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Personality Disorders

 

What is Personality?  What is a Disorder?  Borderline Personality Disorder   Antisocial Personality Disorder   Paranoid Personality Disorder   Narcissistic Personality Disorder   Obsessive-Compulsive Personality Disorder   Other Disorders


 

Personality Disorders


 

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Cluster A What is ‘Personality’?

 

There are any number of descriptions and ideas about what a ‘personality’ is and how it can be defined. Perhaps the best way of describing it is consider it to be the 'unique, entrenched & enduring internal qualities of an individual and the corresponding behavioural patterns. Incorporated into this is the manner in which the individual perceives the world and themselves and how they relate to and interact within their society'. This may seem a little ‘long winded’ and somewhat irrelevant, though the need to define ‘personality’ is necessary if we are to establish any deviance from what would be considered ‘normal’ or ‘appropriate’.

 

Social & cultural anomalies and influences will effect how a ‘personality’ develops and the differences are evident between cultures & nationalities. For example: the culturally ‘normal’ personality type of Middle Eastern nations varies significantly to that of Western society. The demonstrative emotions of the Italian differ from the stoic Englishmen’s demeanour.

 

This brings us to the vexing question of ‘what is normal’? The term is bandied around by everyone and is basically used in a subjective and rather opinionated way. What is normal for one person might not be normal for another. What is normal for the Rugby League player varies considerably from that which is considered normal for a bank teller or accountant, unless of course there is the duplicity of an accountant who is also a footballer. Do the laws of our nations establish normality? Do our parents, schools, religions decide what is normal? The answer, philosophically, is there is no such thing as normal.

 

What needs to be established is the essence of appropriateness and accepted thinking and behaviour for an individual within a culture and society, taking into consideration the various influences that have affected the development of the personalities of those within that culture or society.    

 

 

 

 

 

Cluster A What is a ‘Disorder’?

 

A disorder then can be determined as a manifestation that deviates significantly from this concept of ‘normality’ or that which seriously affects ones functioning within society. The way someone behaves or thinks, the way they perceive themselves and others, the way they interact and relate to their world around them and according to the vast majority of the population. 

 

The area of ‘Personality Disorders’ is intrinsically linked to ‘Developmental Processes & Coping Mechanisms’. The presence or diagnosis of a ‘Personality Disorder’ can often be linked to the unsuccessful or poor transition through one (1) or more of the various stages of development, or significant events, incidents & circumstances experienced during these stages, though this is not the definitive ‘sole’ reason. Other factors such as genetic pre-disposition (heredity), other biological/chemical or organic reasons and life experiences (current & past) can similarly contribute to the development of a ‘personality disorder’.

 

One must be mindful not to ‘tag’ someone as having a ‘Personality Disorder’ if they exhibit certain signs, symptoms, behaviours etc. of the disorder. We all have the capacity to exhibit some of these, particularly in times of stress or when we are placed in an awkward position, out of our ‘comfort zone’. The effects of illicit drugs & alcohol can also have a bearing on the manifestation of behaviours.

 

As such, it is important that we differentiate between ‘Personality Traits’ & ‘Personality Disorders’. ‘Traits’ are the behaviours, thoughts & actions displayed or exhibited in an individual that comprise their basic personality. We all have ‘personality traits’; some are characteristics or learned behaviours developed through role modeling our parents and/or significant others; some may be genetically based, and some may be akin to those symptomatic of a ‘Disorder’ or ‘illness’.

 

‘Personality Disorders’ were once not considered a ‘mental illness’, though later diagnostic tools now include them in their classification for mental illness. In reality, it is somewhat irrelevant whether it is a mental illness or not; the condition remains the same with the same symptoms & problems. Changing its’ classification does not change what the individual experiences or what we see. ‘Personality Disorders’ can be separated into three (3) ‘clusters’ or ‘groups’, under which sits the various specific disorders.

 

 

 

Cluster A Cluster A

 

                  Comprises behaviour that is eccentric or odd, it includes schizoid, paranoid & schizotypal disorders.

 

 

Cluster A Cluster B

 

                   This cluster is marked by emotional, dramatic, explosive & erratic behaviour; it includes histrionic,  narcissistic, anti-social & borderline personality disorders.

 

Cluster A Cluster C

 

                   Marked by fearful, dependant, anxious & introverted behaviour; it includes avoidant, dependant, obsessive-compulsive & passive-aggressive disorders.

 

 

 

 

 

The following are examples & descriptions of some of the Personality Disorders:

 

 

 

Antisocial Personality Disorder (Cluster B)

 

 

Irresponsible & socially deviant, aberrant behaviour are the trademarks of this disorder. As a child, behaviour such as lying, wagging school, vandalism & petty theft are common. As an adult they find it difficult to keep intimate relationships or hold down a steady job. They are frequently in trouble with the law, participate in crime, show little regard for other’s property, display aggression & hostility and often engage in use & abuse of drugs and alcohol as a means of coping with any stress, anger or boredom. Assaults and fights are common with the Anti social Personality Disordered person. They are rarely remorseful for their behaviour and often blame others or society for the predicaments they find themselves in. They sometimes also feel they are ‘owed’ or that society ‘owes them’. People with this disorder may have a family history of similar behaviour and generally a lack of boundaries as a developing child.

