What is a Personality Disorder?
Everyone uses the term “personality,” but what exactly is a personality anyway? If you think about it, the meaning of personality is multi-layered. We can say personality contains our preferences, dislikes, thoughts, feelings and behaviors. We could say it includes our demeanor, our sense of humor, and how social we are. And none of those answers would be wrong. However, when we go a little deeper, we can also consider personality to center around how we see ourselves, and others, and how we developed these perceptions. If someone has a personality disorder, they struggle with how they see themselves and other people, which often creates problems in close relationships with family, friends and romantic partners. People with personality disorders have challenges on the cognitive, or thinking level, but also in the realm of emotions, gut reactions and responses specifically involving others and how they relate to them, and react to them. This affects how they exist in both their inner and outer worlds. People with personality disorders are some of the most charismatic, vivacious, intelligent and intuitive people in existence. Frequently they are founders of companies with loyal die hard fans. Others tend to react to them with intense feelings of love or hate. Simultaneously people with a personality disorder suffer more than the average person, which is why getting treatment from a trained clinician who understands their experiences is imperative.
Stigmatization & Gender
Personality Disorders are highly stigmatized. People with a personality disorder are frequently viewed as manipulative, calculating, lacking empathy and cold. Women tend to get labeled as having a Borderline Personality Disorder or even Histrionic Personality. Men tend to get labeled as having Narcissistic Personality Disorder. With inaccurate statistics floating around the internet, and the term“Borderline” being used to degrade women and “Narcissist” to degrade men. It’s no wonder people hesitate to ask for help, and be honest with others about their experiences. Personality disorders are serious conditions and should be diagnosed by a mental health professional and not used in a derogatory manner. At the Center for Growth, we understand the complexity of personality disorders, and the stigma surrounding them.
Nature And Nurture
When considering an expanded view of what personality means, we must ask how people’s experiences shape the view they have of themselves, others and the world around them. It’s impossible to say that personality disorders are caused purely by genetics, nor is it possible to say they are caused by means of experience, or nurturance alone. We strive to see people with personality disorders as complex beings who have developed into who they are by means of both nature and nurture combined. When thinking about early traumatic experiences and their effect on how children begin to experience bonding with others, we can make connections to later diagnoses of personality disorders, but two people can experience similar early-life traumas and one will not end up with a personality disorder. In treating people with personality disorders, we take into account that everyone has a unique story that’s individual to them and their development.
Treatment at the Center for Growth
In the regular population many people are intrigued by people with personality disorders, but others are turned off by them. Within the world of therapy, a large number of therapists are not equipped to treat personality disorders, because they are not trained thoroughly in school. Plus, the best clinicians have somehow been touched by someone with a personality disorder, or have special understanding of these conditions and the challenges they bring. Unfortunately, without the right treatment, it’s possible to make someone worse. There are many ways of treating personality disorders. You may hear that Dialectical Behavioral Therapy (DBT) is the only way, but that is far from the truth. The therapeutic relationship is the most important thing when working with any condition, especially personality disorders.
What is Borderline Personality Disorder?
A person with Borderline Personality Disorder will experience emotions intensely, and for longer periods of time than someone without BPD. Their joy might feel ecstatic, but their pain might feel as though it has no beginning and no end. This makes it more difficult for them to come back to a baseline feeling of neutrality. A lot can happen within that longer duration of emotional intensity, like: impulsive actions, fighting, trying to soothe discomfort through self-harming, using substances to cope or driving recklessly to blow off steam. Many people with Borderline Personality Disorder (BPD) experience intense fears around abandonment, and may react to real or perceived threats of abandonment, creating confusion in those who love them. The act of trying to ward off abandonment causes a lot of suffering, anxiety and insecurity for the person with Borderline Personality Disorder. The tendency to fear abandonment may also lead someone with BPD to attach to someone who isn’t good for them, trading in their boundaries for a false sense of companionship. People with Borderline Personality Disorder are often creative, intuitive and deeply feeling human beings. They are exciting to be around, colorful in their self-expression and ultra empathic. However, it’s often that the people around them are unsure how to best support their changing moods and intense demeanor.
Part of treatment is to help someone with Borderline Personality Disorder to better understand themselves, and teach other people about their style of communication. The therapist should help the person with Borderline Personality Disorder to discover what they need and how to ask for it. The therapist should also help the person with Borderline Personality Disorder to learn how to self-soothe.
Can an Adolescent be Diagnosed with BPD?
