By Valerie Rice | November 19, 2020
There are numerous times someone walks into my office, is evaluated, and I know I can help them. And there are times I am paired up with someone who has a personality disorder. It isn’t that they can’t be helped, but that this particular type of disorder never goes away. Unlike most mental illnesses, this one is not a matter of treatment and remission, nor is it a chemical fi for alleviating symptoms. Personality Disorders require intense work and daily maintenance to control and maintain. I hope I didn’t just upset you; there is still hope. It is a matter of training yourself, and I can’t promise it gets all better because that would be lying, but an alleviation of symptoms is better than nothing.
WHAT IS PD?
Personality disorder, or PD, is a rare and incurable form of mental illness. This type of mental illness is where the person has a very strict and unhealthy way of thinking and viewing the world, relating to and interacting with people, as well as functioning and behaving. These disorders are not diagnosed until after a person is an adult simply because children and their way of thinking are about as unpredictable as it gets. In all honesty, we talk about the bell curve and age appropriate behavior, but for someone under 18, or 25 when you realize the brain isn’t mature until then, it is just a bunch of hot air.
There are ten personality disorders and the symptoms are scattered all over the map. Some, like Antisocial PD, are the types of people least likely to get help and probably won’t even notice or care that they need it. These people are sometimes called sociopaths or psychopaths. There really is no difference. Another individual who would not seek treatment but is equally terrifying is the Narcissist, the type many people have claimed applies to Trump due to his excessive need for praise, inability to handle criticism, disregard for others’ feelings, and sense of entitlement. Yeah. Textbook, actually. Any way. These types of people are likely to be found in prisons or court ordered to treatment, but very rarely will they wander in on their own. On the less dangerous side we have the Borderline PD, which is instability in mood, relationships and behavior. Or the Avoidant PD, someone who has severe fear and limitations surrounding social interactions. These people are much more likely to be found in an office setting.
Treating PD requires therapy and occasional medications if symptoms are severe. There is no miracle pill, the medications are likely to be mood stabilizers and anti anxiety meds. The typical therapy focuses on talking, to work through interactions and behavior modification. Like I said, there is no fix, but there is help. People with PD typically need a guide to navigate through daily life, and that is what treatment focuses on. Perhaps in the future, when we discover more about the actual cause (we are guessing it is mostly the environment that triggers genetics) we can find a cure. When you think about it, it is nice to be able to change how people behave and all but that does not actually change the underlying problem, does it? Uh oh, I feel a CBT argument brewing…. Moving on. (no, it doesn’t work either. See? I win!)
There is absolutely no reason to be afraid of people with these disorders. Okay, yeah, some of them are dangerous, but the majority are not. And even the ones who do have total disregard for laws and the rights of others are not free range murderers or anything, that stuff is totally rare. I’m much more afraid of my neighbor’s chihuahua. And you should be, too, it is always yipping at me when I take the garbage out. What if it eats my slippers, hmm? Some therapists avoid treating people with these disorders because they get easily burned out. I get it. Progress is slow and there is no quick fix. Plus it invalidates their modality quickly. How sad for them, right? Yeah, therapists are people too. So until next time, Be Well.