There are many personality disorders recognised by psychologists today. It’s also known that these often co-occur, with symptoms of more than one presenting themselves at any one time. With this in mind it’s often inaccurate to simply put somebody in a box labelled Obsessive-Compulsive Personality Disorder or Dependent Personality Disorder when they fit the criteria for multiple conditions. For this reason personality disorders are clustered into three groups: A, B and C. These are by no means isolated and many people show signs of personality disorders from all three groups. However they are helpful in reaching a broader understanding of the main traits associated with them.
Cluster A: The Eccentric Personality
Three personality disorders make up cluster A: Paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder. These are all linked by a certain eccentricism during social situations and by the way in which a person views themselves.
Paranoid Personality Disorder
Individuals with paranoid personality disorder tend to come across as distrustful and suspicious of others, even if they have good intentions. They often assume that others are trying to manipulate them or talk behind their back, behaviour which can become a self-fulfilling prophecy as it can make them more likely to stand out and be talked about. With this comes an obsession about keeping the loyalty of family and friends – behaviour that can, again, have the reverse effect; pushing close relations away from their spotlight.
Because those with Paranoid personality disorder perceive others as inherently suspicious they are hesitant to confide in others, lest the information be used maliciously against them. In a similar vein they can be quick to see personal attacks and slights where there are none, reacting angrily and creating a vicious cycle whereby their negative perception of others becomes justified.
Schizoid Personality Disorder
Like those with Paranoid personality disorder, individuals with Schizoid personality disorder can find themselves socially isolated. However, unlike other disorders, those with schizoid symptoms do not pursue social interaction, they are simply not interested. It’s for this reason that people with this disorder are often seen as ‘aloof’ or ‘distant’ by others, although they generally harbour no ill feelings towards other people. One defining symptom for schizoid personality disorder is presence of ‘the flat effect’, whereby emotions tend to stay neutral – lacking the peaks of joy and moments of sadness that others display. This is sometimes referred to as ‘emotional blunting’.
Schizotypal Personality Disorder
Not to be confused with Schizoid Personality Disorder, individuals displaying Schizotypal personality disorder actively seek social interactions but are often hindered by an outward ‘awkwardness’ that, like the other cluster A personality disorders, leaves them socially isolated. Part of this derives from a way of viewing the world known as ‘magical thinking’, whereby a person sees two unrelated events as directly linked. As an example, someone might think that because they wore a certain pair of jeans that the weather was sunny, even though the two events had nothing to do with one another.
In addition to magical thinking, people with schizotypal personality disorder are liable to view all events as part of a grand plan relating to their destiny. In turn, this can lead to an overriding overconfidence where the person believes themselves to be at the centre of their own universe – everything else a story revolving around them. Seen from the outside, people who view events in such a way often speak in a self-centred way that is socially inappropriate.
Cluster B: The Wild Personality
The personality disorders in cluster B all have genetic links to mood disorders such as depression and bipolar disorder, as well as substance abuse disorders. That’s not to say the personality disorders; borderline personality disorder, histrionic personality disorder and narcissistic personality disorder, always go hand in hand – but it does mean they are more likely to co-occur.
Antisocial Personality Disorder
Despite its name, people with antisocial personality disorder are generally found to be at ease in social situations, coming across as noticeably charming and easy to talk to a great deal of the time. The term antisocial refers to the recklessness, lack of empathy and disposition to criminal behaviour that characterises the disorder.
Sometimes a person will use their natural charm as a way to manipulate others for personal gain. Paired with a disregard for societal norms and poor impulse control, people with a diagnosis of antisocial personality disorder can be difficult to be around, as they can be prone to aggression. Like all personality disorders it sits on a spectrum. On one end are those who may find it difficult to keep a lid on their self-control but stay relatively calm. At the other are individuals who are labelled as sociopaths or psychopaths, completely unable to comprehend the impact of their actions on others.
In contrast to the other kinds of personality disorders, individuals must be over 18 years of age to meet the diagnostic criteria for antisocial personality disorder. However more often than not, there will be a history of conduct disorder that predates the diagnosis.
Borderline Personality Disorder
While most people are relatively stable in their moods, those diagnosed with borderline personality disorder are prone to extreme swings of emotion; finding themselves stood on peaks of joy one minute and in the pits of despair the next. This pattern is sometimes known as ‘stable instability’ because the only thing that’s certain is uncertainty.
The elated high points can make people with borderline personality disorder wonderful to hang around, leading to intense relationships. However, over time these often become dramatic and sour with the passage of time. That said, individuals with borderline personality disorder are terrified of abandonment and are known to go to extremes to prevent people leaving them, such as the threat of self-harm. This makes such relationships difficult to leave, perpetuating a sense of resentment that makes the relationship even worse.
Another trait that defines borderline personality disorder is a defence mechanism known as ‘splitting’, a term that describes a black and white way of viewing the world. For people demonstrating this trait, things are either completely good or bad, with no room for nuances in between. It is actually an exceptionally common defence mechanism and its presence is one of many diagnostic criteria used to diagnose borderline personality disorder. When politicians present an issue in a polarised manner or groups talk of an “us” versus “them” mentality it is an example of splitting in practice.
