Disordered personalities
At some time we’ve all met people who are ‘over the top’, whose behaviour or attitude goes beyond what we consider normal. They might be reckless risk takers, or conceited and self-important, or overly demanding, too needy, suspicious, aggressive, emotional, self-destructive perhaps, or unpredictable and volatile. The chances are that such people have some sort of personality disorder.
So what is a personality disorder and how serious is it?
Each of us has a unique personality made up of a host of things such as our preferences, habits, moods, motives, values, attitudes, and morals. Who we are includes what we love and hate, what we believe, fear, desire and care about, and how we have learnt to see ourselves and others, which all combine to determine how we act and react.
But at the foundation of our personality lies our traits. A personality trait is a noticeable, unchanging and lasting pattern of thoughts, feelings, and behaviour, a consistent way of understanding and interacting with the world, other people, and ourselves. We are all, for example, sometimes shy, short-tempered, impulsive, or narcissistic. But these universal human characteristics only become traits when they are regularly and routinely apparent in a person. We invariably describe ourselves and others by listing traits (generous, patient, sociable, etc) which we assume exist from the way people behave most of the time.
There are a host of personality traits (such as submissiveness, introversion or extroversion, optimism, honesty, or sensitivity to name just a few). Some people will show no sign of a particular trait, others will exhibit some level of it and others a great deal. Any trait can be just a small part of who a person is or it can be so predominant that it governs every aspect of their life and be the motive behind virtually everything they do. So if a characteristic is occasional, it is simply a part of human nature common to us all, if it is pronounced, it is a trait, and if it is pervasive and excessive it becomes a personality disorder.
It’s all a matter of degree. Someone with a personality disorder has one trait (or more) that is extreme, inflexible, unchanging, impairs functioning, or adversely effects the person or others. A person can be shy for example without the trait unduly hindering their life. But when shyness is extreme and leads to incapacitating social withdrawal it is classed as Avoidant Personality Disorder.
There is not always a clear distinction between what is normal and what is not and there is no precise measurement for abnormal traits or disordered personalities but in general the difference is flexibility. Normal people learn, change, grow, adapt to circumstances, and behave in ways that promote the wellbeing of themselves and others. People with personality disorders do not.
People with disordered personalities often behave in ways that are harmful to others and/or themselves. Some of history’s most notorious characters were driven by disordered personalities - Hitler and Stalin for example saw themselves in godlike dimensions. Many believe that Marilyn Monroe’s emotional extremes, intense but short-lived relationships and desperate fear of abandonment were due to Borderline Personality Disorder. And our modern day media is full of the gossip, scandals, outrageous doings, and crimes of people with extreme personalities. People with disordered personalities are not insane or mentally ill but they are not normal.
Personality disorders affect around 15% of adults with perhaps as many again exhibiting the characteristics of a personality disorder but in a milder, less problematic, or subclinical form. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM) lists ten major personality disorders based on extreme personality traits:
- Narcissistic (a sense of superiority and lack of empathy)
- Paranoid (characterized by suspicion)
- Borderline (instability)
- Histrionic (excessive attention-seeking and emotional theatricality)
- Antisocial (irresponsible and anti-social behaviour)
- Obsessive-Compulsive Personality, not to be confused with Obsessive Compulsive Disorder or OCD (extreme, inflexible perfectionism and control)
- Schizoid ( indifference to social relationships and limited emotions - the loners)
- Dependent (an excessive need to be taken care of)
- Avoidant (social inhibition and feelings of inadequacy)
- Schizotypal (eccentricity, isolation, social discomfort)
Some people have more than one personality disorder or a combination of features from more than one disorder. Some people with personality disorders do far more harm to themselves than others but the disorders that feature self-importance and lack of empathy (Narcissistic, Antisocial, Paranoid, Histrionic, and Obsessive-Compulsive) can be troublesome if not dangerous.
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