Pilar Pérez Madrid
Madrid
Updated Tuesday, March 19, 2024-11:30
For more than three decades he has tried to biologically dissect personality disorders and individual identity.
José Luis Carrasco
started with the psychiatrist Jerónimo Saiz at the Ramón y Cajal University Hospital in Madrid. And he wanted to base his thesis on the "study of the psychobiological phenomena of impulsivity because it caught my attention." That curiosity was the germ that led him to become one of the
experts in Psychiatry in an area little explored
until then.
Today he trains other students as a professor of Psychiatry at the Complutense University of Madrid and consults as
head of Psychiatry at the San Carlos Clinical Hospital
. From his office, where he attends to EL MUNDO, days before the publication of his latest book
The Personality and Its Disorders
of Him (Arpa), you can see a tree line that is part of the Jaime del Amo Park.
That light that enters the office could well serve the psychiatrist as an element to clear his mind. Something that sometimes human beings need to organize ideas and find the balance that external factors break. And that is what Carrasco emphasizes. "
We are in a society that facilitates the appearance of personality disorders
." Before talking about what type of disorder, you have to "know how to distinguish the personality, its traits and when and how they appear." The psychiatrist regrets that there is little knowledge in this aspect. "And we mix concepts without knowing."
Q. You became interested in disorders at the beginning of your career. What was it that caught your attention?
A.
I was very interested that personality could have a biological basis. I wanted to know how to measure factors that were related to impulsivity traits; for which we did a study.
Q. What did it consist of?
A.
That was very striking. We looked for three professional profiles that could have it: tedax, bullfighters and gamblers. We look for the pathological part of impulsivity in gamblers. But there was another, non-pathological part, in the search for the risk that the bullfighters, who are not sick, were pursuing. Both had irregular activity of monoamine oxidase A, which is an enzyme that regulates the metabolic degradation of serotonin and norepinephrine in the nervous system. In gamblers and bullfighters the levels were low, but not in explosive defusers.
Q. What does it mean?
A.
The latter did not seek risk, but the others did. Explosive defusers are not reckless. And it is logical. The police select them based on a series of tests, looking for the most methodical ones. So, the issue of personality and how it adapts in methodical obsessives plays a key role there.
Q. How do you distinguish a person who develops a disorder through exploration and sensation seeking?
A.
When you select a person to be an explosive device defuser because they have sensation-seeking traits, you will fail. Because what he wants is for the bomb to explode. And, of course, that is not a normal trait, nor is it useful for the objective.
Q. Patients with personality disorders are difficult to identify. What do they have in common or not with other mentally ill people?
A.
These individuals are not psychotic. That is, they do not become delirious, they do not lose their sense of judgment and reality. They don't just show anxiety and/or neurotic depression, they are something more. They are people who distort a lot and have serious behavioral alterations. They often develop episodes of suicide attempts. In general, they have behaviors that are very maladaptive to the environment.
Keys to personality
Identity.
Today it is very important because it gives us the emotional stability of the individual. It is built with self-image.
Personality.
It is formed through the traits of each one. Altogether, it is the psychic skeleton of people
Disorder.
It appears with inflexibility when modifying actions in coexistence with other subjects and requires therapy.
Traits.
Q. What clues do allow us to identify this type of individuals?
A.
In this whole world of personality disorders there are people with very maladaptive, very serious behaviors, but who have not lost their minds, nor are they bipolar. That's why I was interested in knowing what they had that made them different. But they were few. What happened is that they ended up in marginal environments, they fell into drugs, prostitution, crime...
Q. Why did they end badly and without help?
A.
Before there was no diagnosis for impulsive conduct disorder. People were more or less prone to fighting. Sometimes they did not succeed and died in these fights or from the abuse of addictive substances... There was ignorance and few cases. For example, schizophrenia has not changed: it is the same now as it was 200 years ago, what happens is that it is treated better now.
Q. Nowadays, you say that the situation has changed after decades of study. As?
A.
Personality disorder is conditioned by the environment in which we develop: what the family is like, what the authority figures are like, how the social environment is structured... All of this influences how the inner self develops, the personality. If evolution is allowed without alterations, nothing will happen, but if desires are blocked or an attempt is made to change traits, problems appear.
