Personality Disorders

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“…repeated trauma in childhood forms and deforms the personality. The child trapped in an abusive environment is faced with formidable tasks of adaptation. She must find a way to preserve a sense of trust in people who are untrustworthy, safety in a situation that is unsafe, control in a situation that is terrifyingly unpredictable, power in a situation of helplessness.”

–Judith Lewis Herman, MD

What is your personality?

Your personality is the way you see, understand and relate to the outside world. It is how you combine thoughts, feelings, and behaviors so that they make you unique. Personality forms during childhood and is created by (epi)genetic influences (your parents’ personalities) as well as by environmental influences (life experience, friends, etc.).

Some people have a hard time understanding situations and relationships to others. These people have a rigid and unhealthy pattern of thinking and behavior that can lead to problems in relationships, social encounters, work and school.  When a person during childhood was unable to care for or protect herself, she must compensate for the failures of adult care and protection with the only means at her disposal, an immature system of psychological defenses…. When someone’s personality style and / or behavior as a result of this, creates a meaningful burden on themselves or others, or when their behaviors consistently go against society’s expectations, the person may be labeled with what is known as a “Personality Disorder”.

Some behaviors / beliefs that indicate a personality disorder include:

  • Mood fluctuations
  • Stormy or unstable relationships
  • Social isolation
  • Sudden outbursts of anger
  • Suspicion or mistrust of others
  • Difficulty making friends
  • Need instant gratification
  • Weak impulse control
  • Alcohol and / or substance use

It is important to note that many of these signs appear in childhood or adolescence and resolve on their own in early adulthood. It is not uncommon for a child to suddenly have anger, or for a teenager to have weak impulse control. It is considered a personality disorder when these problems persist through adulthood (18 years or older). Research shows that most people get better, either with time or with treatment.

Types of Personality Disorders

Below is a system of diagnosis which identifies ten types of personality disorder. These are grouped into three categories.

Suspicious:

  • Paranoid personality disorder
    • The thoughts, feelings and experiences associated with paranoia may cause you to:
      • find it hard to confide in people, even your friends and family
      • find it very difficult to trust other people, believing they will use you or take advantage of you
      • have difficulty relaxing
      • read threats and danger (which others don’t see) into everyday situations, innocent remarks or casual looks from others.
    • This might become such a big problem in your life that you are given a diagnosis of paranoid personality disorder.
  • Schizoid personality disorder
    • Many people with schizoid personality disorder are able to function fairly well. Unlike in schizophrenia or schizoaffective disorder, you would not usually have psychotic symptoms. However, as a result of the thoughts and feelings associated with this diagnosis you may:
      • find difficulty forming close relationships with other people
      • choose to live your life without interference from others
      • prefer to be alone with your own thoughts
      • not experience pleasure from many activities
      • have little interest in sex or intimacy
      • have difficulty relating to or are emotionally cold towards others.
  • Schizotypal personality disorder
    • Everyone has their own eccentricities or awkward behaviours. But if your patterns of thinking and behaving make relating to others very difficult, you may receive a diagnosis of schizotypal personality disorder.
    • Unlike in schizophrenia, you usually would not experience psychosis. However, you may:
      • experience distorted thoughts or perceptions 
      • find making close relationships extremely difficult
      • think and express yourself in ways that others find ‘odd’, using unusual words or phrases, making relating to others difficult
      • believe that you can read minds or that you have special powers such as a ‘sixth sense’
      • feel anxious and tense with others who do not share these beliefs
      • feel very anxious and paranoid in social situations, finding it hard to relate to others.
  • Antisocial personality disorder
    • It is natural to sometimes put our own needs, pleasure or personal gain before those of others around us. However, if these actions occur very frequently and you struggle to keep stability in your life, or you regularly act impulsively out of anger or lack of consideration for others, this could lead to a diagnosis of antisocial personality disorder.
    • You may:
      • put yourself in dangerous or risky situations, often without thinking about the consequences for yourself or other people
      • behave dangerously and sometimes illegally (you may have a criminal record)
      • behave in ways that are unpleasant for others
      • feel very easily bored and act on impulse – for example, you may find it difficult to hold down a job for long
      • behave aggressively and get into fights easily
      • do things even though they may hurt people – to get what you want, putting your needs and desires above other people’s
      • have problems with empathy – for example, you may not feel or show any sense of guilt if you have mistreated others
      • have had a diagnosis of conduct disorder before the age of 15.
    • This diagnosis includes terms like ‘psychopathy’ and ‘sociopathy’.

Emotional and impulsive:

