Personality disorders are notoriously hard to treat. But research suggests that dialectical behavior therapy and cognitive therapy can help people with one of the most common disorders.People with personality disorders experience abnormal thoughts and behaviors that keep them from functioning as well as they should.The term “Personality Disorder” implies there is something not-quite-right about someone’s personality.
The nature of those thoughts and behaviors depends on which personality disorder a person has, such as obsessive-compulsive disorder, paranoid personality disorder or borderline personality disorder. The disorders do have one thing in common: They usually don’t go away without treatment.
Changes in Mood or Emotions
A common trait parents notice in their children who may have a personality disorders is a change in his or her mood or overall feelings expressed. Children often express their feelings in a number of ways. If a child is feeling sad, he or she may have difficulty concentrating, lash out at peers, irritable, or socially withdrawn. A child with a personality disorder will say they feel “empty”, or express their detachment from others.
Relationships with Others
Children with personality disorders tend to have difficulties having and maintaining healthy relationships with others. This can lead to the child feeling lonely and hopeless. Personality disorders in children can hinder their ability to have friends due to the presenting symptoms interfering with social activities.
Self-destructive behaviors can also be a sign of a possible personality disorder. These behaviors include self-harm (i.e. cutting), contemplating harming themselves or others, and thoughts of suicide.
Treatment of Personality Disorders in Children
Psychotherapy is often an effective treatment option for parents concerned with a possible personality disorder in their child. Psychotherapists can help parents address defiant or disruptive behaviors, anxieties, depression, and other symptoms the child is facing.
In addition, psychotherapy techniques can help families to develop skills to enhance attachment, improve communication, and improve the family dynamic. Many mental health professionals will have children with personality disorders participate in both individual and family psychotherapy sessions.
The family is an important part of the overall treatment process. Furthermore, personality disorders in children often require for the family members to maintain their support and build a stronger relationship with the patient.
What are the signs of a personality disorder?
You might be given a diagnosis of personality disorder if all three of these apply:
- The way you think, feel and behave causes you or others significant problems in daily life. For example, you may feel unable to trust others or you may often feel abandoned, causing you or others unhappiness.
- The way you think, feel and behave causes significant problems across different aspects of your life. You may struggle to start or keep friendships, to control your feelings and behaviour or get on with people at work, for example.
- These problems continue for a long time. These difficult patterns may have started when you were a child or teenager and can carry on into your life as an adult.
You may welcome your diagnosis, finding it a way to make sense of your experience. Or you may find it more difficult to come to terms with.
Paranoid personality disorder
- find it hard to confide in people, even your friends
- find it very difficult to trust other people, believing they will use you or take advantage of you
- watch others closely, looking for signs of betrayal or hostility
- read threats and danger – which others don’t see – into everyday situations.
Schizoid personality disorder
- be uninterested in forming close relationships with other people, including your family
- feel that relationships interfere with your freedom and tend to cause problems
- prefer to be alone with your own thoughts
- choose to live your life without interference from others
- get little pleasure from life
- have little interest in sex or intimacy
- be emotionally cold towards others
Schizotypal personality disorder
- find making close relationships extremely difficult
- think and express yourself in ways that others find ‘odd’, using unusual words or phrases
- behave in ways that others find eccentric
- believe that you can read minds or that you have special powers such as a ‘sixth sense’
- feel anxious and tense with others who do not share these beliefs
- feel very anxious and paranoid in social situations.
Antisocial personality disorder (ASPD)
You will be at least 18 years old. You may:
- put yourself in dangerous or risky situations, often without considering the consequences for yourself or for other people
- behave dangerously and sometimes illegally
- behave in ways that are unpleasant for others
- feel very easily bored and act on impulse – you may find it difficult to hold down a job for long
- behave aggressively and get into fights easily
- do things – even though they may hurt people – to get what you want, putting your needs above theirs
- have a criminal record
- feel no sense of guilt if you have mistreated others
- believe that only the strongest survive and that you must do whatever it takes to lead a successful life because if you don’t grab opportunities, others will
- have had a diagnosis of conduct disorder before the age of 15.
