For the last ten years, I have made working with people who have a personality disorder and their family members the main part of my practice. I made this choice for several reasons. First, there are numerous family members within my own family that have a personality disorder and I have a natural talent for handling this population. Second, this is an area of care that most therapists avoid and therefore there is limited help. Third, I believe that everyone can get better and seeing that change in this population is wholly satisfying.
Having said that, there are several mistaken assumptions many people make when dealing with a person who has a personality disorder. Here are ten examples:
- Personality Traits = Personality Disorder. A person can have the traits of a personality disorder without being fully diagnosed. For instance, they may demonstrate narcissistic behavior at work but not at home. In order to be a personality disorder, the symptoms must be pervasive in multiple environments. Younger people may display some traits but not have the disorder.
- Personality Disorder = Abusive Behavior. Not all persons with diagnosed personality disorder demonstrate abusive behavior. Nor does all abusive behavior mean a person has a personality disorder. A person can have a personality disorder and not treat others in an abusive manner. Likewise, a person with a personality disorder may be abusive towards others. Abuse is not a natural outcome of a personality disorder although some personality disorders such as antisocial do tend to act abusively.
- Personality Disorder Looks the Same on Everyone. The reason for the classification of different types of personality disorders is that there are noticeable similarities. A person with Borderline Personality Disorder may not look the exact same as another person with the same disorder. They might share similar characteristics but their life experience, emotions, reactions, work history, and relationship history might look very different.
- Personality Disorder = Work Dysfunction. While some individuals may struggle at work, there are many persons with a personality disorder who function quite well in work environments. Some professions are even better suited to a particular type of personality disorder. For instance, a person with Paranoid Personality Disorder can make an excellent detective, investigator or intelligence officer. A person with Obsessive-Compulsive Personality Disorder tends to do well as an engineer, attorney, or pilot.
- Personality Disorder Explains Everything. To the contrary, a personality disorder is frequently the beginning of understanding not the end of it. Personality disorders can be co-mingled with a variety of other disorders including another personality disorder. The personality disorder just helps to frame the other disorders such as depression, anxiety, addiction, or conduct disorders.
- Personality Disorders Display All the Characteristics. There is a reason the DSM-V states that a person needs four or more of the eight possible characteristics of Obsessive-Compulsive Personality Disorder. Not all persons with the same diagnosis display all traits. Discounting the diagnosis because a few traits are missing does an injustice to the diagnosis. There often is cross-over from one personality disorder to another one so some of the missing traits may be found in another disorder.
- Culture Has No Bearing on Personality Disorders. A person’s cultural background must be taken into account prior to diagnosing a personality disorder. For instance, some cultures encourage emotional detachment while others encourage strong emotional attachment. Taken out of context, a person might appear to have a personality disorder when they are actually following the norm of their cultural background.
- Personality Disorders Should Be Avoided. Many people with a personality disorder make excellent friends, spouses, parents or co-workers. Some do not. The judgment call to engage or maintain a relationship with a person who has a personality disorder should be based on their individual merits, not on having the disorder.
- Personality Disorders Are Gender Specific. They are not. There might be more recorded cases of Histrionic Personality Disorder in females over males, but this does not mean that it cannot occur in males. There are even slight differences in how a personality disorder manifests in each gender. The diagnosis does not take into account a gender before making the determination of one personality disorder over another.
- Personality Disorders Are Untreatable. As always in counseling, a person gets out of it what they put in it. Anyone can change if they make the choice but only the individual can choose. Begging, pleading, manipulating, or intimidating is not good methods for inspiring healthy change. Even a person with an Anti-Social Personality Disorder can change to conform to social norms but they must want to do it for themselves.
These assumptions impede a person’s ability to get help. If you or someone you know has a personality disorder, don’t lose hope. There are ways to get better if you or they choose.