Personality Disorders
- What is a Personality Disorder?
- What are the different types of Personality Disorders?
- What causes Personality Disorders?
- Frequently Asked Questions about Personality Disorders
What is a Personality Disorder?
Personality Disorders describe persistently maladaptive ways of perceiving, thinking, and relating to the world and other people. They involve long-standing and inappropriate patterns of perceiving and responding to other people and to stressful circumstances. The person suffering from these issues experiences significant impairment in functioning and in some cases subjective distress. Individuals with personality disorders are seen to "act out" patterns of behavior rather than experiencing internal conflicts. For example, the person behaves in ways that are contrary to social attitudes or expectations rather than stifling such behavior, which would cause them to experience inner anxiety.
What are the different types of Personality Disorders?
Borderline personality disorder (BPD) refers to a prolonged disturbance of personality function characterized by depth and variability of moods. The disorder typically involves unusual levels of instability in mood; “black and white” thinking, or splitting; chaotic and unstable interpersonal relationships, self-image, identity, and behavior; as well as a disturbance in the individual’s sense of self. Since Borderline Personality Disorder contains many aspects of several personality disorders, it has been referred to as “the personality disorder that decided not to specialize.” In extreme cases, this disturbance in the sense of self can lead to periods of dissociation. These disturbances can have a pervasive negative impact on many or all of the psychosocial facets of life. This includes difficulties maintaining relationships in work, home and social settings. Attempted suicide and completed suicide are possible outcomes, especially without proper care and effective therapy.
Narcissistic Personality Disorder describes persons with an exaggerated sense of self-importance or uniqueness and a preoccupation with receiving attention. They will often exaggerate their achievements and talents, or focus upon the special nature of their problems. In essence, the narcissist’s fragile self-esteem is revealed by their preoccupation with how other’s regard them. Features of a narcissistic personality include a preoccupation with fantasies of unlimited success, power, brilliance, beauty, or ideal love; a need for constant attention and admiration; and a cool indifference or feelings of rage, inferiority, shame, humiliation, or emptiness in response to criticism, indifference of others, or defeat.
Histrionic Personality Disorder describes persons who exhibit excessive emotionality, with a focus on attention seeking behavior. A person with histrionic personality disorder will have a distorted self-image, unstable emotions, and low self-esteem. They may exhibit competent social skills, but they use manipulation to put themselves in the center of attention. Other characteristics of histrionic personality disorder include hypersexual behavior, preoccupation with physical appearance, sensitivity to criticism, short attention span, and difficulty initiating or maintaining relationships.
Schizoid Personality Disorder is characterized by avoidance of social situations and close contact with other people. Persons with schizoid personalities often have a “flat affect” showing a lack of emotional expression with a mask like face. They are considered “loners” who manifest a profound inability to connect with other people. They do not form intimate relationships or close friendships and they are perceived as aloof, indifferent, and unengaged when in a social environment. Persons with schizoid personalities may be married, but they do not form intimate relationships with their spouse. Similarly, they may hold jobs that do not require close interpersonal interactions.
Dependent Personality Disorder is described as a pervasive psychological dependence on another person or persons to meet their emotional or physical needs. People with dependent personalities have low self-esteem and feel inadequate and helpless. They may demonstrate submissive and clinging behavior with a fear of separation. There is passivity and an inability to cope without the support of others. Thus, they involve themselves in unhealthy or inappropriate relationships to avoid being alone. While dependent behavior is normal in childhood, by early adulthood and beyond this behavior is pathologic.
Paranoid Personality Disorder characterizes a person with an irrational fear of and mistrust of others. Antisocial Personality Disorder is a pervasive pattern of disregard and violation of social norms and boundaries. A person with an antisocial personality shows reckless disregard for the rights of others with little remorse.
What causes Personality Disorders?
Personality disorders evolve from the foundation of a person’s temperament, their innate or biologically shaped disposition. It is felt that personality disorders arise from an interplay between genetic factors (temperament) and environmental factors (trauma). Childhood physical or sexual abuse, an unstable family life as a child, or severe loss (such as death of parents or siblings) results in a higher risk of development of a personality disorder. Acute life stressors, such as chronic insomnia, overworking, financial hardship, substance abuse, medical problems, and difficulties with family or other interpersonal relationships can exacerbate deleterious symptoms of a personality disorder.