This diagnosis includes ‘psychopathy’. This term is no longer used in the Mental Health Act but a ‘psychopathy checklist’ questionnaire may be used in your assessment.
Borderline personality disorder (BPD)
- feel very worried about people abandoning you, and would do anything to stop that happening
- have very intense emotions that last from a few hours to a few days and can change quickly (for example, from feeling very happy and confident in the morning to feeling low and sad in the afternoon)
- not have a strong sense of who you are, and it can change depending on who you’re with
- find it very hard to make and keep stable relationships
- act impulsively and do things that could harm you (such as binge eating, using drugs or driving dangerously)
- have suicidal thoughts or self-harming behaviour
- feel empty and lonely a lot of the time
- get very angry, and struggle to control your anger.
When very stressed, sometimes you might:
- feel paranoid
- have psychotic experiences, such as seeing or hearing things that other people don’t
- feel numb or ‘checked out’ and not remember things properly after they’ve happened.
Histrionic personality disorder
- feel very uncomfortable if you are not the centre of attention
- feel much more at ease as the ‘life and soul of the party’
- feel that you have to entertain people
- flirt or behave provocatively to ensure that you remain the centre of attention
- get a reputation for being dramatic and overemotional
- feel dependent on the approval of others
- be easily influenced by others.
Narcissistic personality disorder
- believe that there are special reasons that make you different, better or more deserving than others
- have fragile self-esteem, so that you rely on others to recognise your worth and your needs
- feel upset if others ignore you and don’t give you what you feel you deserve
- resent other people’s successes
- put your own needs above other people’s, and demand they do too
- be seen as selfish and ‘above yourself’
- take advantage of other people.
Avoidant (or anxious) personality disorder
- avoid work or social activities that mean you must be with others
- expect disapproval and criticism and be very sensitive to it
- worry constantly about being ‘found out’ and rejected
- worry about being ridiculed or shamed by others
- avoid relationships, friendships and intimacy because you fear rejection
- feel lonely and isolated, and inferior to others
- be reluctant to try new activities in case you embarrass yourself.
Dependent personality disorder
- feel needy, weak and unable to make decisions or function properly without help or support
- allow others to assume responsibility for many areas of your life
- agree to things you feel are wrong or you dislike to avoid being alone or losing someone’s support
- be afraid of being left to fend for yourself
- have low self-confidence
- see other people as being much more capable than you are
- be seen by others as much too submissive and passive.
Obsessive compulsive personality disorder (OCPD)
- need to keep everything in order and under control
- set unrealistically high standards for yourself and others
- think yours is the best way of making things happen
- worry when you or others might make mistakes
- expect catastrophes if things aren’t perfect
- be reluctant to spend money on yourself or others
- have a tendency to hang onto items with no obvious value.
OCPD is separate from obsessive compulsive disorder (OCD), which describes a form of behaviour rather than a type of personality.
Dialectical Behavior Therapy
People with borderline personality disorder can be challenging to treat.
- While they often seek help, they also tend to drop out of therapy. While they’re quick to open up, they’re even quicker at shutting down. And while they crave approval, a small provocation can result in abusive or violent behavior toward those trying to help.
- Dialectical behavior therapy helps clients stop bouncing between these two extremes. The approach features weekly one-on-one sessions with a counselor, plus group skills training.
- Helping clients regulate emotion is key, especially since many harm themselves as a way of stabilizing their emotions. Dialectical behavior therapy teaches clients alternative ways to control overwhelming or confusing feelings.
- Therapists might share a technique called mindfulness, which allows clients to observe their emotions without reacting.
- At the same time, therapists acknowledge clients’ emotions. People with borderline personality disorder may crave emotional acceptance, for example, because their parents never provided it.
- Evidence suggests that dialectical behavior therapy works.
- In a study comparing dialectical behavior therapy and traditional psychotherapy, women who underwent dialectical behavior therapy were more successful at reducing suicide attempts, self-mutilating and such self-damaging behaviors as gambling and substance abuse.
