All of us have our own unique
ways of feeling and thinking
and expressing ourselves. Most of the
time, our uniqueness is seen simply as an individual
difference - or something special about each of us.
In fact, this is what brings interest and variety to
the people in our lives. This is a positive thing. One
of the healthiest things we can do is to achieve a
fairly objective understanding of just how we are
unique or different from other people. Then we
can understand how our behavior impacts other
people and we can adjust the way we act around
other people accordingly. That is, we can problem-solve our way through situations when we have
a good understanding of our unique personality
characteristics. We are talking here about personality
style - and all of us have our own styles.
Some of us, though, have personalities that vary significantly from the expectations of the culture.
This can involve patterns of feeling, thinking,
impulse control and interpersonal functioning
that cause distress - sometimes to the person,
but especially to those around the person. If the
pattern is enduring and pervasive (that is, it persists
over time and can be found across a broad range
of situations), then it might meet the criteria for
a personality disorder. One of the features of a
personality disorder is that the person may not
realize how their behavior affects others - and
that's why it continues over time and with a variety
of different people. So a person with a personality
disorder may have difficulty with problem-solving,
which impairs their ability to adapt to life's
challenges. People with personality disorders don't
feel distressed about their personality traits,
but may suffer from the reactions of others to
them. Personality disorders seem to begin fairly
early in life, and, unless a change in made, they
may continue on through the person's adulthood.
It is important to realize that the behavior of those
with personality disorders may have served a
positive function at one point in the person's life
- but now those behaviors are an ingrained part
of the personality but no longer serve the person
well. They actually work against the person's
ability to adapt.
Professional therapists help people to address
a number of problems in everyday living,
such as mood and thinking disorders, anxiety,
impulse control problems or addictive behavior.
Personality disorders fall into their own category,
however. That is, personality disorders may, or
may not, be related to these more traditional areas
of treatment. For example, a person suffering
from depression may, or may not, also have a
personality disorder. Fortunately, there is help for
people suffering from personality disorders, as
well as their families, work colleagues and close
friends. In most cases, people who suffer from a
personality disorder can learn to make changes
in the behavior that causes distress. It's not
really feasible to say that therapists can "cure" a
personality, but they can help the person learn to
manage life's details and responsibilities better.
A Word of Warning: Read the following as an
educational pursuit, not as an exercise in self-diagnosis or the diagnosis of anyone else. Many
people, when they read the definitions of the
various personality disorders, tend to personalize
them. That is, they see themselves or others in
the definition. This can be a very dispiriting
experience. All of us, from time to time, have
experiences that are common to many people
- but a few experiences hardly constitute the
evidence needed for a diagnosis of personality
disorder. We can find at least some of our own
behavior, or the behavior of someone else, in all
of the definitions that follow. Above all, remember
that you can do harm to someone by loosely
categorizing their behavior based on a few bits
of evidence, and you would not want to do this.
Diagnosis is best left to those with the training to
do it, and it used only when it can help the person.
With that in mind, here are descriptions of the ten
common personality disorders.
Paranoid Personality Disorder
The paranoid
personality constitutes about one percent of the
population. The pattern is long-standing, often
beginning in early adulthood. People with paranoid
personality disorder tend to have a pervasive
distrust of others. They attribute malevolent
motives to other people. Without any real basis for
their beliefs, they feel that others are harming or
exploiting them. They become preoccupied with
the issue of who can be trusted and who cannot.
They read demeaning messages into the words
and behavior of others, and they frequently bear
grudges against others. They perceive attacks
against them that are not apparent to other people.
They have difficulty in confiding in others for
fear that information will be used against them.
They become angry quickly and they are quick to
counter-attack.
Schizoid Personality Disorder
This is a rare
disorder that constitutes less than one percent of
the population. It usually begins in early adulthood
and presents itself as a pervasive problem affecting
virtually every aspect of the sufferer's life. The
person feels detached from virtually all social
relationships. They show a restricted range of
emotions around others. They almost always
choose solitary activities, but they show pleasure
in few, if any, of these activities. They are often
indifferent to the praise or criticism they receive
from others. They lack close friends or people they
can open up to.
Schizotypal Personality Disorder
This begins
in early adulthood and is more common in that
about three percent of the population could be
described by this diagnosis. These people tend
to be described as eccentric in their dress and
behavior. They feel uncomfortable with close
relationships. They tend to have odd beliefs and
engage in what is called "magical thinking," that
is, they draw conclusions without considering the
logic behind their inferences. Their thinking and
speech are often described as odd. They tend to
be suspicious of others and their range of emotion
is limited. People with schizotypal personality
disorder usually have few close friends and they
feel anxious in social situations.
Antisocial Personality Disorder
About three
percent of men and one percent of women can
be described by this diagnosis - and the pattern
becomes obvious during adolescence, if not
before. People with antisocial personalities tend
to violate the rights of others. They often have
brushes with the law and fail to conform to social
norms. They may lie to others or con others for
personal gain. They are impulsive and fail to
plan ahead. They manipulate others and often
disregard their own safety or the safety of others.
They are irresponsible with their work or financial
obligations. People with antisocial personality
disorder get into fights, and are irritable and
aggressive around other people. A lack of remorse
is one of the defining characteristics of this
disorder.
