Familiar Personality Disorders (PDs) include narcissistic, antisocial, dependent, histrionic, borderline, and avoidant ones, although about 10 conditions are recognized by psychiatrists and psychologists as PDs. Everyone knows that individuals with this type of disorder have a problem - except for them. They often seek professional treatment only after persuaded to do so by another person.
PDs are among the most difficult cases to successfully treat. They don't exist apart from an individual's core personality, like something like an anxiety disorder does; rather, they wind through a person's entire personality and, generally speaking, IS the personality, not just an adjunct to it. It is estimated that about 40 percent of individuals suffering from a PD can find some improvement with a combination of medication and some form of 'talk' therapy.
The cost to society resulting from PDs is great. Individuals suffering from a PD are often perpetrators of spousal and child abuse and other forms of violence, creating unhealthy living conditions for others. Even if they are able to be persuaded to undergo therapy, they may continue to deny that they have a problem, preferring to list everything that is wrong with everyone else - blaming everyone else, or the situation, for their problems. They seek therapy under duress, often using the sessions in order to bolster their claim that they don't have a problem; that it is others - their spouse, their colleagues - who are to blame for the way they act and that their actions are completely justified. They are usually self-absorbed, believing that they have every right to be because they're 'so hard done by' at home, or at work. When the therapist doesn't provide them with the expected validation for their behaviour, they simply fire the therapist.
PDs are extremely complex and as noted above, difficult to treat. They are often heritable conditions, but can also come about as a result of conditioning during a person's early years because of things like childhood abuse or some other trauma. A PD doesn't usually manifest itself until the late teenage years; however, earlier signs may simply have been missed by parents. Alternatively, because a parent may have the disorder, they can't see that anything is wrong with the child. Even when environmental factors such as child abuse take place, it is hard to determine whether the reason the child ended up with, for example, a narcissistic personality disorder, was simply because of the abuse which led to self-loathing and low self-esteem - to then be covered up by self-aggrandizement - or that the abuse ended up manifesting as it did because it triggered the heritable condition. In other words, that is how the abuse manifested itself in that particular child due to genetic factors, whereas in another child it may have manifested itself in another type of PD, or in anxiety or depression.
According to Jeffrey Kluger's article "Pain, Rage and Blame" in a special edition of Time magazine, "personality disorders are ego syntonic: individuals believe that the drama, self-absorption, and other traits that characterize their condition are reasonable responses to the way the world is treating them." (1) As a result, because the patient doesn't accept that there is something wrong with them - as they do when they have something like panic disorder or a phobia - how can they accept the treatment required to give them any chance at all towards healing?
While antidepressant and anxiety medications do little to change something as fundamental as personality, they may help to smooth out the rough edges, to calm the stress that comes from living so disordered a life. Once some patients feel less stressed, they may be motivated enough to take on the harder work of a therapy like cognitive behavioural therapy in which new ways of thinking and reacting about life situations are taught, and then utilized, in order to enable patients to repair what is not working in their lives.
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(1) "Pain, Rage and Blame", Jeffrey Kluger, Time magazine special edition: "Your Brain: A User's Guide", p. 52.
About Me
- Deborah K. Hanula
- Deborah K. Hanula has a year of Journalism training from Humber College, a Political Science degree from the University of Waterloo, and a Law degree from the University of British Columbia. In addition, she has Diplomas in Cognitive Behavioural Therapy, Child Psychology, and Psychotherapy and Counselling as well as a Family Life Educator and Coach Certificate and Certificates in Reflexology, Assertiveness Training, and Mindfulness Meditation. She is the author of five cookbooks, primarily concerned with gluten-free and dairy-free diets, although one pertains to chocolate. As an adult, in the past she worked primarily as a lawyer, but also as a university and college lecturer, a tutor, editor, writer, counsellor, researcher and piano teacher. She enjoys a multi-faceted approach when it comes to life, work and study, in order to keep things fresh and interesting. Check out her new book: A Murder of Crows & Other Poems (2023).
