Personality Disorders: A Short History of Narcissistic, Borderline, Antisocial, and Other Types by Allan V. Horwitz (review)

Abstract

Reviewed by:

• Personality Disorders: A Short History of Narcissistic, Borderline, Antisocial, and Other Types by Allan V. Horwitz
• Sharrona Pearl

Allan V. Horwitz. Personality Disorders: A Short History of Narcissistic, Borderline, Antisocial, and Other Types. Baltimore: Johns Hopkins University Press, 2023. xii + 227 pp. $35.00 (978-1-4214-4610-3).

Here's a pro tip: if you want someone to review your book, be sure to include "short" in the title. Read a short history of a compelling topic in my field? Sign. Me. Up. I didn't, I admit, stop to reflect too closely on what "short" might mean in the context of A Brief History of Personality Disorders. It could mean the book is short, or the history is short, or (stretching a grammatical point) the history of personality disorders is itself, relative to history as a whole, short. Spoiler alert: it's not the first one. The book itself isn't, on the scale of academic-trade writing, particularly short, at 227 pages. What "short" means here is more like synthetic, or sweeping, or broad: this is an overview not just of personality disorders, but personality as a whole, and, indeed, disorders as a (culturally contingent) category. That's a lot to squeeze in; no wonder it isn't actually all that short, and to be honest, I'm glad it's not.

The book is in fact a bit breathless: a race (or at least a jog) through a couple of hundred years of history (and a look back to antiquity, as one does) to discuss not just the history of personality disorders, but indeed the history of both personality and disorders. If that means that the actual disorders get … errr … short shrift, it's worth it: as Horwitz compellingly explains, personality disorders are a particularly complicated category both as an entity, and indeed as individual components. As is true for a lot of mental illness, disease models simply do not fit. It's more acute in this case: personality, Horwitz outlines, is deeply shaped by social, political, and historical conditions. That makes it fair game for a variety of disciplines to study and claim, and at the same time, hard to determine norms. It's also really hard to study in traditional tests: with, say, IQ tests, there is an internal motivation to get it right. That's not that different to personality tests, except that "getting it right" is itself contingent on what the test-taker believes to be the best outcome. It's a motivated approach based on circumstance: if you want a job (or to get out of a job) you'll frame your answers accordingly. And even in cases where the test is untethered to an outcome, the answers reflect what the test-taker believes to be true about themselves rather than what might actually be the case. Personality is hard to measure, and it's hard to determine where a personality stops and a disorder starts. Unlike the classic medical model, which understands [End Page 169] illness and its symptoms to be layered on top of the afflicted individual, the personality, disordered or otherwise, is the individual.

Not only is personality as a category and an entity deeply socially and culturally contingent, so too is when it goes "wrong." But, as Horwitz demonstrates, we can't really get to that point until we understand the history of personality itself. The book opens with a long look back to antiquity, and races (quite quickly) to the nineteenth century and the emergence of systemic systems to study the mind. While some of this is a classic history of the mind narrative, Horwitz's focus on personality disorders as the organizing thread brings a new and highly useful perspective to the phrenology to Freud (to DSMs 1–5).

As the book moves through the history of personality, it offers a compelling discussion of the history of psychology, from quantitative to psychoanalytic to social to neo-Freudian approaches to the study of the mind and the self. Each of these methods, Horwitz shows in compelling and accessible ways, emerges from and is deeply intertwined with particular historical and cultural events. The book...