Personality Disorders

How do personality disorders form?

Before explaining personality disorders in greater detail, it might be useful to start by explaining how such disorders can form. We all have a myriad of emotional responses that are influenced by our lifetime of experiences. These can be real or imagined situations, interactions with others or beliefs and understandings that we internally hold about ourselves. Our presumptions and expectations of others also influence us hugely.

These all come together to enable us to form a sense of self, as a unique individual. This includes development of patterns of relating to and strategies to cope with, challenges we face within ourselves and with others. We all have our own unique cocktail of helpful and unhelpful ways of looking at things, situations and interactions with others.

Within our formative years we will have experienced distress, support, abandonment, love, fear, understanding, aggression, encouragement, neglect, safety, blame, adoration, criticism, joy, loss and much mor. Some individuals have experienced less of the good stuff and more of the painful. This powerfully influences the developing psyche.

We will all recognise some symptoms and descriptions of any given personality disorder, but they will be in much more diluted forms and perhaps more noticeable in times of great distress.

Personality disorders are conditions in which an individual differs significantly from an average person. This can be in terms of how they think, perceive things, feel and/or relate to others.

The NHS N.I.C.E guidelines suggest that 1 – 2% of the population have a personality disorder.

Personality DisorderNarcissism

Someone diagnosed as Narcissistic might display the following characteristics: dramatic, over-emotional, erratic, grandiose, self-important, bitter of others success, powerful sense of superiority, arrogance, display great vulnerability, hypersensitivity to any criticism and a fragile sense of self. Therefore narcissists need constant reassurance and affirmation of others’ adoration for them. This doesn’t really matter who, it could be loved ones, work colleagues, even strangers such as an adoring public/audience. Narcissists have not developed a capacity to feel empathy; therefore they lack awareness of how they might impact others, so there is no capacity
to imagine others feelings.

Believing that everything that happens is an extension of the self is a common example. For instance one might drive into a car park and be frustrated that it’s full and that there are no available spaces. A person with narcissism might execute the same task but believe that the lack of space is deliberate to make them suffer. This is not just a fleeting thought amongst other possibilities, but a knowing and total belief that everything that happens is ‘about them’.

Someone with narcissism is split between a very fragile, needy and dependant inner core and an external personality that is demanding of attention (larger than life). Often when the narcissist is feeling good they are great fun to be with, often described as vivacious, energetic, captivating, entertaining. However this is driven by the need to feed from the adoration of others, to sooth the desperately hollow inner self. If this inner vulnerability is n
ot soothed or becomes exposed the individual can become very controlling, aggressive and blaming of the other. They can also attack the self by harmful and destructive impulses, thoughts and actions.

Symptoms of Narcissistic Personality Disorder from Diagnostic and Statistical Manual of Mental Disorders – DSM IV

For a person to be diagnosed with narcissistic personality disorder (NPD) they must meet five or more of the following symptoms over a sustained period of time:

  • Has a grandiose sense of self-importance (e.g. exaggerates achievements and talents, expects to be recognised as superior without commensurate achievements).
  • Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
  • Believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
  • Requires excessive admiration.
  • Has a sense of entitlement, i.e. unreasonable expectations of especially favourable treatment or automatic compliance with his or her expectations.
  • Is interpersonally exploitative, i.e. takes advantage of others to achieve his or her own ends.
  • Lacks empathy: is unwilling to recognise or identify with the feelings and needs of others.
  • Is often envious of others or believes that others are envious of him or her.
  • Regularly shows arrogant, haughty behaviours or attitudes.

Other personality disorders include:

Depressive Disorder

Anxiety Disorder

Avoidant Personality Disorder

Obsessional Compulsive Disorder

Trauma and Stressor Related Disorder

Dissociative Disorder

Somatic Symptom and Related Disorder

Feeding and Eating Disorder (Anorexia and Bulimia)

Sleep – Wake Disorders (Insomnia and Hyper somnolence)Borderline Personality Disorder – histrionic / emotionally unstable

Please feel free to take a further look at our website or get in contact with us, at Hertford Counselling Service, to see how we can help with personality disorders.

Written by Karen Richards.