Q. In the book you mention 'feedback'. That response that children or babies expect through the parents' gaze of approval or not. How does this condition the development of individual personality?
A.
It is about identity, which is the very core of personality. It develops through contact with the world. This is key, because depending on the environment in which one grows up, some teachings or others will be given back.
Q. What is there in that look that shapes our personality for better or worse?
A.
The answer is to maintain the balance between will and freedom. And today the answer to the increase in disorders is in the breaking of this, because the flexibility of authority and the fall of limits has increased. And that makes one develop in a different way and with fewer references. The new generations lack the authority that should come from key figures in their formation as people: parents and teachers. The rise of the individualism movement that we have experienced since the end of the 20th century and that has been consolidated in recent years is also partly responsible. That mania of justifying that today "man can do everything"; when he can't. Each one has to find his limitations. This does not mean that we do not have goals, we must have them. But each individual must have their own, those that suit their personality and traits. All this has left people who have doubts, difficulties, who tend to be lonely much more exposed. The feeling of emptiness grows in them, that life has no meaning. And we arrive at the dramatic moment: the response through suicide.
Q. What have we done wrong as a society to be behind this generation that had everything to avoid the disasters of the past?
A.
A feeling of emptiness and hopelessness has been created for them with which they live. Paradoxically, with all forms of social media today, there is less social communication and fewer networks of friends. Family networks are much more diluted.
Q. In the field of mental illnesses, the pandemic marked a before and after. In the case of personality disorders, too?
A.
There are more and more. In the last five years, with the pandemic in the way, we still do not know exactly why they have skyrocketed. During confinement and after, the rate of self-harm has increased. This is one of the indicators that has to do with these processes. It also indicates the presence of a malaise that translates into "I have no future, no hope, I am angry with the family." That feeling of being lost.
Q. How do we redirect the situation?
A.
Knowing the other's personality helps us understand them more; It can help us love more and better. But it also helps us avoid relationships in which we do not have to be, because we understand that the other is impossible and it is better to withdraw and avoid the wear and tear of a continuous aggressive fight. Understanding the personality of another is essential to avoid personality disorders and also mental disorders in general, because we accept what there is. A practical case: I have a son with a certain personality, more extroverted, restless, a bit impulsive. If I don't understand him and continually criticize him and compare him with someone else who is not, I ultimately undermine his self-esteem, which is growing under a continuous gaze of reproach. The child comes to think "I'm a disappointment," "I don't know how to do things." There are some expectations that he feels he does not meet because his personality does not allow it.
Q. This happens when society requires us all to be equal...
A.
Exactly. If you have an introverted boy who is not very talkative, he is going to be like that. So you have to understand the diversity of traits and personalities. This is what makes up social wealth. But, if you insist that he has to be sociable, without having the traits, you can cause poor growth.
Q. Again we return to the corrective look. Is it always the germ of the disorder?
A.
Yes, because this poor growth is what causes the connections of identity, self-esteem, self-image, how others see me and what my future is, to become blocked and that is where the disorder comes. It is very important to understand the personality of others, accept it, understand it and enhance it to the extent that it is not destructive.
Q. Whether as parents, teachers, friends... how can we learn to respect personality and allow healthy growth?
A.
With the publication of my book I want people to understand well what personality, types and their traits are. And, on the other hand, the disorders. In this way one can understand what is happening to a family member, friend or close person. It is an educational manual that serves to teach what personality is, how we are and what others are like. With tools to prevent, one of them would be to have empathy, to put yourself in the other person's shoes. And this is not easy.
Q. It seems that we have trivialized mental illness. We have gone from taboo to the exhibition of social networks. Where is the balance?
A.
You have to look for it. Teach to distinguish discomfort and anguish from depressive pathology and anxiety, and of course from the rest of the disorders. That is why we do not always need a psychologist or a psychiatrist, sometimes a coach is enough to return us to the path of our personality and balance.
Q. How do we differentiate who needs what?
A.
In life there will be suffering and stress, and without it being something bad, you have to learn to deal with it. At this level, coaches are good. When we talk about that this suffering has become a ball and has become pathological in the person (in the form of anxiety, depression), we must turn to psychologists and psychiatrists. With an ulcer you go to the doctor, but to avoid it you look for someone to teach you how to eat well. The same thing happens with the mind: you have to prevent before you cure.