Personality Disorders

Personality disorders, formerly referred to as character disorders, are a class of personality types which deviate from the contemporary expectations of a society. Personality disorders are defined by the APA as “an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it.”

Over the years I have treated many individuals with personality disorders. I have some brief thoughts on treatments and my approach for each.

1. Borderline Personality Disorder (BPD) is a psychiatric diagnosis in the DSM-IV that describes a prolonged disturbance of personality function characterized by depth and variability of moods. The disorder typically involves unusual levels of instability in mood; “black and white” thinking, or “splitting”; chaotic and unstable interpersonal relationships, self-image, identity, and behavior; as well as disturbance in the individual’s sense of self. In extreme cases, this disturbance in the sense of self can lead to periods of dissociation. These disturbances can have a pervasive negative impact on many or all of the psychosocial facets of life. This includes difficulties maintaining relationships in work, home or social settings. Attempted suicide and completed suicide are possible outcomes, especially without proper care and effective therapy.

If you have a history of unstable interpersonal relationships and a history of thinking someone is just the most wonderful person in the world one minute and the next day you feel hate towards them and this is a repetitive pattern, you may want to look at this as an issue. Frequently, along with these signs I see self-mutilation or suicidal gestures. Anger, and inability to control anger is displayed too. Anger is all about feeling like a victim and borderlines do feel like victims frequently. This is a way of boosting self-esteem, the underlying problem with most personality disorders, a lack of a fully self loving and fully functional personality.

Histrionic Personality Disorder (HPD) is defined by the APA as a personality disorder characterized by a pattern of excessive emotionality and attention-seeking, including an excessive need for approval and inappropriate seductiveness, usually beginning in early adulthood. These individuals are lively, dramatic, enthusiastic, and flirtatious. They may be inappropriately sexually provocative, express strong emotions with an impressionistic style and be easily influenced by others.

Dependent Personality Disorder (DPD) formerly known as asthenic personality disorder, is characterized by a pervasive psychological dependence on other people. The difference between a “dependent personality” and a “dependent personality disorder” is somewhat subjective, which makes a diagnosis sensitive to cultural influences such as gender roles expectations. The DSM IV defines dependent personality disorder as a “pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts.

Avoidant Personality Disorder (AvPD) is characterized by a pervasive pattern of social inhibition, feelings of inadequacy, extreme sensitivity to negative evaluation and avoidance of social interaction. People with AvPD often consider themselves to be socially inept or personally unappealing, and avoid social interaction for fear of being ridiculed, humiliated, rejected or disliked. AvPD is usually first noticed in early adulthood, and is associated with perceived or actual rejection by parents or peers during childhood. Whether the feeling of rejection is due to the extreme interpersonal monitoring attributed to people with the disorder is still disputed.

Antisocial Personality Disorder (ASPD) is defined by the APA as a pervasive pattern of disregard for, and violation of , the rights of others that begins in childhood or early adolescence and continues into adulthood. The individual must be age 18 or older, as well as have a documented history of a conduct disorder before the age of 15. People having antisocial personality disorder are sometimes referred to as “sociopath” and “psychopaths”, although some researchers believe these terms are not synonymous with ASPD.

Obsessive Compulsive Personality Disorder (OCPD) is characterized by intrusive thoughts that produce anxiety, by repetitive behaviors aimed at reducing anxiety, or by combinations of such thoughts (obsessions( and behaviors (compulsions). The symptoms of this anxiety disorder range from repetitive hand-washing and extensive hoarding to preoccupation with sexual, religious or aggressive impulses. These symptoms can be alienating and time-consuming, and often cause severe emotional and economic loss. Although the acts of those who have OCD may appear paranoid and come across to others as psychotic, OCD sufferers often recognize their thoughts and subsequent actions as irrational, and they may become further distressed by this realization.

OCD is the 4th most common mental disorder and is diagnosed nearly as often as asthma and diabetes. In the US 1 in 50 adults has OCD. The phrase “obsessive-compulsive” has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is meticulous, perfectionistic, absorbed in a cause or otherwise fixated on something or someone.

Paranoid Personality Disorder (PPD) is a psychiatric diagnosis characterized by paranoia and a pervasive, long-standing suspiciousness and generalized mistrust of others. Those with PPD are hypersensitive, are easily slighted, and habitually relate to the world by vigilant scanning of the environment for clues or suggestions to validate their prejudicial ideas or biases. They tend to be guarded and suspicious and have quite constricted emotional lives. Their incapacity for meaningful emotional involvement and the general pattern of isolated withdrawal often lend a quality of schizoid isolation to their life experience. (Because of the surface similarities of the paranoia involved, it is important that the PPD not be confused with paranoid schizophrenia, another totally different type of mental disorder where the patient has constant feelings of being watched, followed or persecuted.)

Schizoid Personality Disorder (SPD) is a personality disorder characterized by a lack of interest in social relationships, a tendency towards a solitary lifestyle, secretiveness, and emotional coldness. SPD is rare compared with other personality disorders. Its prevalence is estimated at less than 1% of the general population. SPD is NOT related to schizophrenia.

Schizotypal Personality Disorder (SZPD) is characterized by a need for social isolation, odd behavior and thinking and often unconventional beliefs. SZPD is a pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for, close relationships as well as cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts.

Narcissistic Personality Disorder (NPD) is described by the DSM IV as a pervasive pattern of grandiosity, need for admiration, and a lack of empathy.

The narcissist is described as turning inward for gratification rather than depending on others and as being excessively preoccupied with issues of personal adequacy, power, and prestige. narcissistic personality disorder is closely linked to self-centeredness. It is also colloquially referred to as “the God complex”.

This clustering categorizes the NPD as a cluster B personality disorder, those disorders having in common an excessive sense of self-importance. Also in that cluster are the borderline personality disorder, the histrionic personality disorder and the antisocial personality disorder.

 

Dr. Lewis Jordan has over 20 years experience in psychotherapy, counseling, education and public speaking. Dr. Lewis Jordan’s Psychotherapy ServicesFlorida therapy offices for Therapy & Neurofeedback Services are located in various locations throughout South Florida as well as offices in New York City and South Carolina.  Please click here for Dr. Lewis Jordan’s current Educational Videos

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Blessings to you.

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