Personality disorder is a general term for the different types of mental illnesses, that affects a person’s social-, family- and work life. Many times people suffering from mental illness do not realize that they are suffering from such a disorder.
The scientific study of psychological disorders is known as abnormal psychology. When one deviates from a norm, or the accepted behavior in a society or culture, people term it as abnormal behavior. It is studied, researched and treated by clinical psychologist, psychiatrists and social workers. Personality disorders are similar to physical illness. There are different types of psychological conditions that can affect an individual. The many myths pertain to the term ‘mental’, as one can’t see the chemical imbalance in the brain. The person suffering from such psychological imbalances himself doesn’t realize, what is going wrong with him. History shows how people misunderstood the abnormal personality disorders and imprisoned or banished patients from the main society.
History of Abnormal Psychology
The abnormal personality disorders were not understood as clinical manifestations, but the work of demons, ghosts and evil spirits. This gave rise to stories of witches and wizards, witch-crafts and magic. These personality disorders were treated using a method known as ‘Trepanation’. Trepanation was practiced in the prehistoric era, classical and Renaissance periods. The procedure for this spine chilling procedure was to drill a hole in the skull exposing the dura mater for treating the personality disorder. This process was used for treating seizures and many more mental illnesses.
Hippocrates was the first to point out brain as the root cause for these abnormal psychological personality disorders. Mentally ill patients were treated as outcasts and were socially abolished. They were kept under inhumane conditions and were treated with demonological methods. Patients died or were permanently disabled due to the cruel methods adopted for treating personality disorders. The Salem Witch Trial in 1692, is the proof of many innocent people with or without mental disorders being sentenced to prison or death. Bethlehem Hospital in London was the first hospital to be converted into a mental asylum. Philippe Pinet (1745-1826), a Frenchman who was then the chief physician at La Bicetre asylum in Paris, believed the mental disorder patients as sick who needed kindness and care. He is one of the great humanitarians who ordered to remove chains from patients at the Paris asylum for insane women. The other humanistic psychotherapists were Carl Jung, Alfred Adler, Abraham Maslow, Carl Rogers, Ivan Pavlov, J.B Watson and B.F. Skinner.
What is Personality Disorder?
The fourth (1994) edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) defines personality disorder as “‘enduring pattern(s) of inner experience and behavior that are sufficiently rigid and deep-seated to bring a person into repeated conflicts with his or her social and occupational environment.”
Each and every person has a personality. The way a person thinks, behaves and expresses emotions are specific to each individual. These traits, specific to an individual mindset get converted into disorders, when the behavior becomes extreme and inflexible. Most of these conditions begin in childhood and develop into a full-blown personality disorder in adulthood. Any trauma emotion or mental, suffered during childhood, may lead to it. Such people are affected by their own thinking about themselves and the world around them. They experience emotions different from the normal pattern and function differently in society. They cannot control their impulses at times and become a danger to themselves and others around them.
Types of Personality Disorders
• Cluster A: The personality disorders that are odd or eccentric are grouped in Cluster A. These disorders include suspicious behavior like:
• Cluster B: The personality disorders that are related to emotional or erratic disorders are grouped under Cluster B. These emotional and impulsive behavior disorders include:
•Cluster C: Anxious or fearful disorders are clubbed together under Cluster C. These anxious behavior include:
- Obsessive compulsive
It has been found that one person may fall under various categories. Thus, need treatment for various disorders simultaneously or an unconventional line of psychotherapy.
CLUSTER A ~ People with a Difference
Paranoid personality disorder
People suffering from this condition show distrust and are suspicious of people around them. These people will suspect every move of others. Everything one says, does or wants, will be suspected as deceiving, harmful or exploiting. They tend to hold grudges and will lose no opportunity to inflict insults, slights and injuries on others. They will suspect and doubt their partners fidelity and will show no trust on them. However, these people do not suffer from auditory hallucinations, and their beliefs are well under the line of reality.
Schizoid personality disorder
A schizoid person becomes detached from social interactions and relationships. The emotional expression of these people is restricted. They neither have any desires and they do not form close relationships like being a part of family. They are mostly loners and have little interest in sexual relationships. You will find them to be extremely detached and emotionally cold.
Schizotypical personality disorder
This behavior is marked by pervasive pattern of interpersonal behavior. The person faces discomfort in social settings and has reduced capacity for close relationships. Their thinking and perception power becomes distorted and exhibit eccentric behavior. They form odd beliefs and fantasies. These people have an odd way of speaking or thinking. They have a strong notion about telepathy or sixth-sense.
CLUSTER B ~ I, Me, Myself
Antisocial personality disorder
People suffering this personality have little or no regards for others and violate the rights of people around them. They are generally referred as psychopaths or sociopath. They fail to conform to a given norm and will break all rules, that leads to their arrest. They are used to lying, conning people and using aliases mostly for personal gain and pleasure. They never show remorse for their actions and never honor any emotional or financial obligations.
