Personality Disorder - Not Otherwise Specified (PD-NOS)

Introduction

Personality Disorder - Not Otherwise Specified is a catch-all diagnosis in the American Psychiatric Association's Diagnostic & Statistical Manual (DSM) for those who exhibit specific traits of personality disorders but who do not fit neatly into the other personality diagnoses.

DSM Criteria for Personality Disorder - Not Otherwise Specified (PD-NOS)

Personality Disorder - Not Otherwise Specified (PD-NOS) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as follows:

This category is for disorders of personality functioning that do not meet criteria for any specific Personality Disorder.

  • An example is the presence of features of more than one specific Personality Disorder that do not meet the full criteria for any one Personality Disorder (“mixed personality”), but that together cause clinically significant distress or impairment in one or more important areas of functioning (e.g., social or occupational).
  • This category can also be used when the clinician judges that a specific Personality Disorder that is not included in the Classification is appropriate.
  • Examples include depressive personality disorder and passive-aggressive personality disorder (see Appendix B in DSM-IV-TR for suggested research criteria).

General Criteria for a Personality Disorder

The American Psychiatric Association's Diagnostic & Statistical Manual (DSM) defines general criteria for a personality disorder. The definitions in the current 4th edition (DSM-IV) and the new forthcoming 5th edition (DSM-V) differ slightly as follows:

DSM General Criteria for a Personality Disorder

A. An enduring pattern of inner experience and behavior the deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:

  1. Cognition (i.e., ways of perceiving and interpreting self, other people and events)
  2. Affectivity (i.e., the range, intensity, liability, and appropriateness of emotional response)
  3. Interpersonal functioning
  4. Impulse control

B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.

C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.

D. The pattern is stable and of long duration, and its onset can be traced back at least to adolescence or early adulthood.

E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.

F. The enduring pattern is not due to the direct physiological effects of a substance (e.g., a drug abuse, a medication) or a general medical condition (e.g., head trauma).

Obsessive-Compulsive Personality Disorder (OCPD)

Introduction

Obsessive Compulsive Personality Disorder (OCPD) is characterized by an inflexible adherence to rules or systems or an affinity to cleanliness and orderly structure.

OCPD is sometimes referred to as Anankastic Personality Disorder.

OCPD people may be mistrusting of others who may not hold the same convictions or understand their need for things to be just right. They may have trouble delegating, trusting others, sharing responsibilities or compromising. They may be obsessively clean or hygienic.

OCPD vs OCD

Although they may be similar, Obsessive-Compulsive Personality Disorder (OCPD) is a different condition from the more commonly known Obsessive Compulsive Disorder (OCD). OCD is often characterized by a repetition or adherence to rituals. OCPD is characterized more by an unhealthy adherence to perfectionism.

Obsessive-Compulsive Personality Disorder (OCPD) - The DSM Criteria

Obsessive-Compulsive Personality Disorder (OCPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster C (anxious or fearful) Personality Disorder.

Obsessive-Compulsive Personality Disorder (OCPD) is defined by exhibiting at least four of the following:

  1. Preoccupation with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost.
  2. Showing perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met).
  3. Excessive devotion to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity).
  4. Being over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification).
  5. Inability to discard worn-out or worthless objects even when they have no sentimental value.
  6. Reluctance to delegate tasks or to work with others unless they submit to exactly his or her way of doing things.
  7. Adopting a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes.
  8. Shows rigidity and stubbornness.

OCPD Characteristics & Traits

Every relationship between a Personality-Disordered Individual and a Non Personality-Disordered Individual is as unique as the DNA of the people involved. Nevertheless, there are some common behavior patterns.

The following are descriptions of characteristics and behaviors which may be observed in an individual who suffers from obsessive compulsive personality disorder. This list includes direct traits which occur in OCPD sufferers and comorbid traits from other related personality disorders which may also occur in an OCPD sufferer. The list below contains descriptions as observed by family members and partners. Examples are given of each trait, with descriptions of what it feels like to be caught in the crossfire and some good (and bad) ideas for coping.

Please note that these descriptions are not intended for diagnosis. No one person exhibits all of the traits and the presence of one or more traits is not evidence of a personality disorder.  For a list of traits used in clinical diagnosis of OCPD refer to the OCPD DSM Criteria section.

These descriptions are offered in the hope that non-personality-disordered family members, caregivers & loved-ones might recognize some similarities to their own situation and discover that they are not alone. Click on the links to read more about each trait.

Alienation - The act of cutting off or interfering with an individual's relationships with others.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Hoarding - Accumulating items to an extent that it becomes detrimental to quality of lifestyle, comfort, security or hygiene.

Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Mood Swings - Unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Objectification - The practice of treating a person or a group of people like an object.

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Passive-Aggressive Behavior - Expressing negative feelings in an unassertive, passive way.

Perfectionism - The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.

Projection - The act of attributing one's own feelings or traits to another person and imagining or believing that the other person has those same feelings or traits.

Proxy Recruitment - A way of controlling or abusing another person by manipulating other people into unwittingly backing “doing the dirty work”

Push-Pull - A chronic pattern of sabotaging and re-establishing closeness in a relationship without appropriate cause or reason.

Ranking and Comparing - Drawing unnecessary and inappropriate comparisons between individuals or groups.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Triggering -Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

OCPD Treatment

Treatment of OCPD is usually centered around a combination of psychotherapy and behavioral therapy. Secondary symptoms such as depression and anxiety are often treated using antidepressants. See our Treatment Page for lots more information about treatment of personality disorders

Movies Portraying Obsessive-Compulsive Personality Disorder Traits

Strictly speaking, these movies portray individuals with the closely related Obsessive-Compulsive Disorder.

As Good As It Gets - As Good As It Gets s a 1997 romantic comedy starring Jack Nicholson who portrays an obsessive-compulsive author and Helen Hunt, who plays a waitress who has to deal with him.

Mommie Dearest - Mommie Dearest is a 1981 biography of Hollywood Actress Joan Crawford, played by Faye Dunaway, who, according to the account in the movie, exhibited Obsessive Compulsive, Borderline and Narcissistic Traits.

Sleeping With The Enemy - Sleeping with the Enemy is a 1991 psychological thriller starring Julia Roberts, who tries to escape from her abusive husband, who suffers from Obsessive Compulsive Personality Disorder.

The Aviator - The Aviator is a 2004 drama film starring Leonardo DiCaprio based on the life of aviation pioneer Howard Hughes, a successful inventor, film producer and aviation pioneer who exhibits a number of severe obsessive-compulsive traits.

OCPD Support Groups & Links:

Out of the FOG Support Forum - Support for family members and loved-ones here at Out of the FOG.

http://ocpd.freeforums.org/index.php - Obsessive-Compulsive Personality Disorder Support Group - for those with OCPD and their loved ones.

Dependent Personality Disorder (DPD)

Introduction

Dependent Personality Disorder is a mental illness which results in submissive and clinging behavior, a fear of separation and an inappropriate reliance on others.

The DPD sufferer often feels helpless or unable to cope independently - and frequently and inappropriately seeks to transfer responsibility for their situation or well-being onto another.

It's unusual for DPD to be diagnosed in children, since dependent reliance on adults is considered appropriate in minors. The disorder only has meaning in adults, for whom pervasive dependent tendencies are unhealthy or inappropriate.

People who suffer from DPD generally avoid professional occupations or positions of responsibility and become agitated or anxious when faced with certain routine, sometimes trivial decisions.

People who suffer from DPD often maintain a very small number of relationships with people who provide for them the kind of environment that protects them from having to take responsibility for themselves.

People who suffer from DPD may also exhibit symptoms of other personality disorders such as BPD, HPD or Avoidant Personality Disorder. They are also at an increased risk of: depression; substance abuse, and of suffering abuse at the hands of others.

Dependent Personality Disorder, is believed to occur in about 1 in every 200 adults. It is generally diagnosed more often in women than in men. It is most commonly diagnosed in young adults.

DPD is rarely, if ever, diagnosed in children for whom such dependent behaviors are generally considered appropriate. Dependent behavior is considered normal in childhood but, for some, this dependent behavior persists and intensifies into adulthood; thus they become diagnosed with this disorder.

Chronic physical illness, Munchausen's Syndrome or Intense separation anxiety in late childhood may be indicative of an early onset of DPD..

Living with a person who suffers from dependent personality disorder can be a frustrating, frightening, destructive experience. Yet despite being so common, few people have even heard of it.

As a caretaker to a person who suffers from Dependent Personality Disorder (DPD), you can find yourself with an ever growing sense of anger and injustice when a capable adult acts like a helpless child.

While it may seem easier in the short run to provide the kind of caretaking that a person with DPD seeks, in the long run you may be doing more harm than good to yourself and to the person you are caring for.

There are other people who have faced or are facing similar circumstances. Some of them are here on this site. We strongly urge you to read some of the stories, learn about coping with this devastating illness and ask your own questions at our message board.

DSM Criteria for Dependent Personality Disorder

Dependent Personality Disorder (DPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster C (anxious or fearful) Personality Disorder.

