Personality Disorders & Treatment

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Overview of Personality Disorders

Personality disorders are long-standing and deeply rooted beliefs about one’s self, with characteristics that may include lack of insight or self-awareness, inflexibility and limited ability to utilize coping skills to help with positive change.

Those with personality disorders tend to either blame others for their problems or, on the other hand, blame themselves too much and struggle with interpersonal relationships. Because those with personality disorders have a limited capacity for self-reflection and deeply ingrained beliefs -- internally and externally - many don’t see a need or a desire for change and therefore are hard to treat.

According to the National Institute for Health, approximately 23 million Americans have a personality disorders. A large majority of those with a personality disorder have a history of trauma, emotional abuse or neglect and tend to come from families with impaired functioning, as well as poor or harmful communication styles.

Quick Reference

 

Personality disorders are broken down into three clusters:

Cluster A is considered the odd and eccentric cluster with characteristics that include social awkwardness or withdrawal or avoidance of social settings. These personality disorders include:

  • Paranoid Personality Disorder
  • Schizoid Personality Disorder
  • Schizotypal Personality Disorder

Cluster B personality disorders include traits that can be characterized as dramatic, overly emotional or erratic. These include:

  • Borderline Personality Disorder
  • Narcissistic Personality Disorder
  • Histrionic Personality Disorder
  • Antisocial Personality Disorder

Cluster C personality disorders include traits of being anxious and fearfulness and include the following:

  • Avoidant Personality Disorder
  • Dependent Personality Disorder
  • Obsessive-compulsive Personality Disorder (this is not the same as obsessive-compulsive disorder, which is a type of anxiety disorder).

Differences in the Type of Personality Disorders

There several subtypes of personality disorders. Below is a brief overview each:

Cluster A -- Odd and Eccentric

Paranoid Personality Disorder -- a person has the belief that others dislike them or out at to get them and utilize defense mechanisms to protect themselves by treating others badly. As a result, they tend to be guarded, as well as critical, suspicious, defensive and jealous of others, and therefore have troubling maintaining relationships

Schizoid Personality Disorder - a pattern of detachment from social situations and tendency to like solitary activities and avoid intimate or social relationships. This person can seem aloof or indifferent and have difficulty showing emotions.

Schizotypal Personality Disorder -- features of this disorder include paranoia and superstitious and people tend to be guarded or hypersensitive. People with schizotypal disorder tend to be described as odd or eccentric and have very few interpersonal relationships except with close family.

Cluster B -- Dramatic or Emotional

Borderline Personality Disorder -- characterized by a pervasive pattern of emotional and relationship instability, with a lack of a positive view of self. People with borderline personality disorder often see the world in extremes -- either good or bad -- and therefore struggle with intimacy and interpersonal relationships, as those who are close to people with borderline personality struggle with their extreme mood changes and irrationality. This disorder is also characterized by impulsive behaviors and inappropriate anger.

Narcissistic Personality Disorder -- includes personality traits of grandiosity, superiority or egocentric and tend to lack empathy. While people with narcissistic personality disorder present as confident and superior, underneath they have pervasive feeling of inferiority and vulnerability that must be defended against. This disorder is characterized by strong reactions to criticism, disregard of other’s feelings, a sense of entitlement and belief that they are right.

Histrionic Personality Disorder - people with this disorder seek attention and need constant reassurance and praise. They tend to place high importance on physical attractiveness, are seen as self-centered, as well as dramatic. Additionally, people with histrionic personality disorder tend to be jealous and manipulative, and can experience extreme changes in mood based on how people react to them.

Antisocial Personality Disorder -- this is the only disorder that must be diagnosed after the age of 18. People who struggle with antisocial personality disorder react negatively to social norms or roles, typically through impulsiveness or aggression. People with this disorder are prone to manipulation, lying and theft, as well as violence toward people and animals, and may feel no remorse or guilt for their action. They have a strong need for admiration and attention and react negatively when they feel rejected.