  • Borderline personality disorder (BPD)
    • Borderline personality disorder (BPD) is also known as emotionally unstable personality disorder (EUPD).
    • We can all experience difficulties with our relationships, self-image and emotions. But you might get a diagnosis of BPD/EUPD if these feel consistently unstable or intense and cause you significant problems in daily life.
    • You may:
      • feel very worried about people abandoning you, and either do anything to stop that happening or push them away
      • have very intense emotions that can change quickly (for example, from feeling very happy and confident in the morning to feeling low and sad in the afternoon)
      • not have a strong sense of who you are or what you want from life, with your ideas about this changing significantly depending on who you’re with
      • find it very hard to make and keep stable relationships or friendships
      • act impulsively and do things that could harm you (such as binge eating, using drugs or driving dangerously)
      • have suicidal thoughts
      • self-harm
      • feel empty and lonely a lot of the time
      • get very angry, and struggle to control your anger
      • struggle to trust other people
      • experience other mental health problems alongside BPD, including anxietydepressioneating problems and post-traumatic stress disorder.
    • When very stressed, sometimes you might:
      • feel paranoid
      • have psychotic experiences, such as seeing or hearing things that other people don’t
      • feel numb or ‘checked out’ and not remember things very well after they’ve happened (known as dissociation).
    • BPD is currently the most commonly diagnosed personality disorder.
  • Histrionic personality disorder
    • Most people enjoy being given compliments or positive feedback about their actions. But if you depend very heavily on being noticed, or are seeking approval so much that this affects your day-to-day living, you might get a diagnosis of histrionic personality disorder.
    • You may:
      • feel very uncomfortable if you are not the centre of attention
      • feel that you have to entertain people
      • constantly seek, or feel dependent on, the approval of others
      • make rash decisions
      • flirt or behave/dress provocatively to ensure that you remain the centre of attention
      • get a reputation for being dramatic and overemotional
      • be easily influenced by others.
  • Narcissistic personality disorder
    • It is human nature to be aware of our own needs, to express them, and to want others to be aware of our abilities and achievements. These are not bad traits. However, if these thoughts, feelings and behaviours are very extreme and cause problems in relating to others, you may get a diagnosis of narcissistic personality disorder.
    • You may:
      • believe that there are special reasons that make you different, better or more deserving than others
      • have fragile self-esteem, so that you rely on others to recognise your worth and your needs
      • feel upset if others ignore you and don’t give you what you feel you deserve
      • resent other people’s successes
      • put your own needs above other people’s, and demand they do too
      • be seen as selfish and dismissive or unaware of other people’s needs.

Anxious:

  • Avoidant personality disorder
    • We all have things, places or people we don’t like, or which make us anxious. But if these things cause so much anxiety that you struggle to maintain relationships in your life, you may get a diagnosis of avoidant personality disorder (sometimes also called anxious personality disorder).
    • You may:
      • avoid work or social activities that mean you must be with others
      • expect disapproval and criticism and be very sensitive to it
      • worry constantly about being ‘found out’ and rejected
      • worry about being ridiculed or shamed by others
      • avoid relationships, friendships and intimacy because you fear rejection
      • feel lonely and isolated, and inferior to others
      • be reluctant to try new activities in case you embarrass yourself.
    • See our pages on anxiety and panic attacks for more information on how to cope with anxiety.
  • Dependent personality disorder
    • It is natural to need other people to care for us or give us reassurance sometimes. A healthy balance involves being able to both depend on others as well as being independent from others sometimes. However, if feelings and thoughts about needing others become so overwhelming that they impact your daily life and relationships, you may get a diagnosis of dependent personality disorder.
    • You may:
      • feel needy, ‘weak’ and unable to make decisions or function day-to-day without help or support from others
      • allow or require others to assume responsibility for many areas of your life
      • agree to things you feel are wrong or you dislike to avoid being alone or losing someone’s support
      • be very afraid of being left to fend for yourself
      • have low self-confidence
      • see other people as being much more capable than you are.
  • Obsessive compulsive personality disorder (OCPD)
    • Obsessive compulsive personality disorder (OCPD) is separate from obsessive compulsive disorder (OCD), which describes a form of behaviour rather than a type of personality.
    • However, similarly to OCD, OCPD involves problems with perfectionism, the need for control, and significant difficulty being flexible in how you think about things.
    • You may:
      • need to keep everything in order and under control
      • set unrealistically high standards for yourself and others
      • think yours is the best way of doing things
      • worry about you or others making mistakes
      • feel very anxious if things aren’t ‘perfect’.

Each personality disorder has its own set of diagnostic criteria. To get a specific diagnosis you must meet some of these criteria. 

Personality disorder not otherwise specified (PD-NOS)

Everybody is individual and behaves in unique ways, so it is only natural to not fit neatly into the categories described above.

If you experience a number of personality disorder traits but not enough to fully meet the criteria of a specific type, you may receive a diagnosis of personality disorder not otherwise specified (PD-NOS). This diagnosis may also be known as personality disorder trait specified.

Treatment of personality disorders

Adequate intervention of personality disorders based on a bio-psycho-social approach that focuses on the developmental and social needs of the individual and the family.includes:

  • Individual Therapy: Individual Therapy begins with identifying your erroneous cognitive, emotional, and / or behavioral patterns that contribute to interpersonal difficulty. Therapist and you then work together to identify, practice and integrate transformation and self-management skills to replace ineffective patterns. At IBI we work with all levels of personality: body, emotions, thoughts, will and spirit. We use a map of consciousness (an evolutionary process) and a map of personality.
  • Family therapy (including couple / couple therapy): Family members often bear the lion’s share of the burden because they are the ones most frequently in contact with the client. Family therapy helps family members better understand the nature of the client’s disorder, as well as take on their own role and responsibility, and better prepare to provide the empathy and support the client and system will need to change.
  • Group Therapy: Group therapy, provides you with a supportive atmosphere to learn emotional regulation, self-calming techniques, and work on your interpersonal relationships.
  • Medical Evaluation: In some cases medication can sometimes be useful in treating certain symptoms of the personality disorder, or treating concomitant conditions that co-exist with the personality disorder.

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Individual therapy sessions

Dirk Marivoet psychotherapist in Belgium

Dirk Marivoet, MSc. is a European certified psychotherapist (ECP). He studied physiotherapy as well as psychomotor therapy at the University of Leuven. For over 30 years he has worked in a holistic way and is especially interested in the integration of body and mind.

Dirk Marivoet and his colleagues at the IBI (International Institute of Bodymind Integration) offer individual therapy sessions for those interested in this mind-body approach.

In Ghent (Belgium), Europe, the rest of the world and online.

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