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by Lucy McCarraher & Annabel Shaw

6/08/2011

Personality Disorders - The Rule of Thumb

Given the huge range of personality types (see earlier post here) how useful or helpful is it to talk about personality disorders? What is a normal personality against which abnormal can be defined? Can a personality be so abnormal that it warrants being classified as a form of mental illness?

The Rule of Thumb
The answer is straightforward. A normal personality is extremely difficult to define; an abnormal personality, on the other hand, sticks out like a sore thumb. And that’s because abnormal personalities are defined by consistently odd and unpredictable behaviour which causes real problems for the person, their family, colleagues and friends. This rule of thumb works very well for most behaviours across a wide range of experiences.

In short, if your personality causes distress either to yourself or to others and interferes with your everyday life then it’s abnormal. The occasional episode of outrageous behaviour is not what is meant here and nor are we talking about normal eccentric behaviour. Normal eccentrics don’t usually recognise themselves as eccentric and we typically delight in their eccentric behaviour. It’s when the eccentric behaviour turns to distress that we have a form of personality disorder. According to the rule of thumb - if it sticks out but isn’t sore then it’s just plain eccentric. If it sticks out and causes distress then its ‘Odd-Eccentric’ - abnormal.

Personality disorders affect around 1 to 3 % of the population. Mainstream psychiatry identifies ten personality disorders. Here they are, classified into three groups. First is the odd-eccentric, next the anxious/fearful and third the dramatic-emotional.

Odd/Eccentric
This is further broken down into three sub-types.
Paranoid personality disorder
You are constantly distrustful of others and imagine yourself to be threatened by others' intentions - constantly. No let up. And you don’t really exhibit much insight into this as a problem - as far as you are concerned it’s really true. This makes treatment difficult. People with paranoid personality disorder distrust everyone including doctors. The condition makes life difficult because of the effect that the paranoia has on all relationships.
Schizoid Personality Disorder
You are a loner whose behaviour is considered by others to be cold and unemotional. Schizoid personality disorder is a condition in which affected people avoid social activities and consistently shy away from interaction with others. If you have schizoid personality disorder, you may feel as though you have no idea how to form personal relationships. To others, you may appear dull or humourless. Because you don't tend to show emotion, you may appear as though you don't care about what's going on around you. However, although you may seem aloof, you may actually feel extremely sensitive and lonely.
Schizotypal Personality Disorder
If you have schizotypal personality disorder you will have great difficulty in establishing and maintaining close relationships with others. A person with schizotypal personality disorder may have extreme discomfort with such relationships, and therefore have less of a capacity for them. Between 30% and 50% of people with schizotypal personality disorder also have a major depressive disorder. A second personality disorder, such as paranoid personality disorder, is also common with this condition. People with this disorder may be unusually superstitious or preoccupied with paranormal phenomena that are outside the norms of their subculture and this, of course, makes relating to others even more difficult. Schizotypal personality disorder is closely linked to schizophrenia.

Anxious/Fearful Disorders
These include three sub-types.
Avoidant Personality Disorder
Your self-esteem is zero. You are extremely anxious that your perceived inadequacies will be exposed and then ridiculed by others and so you avoid social situations. People with avoidant personality disorder can't stop thinking about their own shortcomings. They form relationships with other people only if they believe they will not be rejected. Loss and rejection are so painful that these people will choose to be lonely rather than risk trying to connect with others.
Dependent Personality Disorder
Exactly as described - you don’t feel able to make decisions for yourself and rely on others to organise your life. People with this disorder feel that they cannot cope on their own and are terrified at the thought of having to do so.
Obsessive-Compulsive Personality Disorder
Are you a perfectionist obsessively devoted to order and routine? Do you require absolute control over everyday tasks? Relationships suffer because here it’s always difficult to have absolute control and this then leads to frustration and anxiety.

Dramatic-Emotional Disorders
These include four sub-types.
Antisocial Personality Disorder
Are you deceitful, violent, care nothing for the safety of yourself and less than nothing for others' safety? Do you lie and steal and manipulate others to do your willing? You are angry and arrogant and show no signs of guilt or remorse. The behaviour of someone with antisocial personality disorder is thankfully rare; hard to treat, it is most often dealt with in a court of law.
Borderline Personality Disorder
This condition is characterised by severe emotional pain and the fear of abandonment. Relationships are chaotic and unstable. You may idealize someone one moment and then abruptly and dramatically shift to fury and hate over perceived slights or even minor misunderstandings. With borderline personality disorder your image of yourself is distorted, making you feel worthless and fundamentally flawed. Your anger and frequent mood swings may push others away, even though you are so fearful of being abandoned. Your relationships are usually in turmoil.  Drug abuse, self harm and suicidal thoughts are common.
Narcissistic Personality Disorder
If you have narcissistic personality disorder then you have an inflated sense of your own importance and a deep need for admiration. Those with narcissistic personality disorder believe that they're superior to others and have little regard for other people's feelings. But behind this mask of ultra-confidence lies a fragile self-esteem, vulnerable to the slightest criticism. People with this condition need constant reassurance and admiration and they will manipulate and exploit others in order to get it.
Histrionic Personality Disorder
Histrionic personality disorder is characterised by a long-standing pattern of attention-seeking behavior and extreme emotionality. Someone with histrionic personality disorder wants to be the centre of attention - all the time - and will become ‘dramatically’ upset if they lose that attention. Perceived as shallow by others they have real difficulties in maintaining relationships. The behaviour is often hysterical.

Conclusions
Very few of us suffer these personality disorders in their true forms and many of us share an understanding of the facets of each from time to time. There is treatment for many and no good reason to suffer in silence if you feel that your life and relationships are being unduly affected by problems that you believe may be based on personality characteristics. Your shyness, for example, may be crippling and seriously affecting your social life but this does not mean that you have avoidant personality disorder - what it does mean is that you should speak with your GP and see what help there is available. 

Posted by Annabel

The Real Secret 12 Step programme may help personality issues through raising self esteem and positive attitude, advice on relationships and friendships, as well a bringing insights on a range of emotional issues. It is available in paperback and kindle formats on www.amazon.com and www.amazon.co.uk.

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