Dependent Personality Disorder (DPD) is listed in the DSM-IV-TR as a "Cluster C" (anxious or fearful) Personality Disorder. It is defined as:

A pervasive and excessive need to be taken care of that leads to submissive and clinging behavior and fears of separation, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Has difficulty making everyday decisions without an excessive amount of advice and reassurance from others
  2. Needs others to assume responsibility for most major areas of his or her life
  3. Has difficulty expressing disagreement with others because of fear of loss of support or approval. Note: Do not include realistic fears of retribution.
  4. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-confidence in judgment or abilities rather than a lack of motivation or energy)
  5. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
  6. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself
  7. Urgently seeks another relationship as a source of care and support when a close relationship ends
  8. Is unrealistically preoccupied with fears of being left to take care of himself or herself

A formal diagnosis of DPD requires a mental health professional to identify 5 of the above 8 criteria as positive. Some people exhibit all 8. Most exhibit only a few. 

Most people occasionally exhibit one or more of the above criteria from time to time. This does not make a person DPD. A pervasive pattern of several of the above criteria is required for a diagnosis of a personality disorder and diagnosis can only be made by a qualified mental health professional.

Understanding the clinical criteria for DPD is helpful but learning how to cope with a loved-one who suffers from DPD is quite different and is not covered in the psychological literature..

One of the most effective ways we have found to deal with that is to get support from people who understand what it feels like to try to convince a partner to take responsibility for themselves, or try not to become a 'parent' to their own parent, or try to escape the inappropriate burden of being held responsible for someone else's decisions.

Dependent Personality Disorder Traits

The following list is a collection of some of the more commonly observed behaviors and traits of those who suffer from Dependent Personality Disorder (DPD). Note that these are not intended to be used for diagnosis. People who suffer from DPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "dependent" behaviors from time to time. Therefore, if a person exhibits one or some of these traits, that does not necessarily qualify them for a diagnosis of Dependent Personality Disorder. See the DSM Criteria on this page for diagnostic criteria.

Click on the links on each trait for much more information about a particular trait or behavior and some ideas for coping with each.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Engulfment - An unhealthy and overwhelming level of attention and dependency on another person, which comes from imagining or believing one exists only within the context of that relationship.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Mirroring - Imitating or copying another person's characteristics, behaviors or traits.

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Parentification - A form of role reversal, in which a child is inappropriately given the role of meeting the emotional or physical needs of the parent or of the family’s other children.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Self-Victimization - Casting oneself in the role of a victim.

Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Stalking - Any pervasive and unwelcome pattern of pursuing contact with another individual.

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Movies Portraying Dependent Personality Disorder Traits

Single White Female - Single White Female is a 1992 Columbia Pictures Release starring Bridget Fonda and Jennifer Jason Leigh which portrays the events after a young woman takes in a roommate who exhibits some of the symptoms of Borderline Personality Disorder (BPD) and Dependent Personality Disorder (DPD) including mirroring, impulsivity and fear of abandonment.

Avoidant Personality Disorder (AVPD)

AVPD Introduction

Avoidant Personality Disorder (AVPD) is a serious condition which has been found in clinical studies to affect between 1.8% to 6.4% of the general population.

Avoidant Personality Disorder is listed in the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) as a "Cluster C" anxious or fearful disorder.

AVPD is characterized by a pattern of withdrawal, self-loathing and heightened sensitivity to criticism. People who suffer from AVPD often consider themselves socially unsuccessful and tend to remove themselves from social situations in order to avoid the feeling or the risk of feeling rejected by others.

People who live in a relationship with a person who suffers from avoidant personality disorder often recognize that something is not quite right with the behavior of their family member or loved-one but often do not know what to do about it or that there is even a name for it. They may feel trapped in the relationship and frustrated by their loved-one's tendency to pull them away from family, friends and other "everyday" social settings.

People who are in a relationship with a person who suffers from AVPD may also experience pressure to isolate themselves along with them or pressure to protect them from criticism or to create an artificial or dysfunctional "bubble" or ideal environment around them in which they can escape the risk of negative self-thought.

People who suffer from AVPD may use withdrawal as a form of communication or as a form of emotional control over friends, partners and family members.

Alternate Names for AVPD

Avoidant Personality Disorder (AvPD) is described in the World Health Organization's International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) by the alternate name Anxious Personality Disorder or Anxious (Avoidant) Personality Disorder.

Avoidant Personality Disorder (AVPD) - The DSM Criteria

Avoidant Personality Disorder (AvPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster C (anxious or fearful) Personality Disorder.

Text in Italics is quoted from the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM-IV-TR)

Avoidant Personality Disorder (AvPD) is defined as:

A pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.
  2. Is unwilling to get involved with people unless certain of being liked.
  3. Shows restraint initiating intimate relationships because of the fear of being ashamed, ridiculed, or rejected due to severe low self-worth.
  4. Is preoccupied with being criticized or rejected in social situations.
  5. Is inhibited in new interpersonal situations because of feelings of inadequacy.
  6. Views self as socially inept, personally unappealing, or inferior to others
  7. Is unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

A formal diagnosis of AvPD requires a mental health professional to identify 4 out of the above 7 criteria as positive. Some people with AvPD may exhibit all 7. Most will exhibit only a few. 

Nobody’s perfect. Even normal healthy people will experience or exhibit a few of the above criteria from time to time. This does not make a person AVPD.

Understanding the clinical criteria for Avoidant Personality Disorder (AVPD) is helpful but learning how to cope with having a loved-one who suffers from AVPD is quite different and is not covered in any psychological manual.

Characteristics of AVPD

The following is a list of some of the more common characteristics & traits of people who suffer from Avoidant Personality Disorder (AVPD). Click on the links to see more information on each trait.

Note that these traits are given as a guideline only and are not intended for diagnosis. People who suffer from AVPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "avoidant" behaviors from time to time. Therefore, if a person exhibits one or some of these traits, that does not necessarily qualify them for a diagnosis of AVPD. See the DSM Criteria on this page for diagnostic criteria for AVPD.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

"Control-Me" Syndrome - This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or "acting-out" nature.

Cruelty to Animals - Acts of Cruelty to Animals have been statistically discovered to occur more often in people who suffer from personality disorders than in the general population.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Escape To Fantasy - Taking an imaginary excursion to a happier, more hopeful place.

Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Magical Thinking - Looking for supernatural connections between external events and one’s own thoughts, words and actions.

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

Objectification - The practice of treating a person or a group of people like an object.

Obsessive-Compulsive Behavior - An inflexible adherence to arbitrary rules and systems, or an illogical adherence to cleanliness and orderly structure.

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Parentification - A form of role reversal, in which a child is inappropriately given the role of meeting the emotional or physical needs of the parent or of the family’s other children.

Passive-Aggressive Behavior - Expressing negative feelings in an unassertive, passive way.

Perfectionism - The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Self-Victimization - Casting oneself in the role of a victim.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

AVPD Statistics

Refer to our page on Personality Disorder Statistics for More Information.

Avoidant Personality Disorder has been found in separate clinical studies to affect anywhere from 1.8% to 5.2% of the general population.

People who are diagnosed with Avoidant Personality Disorder also frequently meet the criteria for other personality disorders.

The table below shows statistically how likely it is that a person who is diagnosed with AVPD will also meet the criteria for another personality disorder. The more positive the number, the more likely it is that a person will be diagnosed with the second personality disorder listed. The more negative the number, the less likely it is that a person will be diagnosed with the second personality disorder in the table.

Personality Disorder Comorbidity Odds-Ratio
Paranoid Personality Disorder 0.70
Schizoid Personality Disorder 0.55
Schizotypal Personality Disorder 0.53
Antisocial Personality Disorder 0.05
Borderline Personality Disorder 0.54
Dependent Personality Disorder 0.70
Obsessive-Compulsive Personality Disorder 0.63

Source: Lenzenweger et al, 2007 - DSM-IV personality disorders in the National Comorbidity Survey Replication

UK Hospital Admission Statistics in 2006/2007 show that 43% of those admitted with a diagnosis of AVPD were male and 57% female.

AVPD Treatment & Causes

The precise causes of AVPD are not well understood. Genetic traits and child abuse or neglect are most often associated with the disorder, but no conclusive study exists.

Most people who suffer from Avoidant Personality Disorder are, by nature, reluctant to seek out treatment and programs such as individual therapy, couples therapy and group therapy are likely to make someone with AVPD feel very uncomfortable. As a result, most cases of AVPD go undiagnosed and untreated and it is left to spouses, partners and family members and friends to do the best they can.

For those who have sought treatment, some symptoms of AVPD have been found to be reduced through prescription of SSRI antidepressants. Therapy programs typically involve social skills training, cognitive behavioral therapy and group therapy.

Movies Portraying Avoidant Personality Disorder (AvPD)

The Remains of the Day - The Remains of the Day is a 1993 Columbia Pictures Release, starring Anthony Hopkins & Emma Thompson which portrays the life of a head butler in an English Manor who manifests some of the traits of schizoid personality disorder.

