Personality Disorders Counselling in London | Treatment & Therapy
What are Personality Disorders?
Personality Disorders (also known as PDs) are mental health conditions that affect how the individual cope with life, particularly in how they relate to other people. The onset of Personality Disorders occurs in adolescence or early adulthood.
Personality disorders are among the most difficult disorders to treat in mental health. Patient’s suffering from mood disorders such as depression or anxiety face many challenges, but are able to recover from their symptoms at some point. Patients with Personality Disorders on the other hand face life-long challenges in all avenues of life including, relational, recreational, and professional. It’s important to note that when a person has a personality disorder, it’s not just the patient that suffers, it’s the patient’s family and friends who also suffer.
Signs of Personality Disorders
Personality Disorders have four core features in common:
- Presence of distorted thoughts and maladaptive behaviour.
- Emotional dysregulation.
- Persistent relational problems.
According to the DSM 5 the essential features of a personality disorder are impairments in personality (self and interpersonal) functioning and the presence of pathological personality traits. To diagnose a personality disorder, the following criteria must be met:
- Significant impairments in self (identity or self-direction) and interpersonal (empathy or intimacy) functioning.
- One or more pathological personality trait domains or trait facets.
- The impairments in personality functioning and the individual's personality trait expression are relatively stable across time and consistent across situations.
- The impairments in personality functioning and the individual's personality trait expression are not better understood as normative for the individual's developmental stage or socio-cultural environment.
- The impairments in personality functioning and the individual's personality trait expression are not solely due to the direct physiological effects of a substance (e.g., a drug of abuse, medication) or a general medical condition (e.g., severe head trauma).
Types of Personality Disorders
The specific personality disorders are grouped into the following three clusters based on descriptive similarities:
- Cluster A: PD characterised by odd or eccentric behaviours. This group includes Paranoid PD, Schizoid PD, Schizotypal PD.
- Cluster B: PD characterised by dramatic, emotional or erratic behaviours. This group includes Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD.
- Cluster C: PD characterised by anxious or fearful behaviours. This groups include Avoidant PD, Dependent PD, Obsessive-compulsive PD.
- One variation of personality disorder is a condition that has yet to be identified or the clinician is unsure of. In technical terms, this condition is listed as “Personality Disorder Not Otherwise Specified”.
Paranoid Personality Disorder: This condition describes a person who has a pattern of paranoid thinking and distrust of others. The symptomology includes distrust of others, paranoid ideations, rigid and unforgiving, and can be overly sensitive to criticism.
Schizoid Personality Disorder: Schizoid personality disorder is characterized as a pattern of social isolation. People with this disorder can be seen as odd, eccentric and may have trouble communicating their thoughts and feelings. While this disorder has some similarities with schizophrenia, it’s actually different due to the lack of psychosis and hallucinations.
Schizotypal Personality Disorder: this condition is characterized by an odd or eccentric thinking pattern, and the general inability (or unwillingness) to socialize with others. Strange behavior, difficulty with intimacy, and chronic cognitive distortions are common with this condition.
Antisocial Personality Disorder: also sometimes referred to as psychopathy, this condition is characterized a pattern of misbehavior which may include, but not be limited to manipulation of others, machiavellistic tendencies, superficial charm, coldness, and even criminal behavior. This disorder is thought to have a heavy presence in the criminal population.
Borderline Personality Disorder: this disorder is characterized by extreme inappropriate anger, chronic feelings of emptiness, unstable relationships, and a pervasive pattern of lack of identity. People with this condition have a high mortality rate as suicide (along with Non-Suicidal Self-Harm) is widely present.
Histrionic Personality Disorder: this condition is characterized by an excessive need to be the center of attention, as well as seductive dress and behavior. People with this condition are thought to be hysterical (which they mask well), and have a great need for approval and admiration.
Narcissistic Personality Disorder: this well-known disorder is a characterized by an over-inflated sense of self-worth or importance.
Avoidant Personality Disorder: people with this condition have an anxious over-reaction to normal events and criticism. They suffer from low self-esteem, and are considered fearful of rejection. The intense anxiety and fear of rejection causes them to avoid other people or social situations.
Dependent Personality Disorders his condition is characterized by excessive fear of independence. People with this condition often cling to others, and have difficulty making decisions free of input from others.
Obsessive Compulsive Personality Disorder: this condition is marked by a pattern of obsessive rituals which a person must perform in order to be able to relax. Some people with this condition wash their hands excessively, others perform a series of complex rituals which usually revolve around cleanliness.
