There are several reasons why people may be curious about what personality disorders are. One of the reasons may be an interest in psychology in general, to understand others better or to understand one’s own symptoms. Personality disorders are often portrayed in the media, TV shows, movies, and books. Unfortunately, stigma can be part of the narrative about personality disorders. We can try to reduce the stigma by learning the facts about personality disorders and listening to those who suffer from them. It is important to remember that a person with a personality disorder is just one person with a personality disorder.

So, what exactly are personality disorders? They are a group of mental health conditions that are characterised by patterns of thoughts, feelings, and behaviours that deviate from the norm and may cause distress or impairment in everyday functioning. These profoundly ingrained patterns are stable, often developing in adolescence or early adulthood. Of course, this is just a general definition. Someone diagnosed with a personality disorder may be able to express a more personal outlook on what it means to them and how it affects their life. To find out more about the personal accounts of individuals who were diagnosed with BPD and NPD, take a look at this YouTube channel.

There are several different types of personality disorders, each with its own set of defining characteristics. Some of the most common personality disorders include Borderline Personality Disorder (BPD), Narcissistic Personality Disorder (NPD), Antisocial Personality Disorder (APD), and Obsessive-Compulsive Personality Disorder (OCDP). In this blog, I will describe BPD, NPD and OCDP in more detail as these presentations prevail in my clinic.

People who suffer from Narcissistic Personality Disorder (NPD) are individuals whose personalities are organised around maintaining their self-esteem by getting affirmation from outside themselves. Everyone likes to have approval or praise from more significant others or even those less significant; it makes us feel good about ourselves, and a constructive compliment can make our day. When it comes to narcissistic personality disorder, there is a disproportionate level of self-concern and sometimes extreme sensitivity and response to criticism from others. The term narcissism comes from the Greek myth of Narcissus, where a young man fell in love with his own reflection and died from longing for the perfect image of himself that could never be obtained in reality. Narcissus pushed away anyone romantically interested in him, even Echo, who followed him and, from desperation, just echoed his words for forsaking her own. Narcissistic individuals can be so preoccupied with how they appear to others that deep down, they may feel unworthy of love or like imposters. There is also an intense fear of being shamed and humiliated by others, and therefore, someone who’s on the narcissistic spectrum may appear cold, inflated and hard to reach. A person with NPD may also feel intense envy towards others due to the conviction that they lack in some way. Therefore, they may fear that someone or something will expose those deficits and envy others who seem content and possess resources that would make up for what they lack. A person with NPD may resort to scorning, deploring, or criticising someone that they envy to try to destroy what this person has. Narcissism is often misused in the media due to a lack of understanding. NPD is a disorder, and a person who experiences it displays behaviours and has feelings that often they cannot help, and there is a lot of suffering attached to it.

Borderline personality disorder (BPD)- is a personality disorder on the border with psychotic and neurotic states. Patients who are diagnosed do not often report hallucinations or delusions but also lack the stability and predictability of someone who is neurotic. Individuals with BPD have an inconsistent sense of self. For example, if asked to describe what sort of person they are, they may be at a loss. Similarly, when asked to describe essential people, they may use simple descriptions, such as, ‘My brother is just a regular brother’. Sometimes a person may react with irritability or even fury at questions asking them to describe themselves to avoid looking into their own complexity. Individuals with BPD often come to therapy complaining about depression or panic attacks but don’t see how changing the structure of their personality would help; they wish to stop the suffering. Individuals with BPD often see other people as all good or all bad. They tend to either idealise or denigrate those who are close to them. Other people may experience them as extremely harmful or all-consuming, even if the attitude is more positive. At times, the emotions that a person with BPD experiences are strong, and there seems to be no way out of those spiralling emotional states. They may resort to self-harm to bring relief from feeling entangled in their emotional states. A person may also act on impulse when it comes to relationships with others or participate in risky activities. It is said that BPD may be linked to a traumatic, neglectful childhood.

Obsessive Compulsive Personality Disorder (OCDP), often confused with OCD, which is an anxiety disorder, is, in fact, a personality structure disorder. A person may suffer from OCD and OCPD at the same time. The main difference between OCD and OCPD is that people with OCD usually have the awareness that the compulsion or obsession (or both) causes their behaviours and suffering, and they accept the need for change to get better. At the same time, someone with OCPD has little to no awareness or insight that their rituals or behaviours need to change for their quality of life to improve. In OCD, compulsions and obsessions persist because of feared consequences, whereas in OCPD, it is about the rigidity around rules in themselves rather than any consequences. The main symptom of OCPD is a preoccupation with orderliness and perfectionism (it could be towards cleanliness or just order; for example, all of the books on the shelf are in an alphabetical order that cannot be changed). Those features persist at the expense of being flexible and open to change in their relationships with others. Individuals with this personality disorder attempt to keep control with attention to detail in relation to things that are important to them. They can also be unaware that other people may be irritated by the extent to which they perform the tasks and the delays it may cause. Some with OCPD believe they are correct, and others do not work to the same standards.

Treatment for personality disorders typically involves a combination of therapy and medication, depending on the specific symptoms and needs of the individual. It is vital to seek professional help if you suspect you or someone you know may be struggling.

This blog was written with the help of a book by Nancy McWilliams, "Psychoanalytic Diagnosis" (2011)