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Personality Disorders
Definition of Personality Disorders
The word personality is difficult to define. Personality refers to an enduring of perceiving, thinking and relating to situations and oneself that occurs repetitively in a wide range of social and personal situations. An individual's personality is stable and predictable and characterizes that individual in most circumstances. The normal personality is flexible and adaptable. When the personality is disordered, it is maladaptive and distressing for the patient and others. Personality disorders are maladaptive patterns of perceiving, relating and thinking about one's surroundings and oneself. They are usually negatively impact one's work, family, and interpersonal relationships.
The severity of personality disorders exists on a continuum, from mild to severe. While most people can live relatively normal lives with mild personality disorders, during times of increased stress, symptoms may become more severe and seriously interfere with emotional and psychological functioning.
Personality disorders are characterized by several distinct psychological features including disturbances in self-image, appropriate range of emotion, impulse control, interpersonal relationships, and perceptions of oneself, others and the world. There are ten different types of personality disorders that exist, which all have various emphases. Personality disorders often overlap and there are not always clear cut boundaries between them. An individual can show characteristics of more than one personality disorder. For example, borderline and narcissistic features can coexist in the same individual.
Personality disorders are grouped into three clusters.
Cluster A: Paranoid, Schizoid and Schizotypal -- Odd and eccentric
Cluster B: Antisocial, Borderline, Histrionic and Narcissistic– Dramatic emotional
Cluster C: Avoidant, Dependent, Obsessive-Compulsive – Anxious and fearful
Some of the more common personality disorders include the avoidant, dependent, paranoid, narcissistic, obsessive-compulsive and borderline.
Avoidant Personality Disorder
The avoidant personality disorder is characterized by a long-standing and complex pattern of feelings of inadequacy, extreme sensitivity to what other people think about them, and social inhibition. It typically manifests itself by early adulthood and includes a majority of the following symptoms: avoiding occupational activities that involve significant interpersonal contact due to fears of criticism, disapproval, or rejection, being unwilling to get involved with people unless certain of being liked, showing restraint within intimate relationships because of the fear of being shamed or ridiculed, being preoccupied with being criticized or rejected in social situations, being inhibited in new interpersonal situations because of feelings of inadequacy, viewing oneself as socially inept, personally unappealing, or inferior to others, and being reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.Dependent Personality Disorder
The dependent personality disorder is characterized by a long-standing need for the person to be taken care of and a fear of being abandoned or separated from important individuals in his or her life. This pervasive fear leads to "clinging behavior" and usually manifests itself by early adulthood. It includes a majority of the following symptoms: difficulty making everyday decisions without an excessive amount of advice and reassurance from others; needs others to assume responsibility for most major areas of his or her life; has difficulty expressing disagreement with others because of fear of loss of support or approval; has difficulty initiating projects or doing things on his or her own because of a lack of self-confidence in judgment or abilities; goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant; feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself; and urgently seeks another relationship as a source of care and support when a close relationship ends
Paranoid Personality Disorder
The paranoid personality disorder includes a pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts. Some symptoms that may be shown include: suspiciousness, without sufficient basis, that others are exploiting, harming, or deceiving him or her; being preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates; being reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her; reading hidden demeaning or threatening meanings into benign remarks or events; persistently holding grudges and being unforgiving of insults, injuries, or slights; perceiving attacks on his or her character or reputation that are not apparent to others and being quick to react angrily or to counterattack; and having recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
Narcissistic Personality DisorderThe narcissistic personality disorder includes a pervasive pattern of grandiosity, need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts. Persons with this disorder may have a grandiose sense of self-importance exhibited by exaggerating achievements and talents and expecting to be recognized as superior without reason. They may be preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love, and believe that they are "special" and unique and can only be understood by, or should associate with, other special or high-status people. Such persons often require excessive admiration, have a sense of entitlement, are often interpersonally exploitative and take advantage of others to achieve their own ends. They have a sense of entitlement and believe they are entitled to things before others. They view everything as revolving around themselves. They often lack empathy, being unwilling to recognize or identify with the feelings and needs of others, are often envious of others, believe others are envious of them, and display arrogant behaviors and attitudes.
Obsessive-Compulsive Personality DisorderThose with obsessive-compulsive personality disorder are preoccupied with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility, openness, and efficiency. They may be preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost; have perfectionism that interferes with task completion; be excessively devoted to work and productivity to the exclusion of leisure activities and friendships; be over-conscientious, scrupulous, and inflexible about matters of morality, ethics, or value; have difficult discarding worn-out or worthless objects even when they have no sentimental value, and may be overly frugal, rigid and stubborn.
Borderline Personality Disorder
Persons with borderline disorders usually have labile interpersonal relationships characterized by volatility and instability. This pattern of interacting with others has persisted for years and is usually closely related to the person's self-image and early social interactions and may be marked by frantic efforts to avoid real or imagined abandonment. Impulsivity is a common feature.
Causes
Potential causes of personality disorders include a combination of upbringing, personality and social development, as well as genetic and biological factors. Research has not narrowed down the cause to any factor at this time. These disorders will most often manifest themselves during increased times of stress and interpersonal difficulties in one's life.
Treatment
Psychotherapy can be helpful in treating these disorders. Psychotherapy can effectively increase coping mechanisms and interpersonal skills. The main goal is to assist the patient in identifying and addressing the ways in which their personality style is maladaptive and achieve change by motivating them to discard these unacceptable behaviors. It has recently been found that medication, when carefully chosen, can be helpful. The biological dimensions of the personality which may respond to medication include aggression, impulsivity, anxiety and depression. Individual therapy and certain types of group therapy are helpful.
If you want more information about personality disorders, want to discuss your particular needs, or want to schedule an appointment, call our offices today. We can help match you with a therapist that best meets your needs.
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