Technically, according to the DSM 5TR, Borderline Personality Disorder can be diagnosed in late teenhood, but there are often signs throughout adolescents that may indicate an increased risk of developing Borderline Personality Disorder. The earlier a parent or caregiver is able to detect the emerging BPD, the earlier therapeutic interventions can take place and the better the outcome of treatment. It is possible to treat emerging symptoms of Borderline Personality Disorder, preventing them from accumulating into a diagnosis. At the Center for Growth we offer tweens and teen therapy to treat emerging personality disorders. Let’s look at some of the signs below.
Self-Harm
Self-harm is a warning sign of emerging Borderline Personality Disorder. Self-harm is the act of harming one’s own physical body, often to alleviate mental stress, or in efforts to “feel something”, if the person has felt emotionally numb, empty or disconnected from themselves. Sometimes people with BPD describe this disconnection as feeling “far away from themselves”, or “not in their bodies.” Self-harm can take the form of cutting (any part of the body), burning, hitting oneself, pinching or scratching oneself. As a parent, it can be scary to witness this activity in your child or teen. This is also a clear sign that therapeutic intervention is needed. Self-harm is different from a suicide attempt, but sometimes self-harm can become dangerous or life-threatening, which is a huge cause of concern. Sometimes an attempt to alleviate stress, or a call for help via self-harming, can result in an emergency room visit if the cut becomes too deep, or your teen becomes concussed.
Although self-harming is not the same as a suicide attempt, suicidality is a huge concern amongst teens with emerging Borderline Personality Disorder. Due to teenager’s increased impulsivity, any kind of suicidal threat needs to be taken seriously, and should result in immediate intervention from a psychiatrist, therapist, or crisis response center/emergency room.
Emotion Dis-regulation
It’s common for teens to experience mood fluctuations, but if they become extreme, or result in harm to themselves or others, it’s time to hire a therapist to help. Emerging Borderline Personality Disorder in teens can look like inconsolable anger, rage, sadness, anxiety and depression. In addition to self-harm, you might experience your teen having outbursts at school, grades are slipping, fights happen with teachers and relatives. You might experience them happy one minute, and inconsolable the next. They might act out behaviorally from this place of dysregulation by throwing things around the house, acting out sexually, using drugs and getting into trouble. Relationships may become harder to maintain due to their emotional dis-regulation, so your teen may start to appear more isolated.
Fear of Abandonment
Fear of abandonment is central to Borderline Personality Disorder, and you can often see signs of these fears starting in adolescence. The fear of abandonment is complex, but it’s often experienced as a fear of aloneness, and feeling unsafe in that aloneness. It may sound counterintuitive, but helping someone with Borderline Personality Disorder to embrace their aloneness, and their uniqueness (instead of trying to fit in), can actually help them to set up a stronger community of people around them who genuinely accept them for who they are. The key is to not fight emotions, like feeling alone, but recognize how to use emotions as indicators, messengers and beacons of truth. When we turn towards emotions, we become more regulated, when we run, we become less regulated.
Accommodating a Teen with Emerging Borderline Personality Disorder
If you have a tween or teen with emerging Borderline Personality Disorder, you have to validate their experiences first and foremost. You have to learn how not to rush in and fix whatever situation is unfolding, but focus on emotionally supporting them. Helping teens to educate those around them about their use of colorful or intense language is also a key skill. The therapist will help the teen embrace their style of emotion instead of changing the emotion. Embracing means stop fighting and work with what you have, what’s already here. This could be viewed as a mindful approach. And the therapist will work with parents to learn to trust the teen and their process.
The therapist might also help your teen with time management, decreasing impulsivity and helping them to create a stronger sense of self. The therapist will explore themes like friendships, what can the teen focus on that’s in their control and help them to identify what they’re getting out of the media they consume.
What is Narcissistic Personality Disorder?
Narcissistic Personality Disorder is more common in men than in women, partially due to stigmatization regarding gender, but also environmental and social factors that might influence the development of narcissistic traits in men more often than in women. An example of this would be that young boys are sometimes instructed not to cry or show emotion. This leaves them without the ability to regulate their emotions and learn about true empathy given towards themselves and others. If someone has Narcissistic Personality Disorder, they may view the world through a “selfish” lens, meaning they see the world in reference to themselves, or they view, and act as though others are an extension of themselves. They have trouble with empathy, and may come off uncaring as they aren’t naturally good at empathizing with the feelings of others. However, this does not mean that someone who displays narcissistic traits cannot love and care about others, it just means they need to come to terms with their struggles around empathy and their need for admiration. They have to understand that another person cannot be there only to inflate the parts of themselves that feel small or inadequate. They need to learn that others are whole people, with full lives and differing desires and experiences.
