Personality Disorders: Symptoms and Treatment

Symptoms of personality disorders often develop in late adolescence or early adulthood. According to the American Psychiatric Association, this mental illness has long-term personality patterns that significantly differ from what is considered within normal limits and have a substantial impact on social interactions and relationships.

There are 10 different forms of personality disorders. These include:

  • Obsessive-Compulsive
  • Borderline
  • Narcissistic
  • Antisocial
  • Avoidant
  • Histrionic
  • Dependant
  • Schizoid
  • Schizotypal
  • Paranoid

All of these disorders include symptoms that are characterized by distorted thinking, difficulties with relationships and rigid personality characteristics, such as an inability to adjust to change or transitions, fear of others, overreactions normal behavior in others or a grandiose sense of self, just to name a few.

Additionally, it is very common for individuals with serious mental health disorders to have more than one health condition. These conditions can include other mental health disorders, such as Post Traumatic Stress Disorder (PTSD), anxiety disorder, depression and more. Other co-occurring conditions include drug and alcohol dependence, self-medication, diabetes, and other serious health concerns. Another term for co-occurring conditions is a dual diagnosis.

While mental health conditions related to personality are very serious, there are many effective treatments available. Such treatments also allow individuals to live normal lives, with healthy relationships, long term employment and overall success in life.

Dialectical Behavior Treatment (DBT)

One of the most effective treatments for Borderline Personality Disorder is Dialectical Behavior Treatment (DBT). This form of treatment involves working closely with a DBT therapist, both individually and in group sessions. DBT was developed in the late 1980s as a form of treatment for Borderline behaviors.

DBT is based on four essential components:

  • Mindfulness – Mindfulness is at the core of DBT. With mindfulness, clients are encouraged to slow their automatic reactions to triggers and ask themselves what they are reacting to and how is the best way to respond. This concept helps clients integrate other skills taught as part of DBT treatment.
  • Interpersonal Effectiveness – Interpersonal effectiveness skills relate to communication and interpersonal relationships. Clients are taught effective listening skills and how to be flexible when met with resistance to requests. Frequently, role-playing is used as a learning method to model effective behaviors.
  • Distress Tolerance – Frequently individuals with borderline disorders have difficulty tolerating distressful situations. Instead of listening and considering the situation from other perspectives, they react impulsively and destructively, resulting in problematic interactions. Distress tolerance helps clients learn how to be flexible, identify distressful situations and learn alternative healthy options. The goal of distress tolerance is to help clients move toward acceptance of the situation at the moment.
  • Emotional Regulation – Individuals with borderline disorders feel extremely intense emotions and respond accordingly. Emotional regulation helps clients learn to identify their emotions and slow down their reactions. They are taught to carefully stop and think through their emotional distress and consider alternatives to their automatic reactions. Additionally, they learn to be mindful of the potential consequences of their reactions and behaviors.

Utilizing talk therapy, DBT therapists combine cognitive behavioral concepts with increased self-awareness and accountability. Typically, the therapy requires supportive individual therapy weekly sessions and weekly group sessions that are lead by the therapist.

During individual sessions, therapists help you identify problem behaviors and triggers. Additionally, the therapist collaborates with the client to identify client strengths and alternative behaviors to triggers. The therapist may work with you to improve communication skills and assign homework to reinforce learning from individual sessions.

Group sessions are held weekly and are usually over two hours long. During these sessions, clients collaborate with each other about successes and learn about the experiences of others in similar circumstances. The DBT therapist works with group members to integrate the four components of DBT therapy through modeling, role-play and other group activities.

Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy (CBT) is one of the best-known forms of treatment for personality disorders. In essence, CBT therapy helps clients identify thoughts in a specific situation and how those thoughts impact emotions and reactions.

No matter which type of mental health issue you are addressing, thoughts and feelings are interconnected. Therapists utilizing CBT therapy walk clients through exercises to identify thoughts they have when they are faced with challenging situations. For example, if you have a tendency to be fearful of strangers coming to your front door, your CBT therapist may ask you to imagine a person coming to your front door and ask you what you are thinking. The next step is to help you identify what emotions you experience when you have those thoughts. You may need help identifying those emotions and the therapist also helps you with that skill.

When you identify the thoughts and connect emotional responses, then you have a foundation for beginning to change the thought process and emotional response. Clients are often assigned homework related to problem behaviors. Examples of homework include keeping a log of thoughts that intrude when faced with an identified challenging situation. The next assignment might be to then keep a log of your emotional responses when you have those thoughts.

Variations of Cognitive Behavioral Therapy include working on client strengths and identifying previous times when you were able to successfully cope with a challenging or problematic situation. The therapist would help you identify what strategy you used for success and teach you to apply the successful strategy to other situations.

Motivational Interviewing

For individuals with a dual diagnosis or co-occurring conditions, Motivational Interviewing may be one of the most appropriate forms of therapy. Motivational Interviewing helps clients identify internal inner conflicts about what they want and what they need. The goal is to reach a place of acceptance that behavioral changes are necessary to live a happier and healthier life.

It is very common to enter treatment not wanting to acknowledge there are problems and change is needed. You may be angry that you are in treatment or unwilling to even participate in the process. However, Motivational Interviewing can help you understand your health better and why the choices you make have a significant impact on not only yourself but those around you, including those who are most important to you.

Motivational Interviewing is based on the patient-centered work of Carl Rogers, who believed that the role of the therapist is to be a supportive ally in the therapeutic process. Therapy is focused on what you want and helps you identify positive benefits you can gain from treatment. This form of treatment allows you to express yourself, air your frustrations and tell your own story, maybe for the first time. For many people, Motivational Interviewing is a short term transitional treatment, providing space for you to commit yourself to get better.

At Overland Intensive Outpatient, our goal is to provide you with personalized treatment for personality disorders. We will work with you to find the best treatment method for your needs and stated goals. If you have concurring conditions, we will collaborate with you to help you manage your health needs. We also work with most major health insurance providers, so if you or someone you love is struggling with a personality disorder, please contact us, so we can be a helpful hand on your journey.