Personality Disorders

Personality is what makes each of us individuals. It is the way that we think, feel and behave towards ourselves and others. In most cases our personality is stable, but can vary depending on the situation and who we are with amongst other things. We all have parts of our personality which may cause problems within ourselves or others.

Personality disorders are a type of mental health problem which will affect the way that you think, feel and behave and will cause you problems in your daily life which will be long-lasting and will occur across different aspects of your life. You will find it very difficult to change the unwanted patterns that lead to this behaviour. The experience of personality disorders is unique to each individual, so it is important to speak to a psychologist to find the most appropriate help for you.

There are 10 types of personality disorder, all of which have distinctive symptoms, grouped into three categories:

Suspicious

  • Paranoid
  • Schizoid
  • Schizotypal
  • Antisocial

Emotional and impulsive

  • Borderline
  • Histrionic
  • Narcissistic

Anxious

  • Avoidant
  • Dependent
  • Obsessive Compulsive

Paranoid personality disorder

  • Difficulty confiding in people
  • Difficulty trusting other people, believing they will take advantage of you
  • Being suspicious of others, looking for signs of betrayal or hostility
  • Seeing danger in everyday situations where others see none

Schizoid personality disorder

  • Being uninterested in forming close relationships with anyone
  • Feeling relationships interfere with your freedom and cause problems
  • Preferring to be alone
  • Getting little pleasure from life
  • Low libido
  • Being emotionally cold towards others

Schizotypal personality disorder

  • Finding close relationships difficult
  • Thinking and expressing yourself in ways that others find odd
  • Behaving eccentrically
  • Believing you can read minds
  • Feeling anxious or tense when other people don’t share your beliefs
  • Feeling anxious and paranoid in social situations

Antisocial personality disorder

  • Putting yourself in dangerous or risky situations without considering the consequences
  • Behaving dangerously
  • Behaving in a manner that others find unpleasant
  • Being easily bored and acting impulsively
  • Being aggressive
  • Do what you want to get what you want despite others needs
  • Have a criminal record
  • Not feeling guilt
  • Believing only the strongest survive
  • Having a diagnosis of conduct disorder before the age of 15

Borderline personality disorder

  • Making efforts to avoid real or imagined abandonment
  • Having intense emotions which can be long lasting and fast changing
  • Not understanding who you are and your senses of self can change depending on who you are with
  • Unstable and intense interpersonal relationships
  • Identity disturbance
  • Acting impulsively and doing things which could cause you harm
  • Having suicidal thoughts or self-harming
  • Feeling empty or alone
  • Intense inappropriate anger which is difficult to control
  • When stressed feeling paranoid, having psychotic experiences and feeling numb

Histrionic personality disorder

  • Feeling very uncomfortable if not the centre of attention
  • Feeling at ease when you are the centre of attention
  • Feeling you have to entertain people
  • Flirting or behaving provocatively
  • Being overly dramatic or emotional
  • Being dependent on the approval of others
  • Being easily led by others

Narcissistic personality disorder

  • Believing you are different, better or more deserving than others
  • Having fragile self esteem
  • Being upset if others ignore you and don’t give you what you believe you deserve
  • Resenting others success
  • Putting your own needs above others
  • Being accused of being selfish
  • Taking advantage of others

Avoidant/Anxious personality disorder

  • Avoiding situations when you have to be with others
  • Expecting disapproval and being very sensitive to criticism
  • Worrying about being rejected
  • Worrying about being shamed
  • Avoiding relationships of any form because of a fear of rejection
  • Feeling lonely, isolated and inferior
  • Being reluctant to try new things

Dependent personality disorder

  • Feeling needy, weak and unable to function without help
  • Allowing others to assume responsibility for your life
  • Agree to things against your beliefs to avoid being alone or losing support
  • Being afraid of fending yourself
  • Having low self-confidence
  • Seeing others as being more capable
  • Being seen as passive or submissive

Obsessive compulsive personality disorder

  • Needing to keep everything in order or under control
  • Setting unrealistic standards
  • Thinking your is the best way of doing things
  • Worrying when you make mistakes
  • Expecting catastrophes if things aren’t perfect
  • Being reluctant to spend money on anything
  • Holding onto items with no obvious value

Therapies

NICE guidelines vary dependant on the type of personality disorder being experienced. Commonly, they outline the need for individuals to be assessed in a comprehensive manner before embarking on longer term therapy to reach their personal goals. The approaches below are some of those suggested in the guidelines.

Cognitive Behavioural Therapy (CBT) –CBT is a therapy which assumes that our thoughts lead to our emotions and then our behaviour. Individuals with personality disorders tend to have patterns of thinking which tend to be extreme, inflexible and can cause issue. CBT places the emphasis in this case on identifying and changing these dysfunctional thinking patterns.

Dialectical Behaviour Therapy (DBT) – DBT is an evidence based treatment which helps clients diagnosed with Borderline Personality Disorder who self-harm or engage in self-destructive ways of managing their emotions. DBT is a stage one treatment which helps clients to learn and apply new emotion coping skills, whilst no longer engaging in self-destructive behaviours.

Cognitive Analytic Therapy (CAT) – CAT combines CBT’s practical methods with a focus on the relationship between the client and therapist, helping you to reflect on how you relate to others and why the patterns have developed.

Schema Therapy – Schema therapy is designed to help individuals change limiting life patterns and get their core needs met in a helpful way in order to create a satisfying and fulfilling life. IT can help people with longstanding difficulties who either do not respond to traditional CBT or who have experienced relapses or recurrent problems.

Mindfulness – Mindfulness is a practice which has Buddhist origins and has been around for thousands of years. It is state which is achieved by focusing in on the here and now, acknowledging thoughts, feelings and sensations but not attempting to get rid of them or judge them.

Medication – medication is not recommended for the treatment of personality disorders specifically, although it can be used for comorbid difficulties.

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