People can have many different reactions to being diagnosed with a personality disorder. For some, it can be difficult to accept, with feelings of guilt, anger, denial, or perhaps a sense of shame and a belief that you are somehow responsible. Others, however, can welcome a diagnosis – being told you have a recognised mental health condition may be a relief after many years of struggling to understand your issues. Acceptance and understanding of personality disorders can help you come to terms with your condition and provide hope that treatment options are available to help you manage your symptoms and improve your life.
The good news is that modern therapeutic talking treatments, alongside medication and self-help, make change and improvement entirely possible. With the right therapy, you can actively rewire your brain to escape the prison of your personality disorder.
It’s important to understand that there are many different types of personality disorder. As a result, there is a wide range of behaviours and symptoms which you may experience. Broadly speaking people with personality disorders tend to have long-standing problems with the way they think about things, their feelings and behaviours. For example, you may have a hard time trusting or relating to other people, find it hard to sustain friendships and relationships or experience difficulties in getting along with others, such as your colleagues at work.
Of course, we all think and behave in different ways – sometimes we are happy, sad or angry but typically someone suffering from a form of personality disorder can find that their moods change rapidly, fluctuate without good reason or are uncontainably intense. Some people describe this as like being on an ‘emotional rollercoaster’ – happy and jolly in the morning only to be sad or angry in the afternoon.
While everyone experiences periods of sadness or being upset, personality disorder problems continue for a long time – typically people may have experienced problems for years rather than just a passing feeling. Often symptoms of personality disorder start in childhood.
While personality disorders are a serious mental health issue they do not mean that you are in any way ‘bad’, ‘broken’ or ‘dysfunctional’. Everyone has elements of their personalities which they may find unpleasant or wish they didn’t have. The only difference is that you sometimes might need a little more help.
There are around ten individual types of personality disorder, which mental health professionals tend to group into three broad categories: Suspicious which covers paranoid, schizoid, schizotypal and antisocial personality disorders. Emotional and impulsive which includes diagnosis of borderline, histrionic and narcissistic personality disorders. Finally, Anxious comprising of avoidant, dependent and obsessive-compulsive personality disorders. It’s very important to note that the last of these, Obsessive Compulsive personality disorder (or OCPD for short), is separate to Obsessive Compulsive Disorder (OCD), which is about your behaviours rather than your personality.
In order to understand your personality disorder better, it can be helpful to ask “Where did this come from?” There are many reasons why some people develop personality disorders and others don’t. Generally, it’s normal that there is a broad mix of contributing factors but these break down into:
Biological – including genetic factors and traits you may have inherited.
Environmental – i.e. the culture or environment in which you were raised.
Experiential – how your early childhood and teenage experiences shaped your view of the world.
Personality disorders can have their roots in the earliest times of our life. Birth trauma and certain pre-natal experiences can result in a tendency toward this condition. Just as we can inherit physical traits from our parents, so too can we inherit personality traits as well – this can be as direct inheritance or the result of certain parental traits combining. From birth, we carry an inherited set of predispositions that can help shape the people we grow into. However, it’s important to also realise that we all have the potential to grow beyond simply what genes we have been given by our parents. Behaviours and personality disorders aren’t simply down to biological causes only.
It’s no surprise to learn that the kind of environment which we were born into and grew up in has a big impact on our personalities, as well as how we interact with the world. For example, factors such as having an unstable family life, neglect or abuse are a major influence on the chances of developing a personality disorder. In addition, conditions such as the country and culture we were raised in or inflexible family rules (i.e. “Don’t trust anyone”) can impact the likelihood of developing a personality disorder. Further examples of chaotic or dysfunctional environments, would be living with an alcoholic parent or a caregiver who themselves might have struggled with serious mental illness.
This covers the elements of your early life where your experiences and interpersonal relationships played a major role in determining how you viewed the world. A child or teenager who experiences a lack of support from their family, their peer groups and/or from their school can adopt behaviours which contribute toward developing a personality disorder in later life. Further examples of this can also include difficult or highly traumatic events, such as the death of a parent, incidents of abuse (verbal, physical or sexual), major accidents and life-threatening circumstances. However, even relatively minor negative experiences, such as a lack of attention from a parent or having a parent with mood swings can both unsettle a child and make them feel disorientated. It has been well documented that a lack of consistently in early childhood can make people fear abandonment in later life.
From the examples given above it is easy to see how our childhood can contribute toward our tendency to develop a personality disorder in adult life. From the genes which we inherit to the home life we experience and the major interpersonal events in our lives, all of these have a major impact on both how we view the world, as well as colouring our attitudes to ourselves and other people. In looking back at your own personal history and the things which have affected your mental health it’s probably very easy to see that there are many things which often contribute to developing a personality disorder, rather than one single cause.
