emotions and mental distress are experienced. Self-esteem diminished at times, with overly critical or somewhat distorted self- appraisal. Strong emotions may be distressing, associated with a restriction in range of emotional experience. 2—Moderate Impairment Depends excessively on others for identity definition, with compromised boundary delineation. Has vulnerable self-esteem controlled by exaggerated concern about external evaluation, with a wish for approval. Has sense of incompleteness or inferiority, with compensatory inflated, or deflated, self-appraisal. Emotional regulation depends on positive external appraisal. Threats to self- esteem may engender strong emotions such as rage or shame. 3—Severe Impairment Has a weak sense of autonomy/agency; experience of a lack of identity, or emptiness. Boundary definition is poor or rigid: may be overidentification with others, overemphasis on independence from others, or vacillation between these. Fragile self-esteem is easily influenced by events, and self-image lacks coherence. Self-appraisal is un-nuanced: self- loathing, self- aggrandizing, or an illogical, unrealistic combination. Emotions may be rapidly shifting or a chronic, unwavering feeling of despair. 4—Extreme Impairment Experience of a unique self and sense of agency/ autonomy are virtually absent, or are organized around perceived external persecution. Boundaries with others are confused or lacking. Has weak or distorted self- image easily threatened by interactions with others; significant distortions and confusion around self- appraisal. Emotions not congruent with context or internal experience. Hatred and aggression may be dominant affects, although they may be disavowed and attributed to others. I know that when I first got involved with my uBPDh, I was about a 2. Working with him (I agreed to be his "assistant" shortly after we began dating) brought me down to a 3, as did living together... .I've been clawing my way back ever since. Still, there are some days I'm a 1 and some blissful moments I slip back up to 0, I think. "Full range of emotion" = allowing myself to be angry and sad, to cry! Why is that so hard? I define myself as a mother now, though... .that's different from identifying myself with my child? This is definitely something I need to focus on, along with those darn boundaries! |