Cluster C - Anxious or Fearful

Avoidant Personality Disorder -- tend to view themselves as inferior or unattractive and lacks poor social skills, because of fear of rejection or embarrassment. Unlike schizoid personality disorder, in which they prefer solitary activities and interests, those with avoidant personality disorder have a strong desire for intimacy and companionship but their fear of connection prevents them from establishing these relationships

Dependent Personality Disorder - is characterized by a fear of being alone and a belief they are not capable of making decisions and lack self-confidence for self sufficiency. People with dependent personality disorder are submissive and rely on others to make decisions for them. They require reassurance and acknowledgement and have a fear of rejection.

Obsessive-Compulsive Personality Disorder -- a pervasive pattern of preoccupation with rules, order and perfection and need to control others. People with obsessive-compulsive personality disorder have difficulty delegating things because of a need for perfectionism and fear that it won’t be done correctly. These people tend to be self-critical and difficulty expressing emotions because of fear of vulnerability.

Causes of Personality Disorders

While there is no definitive cause to the development of personality disorders, that are several factors that may play a role. Those include:

Genetics - those with personality disorders may carry a specific genetic makeup, predisposing them to the development of a personality disorder.

Environmental - Research has shown that a number of environmental factors play a large role in the development of personality disorders, including:

Sexual abuse and childhood trauma -- high levels of sexual abuse has been reported in people with personality disorders. Additionally, those with personality disorders have a high reported rate of childhood neglect or physical/emotional and or verbal abuse.

Family chaos and impairment - those whose family life was chaotic, unsupportive and dysfunctional have a higher rate of personality disorders.

 

Treatment for Personality Disorder

The establishment of a sound therapuetic alliance, focused on empathy, compassion and respect, is the strongest predictor of success in treating personality disorders.

At Clarity Clinic our experienced clinicians guide clients towards the proper treatments, including pharmacological and nonpharmacological interventions.

Psychotherapy
At Clarity Clinic, we have highly trained therapists who specialize in the treatment of personality disorders and provide treatment in a safe and nurturing environment to foster the therapeutic alliance. Our therapists work with a variety of treatment modalities to improve the symptoms of those with personality disorders, including Dialectical Behavior Therapy (DBT), a type of cognitive behavior therapy shown to be effective in the treatment of personality disorders, particularly borderline personality disorder.
Additionally, because friends and family members of those who struggle with personality disorders can also be affected by their extreme mood swings and impaired functioning, Clarity Clinic’s marriage and family therapists can work with couples and family to help support them and work through negative emotions connected to the personality disorder.

Medication Management
While there is no medication designed for personality disorders, a high percentage of those with personality disorders have co occurring disorders that can be helped through pharmacological treatment.

Initial Evaluation
At Clarity Clinic, we have highly trained staff who specialize in diagnosing and treating personality disorders To schedule an appointment, click on one of the specialists below to schedule an initial evaluation to and discuss assessment, diagnosis and treatment options.

Additional Resources
For more information on personality disorders, below are several additional resources to help learn more:
https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders
http://www.mayoclinic.org/diseases-conditions/personality-disorders/home/ovc-20247654

Signs and Symptoms

While each specific personality disorder includes specific criteria for accurate diagnosis, the following generic overview of personality disorders in the the Diagnostic and Statistical Manual of Mental Disorders (DSM), a reference manual used by healthcare professionals as the authoritative guide to the diagnosis of mental disorders – provides a topline overview of signs and symptoms of personality disorders:

Personality disorders are characterized by an enduring pattern of inner experience and behavior that is markedly different from the expectations of one’s culture. This pattern of thinking or experience is exhibited through:

Distorted thinking or cognition in the way they perceive themselves, other people or events.
Difficulty in emotional functioning
Struggles with interpersonal relationships
Impulse control issues

This pattern of thinking or behaviors is inflexible and rigid across a broad range of personal and social experiences
These personality traits cause significant distress or impairment in social, work and relationship functioning.
The pattern of thinking and behavior is stable long-lasting and can be traced to early adulthood or adolescents.

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