Borderline Personality Disorder
The
borderline pattern becomes apparent at least by
early adulthood, and it is estimated that about
two percent of the population suffers from this
disorder. The defining characteristic of this
disorder is instability of mood, self-image, and
interpersonal relationships. In their relationships,
people with borderline disorders tend either to
idealize others or devalue them - and this can
switch back and forth quickly. They fear both
being abandoned by and becoming intimate with
others. Their behavior is impulsive, and self-destructive threats are common. Their moods can
change abruptly from happiness to misery, often
over the course of only a few hours. They may
feel empty inside and show frequent displays of
temper, as well as suspicious thinking.
Histrionic Personality Disorder
About two to
three percent of the population can be diagnosed
with histrionic personality disorder, a problem
which begins to show itself by early adulthood.
The defining characteristic of this disorder is
excessive expression of emotions and attention-seeking. Sufferers may feel uncomfortable when
they are not the center of attention. They use
their physical appearance to draw attention to
themselves. They are often theatrical and dramatic
- and they are suggestible and easily influenced
by others. They express emotions in a rapidly
shifting manner. People with histrionic personality
disorder may think that their relationships are
more intimate than they actually are.
Narcissistic Personality Disorder
This is a
fairly rare disorder, affecting about one percent
of the population, and it first appears by early
adulthood. A loose definition of narcissism is
"self love." People with this disorder have a
great need for admiration from others, but little
capacity for empathy. They tend to be grandiose in
their fantasy world and superior to others in their
thoughts. They are preoccupied with fantasies
of unlimited success and power, and they have
a sense of entitlement (that is, they feel they
deserve special treatment). They believe they
are special or unique, and others may describe
them as arrogant. They tend to exploit others and
manipulate them, and they lack empathy for the
feelings of other people.
Avoidant Personality Disorder
This is another
rare disorder that describes less than one percent
of the population. Again, it becomes apparent
by early adulthood. People with this disorder
are inhibited or timid. They feel inadequate,
but are sensitive to negative criticisms. Unless
they are certain they will be liked, they tend to
avoid involvement with other people. They are
preoccupied with being criticized or rejected by
others, and they feel inadequate when people are
being compared or evaluated. They are reluctant
to take risks for fear of being embarrassed.
Dependent Personality Disorder
This
disorder may affect less than three percent of the
population, and it appears by early adulthood. It
is characterized by an excessive need to be taken
care of. People with this disorder tend to cling to
others and to show a submissive stance in their
interpersonal relationships. They have a fear of
separation and they require others to assume
responsibility for most life activities. Dependent
personalities have difficulty in making everyday
decisions, and they have difficulty in disagreeing
with others for fear of being rejected. They are
preoccupied with the fear of having to take care
of themselves. They lack confidence in their own
judgment, so they have difficulty in initiating
projects. They go to any lengths to get nurturance
from other people.
Obsessive-Compulsive Personality Disorder
This disorder, which shows itself by adulthood,
affects about one percent of the population.
People with this diagnosis are preoccupied with
being orderly and perfect and they need a sense
of mental and interpersonal control. They have
difficulty with flexibility and openness. They
often get so involved in rules, procedures and
organization that the point of the activity is lost.
Others may describe them as "workaholics."
They are rigid and miserly, and they have
difficulty in throwing out things. At work, they
find it difficult to delegate tasks.
There is Hope for Those With Personality Disorders
When therapists attempt to achieve behavior
changes in their clients, they usually
assume the absence of a personality disorder. It
is, after all, a major task to work with clients in
making significant life changes without going
through the hurdle of addressing a personality
disorder as well. People with personality
disorders often lack the feeling of distress that
motivates major changes within the therapeutic
setting.
However, when the focus is on specific
behaviors that can be changed to bring
about smoother life adjustments, therapists can
have great success in working with people who
have personality disorders. Most people can
recognize when they have a recurrent pattern
of difficulty in their lives - and this recognition
can serve as the motivator for change in
therapy. A trained professional therapist is able
to find those areas that help a client recognize
the need for change. For example, people with
dependent personality disorder may come
to understand that they may well lose their
significant relationship unless some changes
occur in their need to be taken care of. While
the person's internal needs for dependency may
persist even after the therapeutic intervention,
changes in the person's overt behavior can go
a long way in resolving the situation. When the
outer behaviors are changed, the internal needs
may then undergo adjustments in a healthier
direction.
People with paranoid personality disorder,
for example, can activate their sensitivity
so that they become attuned to the needs of
other people in a productive way. People with
schizotypal personality disorder can transform
a pattern of odd beliefs into a more creative and
socially approved set of responses. Those with
borderline personalities can use their tendency
toward rapidly shifting moods to being more
spontaneous (and sensible) in their responses
toward others. Negative symptoms associated
with these disorders can be turned into positive
qualities which help the person in adapting to
life's demands.
A trained professional therapist is able to
provide a setting in which seemingly
intractable problems can be addressed. A
feeling of safety and trust is built between the
therapist and client - and this opens the door
to trying new behaviors, with support, which
have seemed impossible until now. A whole new
world awaits those who give it a try.