Borderline personality disorder
Patients show instability in interpersonal relationships, self-image, moods and controlling of impulses. They are often confused about their career goals, personal values and even their sexual orientation. These people often threaten to attempt suicide. Their interpersonal relationships are often unstable. Their own identity is unstable and often have different views of self. They have suicidal tendencies and inclined towards self-mutilating behavior. These people often have a chronic feeling of emptiness and tend to show dissociative personality symptoms. These people are extremely manipulative and have little or no empathy. They have a knack of pulling people towards them, then neglecting them and again bring the same person close to them. One is confused about their real nature as they keep changing their personality like one changes clothes.
Histrionic personality disorder
Patients with this condition are hungry for attention, over emotional and over dramatic. They draw people towards them by their flirtatious or seductive nature. But they, themselves, are emotionally shallow. They are easily bored and live in their own romantic, sweet world. They become extremely uncomfortable when the center of attention shifts from them. These patients show extreme self-dramatization and can easily influence any person with their exaggerated emotional expressions. These people often show sexually seductive or provocative behavior that is beyond the limit of appropriate interaction.
Narcissistic personality disorder
In this disorder, patients are craving for admiration, self-importance and show lack of empathy. They cannot stand criticism or losing to someone. These people often exaggerate their talents, achievements and feel superior to others. They feel they are special, and can only be understood by people who are equally talented or unique. They will take advantage of any person or situation till they get what they want. They feel others are envious of them and will themselves show signs of heightened envy. Haughty behavior sprinkled with arrogant attitudes can be a sign of narcissistic personality.
CLUSTER C ~ I’m Not Sure, I’m Nervous… Do You Think I Look Okay???
Avoidant personality disorder
Such patients have feelings of social inhibitions and fear rejections. They shy away from developing close relationships. They fear criticism and humiliation. These patients often are unwilling to get involved in relationships or activities, as they fear humiliation and rejection. They feel they have an unappealing personality or are inferior to others in some way. These people are shy and awkward, who want to make friends and be a part of a social structure, but are afraid of rejection.
Dependent personality disorder
Patients suffering from this condition are afraid of being on their own. They develop submissive behavior as they do not want to displease or hurt people. They have separation anxiety and often ask guidance from people and do not take decisions on their own. They often give up their responsibilities to others as they cannot handle it. They will often do things they do not like as they want the support or acceptance of others. When they lose one relationships, they will willing jump to form another that will offer them care and support.
Obsessive-compulsive personality disorder
These patients are preoccupied with keeping order, attaining perfection, cleanliness, mental and interpersonal control. They spend their time following a strict schedule, rule or plans and will not be flexible or open to change. They face problems in their personal and professional lives as they want things to be done their way. These people are often inflexible when it comes to morals, ethics or personal values. They will find it extremely difficult to delegate tasks as they fear others won’t do it exactly how it should be done.
Most of the causes of personality disorders of a patient lies in his or her childhood. Parental upbringing, social pressures, one’s personality and physical, mental or sexual abuse germinate this problems in childhood. The other causes may include hereditary traits passed on by parents like shyness or anger. Antisocial personality disorder, which generally has a biological cause is more common in men. Women tend to suffer from dependent personality disorder. Certain biochemical imbalances in the brain also lead to personality disorders. Environmental factors and family background also contribute towards the causes of personality disorders.
Personality disorder symptoms are specific to each type of abnormal psychological personality disorders. The general personality disorder symptoms are classified as:
- Frequent mood swings
- Unstable relationships
- Isolating oneself from social interactions
- Anger outburst
- Mistrust and suspicion of family and friends
- Difficulty in making friends
- Alcohol or drug abuse
- Poor impulse control
- Suicidal tendency
- Inflicting harm on others without provocation
Treatment have drastically changed over the years. Patients are no longer treated inhumanely. Treatments available today, aim to control the disorder and introduce the patient back into the society. As personality disorders are mostly chronic disorders, a patient may require life-long treatment. The treatment includes:
- Psychotherapy: Psychotherapy involves talking to the patient regarding the condition and issues related to the disorder. The patient learns about his moods, feelings and behavior during the psychotherapy sessions. The different types of psychotherapy includes cognitive behavioral therapy, dialectical behavior therapy, psychodynamic psychotherapy and psychoeducation. Psychotherapy may be group session or individual sessions.
- Drug Therapy: Medications like antidepressants, mood stabilizing medications, antianxiety medications and anti-psychotic medications are prescribed by doctors to help treat and control these conditions.
- Hospitalization and Rehabilitation: Some extreme conditions may require psychiatric hospitalization. When a patient becomes extremely violent or is unable to take care of himself, hospitalization is recommended. Many times people who get treated for psychological disorders need rehabilitation before entering the social structure.
One needs to improve the coping skills in order to overcome it. The patient needs to set reasonable goals to achieve in life. Speak to the therapist, family and friends for coping with the changes. Maintaining a daily dairy where one can write all the pain, anger, ill-will and negative emotions can also help in controlling personality disorders. Participation in social gatherings and friends get-together will help a person overcome social anxiety and keep away from feelings of social isolation. Support groups help connect with people with similar disorder and help one another to overcome similar challenges. Following a healthy diet and giving up on alcohol and other substance use are among the other things that the person can do to improve his condition. If someone you know is suffering from personality disorder, get over all the myths and fiction and help the person seek medical attention. With love, support and understanding one can help the patients overcome their abnormality.