Mark Hillman, Ph.D., (PSY) LMHC My Therapist is Making Me Nuts!Written by Mark Hillman

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Personality Disorders

Personality disorders are long standing patterns of maladaptive behavior. The personality disorders are when a person uses improper and immature ways to deal with problems or situations.

A personality disorder is identified by a pervasive pattern of experience and behavior that is abnormal with respect to any of the following two: thinking, mood, personal relations, and the control of impulses. The character of a person is shown through his or her personality - by the way an individual thinks, feels, and behaves. When the behavior is inflexible, maladaptive, and antisocial, then that individual is diagnosed with a personality disorder.

There are many different personality disorders, each with their own set of unique symptoms.

The following are common personality disorders

(click on the name to read about that specific disorder)

Antisocial Personality Disorders

The symptoms of antisocial personality disorder include a longstanding pattern (after the age of 15) of disregard for the rights of others. There is a failure to conform to society's norms and expectations that often results in numerous arrests or legal involvement as well as a history of deceitfulness where the individual attempts to con people or use trickery for personal profit. Impulsiveness if often present, including angry outbursts, failure to consider consequences of behaviors, irritability, and/or physical assaults. Some argue that a major component of this disorder is the reduced ability to feel empathy for other people. This inability to see the hurts, concerns, and other feelings of people often results in a disregard for these aspects of human interaction. Finally, irresponsible behavior often accompanies this disorder as well as a lack of remorse for wrongdoings. These behaviors include difficulty with authority, legal altercations, cruelty to animals, fire setting, and a dislike or anger toward authority. This disorder is diagnosed much more frequently in males.

Avoidant Personality Disorder

Individuals with this disorder feel inadequate, have great sensitivity to what others think and say about them, and are socially impotent. This disorder is characterized by someone who is terribly reluctant to take personal risks or try new things because they may be embarrassed. Avoidant personalities don't like to get involved in intimate relationships, constantly think about being criticized or rejected, and see themselves as socially inept and inferior.

Borderline Personality Disorder

A person with a borderline personality disorder often experiences a repetitive pattern of disorganization and instability in self-image, mood, behavior and close personal relationships. This can cause significant distress or impairment in friendships and work. A person with this disorder can often be bright and intelligent, and appear warm, friendly and competent. They sometimes can maintain this appearance for a number of years until their defense structure crumbles, usually around a stressful situation like the breakup of a romantic relationship or the death of a parent.

Relationships with others are intense but stormy and unstable with marked shifts of feelings and difficulties in maintaining intimate, close connections. The person may manipulate others and often has difficulty with trusting others. There is also emotional instability with marked and frequent shifts to an empty lonely depression or to irritability and anxiety. There may be unpredictable and impulsive behavior which might include excessive spending, promiscuity, gambling, drug or alcohol abuse, shoplifting, overeating or physically self-damaging actions such as suicide gestures. The person may show inappropriate and intense anger or rage with temper tantrums, constant brooding and resentment, feelings of deprivation, and a loss of control or fear of loss of control over angry feelings. There are also identity disturbances with confusion and uncertainty about self-identity, sexuality, life goals and values, career choices, friendships. There is a deep-seated feeling that one is flawed, defective, damaged or bad in some way, with a tendency to go to extremes in thinking, feeling or behavior. Under extreme stress or in severe cases there can be brief psychotic episodes with loss of contact with reality or bizarre behavior or symptoms. Even in less severe instances, there is often significant disruption of relationships and work performance. The depression which accompanies this disorder can cause much suffering and can lead to serious suicide attempts.

Dependent Personality Disorder

This disorder is characterized by a need to be taken care of an a fear of being abandoned. Suffers of it are very clingy and usually have the following symptoms: helpless when alone because of exaggerated sense of not being able to care for self, when one close relationship ends the person immediately tries to find another, problems initiating projects or ideas because of a lack of self esteem, difficulty disagreeing with others, needs other to take responsibility for him/her, cannot make decisions with out advice from others.

Histrionic Personality Disorder

Histrionic Personality Disorder is characterized by a person who is always calling attention to themselves, who are lively, and overly dramatic. They are overly dramatic, and minor situations can cause wild swings in emotions. They easily become bored with normal routines, and crave new, novel situations and excitement. In relationships, they form bonds quickly, but the relationships are often shallow, with the person demanding increasing amounts of attention. Associated features may include egocentricity, self-indulgence, continuous longing for appreciation, feelings that are easily hurt, and persistent manipulative behavior to achieve own needs.

