It is often very helpful to use books and movies to illustrate psychological and psychiatric issues, and that old chestnut, “when is it an illness?”
There was an amusing paper (NR193) about a serious problem that was presented last week at the 2007 Annual Meeting of the American Psychiatric Association in San Diego. The writers, from Toulouse in France entitled their offering; “Is Anakin Skywalker Suffering from Borderline Personality Disorder?”
Borderline personality disorder can be an extremely difficult problem to treat in practice, and it often causes a great deal of suffering. There is an interesting sidebar here: Borderline Personality Disorder has been described throughout the world. But it seems to be more common in the United States and Canada than it is in Western Europe, though the rates now appear to be rising in Europe.
Borderline personality disorder is defined as a mental illness primarily characterized by emotional dysregulation, extreme "black and white" thinking, or "splitting", and chaotic relationships. It typically includes a pervasive instability in (1) mood, (2) interpersonal relationships, (3) self-image, (4) identity, and (5) behavior, as well as a disturbance in the individual's sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation.
These problems can have a pervasive negative impact on many or all of the psychosocial aspects of life, including employability and relationships in work, home, and social settings. Comorbidity is very common. People with borderline personality disorder frequently have substance use disorders and affective disorders. Sadly, self-harm , including cutting and suicidality and completed suicide are altogether too common, and there is a lot of discussion about the effectivess of treatment.
The writers of the report concluded that Anakin met five criteria of Borderline Personality Disorder:
- Difficulty controlling anger
- Transient stress-related paranoid ideas and sever dissociative symptoms (after killing the sand people and in the final confrontation at the end of Episode 3)
- Frantic efforts to avoid real or imagined abandonment (as when trying to save his wife)
- Pattern of intense and unstable interpersonal relationships, alternating between extremes of idealization and devaluation (as in his relationships with the Jedi Masters)
They also suggested that the identity disturbance, when he changed into Darth Vader was more evidence of Borderline Personality Disorder.
An amusing piece, but it helps to highlight a problem that can cause great suffering.