Zelig - Zelig is a 1983 movie written and directed by Woody Allen who portrays a man who avoids revealing his own self by adapting his personality to mirror anyone whom he is interacting with.

AVPD Support Groups & Links:

Out of the FOG Support Forum - Support for family members and loved-ones here at Out of the FOG.

https://www.bigtent.com/groups/avoidant - Active Avoidant Personality Disorder Community

http://www.avoidantpersonality.com - Avoidant Personality Disorder Support Site.

http://groups.msn.com/AvoidantPersonalityG...ssageboard.msnw- MSN Avoidant Personality Group.

Psychforums AVPD forum - Psychforums Site

Narcissistic Personality Disorder (NPD)

Introduction

Narcissistic Personality Disorder is a serious condition which affects an estimated 1% of the population. Narcissism is characterized by an extreme self-interest and promotion with an accompanying lack of concern for the needs of others.

Narcissism is named after the mythological Greek character Narcissus, an extremely handsome young man who rejected the love of Echo and, as punishment, was condemned to fall in love with his own reflection in a pool of water. Unable to obtain he object of his desire, he died there in sorrow.

Narcissistic Personality Disorder (NPD) - The DSM Criteria

Narcissistic Personality Disorder (NPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as an Axis II, Cluster B (dramatic, emotional, or erratic) Disorder:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)
  2. is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love
  3. believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)
  4. requires excessive admiration
  5. has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations
  6. is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends
  7. lacks empathy: is unwilling to recognize or identify with the feelings and needs of others
  8. is often envious of others or believes that others are envious of him or her
  9. shows arrogant, haughty behaviors or attitudes

NPD Characteristics & Traits

The following list is a collection of some of the more commonly observed behaviors and traits of those who suffer from Narcissistic Personality Disorder (NPD). Note that these are not intended to be used for diagnosis. People who suffer from NPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "narcissistic" behaviors from time to time. Therefore, if a person exhibits one or some of these traits, that does not necessarily qualify them for a diagnosis of Narcissistic Personality Disorder. See the DSM Criteria on this page for diagnostic criteria.

Click on the links on each trait for much more information about a particular trait or behavior and some ideas for coping with each.

Abusive Cycle - This is the name for the ongoing rotation between destructive and constructive behavior which is typical of many dysfunctional relationships and families.

Alienation - The act of cutting off or interfering with an individual's relationships with others.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Baiting - A provocative act used to solicit an angry, aggressive or emotional response from another individual.

BelittlingCondescending and Patronizing - This kind of speech is a passive-aggressive approach to giving someone a verbal put-down while maintaining a facade of reasonableness or friendliness.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Bullying - Any systematic action of hurting a person from a position of relative physical, social, economic or emotional strength.

Cheating - Sharing a romantic or intimate relationship with somebody when you are already committed to a monogamous relationship with someone else.

Chronic Broken Promises - Repeatedly making and then breaking commitments and promises is a common trait among people who suffer from personality disorders.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dissociation- A psychological term used to describe a mental departure from reality.

Domestic Theft - Consuming or taking control of a resource or asset belonging to (or shared with) a family member, partner or spouse without first obtaining their approval.

Emotional Abuse - Any pattern of behavior directed at one individual by another which promotes in them a destructive sense of Fear, Obligation or Guilt (FOG).

Emotional Blackmail - A system of threats and punishments used in an attempt to control someone’s behaviors.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Favoritism and Scapegoating - Systematically giving a dysfunctional amount of preferential positive or negative treatment to one individual among a family group of peers.

Frivolous Litigation - The use of unmerited legal proceedings to hurt, harass or gain an economic advantage over an individual or organization.

Gaslighting - The practice of brainwashing or convincing a mentally healthy individual that they are going insane or that their understanding of reality is mistaken or false. The term “Gaslighting” is based on the 1944 MGM movie “Gaslight”.

Grooming - Grooming is the predatory act of maneuvering another individual into a position that makes them more isolated, dependent, likely to trust, and more vulnerable to abusive behavior.

Harassment - Any sustained or chronic pattern of unwelcome behavior by one individual towards another.

Hoovers & Hoovering - A Hoover is a metaphor taken from the popular brand of vacuum cleaners, to describe how an abuse victim trying to assert their own rights by leaving or limiting contact in a dysfunctional relationship, gets “sucked back in” when the perpetrator temporarily exhibits improved or desirable behavior.

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

Impulsiveness - The tendency to act or speak based on current feelings rather than logical reasoning.

Intimidation - Any form of veiled, hidden, indirect or non-verbal threat.

Invalidation - The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.

Lack of Conscience - Individuals who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

Narcissism - A set of behaviors characterized by a pattern of grandiosity, self-centered focus, need for admiration, self-serving attitude and a lack of empathy or consideration for others.

Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

Normalizing - Normalizing is a tactic used to desensitize an individual to abusive, coercive or inappropriate behaviors. In essence, normalizing is the manipulation of another human being to get them to agree to, or accept something that is in conflict with the law, social norms or their own basic code of behavior.

"Not My Fault" Syndrome - The practice of avoiding personal responsibility for one's own words and actions.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Objectification - The practice of treating a person or a group of people like an object.

Parental Alienation Syndrome - When a separated parent convinces their child that the other parent is bad, evil or worthless.

Pathological Lying - Persistent deception by an individual to serve their own interests and needs with little or no regard to the needs and concerns of others. A pathological liar is a person who habitually lies to serve their own needs.

Proxy Recruitment - A way of controlling or abusing another person by manipulating other people into unwittingly backing “doing the dirty work”

Ranking and Comparing - Drawing unnecessary and inappropriate comparisons between individuals or groups.

Raging, Violence and Impulsive Aggression - Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Scapegoating - Singling out one child, employee or member of a group of peers for unmerited negative treatment or blame.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Self-Aggrandizement - A pattern of pompous behavior, boasting, narcissism or competitiveness designed to create an appearance of superiority.

Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Sexual Objectification - Viewing another individual in terms of their sexual usefulness or attractiveness rather than pursuing or engaging in a quality interpersonal relationship with them.

Shaming - The difference between blaming and shaming is that in blaming someone tells you that you did something bad, in shaming someone tells you that you are something bad.

Stalking - Any pervasive and unwelcome pattern of pursuing contact with another individual.

Targeted Humor, Mocking and Sarcasm - Any sustained pattern of joking, sarcasm or mockery which is designed to reduce another individual’s reputation in their own eyes or in the eyes of others.

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Threats - Inappropriate, intentional warnings of destructive actions or consequences.

Triangulation - Gaining an advantage over perceived rivals by manipulating them into conflicts with each other.

What it feels like to live with someone with NPD

Contributed by Member Aames

Living with or being involved with a narcissist can be mentally and emotionally exhausting.

It can feel like you have to perform "mental gymnastics" from dealing with the lying (even when confronted with undeniable proof ), the gaslighting, the triangulation, the projection, the constant contradictions, the manipulation, blame-shifting, the charm they lay on, the inflated sense of self - even subtle forms of torture, such as sleep deprivation, these people inflict on their victims - appears to be conscious and calculated to push the target of their "affections" past their limits, into surrender - and ultimately into total compliance - as a source of Narcissistic Supply. 

Children, spouses, friends, lovers - those closest to the Narcissist - are not considered individuals in their own right by the Narcissist - but rather extensions or, in the worst cases, the property of the Narcissist. 

Even after finding out that you are dealing with a mental disorder, if you don't protect or remove yourself from the situation, you may find yourself entering into a state of mind where you instinctively try to fix or fight the narcissist's illogical attitudes and behaviors.

You may find yourself becoming hyper-vigilant, trying to second guess them, trip them up, lay down ultimatums, call them on their lies, or constantly trying to stay one-step ahead of their ever-changing rule-book. You may even find yourself trying to mirror their behaviors to some extent in order to manipulate them, as they have manipulated you. This can be both futile and attractive to the narcissist, as they often relish the challenge. 

If you ever do manage to get "one-up" on a narcissist, it is likely to be a hollow "victory" at best. They may rage, play the victim, or disappear. None of these outcomes gives the victim any true satisfaction. 

More than any other disorder on the PD spectrum, narcissists are like psychological vampires, attaching themselves to you in a way that drains you of your resources (emotional, mental and financial) and leaves you questioning your own worth and sanity.

Often, narcissists are able to imitate or approximate caring about others when it is convenient for them to do so. However, they typically do not perceive that anything outside of their own sphere of wants and needs matters. It simply doesn't occur to them to consider the needs of anyone else, or the long-term consequences of their own behaviors.

Narcissists can be highly intelligent, witty, talented, likable, and fun to be around. They can also elicit sympathy like nobody's business.

Narcissists are opportunistic. They can make a show of being "generous" but their generosity usually has strings attached.

They tend to isolate their victims, sucking up their time and energy, many times robbing their own families, spouses and partners of an external support system.