Most people suffering from Narcissistic Personality Disorder show up to therapy because they are struggling with depression, because in some way the narcissism has “failed”. Meaning, that grandiosity and depression are two sides of the same coin. If the grandiosity fails, the person might start to feel depressed, deflated and unable to regulate their emotions. People with Narcissistic Personality Disorder are often living normal lives, sometimes excelling at career endeavors, looking out for themselves and able to be strategic in who they know and how they present themselves. They are often charismatic. It is not true that all those diagnosed with Narcissistic Personality Disorder are abusive, but it is possible that if the disorder goes untreated, the low empathy will get in the way of experiencing true intimacy within relationships of all kinds. And the need for admiration makes someone with Narcissistic Personality Disorder vulnerable, because it’s impossible to control what others are willing and able to give to you.
People with Narcissistic Personality Disorder often suffer from not being able to truly connect with others, because it feels like their true self is hidden under a mask, or protected so fiercely that it gets in the way of authentically relating. Another example is that if someone who experiences high levels of narcissism is vulnerable, and someone shows them love and compassion, they might interpret that as the person viewing them as weak. This is where the personality (how we see ourselves and others) gets in the way of authentic connection and understanding.
Treatment for Narcissistic Personality Disorder
The treatment for Narcissistic Personality Disorder requires a clinician who is skilled at understanding the disorder itself. And the treatment will first revolve around building trust in the therapeutic relationship. Increasing empathy and understanding of others will be a huge goal in this treatment, but that empathy also has to extend inwardly. The therapist will help the person with Narcissistic Personality Disorder to take care of themselves on the inside, so as to become less dependent on outside sources of admiration. The therapist will take a direct approach and need to call out any abusive, or inconsistent storylines revolving around the client’s life. This can sometimes look like the person with Narcissistic Personality Disorder avoiding responsibility, putting themselves in a victim role to avoid responsibility, or acting as though their actions don’t affect the people around them. This therapy will also involve family of origin exploration, understanding your own history, how you grew up and what has influenced the narcissistic personality to come into fruition. As with Borderline Personality Disorder, and all personality disorders, the origin is often from the source of both nature and nurture.
Other Types of Personality Disorders
Antisocial Personality Disorder
Someone diagnosed with Antisocial Personality Disorder may appear impulsive with a lack of inhibition from a fairly young age. Typically, you cannot be diagnosed with Antisocial Personality Disorder in adulthood unless traits begin to present themselves in adolescence. Antisocial behavior often manifests in adolescence through actions like: fire-setting, cruelty and violence towards people or animals, bullying, threatening, displaying patterns of lying and deceit and missing school and curfew despite consequences.
People with Antisocial Personality Disorder are known to lack regard for others and show little remorse if their behaviors harm their peers. This is why someone with Antisocial Personality Disorder may struggle with getting fired from jobs and having issues with coworkers. People with Antisocial Personality Disorder have a hard time imagining the mental state of another person, and are prone to criminality, intensive outward displays of anger and arrogance. This can look like fighting, avoiding paying bills and having dysfunctional relationships. Antisocial Personality Disorder, like many disorders, comes into fruition as a result of both nature and nurture experiences.
Histrionic Personality Disorder
A person with Histrionic Personality Disorder will often need to be the center of attention. This attention-seeking behavior often starts in childhood, which may not draw up any red flags until adolescence and early adulthood when the person developing Histrionic Personality Disorder suffers in relationships, friendships and amongst peer groups. People with Histrionic Personality Disorder are often dramatic, flirty and extraverted. They are easily impressionable and will often pick up traits of them. Women get diagnosed with Histrionic Personality Disorder far more often than men do, which is why this diagnosis can be controversial. Men who display similar characteristics are often diagnosed with Narcissistic Personality Disorder.
Similar to Narcissistic Personality Disorder, most folks with Histrionic Personality Disorder seek treatment for depression, because they have not been able to meet their desires for attention, and/or relationships begin to suffer as they come of age. They experience a lot of frustration with delayed gratification, which can lead them to act impulsively. People with Histrionic Personality Disorder are often charismatic, drawing others to their orbit. The issue is that when it comes to forming deeper relationships, the person with Histrionic Personality Disorder struggles to be truly intimate and experiences emotions in a shallow form, with connection with others focused on gaining admiration and attention.
