Managing Personality Disorders

Personality disorders are enduring patterns of inner experience and behaviour that differ markedly from the expectations of the person’s culture. In other words, individuals with personality disorders may experience long-term and pervasive differences in their thinking, emotions, relationships, and impulse control, which may cause them distress and impairment in functioning (e.g., work, family, friendships).

 

Different Types of Personality Disorders

There are three different ‘clusters’ of personality disorders:

Cluster A

  • Paranoid: Irrational suspicion and mistrust of others
  • Schizoid: Lack of interest in relationships, apathy, restricted emotional expression
  • Schizotypal: Extreme discomfort in close relationships, distorted thinking, eccentric behaviour

Cluster B

  • Antisocial: Disregard for, and violation, of, the rights of others, lack of empathy, inflated self-image, manipulative and impulsive behaviour
  • Borderline: Instability in relationships, self-image, identity, behaviour, and emotions
  • Histrionic: Excessive emotionality and attention seeking, egocentrism
  • Narcissistic: Inflated self-image, need for admiration, lack of empathy

Cluster C

  • Avoidant: Social inhibition, feelings of inadequacy, hypersensitivity to negative evaluation
  • Dependent: Submissive and clinging behaviour, excessive need to be taken care of
  • Obsessive-compulsive: Preoccupation with order, control, and perfectionism

 

Counselling and Therapeutic Approach

Dialectical behaviour therapy and schema therapy have proven effective in treating personality disorders, particularly borderline, narcissistic, dependent, avoidant, and obsessive-compulsive personality disorders. These therapies focus on cultivating healthy relationships and thought and emotion management skills.

Cognitive behavioural therapy (CBT), mindfulness, acceptance and commitment therapy, existential and emotion focussed therapies can also be helpful. At Eucalyptus psychology, your psychologist will help to find the best treatment and management plan for your particular needs.

 

Diagnostic Review and Reformulation

Personality disorder diagnoses can be complex and are sometimes given too readily, too late, or in ways that don’t fully capture a person’s experience. The psychiatrists at Eucalyptus have a particular interest in personality disorder reformulation, taking a careful, respectful, and nuanced look at existing diagnoses to ensure they are accurate, complete, and helpful as a guide to treatment.

This kind of review is particularly valuable when previous diagnoses have not felt right, when multiple diagnoses have accumulated over time, or when trauma, neurodevelopmental factors, or other conditions may have shaped the clinical picture. A good reformulation does not take diagnoses away, it helps make sense of them in a way that genuinely guides care.

If you or your treating team feel that a psychiatric review of your diagnosis would be helpful, please contact reception to discuss a psychiatry referral. A GP referral is required to access Medicare rebates.