Personality disorders: patterns, signs and treatment

My clients often say that finally receiving a diagnosis of personality disorder gives them some comfort. A diagnosis materialises their internal struggle and they find relief in knowing that their difficulties aren’t “in their head”.

Having said that, I prefer a more person-focused approach to treatment rather than a diagnosis-focused one. This is because I don’t believe that a sole diagnosis necessarily helps clients make sense of their difficulties.

The definition of personality

Personality in psychology to refer to the patterns of how each person thinks, feels and behaves. It’s what makes you unique from others.

Your personality is influenced by several factors:

1. Past and present experiences
2. Environment (surroundings and life situations)
3. Inherited characteristics

Personality disorder explained

Personality disorder means that a person’s way of thinking, feeling and behaving deviates from what we expect. It means that the patterns of their personality are causing them distress and troubles in daily functioning.

There are numerous types of personality disorder but they all share one aspect: a long-term pattern of significantly different behaviour than what’s expected.

When personality disorders are diagnosed

Personality disorders can begin during childhood, though they are more frequently noticed by the late teen years or in early adulthood. This is when distress and problems in functioning become more obvious.

If they’re left untreated

Untreated personality disorders generally result in long-lasting and irregular behavioural and relational patterns. We see these patterns in at least two of four areas:

1. How they think about themselves and others.
2. The way they emotionally respond.
3. How they relate to other people.
4. How they control their own behaviour.

How people with personality disorder feel

My clients with personality disorder come to therapy with complaints of symptoms, rather than the disorder itself. The chief complaints include:

• Chronic depression
• Anxiety
• Feelings of emptiness or disconnection

They might come to therapy also seeking help for:

• Low self-esteem
• Interpersonal difficulties (their ability to communicate in their relationships)
• Drug abuse and/or alcohol abuse
• Self-harm
• Other risk-taking behaviour

Signs of a personality disorder

The general signs of personality disorder are:

1. A client (or a friend or relative) reporting: “I/he/she has always been this way”.
2. They might accept their personality patterns as an acceptable, core part of who they are, and say things like: “I can’t imagine being any other way”
3. When a client insistently avoids their psychological treatment. This can signal that we need to evaluate their personality traits further.
4. When someone abruptly stops coming to therapy without an apparent reason.
5. When a client isn’t aware of their behaviour’s impact on others. They may report how others behaved, but fail to address any provocation or dysfunctional behaviour on their part.
6. The client wants to change but they don’t follow through on an agreed management plan, therefore taking no action despite having the initial motivation.

Approach to treatment

We can conceptualise the treatment of personality disorder as a multi-modal approach. The psychologist and the client aim to address:

1. Cognitive distortions
2. Dysfunctional behaviours
3. Emotional dysregulation
4. Personal and interpersonal difficulties

And to do this, we use three components in treatment: cognitive, expressive and relational.

Take a look at Dr Daniela Rossi’s profile to discover how she can help you manage personality disorder.