Avoidant Personality Disorder
People with Avoidant Personality Disorder suffer with extreme social anxiety and a fear of intimacy. This can unfortunately leave them isolated, fearing anything that could leave them feeling anxious or out of control. They often carry with them a strong sense of inadequacy, not feeling good enough and inferiority when compared to others. People with Avoidant Personality Disorder are often affected by childhood trauma, specifically in the form of childhood neglect. However, like with all personality disorders, the development of Avoidant Personality Disorder is due to a combination of nature and nurture.
Avoidant Personality Disorder includes a fear of rejection and an extreme negative self-image. They evaluate themselves as less than others, which results in isolation, extreme shyness and social inhibition. However, they often really want to feel like they belong and desire social connection. People with Avoidant Personality Disorder may be some of the smartest, most introspective people you know, but they adapt to their fear of judgment and social anxiety by isolating themselves.
Dependent Personality Disorder
People with Dependent Personality Disorder have a difficult time making choices on their own, and some struggle to reach a state of independence. They depend on others, and usually put the opinions of others over their own. This causes them to struggle in relationships, sometimes being the victims of abuse. This personality disorder often starts with childhood abuse and neglect, but it can also develop from being in abusive adult relationships, where the person loses autonomy and begins to experience more and more dependence and less personal power and control.
Someone with Dependent Personality Disorder may experience fear of being alone, anxiety when they separate from a partner or friend and extreme levels of helplessness and trouble self-initiating/self-starting. It’s important to note that personality disorders exist on a spectrum, and even if you don’t meet the criteria for being diagnosed with one, you might still experience symptoms that need addressing by a skilled therapist. Someone who experiences codependency might share some things in common with a person with Dependent Personality Disorder, but not meet criteria. It’s imperative that you find a therapist who is nuanced in their understanding of personality disorders.
Obsessive-Compulsive Personality Disorder
Obsessive-Compulsive Personality Disorder is marked by a need for order and neatness. Some addition experiences of those with Obsessive-Compulsive Personality Disorder are perfectionism, difficult delegating work to others who may have a different approach than them, workaholism that destroys relationships, obsession with morals and ethics as defined by the person with Obsessive-Compulsive Personality Disorder, and possessing a rigid disposition. All of these symptoms can get in the way of having a fulfilling relationship and working life.
One big difference between Obsessive Compulsive Disorder and Obsessive-Compulsive Personality Disorder is that someone with Obsessive Compulsive Disorder (OCD), sees their symptoms as an issue and finds them distressing. There is often a clear “obsession” and “compulsion” when someone has Obsessive Compulsive Disorder. The compulsion temporarily relieves the anxiety that the obsession, or stuck thought brings with it. However, someone with Obsessive-Compulsive Personality Disorder finds their obsessions and compulsions rational, and a vital part of their routine day-to-day life and a mechanism for control. It’s not so much that they are exhibiting behaviors to directly relieve anxiety, as much as it’s become a way of life for them.
Schedule Your First Appointment
The Center for Growth offers unique treatment to assist those suffering with Personality Disorders. To heal and thrive with a Personality Disorder, you need someone who understands what makes it unique and challenging. Call 215- 922 - 5683 x 100 to speak to one of our personality disorder therapists and set up a therapy appointment today. We have 2 locations in Philadelphia PA: Society Hill Therapy Office and Art Museum / Fairmount Therapy Office and in Mechanicsville VA: Mechanicsville Therapy Office and in Santa Fe NM: Santa Fe Therapy Office and in Ocean City NJ, Ocean City Therapy Office and we provide virtual counseling services in Georgia and Florida.
OUR GUARANTEE: you deserve the best couples counselor or marriage therapist possible. If you don't feel like the couples therapist that you met with was the right fit, then free of charge you can try out a different therapist. Being in a group practices allows for flexibility.
The Center for Growth has offices in multiple states. We offer both Couples Counseling and Marriage Therapy inperson as well as virtual appointments.
The Center for Growth Therapy Offices in PA, NJ, VA, RI, NM
- Ocean City Therapy Office
360 West Ave, Floor 1, Ocean City, NJ 08226 - Mechanicsville Therapy Office
9044 Mann Drive, Mechanicsville Virginia, 23116 - Providence Therapy Office
173 Waterman St. Providence, RI 02906 - Society Hill Therapy Office
233 S. 6th Street, C-33, Philadelphia PA 19106 - Art Museum / Fairmount Therapy Office
2401 Pennsylvania Ave, Suite 1a2, Philadelphia PA 19130 - Santa Fe Therapy Office, 2204 B Brothers Road, Santa Fe, New Mexico, 87505
- Telemedicine: We have therapists who are licensed to work in Connecticut, Delaware, Florida, Georgia, New Jersey, New Mexico, Pennsylvania, Rhode Island, and Virginia.
