Personality Disorders

Each of us has specific personality traits, our patterns of perceiving, relating and reacting to people and life events.  We tend to cope with stress in an individual and consistent way, and, regardless of the usual pattern, learn from experience and try a different method if the first approach is ineffective.
In contrast, individuals who have a personality disorder, characterized by inflexible, maladaptive perceptions and responses to problems, do not believe that their thought or behavior patterns are inappropriate and usually do not change those patterns, in spite of countless disappointing outcomes.    They tend to believe that their problems are caused by other people or circumstances beyond their control.  Personality disorders seem to be rooted in a combination of biology and environment, and according to author Dr. Sam Vaknin, are commonly accompanied by the following traits:
Self-centeredness that manifests itself through a “me first” attitude Lack of accountability, blaming others, society and the universe for their problems Lack of empathy Unhappiness, often resulting in depression or other mood disorders Distorted or superficial understanding of self and others, inability to acknowledge his or own behaviors that contribute to problems Maladaptive social skills, tendency to change the rules of the game or otherwise influence the external world to conform to his or her own needs Impaired relationships with family, friends and coworkers      There are ten distinct personality disorders identified in the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association: Antisocial Personality Disorder: Lack of regard for moral or legal standards, chronic irresponsibility and unreliability, persistent lying and/or stealing, aggressive behavior, lack of remorse after hurting others Avoidant Personality Disorder: Extreme shyness in social situations, feelings of inadequacy, hypersensitivity to criticism Borderline Personality Disorder:  Feelings of emptiness, lack of identity, frequent and dramatic changes in mood, opinions and plans; possible suicide attempts or self-mutilation Dependent Personality Disorder: Extreme dependence on others to meet one’s physical and emotional needs, tolerance of poor – even abusive - treatment in order to stay in a relationship, intense fear of being alone, marked lack of decisiveness and self-confidence Histrionic Personality Disorder:  Constant and dramatic changes in emotions, exaggerated displays of emotions, excessive sensitivity to approval from others, attention-grabbing - often provocative – clothing and behavior, excessive concern with physical appearance Narcissistic Personality Disorder:  Inflated sense of one’s importance and achievements, constant admiration-seeking, lack of empathy, manipulation of others to further one’s own desires, exaggerated anger or shame in response to criticism Obsessive-Compulsive Personality Disorder:  Excessive concern with order, rules, schedules and lists;  standards of perfection that are impossible to meet, inability to throw away even worthless items, compulsive devotion to work at the expense of relationships Paranoid Personality Disorder:  Marked distrust of others, including the belief, without reason, that others are exploiting, harming or deceiving him or her; perception of hidden malicious meaning in benign comments, inability to work collaboratively with others, unforgiving and grudge holding behavior Schizoid Personality Disorder:  Extreme introversion, fixation on one’s own thoughts and feelings, emotional detachment, indifference to social relationships Schizotypal Personality Disorder:   Magical thinking – the belief that one can influence people and events with one’s thoughts, suspicion and paranoia, odd, elaborate style of dressing and interacting with others; belief that messages are hidden for oneself in public speeches and displays      Until fairly recently, many mental health clinicians felt that treatment did not help personality disorders.  In The Psychological Letter, Dr. David B. Adams explained that the difficulty in treating these disorders is that the affected individual blocks effective communication, avoids the development of a trusting relationship and cannot be relied upon for an accurate history regarding the problems or how the problems arose.  There is no cure for personality disorders, but a combination of therapy and medication can help, particularly in those who seek therapy on their own and are motivated to stick with the treatment over many years.  While medications may help alleviate the disorders, therapy aimed at building new coping skills must be the cornerstone of treatment.