“My mom has narcissistic personality disorder,” one of my psychotherapy clients said to me. “She is unaware of my feelings as her caregiver.” “You wouldn’t believe the tantrums my mother throws when she doesn’t get her way,” said another. “I think she has borderline personality disorder.” “My father doesn’t feel guilty about hurting anyone’s feelings because of his antisocial personality,” said a third.
It sounded a little odd to hear people who aren’t clinical professionals applying mental health diagnoses to their family members, but psychiatric and psychological terms have always found their way into regular jargon. Thirty years ago, I heard psychotherapy clients say they were afraid they were “codependent” because they relied too much on others’ approval to feel good about themselves. Ten years ago, clients asked me if they were “bipolar” because they reacted to caregiving stressors with up-and-down moods. Nowadays I’m hearing more references to “personality disorders” when describing some care receivers.
I don’t think this is being disrespectful. Caregivers have always struggled to understand why some family members they are caring for are argumentative, demanding or all-around difficult. It is sometimes easier to think of those relatives as having some condition beyond their control that affects their behavior rather than seeing them as personally hostile to the caregiver. “My mother doesn’t mean to ignore my needs,” a caregiver son or daughter might say, “but her narcissism prevents her from understanding what I’m going through.” That’s also a way for caregivers to protect themselves from disappointment by lowering their expectations that care receivers might change.