Narcissists are excellent liars and many prefer to lie even when telling the truth would be more beneficial to them; which suggests that lying is a hallmark of this pathology.

They are often highly competitive and argumentative. They lash out when presented with opinions that contradict their own or when confronted with their own lies or bad behaviors.

They can be calculating and extremely persuasive and susceptible to erratic thinking and impulsive decision making . 

Narcissists can be self-destructive as often as they are destructive to others. They have a great deal of trouble accepting responsibility for their own actions, under any circumstance.

Narcissists are addictive personalities and narcissism is commonly co-morbid with addictions to drugs, alcohol, sex, food, spending and gambling. It has been suggested that Narcissists have a higher rate of ADHD than the general population.

Narcissists are rarely alone. They like to feed on the energy of others, and to have an audience to reflect back to them the person they want to see themselves as.

Narcissists are good at pretending, but typically do not feel compassion or empathy or consider the feelings or well-being of others. They tend to be singularly focused on getting their own needs met, at the expense of the needs of others.

While narcissists generally portray a lack of conscience, they typically have an intellectual awareness of what they are doing and how they hurt others. They simply do not care.

Being kind to a Narcissist in the face of their maltreatment is a common approach of family members and partners. However, this can result in further frustration as it is rarely reciprocated and tends to feed their sense of entitlement, opening the door for more abuse.

Here are some other feelings that you may experience when dealing with a narcissist in the home or at work:

  • You may feel like this person readily puts you down just to elevate themselves.
  • You may find yourself avoiding them because trying to communicate with them leaves you feeling confused, put-down, reduced to a lesser status and emptied of all that you know you really are.
  • You may feel overwhelmed, "out-gunned", tongue-tied or overpowered in the presence of this person. 
  • You may feel blown away by their powerful personality, self-assuredness, self-belief and self-confidence.
  • Your own legitimate needs may be taking a back seat to their own frivolous, self-serving ambitions.
  • When receiving a compliment or apology, you may be left feeling patronized, demeaned, brought down to size and even humiliated.
  • You may attempt to compromise with them only to realize later that you are the only one who gave any substantial ground.
  • You may feel like your hard work and contributions are only being used, abused and and distorted to meet the selfish ambitions of another.

Living with a person who has NPD can have a devastating effect on the self-esteem, confidence and quality of life for family members, friends and partners.

People who live with an individual with NPD sometimes feel as though the Narcissist is refusing to "grow up" or will revert back to childish ways whenever it suits them to do so. The Non-Narcissist often feels used, cheated and taken advantage of by the NPD in their life.

NPD Treatment

There is no known cure for NPD.

People who suffer from NPD rarely seek out treatment or therapy, since they tend to project negative thoughts and blame onto others. Those who do enter into treatment are often resistant to personal change.

As a result, families of people who suffer from NPD are often left to fend for themselves and rely on their own resources.

NPD Possible Causes

The causes for NPD are not precisely known. Some functional MRI studies have shown neurological differences characterizing people who suffer form NPD.

Movies Portraying Narcissistic Personality Disorder Traits

A Streetcar Named Desire - A Streetcar Named Desire is a is a 1947 play written by Tennessee Williams, later adapted for film, which tells the story of a woman who displays histrionic and borderline traits, who goes to live with her codependent sister and her narcissistic husband.

Black Swan - Black Swan is a 2010 psychological thriller about a ballet dancer, played by Natalie Portman, who discovers a dark side to herself as she struggles to please her overbearing narcissitic mother, played by Barbara Hershey.

Charlie Brown - Charlie Brown is the lead character in Charles M. Schulz's classic "Peanuts" cartoons who is generally portrayed as feeling insecure and seeking acceptance. Charlie Brown's character contrasts with the somewhat narcissistic character of Lucy and their relationship is sometimes used to illustrate the relationship between personality-disordered and non-personality-disordered people.

Gaslight - Gaslight is a 1944 MGM suspense thriller set in 19th Century London in which the villain, Gregory Anton (Charles Boyer), in an attempt to cover up his crimes, actively tries to convince his new wife, Paula (Ingrid Bergman) that she is losing her mind. Gaslight gave it's name to the practice known as Gaslighting.

Mommie Dearest - Mommie Dearest is a 1981 biography of Hollywood Actress Joan Crawford, played by Faye Dunaway, who, according to the account in the movie, exhibited Obsessive Compulsive, Borderline and Narcissistic Traits.

Schindler's List - Schindler's List is a 1993 drama which chronicles the suffering of Jews in Nazi-occupied Poland during World War II and Oskar Schindler, a German businessman who rescued over a thousand of them by employing them in his factories. The movie includes a striking portrayal of Amon Göth, a narcissistic SS officer and camp director, played by Ralph Fiennes.

NPD Support Groups & Links:

Out of the FOG Support Forum - Support for family members and loved-ones here at Out of the FOG.

http://www.psychforums.com/narcissistic-personality/ - Psychforums NPD Board

http://health.groups.yahoo.com/group/Adult...enOFNarcissits- Yahoo group for adult children of Narcissistic parents.

http://p208.ezboard.com/bnarcissisticperso...oderfamilyforum- Narcissistic Personality Disorder Family Forum

Light's Blog - Info Sharing Blog for Survivors of Narcissism.

It's All About Him - support site and discussion forum for women with NPD partners.

http://bnarcissisticabuserecovery.runboard.com/ - Narcissistic Abuse Recovery Forum

Antisocial Personality Disorder (ASPD)

Introduction

  • Does your loved one persistently lie to you or steal from you?
  • Do you get the feeling that they have no remorse for hurting you?
  • Does your loved one have a childhood diagnosis of conduct disorder?
  • Are your fearful of your safety? Is your loved one prone to violence and/or aggressive behavior?
  • Is your loved one unable to keep and maintain friendships? 
  • Have you noticed that your loved one has an extreme sense of entitlement, often putting your needs last or not considering them at all?
  • Do you believe your loved one when they compliment you, or does it seem superficial and manipulative?
  • Is your loved one reckless and impulsive? Does it seem as they have no self control? Do they have recurring difficulties with the law because of this?

If you answered "yes" to any of these questions, you may possibly be dealing with somebody who suffers from Antisocial Personality Disorder (ASPD)

Antisocial personality disorder is a serious mental health condition which affects an estimated 1-4% of the population. UK Statistics indicate that over 90% of ASPD diagnoses are given to men.  See Statistics.

People with ASPD can appear to others as if they just don’t care about anybody or anything but themselves. They are frequently distrustful of authority figures and often find themselves in trouble with the law.

Because of their destructive behaviors, people with ASPD are sometimes viewed by others with judgment and without empathy. Their families, especially their parents, often come under criticism. It is important to understand that there is a distinct neurological basis for personality disorders and that the behaviors of those who suffer from them, while often destructive, cannot be adequately explained purely on moral or ethical grounds.

A convincing academy award-winning portrayal of a young woman suffering from ASPD was given by Angelina Jolie who played the role of Lisa Rowe in the 1999 movie Girl, Interrupted.

Antisocial Personality Disorder (ASPD) - The DSM Criteria

Antisocial Personality Disorder (ASPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster B (dramatic, emotional, or erratic) Personality Disorder:

A pervasive pattern of disregard for and violation of the rights of others occurring since age 15, as indicated by three (or more) of the following:

  1. Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
  2. Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
  3. Impulsivity or failure to plan ahead
  4. Irritability and aggressiveness, as indicated by repeated physical fights or assaults
  5. Reckless disregard for safety of self or others
  6. Consistent irresponsibility, as indicated by repeated failure to sustain steady work or honor financial obligations
  7. Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

The manual lists the following additional necessary criteria:

  1. The individual is at least 18 years of age.
  2. There is evidence of conduct disorder with onset before age 15 years.
  3. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.

ASPD Characteristics & Traits

The following list is a collection of some of the more commonly observed behaviors and traits of those who suffer from Antisocial Personality Disorder (ASPD). Note that these are not intended to be used for diagnosis. Click on the links on each trait for much more information about a particular trait or behavior and some ideas for coping with each.

Note that these traits are given as a guideline only and are not intended for diagnosis. People who suffer from ASPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "antisocial" behaviors from time to time. Therefore, if a person exhibits one or some of these traits, that does not necessarily qualify them for a diagnosis of ASPD. See the DSM Criteria on this page for diagnostic criteria.

Acting Out - Acting Out behavior refers to a subset of personality disorder traits that are more outwardly-destructive than self-destructive.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Baiting - A provocative act used to solicit an angry, aggressive or emotional response from another individual.

BelittlingCondescending and Patronizing - This kind of speech is a passive-aggressive approach to giving someone a verbal put-down while maintaining a facade of reasonableness or friendliness.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Bullying - Any systematic action of hurting a person from a position of relative physical, social, economic or emotional strength.

Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Cheating - Sharing a romantic or intimate relationship with somebody when you are already committed to a monogamous relationship with someone else.

Chronic Broken Promises - Repeatedly making and then breaking commitments and promises is a common trait among people who suffer from personality disorders.

