Right now there is a raging debate in the mental health community about the root cause of mental illness. Psychiatrists, who are trained as medical doctors, obviously see in a mostly medical light, as something of biochemical origin. Psychoanalysts, on the other hand, see symptoms such as depression and anxiety as having a basis in the early childhood of the individual, rather than in any kind of genetic medical abnormality.  Suffice it to say, right now the medical community has the upper hand in the argument, both in what is accepted by mainstream society and what is reimbursed by insurance companies. And there is a bunch of empirical evidence that psychotropic drugs do substantially help people suffering from depression, anxiety, bipolar mood swings, and psychosis.  So, a physical component to mental illness is undeniable.  The main question at this point then wouldn’t be whether there is a physical component to mental illness, but what causes it- in other words is decreased serotonin in the brain (which causes depression) or increased dopamine (which factors in psychosis) a purely genetic, physical abnormality or can it actually be exacerbated, if not even created by childhood trauma and disturbed thinking. To put it plainly, can physical problems be created by learned behavior?

Although a root physical cause can be pinpointed to mental illnesses, there is still a large question surrounding the issue of personality disorders. Personality disorders are not mental illnesses in the same sense as being bipolar or schizophrenic, rather they are placed in their own separate category. Common personality disorders include antisocial (where the person has no regard for other people’s welfare), narcissistic (where the individual is preoccupied with their own grandiosity), paranoid and histrionic. These are all ways in which people relate to the world, and in particular to other people. Although there are many theories, no one has a clear idea of where personality disorders come from or how they evolve. This is probably the realm where learned behavior is more of a root cause than neurochemical imbalances. For example, if someone has had a lot of people betray them in the past, then they are probably more susceptible to developing a full blown paranoid personality disorder than someone who has had a stable past.

Antisocial personality disorder types give mental health professionals the most trouble. These are your typical serial killer or even Bernie Madoff style white collar criminals who have absolutely no regard for any other human beings. This type is particularly nasty not just because of the heinous things they can end up doing, but because no form of therapy has been proven effective in helping them change. While most other personality disorders can be alleviated at least somewhat through talk therapy, the antisocial types are least amenable to change.  The case of antisocials is particularly puzzling because there is usually no strong connection uniting any of them.  Many antisocials have no childhood trauma or hardships that would explain their behavior at all. For example, Ted Bundy was in law school and was highly educated and intelligent from a fairly middle class background. The guy who killed a girl he met on Craigslist in a Boston hotel was in medical school. So far no biochemical or childhood link has been found to understand the behavior of antisocials.

However, probably the most convincing argument in favor of life events in the formation of personality disorders is in the case of borderline personality types.  People with borderline personality have trouble maintaining personality relationships, they are very emotional and hot and cold. One moment they can see you as an angel and the next as the devil incarnate. There is not middle ground with them. You are either all good or all bad. As a result, their emotions and as a result, relationships, are like roller coasters.  Also, at the root, they have a deep fear of abandonment, so they may strike out at their partner at the first hint of losing them, as a way of protecting their fragile egos. At any rate, this is a very trouble person and I don’t recommend anyone getting into a relationship with such a person unless you don’t mind your life becoming a living hell. Interestingly enough, there has been research done on what kind of person tends to be more prone to being diagnosed with borderline personality disorder. And interestingly enough, while there seems no rhyme or reason with the antisocials, there has been found to be a strong correlation amongst the borderlines. So what seems to be the most common element amongst them?

Surprisingly, (or maybe not so), most borderlines have been found to be females, but not just any females- highly attractive females. So this begs the following question- it might make sense that certain disorders can be more gender based, due to hormones, etc, but what does physical attractiveness have to do with psychological problems?  If you think about it in terms of a learned behavior, however, the answer becomes obvious. Because the female is highly attractive, many men are more likely to put up with, if not even subtly enable, bad behavior from their “beautiful” girlfriends. If a woman goes psycho on the guy, he will more likely put up with it if she is beautiful than if she is plain. Whether you like it or not, the reality of life is that beautiful women have more leeway in life than plain ones. And same goes in relationships.  Beautiful women who eventually are diagnosed with borderline personality disorder when the crap finally hits the fan and their life has fallen apart are those women who found that they can get their way when they act unreasonable and generally unstable with their partners. Plain women found that they don’t get positive results when they act in similar ways, and so don’t do it, and so don’t end up being diagnosed with borderline personality disorder.

So this begs a further question- is personality disorder a real diagnosis or simply a way to describe someone who has learned in life that they can get their way if they act unpredictably, irrationally, and abusively to other people in their lives.  In the case of the attractive women who tend to make up this group, I think the answer is all too clear.