Think about some of the people in your life; your family, friends, and coworkers. Aside from picturing an image of them, you will likely think of their traits; considerate, loyal, supportive, thoughtful, generous; all the things that make life and relationships so enjoyable. There are other traits: greed, lazy, critical, controlling, abrasive; the reasons why we avoid certain people. All of these are known as Personality Traits.

More severe traits are known as Personality Disorders. These are patterns of behaviors that negatively affect virtually everything about the person including their thoughts, emotions, and behaviors. Disorders can be destructive to everything in a person’s life including their functioning at work, close relationships, and their social functioning.

These disorders include:

  • Paranoid personality disorder is a pattern of distrust and suspiciousness such that others’ motives are interpreted as malevolent.
  • Schizoid personality disorder is a pattern of detachment from social relationships and a restricted range of emotional expression
  • Schizotypal personality disorder is a pattern of acute discomfort in close relationships, cognitive or perceptual distortions, and eccentricities of behavior.
  • Antisocial personality disorder is a pattern of disregard for, and violation of, the rights of others.
  • Borderline personality disorder is a pattern of instability in interpersonal relationships, self-image, and affects, and marked impulsivity.
  • Histrionic personality disorder is a pattern of excessive emotionality and attention seeking.
  • Narcissistic personality disorder is a pattern of grandiosity, need for admiration, and lack of empathy.
  • Avoidant personality disorder is a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation.
  • Dependent personality disorder is a pattern of submissive and clinging behavior related to an excessive need to be taken care of
  • Obsessive-compulsive personality disorder is a pattern of preoccupation with orderliness, perfectionism, and control. *

In many years of practice, I don’t recall any individual presenting themselves with the intent to work on a personality disorder. Often, people around them have strongly “encouraged” them to “get help.” Sometimes, circumstances, such as loss of a job or an impending divorce have forced the issue.

Personality inventories can be very helpful in confirming a pattern. At any rate, gaining trust, forming a therapeutic alliance, and finding motivation for realistic goals are early issues.

The good news is that, given hard work and some time, working with personality disorders can have a significant payoff. Behaviors are within bounds, relationships smooth out, and employment is more consistent.

*Diagnostic and Statistical Manual of Mental Disorders (DSM-5®), Fifth Edition, | Jesse H. Wright, Gregory K. Brown, Michael E. Thase and Monica Ramirez.

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