- They were also almost twice as likely to stay in therapy.
Does your loved one have borderline personality disorder?
In your relationship:
- Do you feel like you have to tiptoe around your loved one, watching every little thing you say or do for fear of setting them off? Do you often hide what you think or feel in order to avoid fights and hurt feelings?
- Does your loved one shift almost instantaneously between emotional extremes (e.g. calm one moment, raging the next, then suddenly despondent?) Are these rapid mood swings unpredictable and seemingly irrational?
- Does your loved one tend to view you as all good or bad, with no middle ground? For example, either you’re “perfect” and the only one they can count on or you’re “selfish” and “unfeeling” and never truly loved them.
- Do you feel like you can’t win, that anything you say or do will be twisted and used against you? Does it feel as if your loved one’s expectations are constantly changing, so you’re never sure how to keep the peace?
- Is everything always your fault? Do you feel constantly criticized and blamed for things that don’t even make sense? Does the person accuse you of doing and saying things you never did? Do you feel misunderstood whenever you try to explain or reassure your partner?
- Do you feel manipulated by fear, guilt, or outrageous behavior? Does your loved one make threats, fly into violent rages, make overly dramatic declarations, or do dangerous things when they think you’re unhappy or may leave?
If you answer “yes” to most of these questions, your partner or family member might have borderline personality disorder.
To help someone with BPD, first take care of yourself
- Avoid the temptation to isolate
- You’re allowed (and encouraged) to have a life
- Join a support group for BPD family members
- Don’t neglect your physical health
- Learn to manage stress
- Listen actively and be sympathetic
- Focus on the emotions, not the words
- Try to stay calm, even when the person with BPD is acting out
- Seek to distract your loved one when emotions rise
- Talk about things other than the disorder
This therapy focuses on thoughts rather than emotions. In weekly sessions, therapists help clients identify and change dysfunctional beliefs about themselves, others and the world.
- People with borderline personality disorder, for instance, often think they’re bad and then interpret everything that happens to them in a way that confirms that belief.
- Cognitive therapy helps clients eliminate such dysfunctional beliefs by revisiting and reinterpreting childhood experiences.
- A client who feels inadequate may come to understand that that belief comes from his parents giving him responsibilities he wasn’t ready for, for instance.
- Once clients understand the origins of dysfunctional beliefs, they can work on changing them. Preliminary research supports the technique’s effectiveness.
- In one study of cognitive therapy, borderline personality symptoms dropped significantly after a year. At follow-up, 55 percent of study participants no longer met the criteria for a diagnosis of borderline personality disorder.
Personality disorders are a type of mental health problem where your attitudes, beliefs and behaviours cause you longstanding problems in your life.The word ‘personality’ refers to the pattern of thoughts, feelings and behaviour that makes each of us the individuals that we are. We don’t always think, feel and behave in exactly the same way – it depends on the situation we are in, the people with us and many other things.
Dialectical Behavioral Therapy
Dialectical Behavioral Therapy (DBT) is a beneficial therapeutic option for adolescents who have issues with self-harming behaviors. Research shows DBT also lessens suicidal ideations and behaviors. Self-injury behaviors are often present in adolescents who have similar symptoms to borderline personality disorder. DBT works well for personality disorders in children.
Children and adolescents are able to learn about mindfulness, tolerating distress, regulating their emotions, and enhance their interpersonal relationships. As a result, the child will learn how to cope with stress and control their emotions. They will also enhance their social interactions with others.
Mental illnesses can be difficult for children to go through. An adequate amount of support is necessary for improving a child’s overall quality of life. Children with personality disorders may not fully understand the changes they are going through or how to react to these changes. Despite going through a difficult time, parents should make time to have fun and relax with their child.
Personality disorders in children can be a confusing and overwhelming time for the child. However, an early diagnosis is beneficial as the mental health professional can help the family cope with the symptoms. Most importantly, this can help work through current problems before they increase.
However, if you have a personality disorder you may often experience difficulties in how you think about yourself and others. And you may find it difficult to change these unwanted patterns.