Personality Disorders

Paranoid Schizoid Schizotypal Characterized by odd or eccentric behavior

Borderline Narcissistic Histrionic Antisocial Characterized by dramatic, impulsive and emotional behavior

Avoidant Dependent Obsessive-compulsive Types characterized by anxiety and anxious behavior

Cluster A Pervasive suspiciousness or distrust of the motives of others See motives of others as intentionally harmful See themselves as purposefully exploited or deceived Distrustful and bear grudges Not psychotic or delusional Antipsychotics do not work Therapist must be empathetic to the paranoia

Cluster A Detached and indifferent to social experiences and relationships Loners, take little pleasure in being with others/sexual relationships Emotionally cold, restricted range of emotions Don’t often seek psychiatric help If they reach out, be respectful of their desire to be alone

Cluster A Similar to schizoid, but also contains some odd or unconventional thought Leans more towards a schizophrenic spectrum condition Main reason for avoiding relationships is fear of people or unconventional thoughts (instead of just not caring about relationships) Not likely to seek treatment During treatment, avoid direct confrontation of eccentricities du to potential paranoia Antipsychotics may be helpful but not always

Persistent and pervasive pattern of disregard for the rights and wellbeing of others Lack of remorse Predators, engage in unethical and illegal activities Generally very manipulative Seem overtly charming or impressive Generally don’t look to get psychiatric treatment unless for secondary gains

Cluster B Persistent and pervasive pattern of disregard for the rights and wellbeing of others Lack of remorse Predators, engage in unethical and illegal activities Generally very manipulative Seem overtly charming or impressive Generally don’t look to get psychiatric treatment unless for secondary gains

Cluster B Patterns of considerable and marked instability in relationships, difficulty with self-image and fluctuating mood states Often in crisis mode in a chronic manner Either idolize or devalue others and switch rapidly between the two Approaches psychotic levels of thinking Impulsive, reckless and damaging to others Self-mutilating behavior and/or suicidal gestures Often DO seek treatment, but often enter into a therapeutic relationship that demands and devalues the therapist

Cluster B Patterns of considerable and marked instability in relationships, difficulty with self-image and fluctuating mood states Often in crisis mode in a chronic manner Either idolize or devalue others and switch rapidly between the two Approaches psychotic levels of thinking Impulsive, reckless and damaging to others Self-mutilating behavior and/or suicidal gestures Often DO seek treatment, but often enter into a therapeutic relationship that demands and devalues the therapist Antidepressants, antianxiety, and mood stabilizing meds are often helpful Blames others and feels victimized

Cluster B Similar to borderline, but not as damaging to the person’s life Tend to be dramatic and overly expressive of emotion Usually quest for attention Can be seductive and provocative, yet feels that relationships are more substantive than they are May potentially be a defense against some other feelings and treatment may be helpful to empathize with the need to be theatrical

Cluster B Grandiose style and exaggerated sense of self-importance Often feel superior to others and act arrogant Will exploit others to improve sense of self-worth Require excessive amounts of admiration and are overly reliant on others for self-esteem Lots of underlying insecurity Envious of others (key feature) Meed states can fluctuate rapidly with other people’s opinions of them Feel lots of shame when they don’t match up to what they want/need to be (Key feature) Initial response to ego injury is anger and lashing out (narcissistic rage) Can look manic during grandiose stages considered on a bipolar spectrum Treatment difficult du to fragile ego Anger towards therapist Goal is to maintain empathy Antidepressants, antianxiety and mood stabilizers may be helpful

Cluster C Extreme anxiety and avoidant of situations in which they might feel scrutinized poor self-esteem Unlike schizoid, tend to want relationships but are too anxious to have them Tend to refrain from most intimate relationships Avoid treatment due to anxiety and fear of criticism As therapist, maintain sensitivity and point out that the anxiety is perpetuated by their avoidance

Cluster C Excessive need to be taken care of can’t make decisions, believe they can’t function on their own Lots of indecisiveness and difficulty disagreeing with others confrontation avoidant Not just lazy, but more have an anxiety that creates these needs May have the desire to be more independent, but can’t for some reason Seek relationships that will provide them with security and assistance they need Treatment is only sought when the patient realizes the limitations to their dependence Therapist needs to be empathic and mindful about the anxiety, but, do not enable the dependent behavior The patient may become dependent on the therapist

Cluster C Hallmark of anxiety Have a need for orderliness, perfectionism, and associated preoccupancy with feeling in control Don’t want to control others, but themselves and their own lives and environment Getting caught up in the details Perfectionism can get in the way of productivity Described as living machines Rigid and inflexible, lament about how things should be Over-think and have difficulty making decisions Often see things in only black and white DO seek treatment therapist must be empathic to the anxiety, helpful to point out that the symptoms may be useful up to a point Helpful to get people to focus on things they can control, forget what they can’t SSRI can be useful Personality type common among successful people, must have dysfunction to be a disorder