 

 

 

 

Borderline Personality Disorder (Cluster B)

 

 

This is probably the most difficult of all the Personality Disorders to cope with or treat and poses the greatest challenge for the mental health practitioner. It is potentially destructive to the individual concerned, their families, partners and friends. The disorder is marked by extreme emotional instability, lack of, or poor sense of self, fear of being alone or abandoned, feelings of worthlessness and viewing themselves as fundamentally ‘bad’. The Borderline Personality generally has unstable patterns of social relationships characterized by sudden and stark contrasts between idealization (great admiration & love) & denigration (hate, contempt, anger). Self harming or self mutilating behaviours such as ‘cutting’, ‘cigarette burns’, self inflicted ‘stabbing’ etc. are evidenced in many cases, along with ‘para suicide’ behaviour & frequent threats of suicide. Those who have suffered this illness often explain their self harming as a way of ‘feeling’, or ‘knowing they are alive’. Despite these frightening behaviours, only one (1) in ten (10) Borderline Personality disordered people actually suicide. Other characteristics of the Disorder are the intense, short lived bouts of anger, depression & anxiety that may last only for hours or at most a day. The overwhelming fear of abandonment and rejection combined with the inner sense of emptiness & lack of self often leads to Drug & Alcohol abuse, ‘risky’ sex, gender identity issues, impulsivity, lack of vocational or educational achievement & continued destruction of social & family relationships. Co-existent mental health illnesses such as Depression, Bipolar Disorder & Anxiety Disorders are not uncommon and can lead to suicide, particularly in the case of Depression. The illness is more common in women, particularly younger adolescents and often entails a history of abuse, particularly sexual abuse.

 

 

 

Obsessive Compulsive Personality Disorder (Cluster C)

 

 

Rigid perfectionism which interferes with an individual’ capacity to complete anything is one of the key symptoms of the OCD personality. Their own achievements and accomplishments and those of others rarely meet their desired ideal standards. As such they appear emotionally ‘cold’, critical & judgemental. Because they are pedantically pre-occupied with perfection, rules, procedures, protocols and social order, they fail to enjoy the pleasure of achievement or the company of others. They have an unrealistic need to control and therefore their interactions with others are overly formal & lacking in spontaneity. Problem solving is unlikely to result in success or resolution with rumination over the persistent unresolved problem leading to intense ‘self criticism'. The two (2) aspects of this disorder are (1) Obsessions & (2) Compulsions.

 

Obsessions can be defined as recurrentand persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress. These thoughts, impulses or images are not simply excessive worries about real-life problems and the individual attempts to ignore, suppress or neutralise them by use of another thought or action. They also recognise that their obsessions are a product of their own mind and not based on reality. 

Compulsions are repetitive behaviours or mental acts that a person feels driven to perform in response to an obsession or according to rules which much be applied rigidly. The Compulsive behaviours or acts are designed to reduce distress & anxiety, though are unrelated and not connected to the actual real source of the anxiety and/or distress.

 

 

 

 Paranoid Personality Disorder(Cluster A)

 

 

As the name suggests, paranoia is a predominant characteristic of this disorder. The sufferer unreasonably and unjustifiably believes others are untrustworthy; deliberately devious & ‘out to get them’. They are often jealous, suspicious, and vengeful; holding grudges and displaying hostility when they feel they are threatened. Their mistrust causes them to be hypervigilant, particularly in new or unfamiliar surroundings or settings. They rarely develop close or intimate relationships and appear angry, secretive & ‘uptight’ to others. They display few affectionate or joyful emotions or behaviours. Psychotic symptoms can develop in some Paranoid Personality Disorders depending on the intensity of the paranoid feelings & the level of stress & anxiety experienced.


 

 

 

Narcissistic Personality Disorder (Cluster B)

 

 

The primary characteristic of the Narcissistic Personality is that of grandiosity; overvaluing their abilities and achievements and pre-occupied with fantasies of perceived power & influence, superior intelligence, unlimited success, beauty & perfectionism. They believe themselves to be ‘special’ & overly important, unique, gifted and entitled to preferential treatment and admiration because of who they are. They tend to only wish to mix with those of higher status or intelligence, believing them to be the only ones to truly appreciate their superiority. They lack empathy toward anyone else and fail to recognize, or envy, the accomplishments of others. At times they devalue others and their achievements in order to boost their own over-inflated, unrealistic opinion of themselves. The NPD presents as arrogant, self opinionated and rather a ‘snob’, though generally there is an underlying low self esteem causing the individual to ‘fish for compliments & acknowledgment’, being pre-occupied with how others perceive them. Because there is an expectation that their work is more valuable than any others, combined with a complete lack of understanding or sensitivity to another person’s needs, the NPD can often unconsciously ‘exploit’ individuals in order to bolster and enhance their own self image.

 


 

 

Whilst the characteristics & behaviour of the Personality Disordered individual are pervasive & continuous, the precipitants or precursors to an overtly demonstrative display of symptoms is generally stress, discomfort & anxiety as a result of an incident or experience the sufferer finds sufficiently disturbing as to unconsciously, and inappropriately, cope.

 

The ‘root cause’ for many of the Personality Disorders is often childhood abuse’. Other factors such as ‘genetic predisposition’, environmental & social elements, rejection or abandonment or overly strict, punitive or rigid parenting may also contribute, as can the 'lack' of boundaries or inadequate, inconsistent boundary setting.

 

These examples of 'Personality Disorders' for each of the 'clusters' (A, B & C) as listed above are not the only types that exist; the others, as determined by accepted 'manuals of diagnostic criteria' are:

 

 

 

Cluster A - Schizoid Personality Disorder & Schizotypal Personality Disorder

Cluster B - Histrionic Personality Disorder

Cluster C - Avoidant Personality Disorder & Dependant Personality Disorder. 



 

 

 

Should you have concerns regarding any issue relating to your 'mental or physical well-being', 'Kick off' strongly recommend you seek professional assistance. This may entail contacting your GP or similar clinician (Psychologist, Psychiatrist, Counsellor etc.). You may also contact the appropriate agency or service that might assist you. Irrespective of your choice, ensure you see someone who might help. 

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