Personality disorders - treatment and psychotherapy

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Personality disorder is a condition that affects a significant part of the population. Research indicates that the number of people meeting the diagnostic criteria for personality disorder ranges from 10 to 13%.  The consequences of the disorder are a noticeable deterioration in functioning and difficulties in establishing interpersonal relationships.

 

What is personality?

 

Personality is the totality of thoughts, emotions and behaviours that gives direction and pattern to a person's life. It is one's way of looking at the world, his or her style of reacting and feeling. Personality is relatively constant throughout life (it can fluctuate slightly) and remains unchanged regardless of the situation. Full development of personality happens in early adulthood.

 

What are personality disorders?

 

A personality disorder is a mental disorder and therefore it is not counted as a mental illness. It is an enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual's culture. In the case of people with personality disorders, an inflexible and maladaptive way of reacting to different individual and social situations is observed, which makes daily functioning very difficult.

 

What are the most common causes of personality disorders?

 

Due to the multitude of types of personality disorders, the causes of this disorder can vary. Both biological and genetic factors may influence its occurrence, but research indicates that psychosocial factors play the most significant role in the pathogenesis of personality disorders.

The most important causes include:

- traumatic experiences during childhood (physical, psychological and sexual violence),

- abnormal relationships in the family,

- disturbed family structure,

- lack of consent in the family to showing emotions,

- lack of emotional support within the family,

- excessive control by parents,

- family pathology.

 

Types of personality disorders

 

There are many types of personality disorders depending on the predominant symptoms present in a person. The main ones include schizotypal personality, schizoid personality, paranoid personality, antisocial personality, histrionic personality, narcissistic personality, anankastic personality, borderline personality and dependent personality.

 

Schizotypal personality

This type of personality disorder is more often diagnosed in men. The main symptom is a bizarre way of thinking, which is noticeable to those around you, but does not yet meet the diagnostic criteria for schizophrenia. People with this type of personality disorder are characterized by an extremely suspicious way of thinking and overly elaborate statements.

 

Schizoid personality

Schizoid personality has some features in common with schizotypal personality, but the main symptom characteristic for this type of disorder is the inability to form social relationships and a lack of sensitivity to the feelings of others. People with this disorder are often perceived by others as alienated and emotionless.

 

Paranoid personality

People with this type of personality disorder are characterised by extreme suspicion and distrust of other people. They often start quarrels and find bad intentions in all people. A common symptom is blaming other people for their own failures.

 

Antisocial personality

People with antisocial personality are characterised by lack of willingness to comply with social norms, as well as tendency to impulsiveness and aggression. People with this disorder do not care about their own safety and the safety of others. They also do not feel guilt as a result of the harm they caused.

 

Histrionic personality

People with this type of disorder are characterized by excessive emotionality and striving for constant attention. Their style of expression can often be perceived by their environment as artificial, although they try at all costs to appear warm and friendly in front of others.

 

Narcissistic personality

Narcissistic personality is characterised by an exaggerated sense of self-importance and a lack of empathy. When their self-image is threatened, people with this disorder react with anger. Because of the complete preoccupation with themselves, they have difficulty forming long-lasting relationships with other people.

 

Anankastic personality

People with this type of disorder are characterized by excessive striving for perfection, as a result of which they demand perfection from themselves and from others. People with obsessive-compulsive personality are perceived by their environment as very conscientious, unable to enjoy pleasures and fond of moralising others.

 

Borderline personality

Sufferers of borderline personality disorder are characterized by instability in interpersonal relationships, frequent mood changes and disturbed self-image. They are easily angered and prone to self-aggressive behaviour.

 

Dependent personality

People with dependent personality are characterized by total subordination to other people. They are not able to make decisions on their own and give the responsibility for making decisions to other people. They subordinate their needs to the needs of the people they depend on.

 

How are personality disorders diagnosed?

 

The symptoms of personality disorders can vary widely, so many people wonder how to diagnose personality disorders. In order to be diagnosed with this disorder, the following criteria must be met:

  • the occurrence of an enduring pattern of inner experiences and behaviours that deviates markedly from the accepted pattern for a particular culture,
  • the dysfunctional pattern of behaviour is rigid and manifests itself in many personal and social situations,
  • the enduring pattern of behaviour leads to a significant deterioration of the person's functioning in important areas of life (professional, social),
  • the pattern is stable over time and long-lasting, it occurs no later than during adolescence or early adulthood,
  • the person's behaviour cannot be explained by the presence of another mental disorder,
  • the behaviour is neither a result of the use of drugs or medication nor a result of trauma.

 

How are personality disorders treated?

 

A common question from people diagnosed with a personality disorder is “how to deal with the disorder"? Treatment of personality disorders is most often based on a combination of pharmacological therapy and psychotherapy. The use of pharmacological agents is mainly aimed at relieving symptoms, while psychotherapy for personality disorders is necessary to achieve lasting improvements in functioning. The most common form of therapy is long-term individual psychotherapy, but it can also be combined with group psychotherapy.

Personality disorder therapy helps to better understand the person's difficulties, improves quality of life and leads to a change in maladaptive patterns that impede daily functioning.

 


mgr Barbara Wróblewska


 

Seligman M.,Walker E., Rosenhan D. (2003). Psychopatologia. Poznań: Wydawnictwo Zysk i S – ka.

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