What are personality disorders?

Personality disorders are a group of disorders that refer to a persistent pattern of experience and behavior which in a significant way deviate from the expectations of the culture the individual is a part of; this definition is offered by the DSM 5 manual (diagnostic and statistical manual of mental disorders).

The second significant manual for diagnosing mental disorders, the ICD 10 (international classification of disease), explains that this group of disorders constitutes differing states and behavior patterns which have clinical significance, are persistent and refer to the expression of individual characteristic lifestyle and way of interacting with others. Also highlighted is the significance of deviating from the way an average individual in a certain culture perceives, feels, thinks and interacts with others. These patterns are often stable and tend to encompass many aspects of behavior and psychological functioning.

The specific disorders in this group are:

-   Borderline personality disorder

-   Narcissistic personality disorder

-   Antisocial personality disorder

-   Paranoid personality disorder

-   Histrionic personality disorder

-   Avoidant personality disorder

-   Schizoid personality disorder

-   Schizotypal personality disorder

-   Dependent personality disorder

-   Obsessive-compulsive personality disorder

Psychologists have for a long time been working on the concept of personality, defining this concept seems easy but isn’t. Different personality traits and their combinations which are interchangeable but also stable in time and define the individual to himself as well as to others seem to be at the center of this concept.

Like many other mental disorders, the point between normality and pathology is defined by the ability to function in everyday life, and so comparing one to the expectations of a culturally conditioned society.

Because of this culture and environmental circumstances play a significant role in the understanding of personality disorders, in different cultures the same behavior can be perceived completely differently. For example, strong familial bonds and emotional dependance on family members could, in a western individualistic culture, be seen as unhealthy, dependent personality disorder comes to mind. These behaviors are completely normal and preferable in more interdependent collectivistic cultures found in Asia, in which familial and societal bonds are perceived and valued differently. The same example can be looked at in the opposite direction, highly individualistic behavior can be viewed through the frame of a narcissistic or antisocial personality disorders from some, more collectivistic, cultural perspectives.

Professor dr. Dragan Švrakić together with prof. dr. Mirjana Divac Jovanović in their book: “The borderline personality and it’s different faces “, speak to many aspects of personality disorders.

The perspective they provide is from the viewpoint of the modern psychoanalytical theory and object relations theory. Many assumptions of this theory, based on decades of previous work of many scientists in the field of personality research, have recently been confirmed on a neurobiological level thanks to the development of modern technology. A detailed review of these mechanisms is complex and requires the understanding of a multitude of factors, we here will attempt to convey the summary of the idea of how personality disorders develop that the authors presented.

Personality disorders develop primarily due to genetics and the interaction with one’s surroundings in a critical formative period of childhood. In this period the child has a developmental task of integrating positive experiences of itself and the world, this forms an integrated self-core, which will later function as a base for the further development of the personality.

The domination of the positive introjects allows the overcoming of the primitive defense mechanism known as splitting which is used in this period, the primary task of this defense mechanism in this period is to polarize experiences as either positive or either negative. If positive experiences, introjects, dominate the child will overcome splitting and develop an understanding which isn’t polarized but rather complex (both good and bad) but predominantly based on positive introjects. If the positive experiences aren’t enough and the child primarily introjects negative experiences of itself and the world, splitting will persist to protect the child from the idea of an overall negative and dangerous world, and it will develop a vulnerable fragmented self which cannot be used as a healthy base for developing the rest of the personality.

This can be viewed as the child developing it’s first core beliefs about itself and the world, if it’s exposed to primarily positive influences and experiences it will develop a belief of itself as good and worthy of love and the world as dangerous and scary.

Still, the mental mechanisms at play are complex and efficient and a personality develops even in the case of overwhelmingly negative introjects. Because of the absence of a safe base in the form of an integrated self-core, a compensatory pathological self is formed, a structure which has the function of a base for the development of personality but distorts reality in order to protect the vulnerable fragmented core. This compensatory self is what the authors consider personality disorders as we know them to be, depending on genetics and circumstances, some will develop for example, a narcissistic compensatory self which will learn to protect its vulnerability by perceiving itself as grandiose and unconditionally better than everybody else. This idea stands for every personality disorder, the assumption is that because of the unsuccessful completion of the developmental tasks people in these situations have different and pathological ways of relating to themselves and the world which are supposed to protect the fragile, vulnerable and fragmented core of their personality.

Personality disorders can be difficult to treat, depending on the specific disorder and situation. Psychotherapy has a significant effect on treating personality disorders, research shows. Medicaments can be prescribed but usually for treating symptoms and potential comorbidities. Personality disorders are complex and difficult to understand, it is necessary to contact a doctor, psychiatrist or clinical psychologist and in cooperation with them construct an adequate treatment plan. Treatment of personality disorders can last months or years.

Written by: Bachelor of Psychology, Aleksa Holcer

ICD-10 version:2016. (n.d.). https://icd.who.int/browse10/2016/en#/F60-F69

Jovanović, M. D., & Švrakić D. (2017). Granična ličnost i njena različita lica (drugo izdanje). Clio

Personality disorders. (n.d.). National Institute of Mental Health (NIMH). https://www.nimh.nih.gov/health/statistics/personality-disorders

*This text is intended for informational purposes only. If you experience any symptoms, it is recommended that you seek advice from your doctor or a qualified healthcare professional.*

*Image taken from the site: https://pixabay.com/illustrations/depression-woman-burn-dark-thoughts-1241819/*