The ancient Greeks were among the first to elicit that certain personality traits are problematic. For instance, they described “melancholia” and “hysteria,” which can be seen as early descriptions of what we now know as personality disorders. Sigmund Freud and his psychoanalytic theory in the late 19th and early 20th centuries greatly influenced the understanding of personality disorders. Freud identified various personality types and proposed that childhood experiences and
unconscious conflicts contribute to the development of personality pathology.
As per DSM 5, a personality disorder can be diagnosed if there are significant dysfunctions in the self or interpersonal functioning altogether, with one or more pathological personality traits. These features must be stable and persistent with time and situations, abnormal for an individual’s age or socio-cultural environment and the cause behind shouldn’t be substance or medicinal.
These disorders can be puzzling and overlapping to each other, hence can be classified into clusters:
A. Odd, Eccentric (Paranoid PD, Schizoid PD. Schizotypal PD)
B. Dramatic, erratic (Antisocial PD, Borderline PD, Histrionic PD, Narcissistic PD)
C. Anxious, fearful (Avoidant PD, Dependent PD, Obsessive-compulsive PD)
Let’s talk about these in a very concise way:
Paranoid PD: Marked by pervasive distrust and fear of others, including friends, family and partner, hence stay guarded and suspicious.
Schizoid PD: Detached/Aloof, indifferent to social norms and culture, stay retreated in the inner world.
Schizotypal PD: perceived odd/strange to people, characterized by magical thinking, illusions, derealization; beliefs or intuitions that events and happenings are somehow related to them.
Antisocial PD: Marked by disregard of others feelings, irritation, aggression, impulsivity, egocentrism; rejects discipline and authority.
Borderline PD: Marked by fear of abandonment, lacks a sense of self, emotional instability, outbursts of anger and violence (when triggered). More medical attention due to self-harm and suicidal attempts.
Histrionic PD: Characterized by flamboyance, impulsiveness, excitement; dependent on others attention; sensitive to rejection and criticism.
Narcissistic PD: Marked by heightened sense of self- importance and grandiosity, self-absorbed, insensitive, destructive anger and revenge, callousness and ignorance of others.
Avoidant PD: Characterized by shyness, feeling of socially inept, crave for companionship and uncritical acceptance.
Dependent PD: Marked by fear of abandonment, relying on others for decision making, requiring extra care, childlike perspective, feels inadequate and helpless.
Obsessive Compulsive PD: excessively concerned with details, rules, lists, order, organization, or schedules; extreme perfectionism leads to incomplete projects; and devotion to work and productivity at the expense of leisure and relationships.
Personality disorders can share traits with a normal personality and overlap with another as well. Hence, they are even more difficult to characterize and diagnose. How far the impairment is significant from the normal personality also determines the course of disorder and possible diagnosis, since not everyone exhibits all the traits of the disorder. To what extent we can use the regular metric system of social and cultural norms and label people with personality dysfunction is totally subjective.
“Personal dislike, prejudice, or a clash of values can all play a part in arriving at a diagnosis of personality disorder, and it has been argued that the diagnosis amounts to little more than a convenient label for undesirables and social deviants.” – Neel Burton
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