ABSTRACT
The controversy surrounding ‘personality disorder’ (PD) was discussed in Chapter 3 where it was acknowledged that even in psychiatry the imprecision of the concept has been a longstanding cause for concern (Lewis 1955; Clare 1977). Yet there are people whose characteristic behaviour is so self-defeating, so disturbed and disturbing that they are often known to all the agencies, reflecting something of the chaos and pain in their lives. Indeed, Chiesa et al. (2002) highlights the cost to health of ‘personality-disordered’ clients who have had far more different types of mental health treatment than any other group, except for group therapy, apparently because they have such difficulties in relating to other people (Bender et al. 2001). The practical issue is, irrespective of definition and assumptions about cause/origin, there are people with ‘persistent patterns and characteristic lifestyles who impact adversely upon others and their own lives’ (WHO 2000) who are diagnosed/described as ‘personality-disordered’ (PD). They pose problems that cross the mental health, crime and child protection fields.