Cruelty to Animals - Acts of Cruelty to Animals have been statistically discovered to occur more often in people who suffer from personality disorders than in the general population.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Domestic Theft - Consuming or taking control of a resource or asset belonging to (or shared with) a family member, partner or spouse without first obtaining their approval.

Emotional Abuse - Any pattern of behavior directed at one individual by another which promotes in them a destructive sense of Fear, Obligation or Guilt (FOG).

Emotional Blackmail - A system of threats and punishments used in an attempt to control someone’s behaviors.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Favoritism and Scapegoating - Systematically giving a dysfunctional amount of preferential positive or negative treatment to one individual among a family group of peers.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

Gaslighting - The practice of brainwashing or convincing a mentally healthy individual that they are going insane or that their understanding of reality is mistaken or false. The term “Gaslighting” is based on the 1944 MGM movie “Gaslight”.

Grooming - Grooming is the predatory act of maneuvering another individual into a position that makes them more isolated, dependent, likely to trust, and more vulnerable to abusive behavior.

Harassment - Any sustained or chronic pattern of unwelcome behavior by one individual towards

Impulsiveness - The tendency to act or speak based on current feelings rather than logical reasoning.

Intimidation - Any form of veiled, hidden, indirect or non-verbal threat.

Invalidation - The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.

Lack of Boundaries - A lack of boundaries is often at the root of long-term abusive relationships. Lack of boundaries means the absence of rules, limits and guidelines for acceptable behavior. Inconsistent or intermittent reinforcement of consequences for inappropriate behavior is common among both abusers and abuse victims.

Lack of Conscience - Individuals who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Mood Swings - Unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.

Name-Calling - Use of profane, derogatory or dehumanizing terminology to describe another individual or group.

Narcissism - A set of behaviors characterized by a pattern of grandiosity, self-centered focus, need for admiration, self-serving attitude and a lack of empathy or consideration for others.

Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

Normalizing - Normalizing is a tactic used to desensitize an individual to abusive, coercive or inappropriate behaviors. In essence, normalizing is the manipulation of another human being to get them to agree to, or accept something that is in conflict with the law, social norms or their own basic code of behavior.

"Not My Fault" Syndrome - The practice of avoiding personal responsibility for one's own words and actions.

Objectification - The practice of treating a person or a group of people like an object.

Pathological Lying - Persistent deception by an individual to serve their own interests and needs with little or no regard to the needs and concerns of others. A pathological liar is a person who habitually lies to serve their own needs.

Physical Abuse - Any form of voluntary behavior by one individual which inflicts pain, disease or discomfort on another, or deprives them of necessary health, nutrition and comfort.

Proxy Recruitment - A way of controlling or abusing another person by manipulating other people into unwittingly backing “doing the dirty work”

Push-Pull - A chronic pattern of sabotaging and re-establishing closeness in a relationship without appropriate cause or reason.

Raging, Violence and Impulsive Aggression - Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

Ranking and Comparing - Drawing unnecessary and inappropriate comparisons between individuals or groups.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Scapegoating - Singling out one child, employee or member of a group of peers for unmerited negative treatment or blame.

Self-Aggrandizement - A pattern of pompous behavior, boasting, narcissism or competitiveness designed to create an appearance of superiority.

Self-Harm - Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Sexual Objectification - Viewing another individual in terms of their sexual usefulness or attractiveness rather than pursuing or engaging in a quality interpersonal relationship with them.

Shaming - The difference between blaming and shaming is that in blaming someone tells you that you did something bad, in shaming someone tells you that you are something bad.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Stalking - Any pervasive and unwelcome pattern of pursuing contact with another individual.

Targeted Humor, Mocking and Sarcasm - Any sustained pattern of joking, sarcasm or mockery which is designed to reduce another individual’s reputation in their own eyes or in the eyes of others.

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Threats - Inappropriate, intentional warnings of destructive actions or consequences.

Triangulation - Gaining an advantage over perceived rivals by manipulating them into conflicts with each other.

Verbal Abuse - Any kind of repeated pattern of inappropriate, derogatory or threatening speech directed at one individual by another.

ASPD Causes and Treatment

Unlike the other personality disorders, people with Antisocial Personality Disorder are somewhat easier to spot than those with other personality disorders, because their behaviors often get them in trouble with institutions and individuals outside of the family.

An estimated 80% of the prison population is believed to meet the criteria for ASPD. ASPD is also associated with a high rate of substance abuse.

The precise cause of ASPD is unknown. However, there is believed to be a strong genetic component and some evidence of a relationship between neurological development and the existence of ASPD.

Treatment of ASPD is notoriously difficult and often ineffective. Many ASPD patients are forced into treatment through the legal system or through hospitalization. ASPD patients often treat the therapist as they would another authority figure leading to an often rocky doctor-patient relationship.

See our Treatment Page for lots more information about treatment of personality disorders.

Movies Portraying Antisocial Personality Disorder Traits

Girl, Interrupted - Girl, Interrupted is a 1999 Columbia Pictures movie which chronicles the experiences of a teenage girl with Borderline Personality Disorder, who is admitted to a mental health institution after attempting suicide.

Dr. Jekyll and Mr. Hyde - The Strange Case of Dr. Jekyll and Mr. Hyde is an 1886 book written by Robert Louis Stevenson which has been adapted into numerous movies and stage productions. The story portrays the mild-mannered Doctor Henry Jekyll, who unleashes his monstrous alternate identity, Edward Hyde, by taking a chemical potion.

Rachel Getting Married - Rachel Getting Married is a 2008 Sony Pictures Classics Release starring Anne Hathaway which chronicles the events surrounding the appearance of a young woman who suffers from Antisocial Personality Disorder at her sister's wedding.

The Silence of the Lambs - The Silence of the Lambs is a 1991 thriller starring Anthony Hopkins and Jodie Foster which features a psychopathic serial killer, Hannibal Lecter, who advises a young FBI agent as she tries to stop another serial killer.

ASPD Support Groups & Links:

psychopathfree - Support site for victoms of psychopathic abuse.

Psychforums ASPD forum - Psychforums Site.

Histrionic Personality Disorder (HPD)

HPD Introduction

Histrionic Personality Disorder is characterized by an extreme interest in drawing the attentions of others, favorable or unfavorable, to oneself.

HPD is estimated to affect up to 1% of the population.

People who suffer from HPD are sometimes accused of being a "drama queen" or "drama major". They are the people who grab the microphone, hog the limelight, always change the subject to themselves, behave outrageously, have tantrums and generally refuse to be ignored.

HPD is a serious condition that isolates those who surround the people who have the disorder.

A mnemonic that has sometimes been used to describe the criteria for histrionic personality disorder is “PRAISE ME”:

P - provocative (or seductive) behavior
R - relationships, considered more intimate than they are
A - attention, must be at center of
I - influenced easily
S - speech (style) - wants to impress, lacks detail
E - emotional liability, shallowness

M - make-up - physical appearance used to draw attention to self
E - exaggerated emotions - theatrical

However, people who suffer from HPD are often just as interested in attracting negative attention, including shock, anger, outrage, shame, guilt and remorse.

Histrionic Personality Disorder (HPD) - The DSM Criteria

Histrionic Personality Disorder (HPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster B (dramatic, emotional, or erratic) Personality Disorder:

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Is uncomfortable in situations in which he or she is not the center of attention
  2. Interaction with others is often characterized by inappropriate sexually seductive or provocative behavior
  3. Displays rapidly shifting and shallow expression of emotions
  4. Consistently uses physical appearance to draw attention to self
  5. Has a style of speech that is excessively impressionistic and lacking in detail
  6. Shows self-dramatization, theatricality, and exaggerated expression of emotion
  7. Is suggestible, i.e., easily influenced by others or circumstances
  8. Considers relationships to be more intimate than they actually are.

HPD Characteristics & Traits

The following list is a collection of some of the more commonly observed behaviors and traits of those who suffer from HPD. Click on the links on each one for more information about a particular trait or behavior and some ideas for coping with each.

Note that these traits are given as a guideline only and are not intended for diagnosis. People who suffer from HPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "borderline" behaviors from time to time. Therefore, if a person exhibits one or some of these traits, that does not necessarily qualify them for a diagnosis of HPD. See the DSM Criteria on this page for diagnostic criteria.

Acting Out - Acting Out behavior refers to a subset of personality disorder traits that are more outwardly-destructive than self-destructive.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Baiting - A provocative act used to solicit an angry, aggressive or emotional response from another individual.

BelittlingCondescending and Patronizing - This kind of speech is a passive-aggressive approach to giving someone a verbal put-down while maintaining a facade of reasonableness or friendliness.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Cheating - Sharing a romantic or intimate relationship with somebody when you are already committed to a monogamous relationship with someone else.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Dissociation- A psychological term used to describe a mental departure from reality.

Emotional Abuse - Any pattern of behavior directed at one individual by another which promotes in them a destructive sense of Fear, Obligation or Guilt (FOG).

Emotional Blackmail - A system of threats and punishments used in an attempt to control someone’s behaviors.