Frequently Asked Questions about Personality Disorders
Is it Difficult to Diagnose a Personality Disorder?
Personality disorders manifest most frequently through conflict with family, friends and loved ones. Usually a family member or friends will steer the person with a personality disorder towards treatment. Less commonly, that person may realize that their life is collapsing around them and seek help. In addition to disturbances in interpersonal relationships, persons with personality disorders usually have significant mood dysregulation. Personality disorders are very difficult to correctly diagnose, and are often misdiagnosed because they are not sharply defined and lack a clear set of diagnostic criteria. Furthermore, the diagnostic categories are not mutually exclusive. Often, people will show characteristics of more than one personality disorder. The dimensionality of personality characteristics, which range from normal expressions of an emotion to pathological exaggerations, make diagnosis difficult, as the same emotional issues can be found on a smaller and less intense scale in many normal individuals.
What is the Prognosis for a Personality Disorder?
The prognosis for recovery from a personality depends on the particular disorder type. Personality disorders are generally life-long disturbances with periods of remissions and exacerbations dependent on life circumstances. Research shows that effective individual psychotherapy coupled with specific group therapies such as Dialectical Behavioral Therapy and anger management can affect positive change in someone with a personality disorder. Additionally, sleep and stress management, psycho-education, and creative diversions such as art, music and writing, can significantly improve the wellness of someone with a personality disorder. Persons with personality disorders usually find it difficult to seek help or stay in treatment. Thus, it is especially important with these psychological issues to find an effective and engaging treatment program.
What factors prevent recovery and what is the prognosis?
The prognosis for recovery from a personality depends on the particular disorder type. Personality disorders are generally life-long disturbances with periods of remissions and exacerbations dependent on life circumstances. Research shows that effective individual psychotherapy coupled with specific group therapies such as Dialectical Behavioral Therapy and anger management can affect positive change in someone with a personality disorder. Additionally, sleep and stress management, psycho-education, and creative diversions such as art, music and writing, can significantly improve the wellness of someone with a personality disorder. Persons with personality disorders usually find it difficult to seek help or stay in treatment. Thus, it is especially important with these psychological issues to find an effective and engaging treatment program.
How Can Loved Ones, Family and Friends Help?
Family, friends or loved ones first need to learn to recognize the symptoms and patterns of someone with a personality disorder. Often, they do not realize that the disruption in their relationships is based on a personality disturbance, attributing problems to external factors or even themselves. Psycho-education is critical for loved ones and family who live in close quarters with a person with a personality disorder, so they can learn to avoid triggering or self-sabotaging behaviors. They also need to be watchful for signs of decompensation and substance abuse, and they may be the person’s best hope to find a successful treatment situation.
Is a Treatment Center the right choice?
When a person with a personality disorder reaches a point where their personality traits have significantly disrupted their interpersonal relationships or resulted in loss of work or school or estrangement from family members, it is time to consider intensive treatment. Once per week psychotherapy or medication may be inadequate at managing serious consequences of a personality disorder. A treatment facility, like PCH Treatment Center, can be a more effective option than simple outpatient therapy, especially when the person with a personality disorder is not fully compliant or resistant to their current treatment situation.
How does PCH Treatment Center treat Personality Disorders?
PCH Treatment Center addresses personality disorders in a profound manner. First, we endeavor to obtain a proper diagnosis. Persons with personality issues are commonly misdiagnosed and improperly treated. Dr. Jeff Ball, the Executive and Clinical Director, has over 25 years of experience in treating personality disorders. He has assembled a highly qualified clinical staff of doctoral level psychotherapists. In the PCH Treatment Program, individual psychotherapy, coupled with somatic experiencing and DBT form the foundation for our treatment of personality disorders. Group therapies such as anger management, sleep hygiene, process groups and neurofeedback supplement this foundation. Alternative or holistic treatments such as yoga, mindfulness meditation and art therapy provide a counterpoint to the intensive treatment. We feel it is also important to involve family members and significant others in the treatment structure for our Clients with personality issues. Each Client is assigned a primary therapist, who is at a doctoral level, when the enter our treatment program. This primary therapist will incorporate family members, as available, into psychotherapy sessions and groups, to build a foundation for the family to deal with the lifelong sequelae of a family member with a personality disorder. We believe this is critical to the success of treatment and endeavor to involve the family whenever appropriate and beneficial to treatment.