Histrionic Personality Disorder
Commonly seen by others as attention seeking, people with histrionic personality disorder are typified by their extreme emotionality in response to even minor occurrences. This trait results in these people sometimes manipulating a situation to draw attention to themselves, often in the form of overly dramatised stories or inappropriately flirtatious behaviour.
While people with histrionic personality disorder are often interesting, lively and popular; their focus on the self can make them seem shallow and egocentric – leading to many acquaintances but few deep, genuine relationships.
Narcissistic Personality Disorder
An individual with narcissistic personality disorder is generally characterised by a grandiose self-image, seeing themselves as more attractive, intelligent and/or talented than the actual reality. Because of this image, they believe they have deserved the best treatment from those around them and may clash with those that fail to understand and support them in their goals.
Narcissistic personality disorder is like a mask, projecting a confidence out to other people. However, should this mask slip, there’s a fragile self-esteem underneath – vulnerable to the slightest criticism. People with this diagnosis can come across as entitled or self centered, a view compounded by a lack of empathy towards others. Indeed, this obliviousness to others’ feelings can lead people with narcissistic personality disorder to become exploitative of those around them, only getting involved in situations that actively aid their personal agenda.
Find out more about traits and treatments for narcissistic personality disorder here.
Cluster C: The Anxious Personality
All of the cluster C personality disorders have associations with anxiety disorders, worried about circumstances where they do not have direct control. The three disorders in this cluster are: Avoidant Personality Disorder, Obsessive Compulsive Personality Disorder and Dependent Personality Disorder.
Avoidant Personality Disorder
As the name suggests, people with avoidant personality disorder tend to avoid social events, appearing shy and inhibited when they do attend. This behaviour stems partly from an extremely low self-esteem, with individuals falsely believing themselves to be incapable, inadequate and ultimately undesirable.
While people with avoidant personality disorder desire meaningful relationships, they rarely take the social risks required to build them, instead opting to avoid social situations altogether. They are also hypersensitive to rejection and negative feedback, becoming withdrawn as a natural response. Together, this makes it difficult for people with avoidant personality disorder to form new friendships.
Avoidant personality disorder bears many similarities with social phobias, the latter of which are not personality disorders in their own right. However, avoidant personality disorder relates to a general anxiety surrounding all social involvement. On the other hand, social phobias tend to be specific, such as a fear of public speaking or using public restrooms.
Obsessive Compulsive Personality Disorder
It is important to note that obsessive compulsive personality disorder (OCPD) is not simply another term for obsessive compulsive disorder (OCD), despite the two names sometimes being used interchangeably. Both relate to an obsession with orderliness, perfectionism and complete control, but OCD is known as an ‘ego-dystonic condition’, meaning that those with it wish that they could stop the behaviour. On the other side of the coin, OCPD is ‘ego-syntonic’, a term given when the person considers the condition part of their self and doesn’t wish to change anything. It is for this reason that OCPD is defined separately, as a personality disorder.
While a dedication to schedules, details and rules are generally seen as positive traits, the slavish adherence to order can actually hinder the lives of those with OCPD, making them inflexible and, rather counterintuitively, less productive than others. This is because they’ll often spend more time planning and worrying about the details of a task than actually doing it. They can also be perceived as stubborn due to a rigid set of beliefs, personal rules and moral standpoints – refusing to do anything that falls outside these strict confines.
Find out more about traits and treatments for Obsessive compulsive personality disorder here
Dependent Personality Disorder
An intense fear of separation or rejection characterises those with dependent personality disorder, ultimately resulting in them ‘clinging’ to relationships that they find themselves in. Lacking self-belief, these individuals believe that they can’t adequately take care of themselves and instead rely on others to do so.
Unfortunately, their passive nature often makes people with dependent personality disorder vulnerable to manipulation, leading them into abusive relationships that they struggle to escape from. For them the uncertainty of living without someone to accept responsibility for the major areas of their life outweighs the negative aspects of the relationship.
People with dependent personality disorder often show considerable diagnostic overlap with avoidant personality disorder, coming across as shy and withdrawn. As is often the case, there is also common overlap with personality disorders in other clusters, notably borderline personality disorder in cluster B.
Getting Treatment For Personality Disorders
Ultimately any treatment plan depends on a number of factors; the symptoms of the personality disorder, the impact it’s having and individual responsiveness just to name a few. Generally speaking, some treatments are more effective for specific clusters than others. For example people with cluster A personality disorders can often find group therapy particularly helpful, allowing a safe space in which they can practice social interaction. On the other hand people diagnosed with type B personality disorders often respond better through psychotherapy, especially cognitive behavioural therapy (CBT) – a method of helping individuals understand and change their thought patterns and behaviour.
If you, or anyone you know, recognise signs of personality disorders that impact day to day life, contact a psychotherapist or local GP to find out what steps can be taken to help. At Psytherapy we help to understand the person beneath the condition, tailoring a treatment plan that creates permanent change. If you’d like to find out more about diagnosing or treating personality disorders, get in touch today or leave a comment below – your voice could be the sign someone’s looking for.