Engulfment - An unhealthy and overwhelming level of attention and dependency on another person, which comes from imagining or believing one exists only within the context of that relationship.

Escape To Fantasy - Taking an imaginary excursion to a happier, more hopeful place.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Favoritism and Scapegoating - Systematically giving a dysfunctional amount of preferential positive or negative treatment to one individual among a family group of peers.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

Frivolous Litigation - The use of unmerited legal proceedings to hurt, harass or gain an economic advantage over an individual or organization.

Harassment - Any sustained or chronic pattern of unwelcome behavior by one individual towards another.

Holiday Triggers - Mood Swings in Personality-Disordered individuals are often triggered or amplified by emotional events such as family holidays, significant anniversaries and events which trigger emotional memories.

Hoovers & Hoovering - A Hoover is a metaphor taken from the popular brand of vacuum cleaners, to describe how an abuse victim trying to assert their own rights by leaving or limiting contact in a dysfunctional relationship, gets “sucked back in” when the perpetrator temporarily exhibits improved or desirable behavior.

Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

Impulsiveness - The tendency to act or speak based on current feelings rather than logical reasoning.

Invalidation - The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.

Lack of Conscience - Individuals who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.

Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

Mood Swings - Unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.

"Not My Fault" Syndrome - The practice of avoiding personal responsibility for one's own words and actions.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Push-Pull - A chronic pattern of sabotaging and re-establishing closeness in a relationship without appropriate cause or reason.

Raging, Violence and Impulsive Aggression - Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Riding the Emotional Elevator - Taking a fast track to different levels of emotional maturity.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Aggrandizement - A pattern of pompous behavior, boasting, narcissism or competitiveness designed to create an appearance of superiority.

Self-Harm - Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Self-Victimization - Casting oneself in the role of a victim.

Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Silent Treatment - A passive-aggressive form of emotional abuse in which displeasure, disapproval and contempt is exhibited through nonverbal gestures while maintaining verbal silence.

Situational Ethics - A philosophy which promotes the idea that, when dealing with a crisis, the end justifies the means and that a rigid interpretation of rules and laws can be set aside if a greater good or lesser evil is served by doing so.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Stunted Emotional Growth - A difficulty, reluctance or inability to learn from mistakes, work on self-improvement or develop more effective coping strategies.

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Threats - Inappropriate, intentional warnings of destructive actions or consequences.

Triggering -Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

What it feels like to live with someone with HPD

Living with a person who suffers from HPD can be an exhausting, humiliating, frustrating and isolating experience. It may feel like living with a toddler or child.

When they create chaos, it is often you who are the one who has to clean it up, be the "reasonable" one, make excuses and pay the consequences.

People who act out with HPD traits typically do not seek solutions to the problems they manufacture, because solutions tend to reduce the amount of attention they are likely to receive. Those closest to them often become frustrated as their attempts to help out or improve the situation often go ignored and may even be sabotaged.

It's also common for people closest to an HPD suffer to temporarily "abandon" caring for the person in an attempt to "teach them a lesson" after their attempts to help have been ignored or rejected. However, this is likely to trigger an equally hysterical "why don't you care" reaction. This often leaves the non-personality-disordered individual feeling trapped, used, and manipulated.

Trying to make someone with HPD happy may feel like trying to fill a black hole or empty the ocean.  Your loved one’s personality disorder often prevents them from seeing the destructiveness of their own behaviors and keeps them from noticing or empathizing with your own needs .

When your loved one acts out in front of other people, you may feel embarrassed or humiliated to be associated with them. You may feel as though others assume that you are guilty by association. You may begin to avoid public groups, settings and situations for fear that it will not go well.

When your loved one acts out destructively, you may fear their next move. You may feel afraid for your own safety or feel angry that you are not being treated with respect.

Other symptoms of living with a person who suffers from HPD:

  • Important problems or concerns take a back seat to trivial, fabricated or exaggerated problems of a loved one
  • You find yourself making excuses or covering up abnormal public behavior.
  • You find them rapidly cycling between extreme emotional highs and lows without pausing at normal.
  • Other healthy relationships and activities you enjoy outside the relationship are seen as competitive and discouraged or forbidden.

HPD Possible Causes

The instinctive desire to attract the attentions of others is an important survival skill in humans. It serves a useful purposeful in early childhood, gaining parental attention amidst a clamor of siblings, gaining social acceptance among childhood peers and in attracting members of the opposite sex during early adulthood. Most adults learn to self-regulate these attention-seeking instincts by considering their other long-term interests such as the advantages of stable relationships, earning the trust and respect of others, and the security of investments. People who suffer from HPD generally do not develop this level of emotional regulation or recognize when their short-term desire for attention is at odds with their own long-term interests.

The causes of histrionic personality disorder are not well understood and there is some debate over to what degree HPD is caused is by "nature or nurture". It is common for HPD to be passed down through family generations. Parents who have histrionic tendencies are often turbulent and inconsistent in their parenting approach. This has led to some debate over whether HPD traits are passed on genetically or by environment.

HPD is more commonly diagnosed in women than in men by a factor of about 4 to 1 (See Statistics).

HPD shares a number of similarities to NPD, which is more commonly diagnosed in men. This has led to some theories that Histrionic Personality Disorder is a feminine manifestation of Narcissistic Personality Disorder.

HPD Treatment

See our Treatment Page.

People who suffer from HPD are often impulsive in nature, which tends to make them inconsistent when it comes to seeking and following up with therapy. They are prone to exaggerating their problems. They may seek out a therapist's help is dealing with a perceived crisis but will often drop away from the therapy program without following through on action items when their feelings change. This makes treatment of people with HPD especially difficult.

People with HPD are often diagnosed as having a depression when they exaggerate the negatives in their situation and may also be diagnosed as bipolar if the therapist observes them alternating between describing high or low emotional states.

It's common for people who suffer from Histrionic personality disorder to go through a repetitive series of failed relationships where a partner is initially idealized for their positive attributes, then devalued or "split black" after a disappointment occurs.

Movies Portraying Histrionic Personality Disorder Traits

A Streetcar Named Desire - A Streetcar Named Desire is a is a 1947 play written by Tennessee Williams, later adapted for film, which tells the story of a woman who displays histrionic and borderline traits, who goes to live with her codependent sister and her narcissistic husband.

Gone With The Wind - Gone With The Wind is a 1939 romantic epic starring Vivien Leigh and Clark Gable, set in the American Civil War portraying the story of Scarlett O'Hara, a southern woman who manifests symptoms of Histrionic Personality Disorder (HPD).

HPD Support Groups & Links:

Psychforums HPD forum - Psychforums Site.

Borderline Personality Disorder (BPD)

Introduction

Borderline Personality Disorder is a serious condition which is estimated to affect between 1-3% of the general population. Yet, despite being so prevalent, BPD is not commonly known about or understood.

People who live in a relationship with a person who suffers from borderline personality disorder often know that something is terribly wrong with the behavior of their family member or loved-one but often do not know what to do about it, or that there is even a name for it.

Alternate Names for BPD

There are a number of different names used around the world for Borderline Personality Disorder:

  • Borderline Personality Disorder (BPD)
  • Emotional Regulation Disorder (ERD)
  • Emotional Dysregulation Disorder
  • Emotional Intensity Disorder (EID)
  • Emotionally Unstable Personality Disorder (EUPD)
  • Emotion-Impulse Regulation Disorder (EIRD)
  • Impulsive Personality Disorder (IPD)

The most commonly used name today is Borderline Personality Disorder - or BPD - as defined in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM-IV-TR).

The term "Borderline" is a historic term coined to describe people who were diagnosed to be on the borderline between a neurotic and psychotic disorder. It is commonly felt that the "Borderline" label is misleading and stigmatizes the disorder. 

Borderline Personality Disorder (BPD) - The DSM Criteria

Borderline Personality Disorder (BPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as an Axis II, Cluster B (dramatic, emotional, or erratic) Disorder:

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Frantic efforts to avoid real or imagined abandonment. [Not including suicidal or self-mutilating behavior covered in Criterion 5]
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self.
  4. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, promiscuous sex, eating disorders, substance abuse, reckless driving, binge eating). [Again, not including suicidal or self-mutilating behavior covered in Criterion 5]
  5. Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.
  6. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)
  7. Chronic feelings of emptiness.
  8. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
  9. Transient, stress-related paranoid ideation or severe dissociative symptoms.

Characteristics & Traits

The following list is a collection of some of the more commonly observed behaviors and traits of those who suffer from BPD. Click on the links on each one for more information about a particular trait or behavior and some ideas for coping with each.

Note that these traits are given as a guideline only and are not intended for diagnosis. People who suffer from BPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "borderline" behaviors from time to time. Therefore, if a person exhibits one or more of these traits, that does not necessarily qualify them for a diagnosis of BPD. See the DSM Criteria on this page for diagnostic criteria.

Abusive Cycle - This is the name for the ongoing rotation between destructive and constructive behavior which is typical of many dysfunctional relationships and families.

