Resolution, Not Conflict

The guide to problem-solving.

Gender Bias in Diagnosing Anger: Batterer or Borderline?

Do men get labeled domestic abusers and women borderline for the same issues?



toxic anger, toxic partners, gender-based diagnostic labelsSome people exress anger in a way that is toxic, spreading negative energy onto everyone around them.  I like that word "toxic" because it can refer equally to verbally abusive men and to verbally abusive women. Toxicity, whether it is spewed by a man or a woman, can kill; toxicity kills personal emotional well-being and also kills relationships.

Most clinical labels for anger are assigned with gender bias.  We name raging women borderlines and raging men either abusive, bipolar, narcissistic or sociopathic. By contrast, the term "toxic" has no gender stereotype attached to it.

What about the term narcissism? Does that term also invite gender bias in diagnosis?

The label narcissistic does fairly well in the gender realm but not well enough.

On the one hand, anyone, male or female, who is self-aborbed, unable or unwilling to take others' concerns into mind, and poor at listening to others can easily earn this label, at least wtih regard to narcissistic habits.

On the other hand, when it comes to narcissism as a diagnosis for character disorders, men disproportionately get labeled as narcissists whereas women with essentially the same symptom picture will tend to receive a borderline personality disorder diagnosis.  Do men with a narcissist personality disorder react with excessively strong emotions, sometimes seeing threat and criticism where it doesn't even exist?  For sure  Do women with a borderline personality tend to behave narcissistically.  You can bet your bottom dollar on that one.

When about gender bias in diagnosis of excessive anger?

There's no simple label for excessive anger in the DSM, as I've written earlier. Too bad because if anger, like anxiety and depressive, was a potential diagnostic label, that would solve the dilemma.

toxic anger, toxic partners, gender-based diagnostic labelsInterestingly also, whereas women seem to get most of the borderline labeling, men get most of the abuser label. For sure, borderline women can be profoundly verbally abusive to everyone that has to deal with them on more than a public and superficial level. They often look attractive, sometimes seductively so, at work and with friends. It's at home that the tongue lashings (and sometimes also physical attacks) become violent. Read reports from adults who grew up with a borderline mother if you have questions about the extent of borderline's abusive behavior even if these individuals seldom get labeled "abusive."

Another trend: If they are male and have too much anger, they get treated with medications and labeled bipolar. If they are female, their toxic anger again is more likely to be considered a sign of borderline features.

Here's another one: In a recent study of gender impacts on ADHD diagnosis, clinicians were twice as likely to assign this label if they thought that the client description they were reading was of a boy than of a girl. Hmmm..

BPD mothers

In the extensive Comments section to one of my posts on mothers with borderline personality disorder I asked the readers their thoughts on why virtually no one was mentioning BPD dads. I received the following particularly thought-provoking response:

"Interesting. I was just discussing this with my husband this morning, talking about the fact that there are more discussions about BPD mothers than there are about BPD fathers. I'm pretty sure I know why. (I grew up with a BPD mother and an Aspberger's father.)

toxic anger, toxic partners, gender-based diagnostic labelsSurveys of prison populations show that prisoners have a very high incidence of personality disorders, and that male prisoners are more likely to have anti-social personality disorder and females are more likely to have BPD. I think the difference is testosterone levels. Empathy-less males are more likely to become physically violent, and females are more likely to be emotionally and psychologically violent. Physical violence is a much shorter route to prison. So, I think that people are far more likely to still be in the custody of an empathyless mother than in the custody of an empathyless father…"

My question is whether men are more likely to "have" anti-social personality disorders, or whether that's the label we give to men who act out in disregard of social norms, whereas women with similar behaviors get labeled borderline personality disorder.

Just wondering…

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Clinical psychologist Susan Heitler, Ph.D. is author of From Conflict to Resolution, a book that explores the role of conflict in generating psychopathology and in the healing impacts of psychotherapy.

 

Susan Heitler, Ph.D., is the author of many books, including From Conflict to Resolution and The Power of Two. She is a graduate of Harvard University and New York University.

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