Narcissistic Personality Disorder

The symptoms of narcissistic personality disorder revolve around a pattern of grandiosity, need for admiration, and sense of entitlement. Often individuals feel overly important and will exaggerate achievements and will accept, and often demand, praise and admiration despite worthy achievements. They may be overwhelmed with fantasies involving unlimited success, power, love, or beauty and feel that they can only be understood by others who are, like them, superior in some aspect of life. There is a sense of entitlement, of being more deserving than others based solely on their superiority. These symptoms, however, are a result of an underlying sense of inferiority and are often seen as overcompensation. Because of this, they are often envious and even angry of others who have more, receive more respect or attention, or otherwise steal away the spotlight.

Obsessive-Compulsive Personality Disorder

Obsessive-compulsive disorder, or OCD, involves anxious thoughts or rituals you feel you can't control.

If you have OCD, you may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals. You may be obsessed with germs or dirt, so you wash your hands over and over. You may be filled with doubt and feel the need to check things repeatedly. You may have frequent thoughts of violence, and fear that you will harm people close to you. You may spend long periods touching things or counting; you may be pre-occupied by order or symmetry; you may have persistent thoughts of performing sexual acts that are repugnant to you; or you may be troubled by thoughts that are against your religious beliefs.

The disturbing thoughts or images are called obsessions, and the rituals that are performed to try to prevent or get rid of them are called compulsions. There is no pleasure in carrying out the rituals you are drawn to, only temporary relief from the anxiety that grows when you don't perform them.

A lot of healthy people can identify with some of the symptoms of OCD, such as checking the stove several times before leaving the house. But for people with OCD, such activities consume at least an hour a day, are very distressing, and interfere with daily life. Most adults with this condition recognize that what they're doing is senseless, but they can't stop it. Some people, though, particularly children with OCD, may not realize that their behavior is out of the ordinary.

Paranoid Personality Disorder

Often misunderstood as malevolent because paranoid personality disorder suffers are distrustful and suspicious of others. Only four of the following are needed to indicate paranoid personality disorder: individual suspects, with no cause, that others are out to get him; is reluctant to confide in others; is suspicious, without cause, that significant other is being unfaithful; doesn't forgive grudges; has doubts about the loyalty of friends and relations; reads hidden threatening messages into benign statements or situations.

Schizoid Personality Disorder

A person who has a detachment from social relationships and a restricted range of emotional expression in interpersonal situations is considered a schizoid personality. This can be verified by four out of seven symptoms. These symptoms are: a loner-always chooses solitary activities, doesn't want or enjoy any close relationships-including family, has very little interest in having sexual experiences with another person, has no close friends except for immediate family, demonstrates emotional coldness and detachment, takes enjoyment in very few activities, and appears indifferent to what others think of him/her.

Schizotypal Personality Disorder

Schizotypal personality disorder is characterized by people who have discomfort with, and a reduced capacity for, close relationships, cognitive or perceptual distortions, and eccentricities of behavior.

Some of the common signs of schizotypal personality disorder include the following:

  1. Discomfort in social situations, extreme social anxiety
  2. Odd beliefs, fantasies, or preoccupations that don't agree with subcultural norms (i.e. belief in clairvoyance)
  3. Odd behavior or appearance
  4. Odd speech patterns
  5. A lack of close friends other than immediate family
  6. Inappropriate displays of feelings
  7. Strange perceptual experiences
  8. Suspicious or paranoid ideas
  9. Inappropriate or constricted affect
  10. Person has ideas of reference

Schizotypal personality disorder should not be confused with schizophrenia. People with schizotypal personality disorder tend to have odd beliefs and behaviors, but they are not profoundly disconnected from reality and usually do not hallucinate.

People with schizotypal personality disorder may be severely disturbed, and their odd behavior may resemble that of people with schizophrenia. They may have unusual preoccupations and fears, such as fears of being monitored by government agencies, which are also common in schizophrenia.

More commonly, however, people with schizotypal personality disorder simply behave oddly and have unusual beliefs (aliens, witchcraft, etc.) that they cling to so strongly that it isolates them from normal relationships. Full-blown hallucinations are unusual.


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