Alienation - The act of cutting off or interfering with an individual's relationships with others.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Baiting - A provocative act used to solicit an angry, aggressive or emotional response from another

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Bullying - Any systematic action of hurting a person from a position of relative physical, social, economic or emotional strength.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Cheating - Sharing a romantic or intimate relationship with somebody when you are already committed to a monogamous relationship with someone else.

Chronic Broken Promises - Repeatedly making and then breaking commitments and promises is a common trait among people who suffer from personality disorders.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

"Control-Me" Syndrome - This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or "acting-out" nature.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Dissociation- A psychological term used to describe a mental departure from reality.

Domestic Theft - Consuming or taking control of a resource or asset belonging to (or shared with) a family member, partner or spouse without first obtaining their approval.

Emotional Abuse - Any pattern of behavior directed at one individual by another which promotes in them a destructive sense of Fear, Obligation or Guilt (FOG).

Emotional Blackmail - A system of threats and punishments used in an attempt to control someone’s behaviors.

Engulfment - An unhealthy and overwhelming level of attention and dependency on another person, which comes from imagining or believing one exists only within the context of that relationship.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Favoritism and Scapegoating - Systematically giving a dysfunctional amount of preferential positive or negative treatment to one individual among a family group of peers.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

Gaslighting - The practice of brainwashing or convincing a mentally healthy individual that they are going insane or that their understanding of reality is mistaken or false. The term “Gaslighting” is based on the 1944 MGM movie “Gaslight”.

Harassment - Any sustained or chronic pattern of unwelcome behavior by one individual towards another.

Holiday Triggers - Mood Swings in Personality-Disordered individuals are often triggered or amplified by emotional events such as family holidays, significant anniversaries and events which trigger emotional memories.

Hoovers & Hoovering - A Hoover is a metaphor taken from the popular brand of vacuum cleaners, to describe how an abuse victim trying to assert their own rights by leaving or limiting contact in a dysfunctional relationship, gets “sucked back in” when the perpetrator temporarily exhibits improved or desirable behavior.

Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

Impulsiveness - The tendency to act or speak based on current feelings rather than logical reasoning.

Infantilization - Treating a child as if they are much younger than their actual age.

Intimidation - Any form of veiled, hidden, indirect or non-verbal threat.

Invalidation - The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.

Lack of Conscience - Individuals who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.

Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

Mirroring - Imitating or copying another person's characteristics, behaviors or traits.

Moments of Clarity - Spontaneous periods when a person with a Personality Disorder becomes more objective and tries to make amends.

Mood Swings - Unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.

Munchausen's and Munchausen by Proxy Syndrome - A disorder in which an individual repeatedly fakes or exaggerates medical symptoms in order to manipulate the attentions of medical professionals or caregivers.

Name-Calling - Use of profane, derogatory or dehumanizing terminology to describe another individual or group.

Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

"Not My Fault" Syndrome - The practice of avoiding personal responsibility for one's own words and actions.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Objectification - The practice of treating a person or a group of people like an object.

Obsessive-Compulsive Behavior - An inflexible adherence to arbitrary rules and systems, or an illogical adherence to cleanliness and orderly structure.

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Parental Alienation Syndrome - When a separated parent convinces their child that the other parent is bad, evil or worthless.

Parentification - A form of role reversal, in which a child is inappropriately given the role of meeting the emotional or physical needs of the parent or of the family’s other children.

Passive-Aggressive Behavior - Expressing negative feelings in an unassertive, passive way.

Pathological Lying - Persistent deception by an individual to serve their own interests and needs with little or no regard to the needs and concerns of others. A pathological liar is a person who habitually lies to serve their own needs.

Perfectionism - The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.

Projection - The act of attributing one's own feelings or traits to another person and imagining or believing that the other person has those same feelings or traits.

Proxy Recruitment - A way of controlling or abusing another person by manipulating other people into unwittingly backing “doing the dirty work”

Push-Pull - A chronic pattern of sabotaging and re-establishing closeness in a relationship without appropriate cause or reason.

Raging, Violence and Impulsive Aggression - Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Riding the Emotional Elevator - Taking a fast track to different levels of emotional maturity.

Sabotage - The spontaneous disruption of calm or status quo in order to serve a personal interest, provoke a conflict or draw attention.

Scapegoating - Singling out one child, employee or member of a group of peers for unmerited negative treatment or blame.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Harm - Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.

Self-Loathing - An extreme hatred of one's own self, actions or one's ethnic or demographic background.

Self-Victimization - Casting oneself in the role of a victim.

Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

Shaming - The difference between blaming and shaming is that in blaming someone tells you that you did something bad, in shaming someone tells you that you are something bad.

Silent Treatment - A passive-aggressive form of emotional abuse in which displeasure, disapproval and contempt is exhibited through nonverbal gestures while maintaining verbal silence.

Situational Ethics - A philosophy which promotes the idea that, when dealing with a crisis, the end justifies the means and that a rigid interpretation of rules and laws can be set aside if a greater good or lesser evil is served by doing so.

Sleep Deprivation - The practice of routinely interrupting, impeding or restricting another person's sleep cycle.

Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

Stalking - Any pervasive and unwelcome pattern of pursuing contact with another individual.

Stunted Emotional Growth - A difficulty, reluctance or inability to learn from mistakes, work on self-improvement or develop more effective coping strategies.

Testing - Repeatedly forcing another individual to demonstrate or prove their love or commitment to a relationship.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Threats - Inappropriate, intentional warnings of destructive actions or consequences.

Triangulation - Gaining an advantage over perceived rivals by manipulating them into conflicts with each other.

Triggering -Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

Verbal Abuse - Any kind of repeated pattern of inappropriate, derogatory or threatening speech directed at one individual by another.

BPD Statistics

An estimated 2% of the US population is estimated to meet the clinical criteria for BPD. However, prevalence results vary widely as shown below. A number of studies have been performed to determine the prevalence of personality disorders and BPD. Prevalence results indicate that BPD affects anywhere between 0.5 and 5.9% of adults

People who have a first-degree relative with BPD are five times more likely to develop BPD themselves. Those who suffer child abuse are also more likely to develop BPD.

Some people who suffer from BPD are prone to suicidal behaviors and self-injury, especially as adolescents. About 8%-10% of diagnosed BPD patients commit suicide.

See Our Statistics section for more statistics on Personality Disorders.

Click here for some statistics on the possible origins of BPD.

BPD Treatment

There is no known cure for BPD. As a result, families of people who suffer from BPD are often left to fend for themselves and rely on their own resources.

However, some treatments do exist which have proven effective in managing symptoms. The most common approach is the combination of SSRI medication and DBT Therapy.

Dialectical Behavioral Therapy - Dialectical Behavioral Therapy (DBT) is a psychosocial treatment which combines intensive individual and group therapy.

SSRI's - Selective Serotonin Reuptake Inhibitors. Popular SSRI's include Celexa, Lexapro, Prozac, Paxil, & Zoloft.

BPD Possible Causes

The causes for BPD are not precisely known. However, recent research has turned up some clues. Further study is necessary to definitively establish a cause. However, theories do exist.

There is some evidence relating the prevalence of BPD to the kind of environment a child grew up in. A significant percentage of people who suffer from BPD were also abused as children. However, this kind of correlation does not always prove that the environment they grew up in contributed to their own disorder.

There is a higher incidence of personality disorders in those who have parents who suffer from a personality disorder. This has led some scientists to suspect there may be a genetic link for BPD.

BPD is more commonly diagnosed in females than males. Read our section on the Amygdala for some information on gender differences in neural activity which may some day lead to a greater understanding of why certain disorders may afflict one gender more than another.

The Amygdala and it's Link to BPD

The Amygdala is a small region of the brain which plays a key role in emotional regulation, emotional memory and responses to emotional stimuli.

Recent technological advances have given neurologists two new ways to create 3-D images of the brain. These techniques are known as Positron Emission Tomography (PET Scanning) and functional Magnetic Resonance Imaging (fMRI). By scanning a person's brain while prompting them to think in a certain way, scientists are unlocking clues as to which regions of the brain are responsible for different kinds of thought.

Much of this work has focused on the amygdala - a small region deep in the brain shown below. There is one amygdala the right side of the brain and one on the left.

The Amygdala, courtesy The Brain From Top To Bottom @ http://thebrain.mcgill.ca/

The Amygdala's Role in Emotional Reactions

It is believed that the amygdala has an important rule in producing lightning-fast emotional responses to events, whenever a person recognizes an event with a strong emotional element (good or bad) such as events that results in fear, anger or rage or events that result in delight, joy or excitement.

The amygdala is believed to be part of our fast, instinctive and reactive brains. Not much conscious thought is involved if an object is hurled towards us and we instinctively duck. This ability to react instinctively to danger is thought to have historically played a critical function in survival of most species. Similarly, witness the reaction of a crowd whenever a sports team scores a goal. There is a universal instant response of throwing hands in the air, widening the eyes, leaping into the air etc, without much thought given. When you see these instinctive reactions occur, the amygdala is at work.