As the old saying goes “The child is father to the man” and so it is that the biological elements we inherit, the environment in which we are raised, as well as our personal experiences growing up, have a profound influence on the adult we will become. Looking at this in terms of your personality disorder you can begin to understand how the answer to “What causes a personality disorder?” is often made up of many different parts.
Understanding ‘why’ something happened is often different from understanding ‘how’, so in this section, we’ll explain a little about how specifically childhood and adolescent traumas can affect the way your brain develops.
It’s a well-established fact that negative and positive thinking both directly affect not only the way you feel but also the operation of your brain. A key part of the very effective Cognitive Behavioural Therapy (CBT) treatment is the idea that you can change the way you feel by changing the way you think. The name given to this by professionals is “Neuroplasticity” and it can have a real impact on the helping the function of your brain.
In literal terms, positive thinking can rewire your brain to work more effectively. In particular, it actually stimulates the growth of nerve connections. These connections (or synapses to use their technical name) actually form new pathways in your brain, specifically in the pre-frontal cortex (or PFC) – an important area of the brain that governs how you control your emotional responses. It might seem like a strange concept but it has been demonstrated that with the correct therapy and training it is entirely possible to improve your view of your surroundings and circumstances, increase mental productivity and even enhance your ability to analyse problems and to think of positive solutions more easily.
In psychology, it has long been understood that people can get into negative thinking spirals. A negative thought can increase their feelings of guilt, shame or anger, leading to yet more negative thoughts and a deeper spiral into negative behaviours. However, it’s heartening to know that the exact opposite is also true: thinking positively and viewing problems in a positive way can improve both your mood and your ability to handle everyday issues and problems.
Despite the wide range of personality disorders, there are a few shared elements which they often have in common. By addressing these areas of difficulty it is possible to start tackling the roots of how and why your personality disorder affects you.
As we saw above there are three areas which are believed to contribute toward developing a personality disorder. While there is no way that you can tackle some of the biological issues behind your problems (such as the genes you have inherited), you can, however, address your environmental and experiential issues through professional therapy and through this rewire your physical brain’s neural connections.
For many sufferers, the idea of therapy for personality disorders might seem like a futile exercise. This is far from true – in fact, it has been demonstrated many, many times that ‘talking treatments’ are vital in both getting better and staying well after recovery. Medication, whilst helpful to regulate your emotional state, should be seen as an aide to recovery in partnership with personality disorder therapy.
There is even some belief that therapy and talking treatments which teach you new, more positive ways of viewing life events and previous traumas can actually change the physical structure of your brain by creating new neural pathways. Scientific evidence for this has been found in the brain scans of patients with mental illnesses – scans before and after treatments have shown that areas of the brain that had previously been overactive returned to a more normal state.
A widespread misconception is that someone’s personality and ways of thinking are fixed and impossible to change. However, this is simply untrue. Talking treatments and therapy have been shown to be effective in helping people to deal with traumatic issues in their past, as well as enabling them to adopt new methods of thinking. By helping people come to terms with existing issues, as well as learning new, more positive ways of dealing with problems, sufferers can find relief and more stability in their life.
There are several forms of therapy that can help. Some of these have been specifically designed for people suffering from personality disorders; others are in general use for many types of mental health conditions. Briefly, these include:
Cognitive Behavioural Therapy (CBT) – This deals with how, by changing the way you think about things, you can change the way you feel. CBT is a well-established and highly practical treatment for many mental health issues, which can be tailored to include Schema therapy, Dialectical Behaviour Therapy (DBT) and Mentalisation Based Therapy (MBT).
Cognitive Analytic Therapy (CAT) – Blending analytical psychotherapy with elements of CBT this concentrates on helping people to tackle past experiences and events, enabling them to understand why they feel as they do and finding new ways to cope.
Psychoanalytic Psychotherapy – Most effective for personality disorders due to generally broader therapist’s knowledge and experience in depth psychology. Uses therapeutic relationship as a safe space to learn a different way of relating as well as build an emotional container, first modelled by the therapist.
From looking at the few examples above it is possible to see that many of these therapies involve helping sufferers to recognise that thoughts and feelings are simply mental events. By learning how misidentification and misinterpretation of these thoughts can be reversed through mindfulness and observation, people with personality disorders can make great strides in managing their condition.
What are your experiences of personality disorder? We’d not only love to hear your stories but also any tips or tricks you’ve learnt about dealing with personality disorders. Leave your thoughts and comments below!