Characteristics of Personality Disorders

Personality disorders are characterized by persistent, unwavering, obstinate, and insistent behavior. They are self-centered, preoccupied with themselves, repetitive, and boring. They seek to manipulate and exploit others, have a diminished capacity to love or intimately share, have poor social skills, and are emotionally unstable. They are characterized by rigid and persistent patterns of traits, emotions, and cognitions that are stable and all-encompassing rather than episodic. Personality disorders contribute to unhappiness and are often associated with mood and anxiety disorders.

The majority of patients are ego-dystonic and dislike and resent who they are, how they act, and the harmful and destructive effects they have on those close to them. They have alloplastic defenses and an external locus of control, leading to paranoid persecutory delusions and anxieties. Cluster B personality disorders (Narcissistic, Antisocial, Borderline, and Histrionic) are mostly ego-syntonic, despite significant character and behavioral deficits, emotional deficiencies and lability, and wasted lives and squandered potentials. 

There is a distinct difference between patients with personality disorders and those with psychoses, with the former suffering from no hallucinations, delusions, or thought disorders. Patients with personality disorders are also fully oriented, with clear senses, good memory, and a sufficient general knowledge fund.

Psychology is an art form rather than a science. There is no "Theory of Everything" from which all mental health phenomena can be derived and falsifiable predictions can be made. Nonetheless, common characteristics of personality disorders can be identified. Most personality disorders share a set of symptoms and signs (as reported by the patient) (as observed by the mental health practitioner).

Patients with personality disorders have the following characteristics in common:

They are persistent, unwavering, obstinate, and insistent (except those suffering from the Schizoid or the Avoidant Personality Disorders).

They believe they are entitled to, and vocally demand, preferential treatment and access to resources and personnel. They frequently complain of multiple symptoms. They engage in "power struggles" with authority figures (such as physicians, therapists, nurses, social workers, bosses, and bureaucrats) and rarely obey orders or follow rules of conduct and procedure.

They believe they are superior to others or, at the very least, unique. Many personality disorders are characterized by exaggerated self-esteem and grandiosity. Such people are incapable of feeling empathy (the ability to appreciate and respect the needs and wishes of other people). They alienate the physician or therapist in therapy or medical treatment by treating her as inferior to them.

Patients with personality disorders are self-centered, preoccupied with themselves, repetitive, and thus boring.

Personality disordered individuals seek to manipulate and exploit others. Because they do not trust or love themselves, they have a diminished capacity to love or intimately share. They have poor social skills and are emotionally unstable.

Nobody knows whether personality disorders are the tragic result of nature or the sad result of the patient's environment's lack of nurturing.

However, most personality disorders begin as problems in personal development in childhood and early adolescence. They become full-fledged dysfunctions after being exasperated by repeated abuse and rejection. Personality disorders are characterized by rigid and persistent patterns of traits, emotions, and cognitions. In other words, they rarely "evolve" and are stable and all-encompassing rather than episodic. By "all-pervasive," I mean that they have an impact on every aspect of the patient's life: his career, interpersonal relationships, and social functioning.

Personality disorders contribute to unhappiness and are frequently associated with mood and anxiety disorders. The majority of patients are ego-dystonic (except narcissists and psychopaths). They dislike and resent who they are, how they act, and the harmful and destructive effects they have on those close to them. Nonetheless, personality disorders are large-scale defense mechanisms. As a result, few patients with personality disorders are truly self-aware or capable of life-changing introspection.

Patients with personality disorder frequently have a slew of other psychiatric issues (example: depressive illnesses, or obsessions-compulsions). They are exhausted by the need to control their destructive and self-defeating impulses.

Personality disorder patients have alloplastic defenses and an external locus of control. To put it another way, rather than accepting responsibility for the consequences of their actions, they tend to blame others or the outside world for their misfortune, failures, and circumstances. As a result, they succumb to paranoid persecutory delusions and anxieties. When they are stressed, they attempt to anticipate (real or imagined) threats by changing the rules of the game, introducing new variables, or manipulating their environment to conform to their needs. They regard everyone and everything as mere means to an end.

Patients with Cluster B personality disorders (Narcissistic, Antisocial, Borderline, and Histrionic) are mostly ego-syntonic, despite significant character and behavioral deficits, emotional deficiencies and lability, and vastly wasted lives and squandered potentials. On the whole, such patients do not find their personality traits or behavior objectionable, unacceptable, disagreeable, or alien to themselves.

There is a distinct difference between patients with personality disorders and those with psychoses (schizophrenia-paranoia and the like). Unlike the latter, the former suffer from no hallucinations, delusions, or thought disorders. Subjects with Borderline Personality Disorder, on the other hand, experience brief psychotic "microepisodes," usually during treatment. Patients with personality disorders are also fully oriented, with clear senses (sensorium), good memory, and a sufficient general knowledge fund.