Personality Disorder not otherwise specified: this condition mostly is given as a tentative or provisional diagnosis during the case conceptualization process. The diagnosis describes a personality disorder that he psychologists has not identified.
Masochistic Personality Disorder: otherwise known as Self-Defeating Personality Disorder is a condition that is currently not in the DSM. This disorder is what the name implies, the person has a pervasive patter of self-sabotage in all avenues of life into include, romantic, sexual, professional, educational, and other types of relationships.
Personality Disorders Treatment in London
There are four general underlying methodologies for treating personality disorders, and they are cognitive, behavioral, psychoanalytic, and eclectic.
The cognitive approach to treating personality disorders theorizes that the maladaptive behavioral patterns are the results of distorted cognition (faulty thinking processes) which must be corrected in order to correct the emotive element, which leads to improvement in the behavioral aspect. For example, recent studies into specialized CBT techniques designed to reduce criminogenic cognition in patients at a forensic correctional institution yielded promising results. By performing specialized Behavioral Experiments (BE), the psychologists were able to significantly reduce criminal thinking and behavior in patients with severe antisocial personality traits.
The Behavioral theory for treating mental disorders differs from the cognitive approach as this personality disorders treatment model only measures observable data. Internal mental processes such as cognition are thought to be unreliable because clinicians have no way to measure them, since they really cannot be seen. Instead, behaviorists postulate that only behavior may be corrected because it is both observable and therefore measurable. According to Behaviorist theories, personality disorders are learned behavior, and any behavior that is learned may be unlearned.
The Psychoanalytic Model of treatment for personality disorders theorize that psychic difficulties derive from childhood traumas, affectional problems with the parents, or disturbances in development. The Psychoanalytic model places a high value on patient-doctor therapeutic rapport, with the express goal of helping the patient understand why they are the way they are. This ameliorative process promotes personal growth as the patients also face the traumatic events or ideas causing the psychic tension which has interfered with growth or caused severe emotional distress.
Eclectic approaches are psychotherapeutic interventions that combines one or more of the aforementioned behavioral approaches. For example, an eclectic model of behaviorist approaches combined with CBT is using both the cognitive and behavioral approaches to correcting a problem (which is often quite effective).
Dialectical Behavioral Therapy (DBT) is one such approach that uses an eclectic model of personality disorders treatment. DBT combines the uses of Cognitive approaches (Cognitive Behavioral Therapy as well as Rational Emotive Behavioral Therapy) as well as some elements of behavioral and mindfulness (meditation) techniques.
Schema Therapy is another example of an eclectic method. This therapeutic approach combines both CBT with Gestalt Experiential Therapy. and Psychoanalytic Theories. The main theory in this approach is to correct both the Cognitive schema (which is thought to have chronic distortions) as well as to correct schematic viewpoints which the patient may have, which may be maladaptive or self-defeating in nature.
Mentalization Based Therapy is based on psychoanalytic principles. Mentalization is the metacognitive process by which people interpret the significance of both their own mental states, behaviors, and motivations, as well as other people’s motivations, behaviors, and mental states. In other words, mentalization is a social construct that helps us to make sense of the affect and actions of not only other people, but ourselves too. Mentalization is a key component in the development of social constructs, which is how we make sense of he world. Studies into Theory of Mind (TOM) discovered that patients with mental illness had difficulty not only understanding their own mental states, but they also had trouble interpreting the mental states of others, and this had a negative impact on not only emotional affect, but on relational connectivity as well. Mentalization should not be confused for Mindfulness. Mentalization Based therapy seeks to improve mentalization in patients to help them better understand the mental states of themselves and others, which improves relational affect, decreases impulsiveness, and improves emotional regulation overall. Contact us for Personality Disorders Therapy & Treatment in London.
How can friends and family help with a Personality Disorder?
Personality Disorders Therapy - It is important to note that the relationships a person provides a foundational network of support, which may be critical to recovery. Personality Disorders Specialists believe that mental illness does not originate in faulty internal mental processing, but rather from unhealthy relational difficulties within the family. Personality Disorders Specialists may work with the patient on a one on one basis, but they would really rather work with the patient and their families. The concept is, once the maladaptive relational patterns are corrected, the patients (and their family members) experience individualistic healing and growth. By being supportive and encouraging treatment, the family and friends of the patient may not only help the patient get better, but they may also save his or her life.
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