The Amygdala and Memory

The amygdala has also been shown to have an important function in enhancing memory functions by releasing stress hormones, such as adrenaline. It has been shown experimentally that rats, who have had their amygdala disabled lose their fear of cats. It has also been shown that increasing stress hormones improves memory of an event. This helps explain why people can remember stressful moments in great detail - such as times of disasters or crises, when adrenaline is released and yet can easily forget long periods when nothing significant seems to have happened.

Gender Differences in the Way the Amygdala is Connected

Another interesting finding resulted from a study comparing amygdala activity in males and females. When shown images containing strong emotionally arousing content, it was found that the amygdala on the right side of the brain was the most active in men, while the amygdala on the left side of the brain was most active in women.

Other experiments with people who are relaxing have shown that in men, the right amygdala is more closely connected to the rest of the brain than the left, while women show a stronger connectivity between the left amygdala and the rest of the brain. Additionally, in men the right amygdala seems to be strongly connected to regions of the brain normally associated with interactions with the external environment while in women, the left amygdala seems to be strongly connected to regions of the brain normally associated with more internal thought. This suggests that in an emotional context, men are biased toward thoughts about the external environment and women toward thoughts about the internal environment.

Source: Human Brain Imaging Studies of Emotional Memory: Uncovering Influences of Sex and Hemisphere by Larry Cahill.

The Link between the Amygdala and Emotional Regulation Disorder / Borderline Personality Disorder

In a famous experiment at Yale University, 15 people diagnosed with BPD and 15 people with no BPD diagnosis were shown photographs of faces with neutral, happy, sad, and fearful facial expressions while mapping the activity in the brain using fMRI. It was found that there is a lot more activity in the left amygdala of people who had been diagnosed with Borderline Personality Disorder when exposed to an emotional stimulus than there is for most other people.

Source: Donegan et al, Amygdala hyperreactivity in borderline personality disorder: implications for emotional dysregulation.

BPD vs. Bipolar Disorder

Borderline Personality Disorder (BPD) and Bipolar Disorder are similar in that both are characterized by dramatic changes in mood. It is thought that many people who suffer from BPD are inaccurately diagnosed as having Bipolar disorder because it generally carries less stigma and is easier to treat with pharmaceuticals. However, there are also some important differences between Bipolar & BPD:

Frequency of Mood Cycles

Mood swings for people who suffer from Borderline Personality Disorder typically cycle much faster than for people who suffer from Bipolar Disorder. BPD sufferers often exhibit mood cycles lasting from a few hours to a few days. People who suffer from Bipolar Disorder typically exhibit mood swings lasting from a few weeks to a few months.

It should be noted that some Bipolar patients are characterized or diagnosed with Rapid Cycling Bipolar Disorder which has the same symptoms as Bipolar Disorder but with a shorter cycle time.

Relationship Basis

People who suffer from BPD often exhibit an acute Fear of Abandonment. The mood swings a person with BPD exhibits are often attached to their fear of being left alone or their preoccupation with not being alone. Sometimes, BPD is described as a "relationship disorder" in that it manifests itself in interactions with others.

Bipolar Disorder tends to be less relationship-based. People who suffer from Bipolar Disorder often display cycles of mood which are more inwardly self-focused and have less to do with how they feel about the relationships they are involved in.

Dissociation

Borderline Personality Disorder comprises both psychotic & neurotic thought processes. This gives rise to the name "Borderline" because it is thought to be on the "borderline" between psychosis & neurosis. The thinking and behavior of a person with Borderline Personality Disorder includes more mental departures from reality, known as Dissociation or "feelings create facts".

In contrast, Bipolar Disorder tends to be more neurotic in that the mood swings tend to be based more on extreme exaggerations of fact.

Response To Treatment

People who suffer from Bipolar Disorder often respond positively to appropriate regimes of medication.

People who suffer from Borderline Personality Disorder may also exhibit some improvement when treated with appropriate medication but typically also require extensive therapeutic intervention such as DBT over a period of months or years in order to see comparable results.

Both groups are often reluctant to seek help and may be resistant to medication. Also, both groups have a tendency to stop taking prescribed medications when they begin to feel better which often leads to relapses.

Movies Portraying Borderline Personality Disorder Traits

A Streetcar Named Desire - A Streetcar Named Desire is a is a 1947 play written by Tennessee Williams, later adapted for film, which tells the story of a woman who displays histrionic and borderline traits, who goes to live with her codependent sister and her narcissistic husband.

Fatal Attraction - Fatal Attraction is a 1987 Movie Thriller starring Glenn Close & Michael Douglas about Dan Gallagher, a New York Lawyer (played by Michael Douglas) who is stalked by Alex Forrest (played by Glenn Close) with whom he has had an affair. The story portrays Alex's increasingly unstable behavior as a result of having Borderline Personality Disorder and feeling abandoned by Dan.

Girl, Interrupted - Girl, Interrupted is a 1999 Columbia Pictures movie which chronicles the experiences of a teenage girl with Borderline Personality Disorder, who is admitted to a mental health institution after attempting suicide.

Mommie Dearest - Mommie Dearest is a 1981 biography of Hollywood Actress Joan Crawford, played by Faye Dunaway, who, according to the account in the movie, exhibited Obsessive Compulsive, Borderline and Narcissistic Traits.

Single White Female - Single White Female is a 1992 Columbia Pictures Release starring Bridget Fonda and Jennifer Jason Leigh which portrays the events after a young woman takes in a roommate who exhibits some of the symptoms of Borderline Personality Disorder (BPD) and Dependent Personality Disorder (DPD) including mirroring, impulsivity and fear of abandonment.

The Wizard of Oz - The Wizard of Oz is a 1944 movie starring Judy Garland which is sometimes used as a metaphor to describe the disconnect between the dissociated reality of the personality-disordered individual (Oz) and the real world experienced by the Non-PD (Kansas). The metaphor is based on the iconic phrase: "Toto - I've a feeling we're not in Kansas any more".

BPD Support Groups & Links:

Psychforums BPD forum - Psychforums Site.

Anything to Stop The Pain - information site, blog and support board for Non-Borderlines, with a particular emphasis on supporting people who have children with BPD and people in a committed relationship with a person who suffers from BPD.

Emergence - http://www.emergenceplus.org.uk - UK site with personality disorder related information and services.

http://borderlinepersonality.ca/board BPD Support Site run by BPD Author A. J. Mahari.

http://www.BPDCentral.com - An information and support site about BPD run by Randi Kreger, co-author of "Stop Walking on Eggshells".

Schizotypal Personality Disorder (STPD)

DSM Criteria for Schizotypal Personality Disorder (STPD)

Schizotypal Personality Disorder (STPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster A (odd or eccentric) Personality Disorder.

A pervasive pattern of social and interpersonal deficits marked by acute discomfort with, and reduced capacity for close relationships, as well as by cognitive or perceptual distortions and eccentricities of behavior, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Ideas of reference (excluding delusions of reference).
  2. Odd beliefs or magical thinking that influences behavior and is inconsistent with subcultural norms (e.g., superstitiousness, belief in clairvoyance, telepathy, or "sixth sense"; in children and adolescents, bizarre fantasies or preoccupations).
  3. Unusual perceptual experiences, including bodily illusions.
  4. Odd thinking and speech (e.g., vague, circumstantial, metaphorical, over elaborate, or stereotyped).
  5. Suspiciousness or paranoid ideation.
  6. Inappropriate or constricted affect.
  7. Behavior or appearance that is odd, eccentric, or peculiar.
  8. Lack of close friends or confidants other than first-degree relatives
  9. Social anxiety that tends to be associated with paranoid fears rather than negative judgments about self.

Schizotypal Personality Disorder and Schizoid Personality Disorder are closely related and share a number of common characteristics particularly evident in a lack of ability to form and maintain social relationships. The diagnoses differ in the attitude in that people who suffer Schizotypal Personality Disorder avoid relationships out of fear while people with Schizoid personality avoid relationships out of disinterest.

A formal diagnosis of STPD requires a mental health professional to identify 5 out of the above 9 criteria as positive. Some people with STPD may exhibit all 9. Most will exhibit only a few. 

Most people will experience or exhibit a few of the above criteria from time to time. This does not make a person STPD.

Understanding the clinical criteria for Schizotypal Personality Disorder (STPD) is helpful, but learning how to cope with having a loved-one who suffers from STPD is quite different.

One of the most effective ways we have found to deal with that is to get support from people who understand what it feels like to be in a relationship or be a family member of someone who suffers from a personality disorder and have learned how to cope. You can find people like that at our Support Forum.

STPD Characteristics

The following list is a collection of some possible behaviors and traits of those who suffer from Schizotypal Personality Disorder (STPD). Note that these are not intended to be used for diagnosis. See the DSM Criteria on this page for diagnostic criteria. Click on the links on each one for much more information about a particular trait or behavior and some ideas for coping with each.

  • "Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

  • Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

  • Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

  • Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

  • Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

  • Chronic Broken Promises - Repeatedly making and then breaking commitments and promises is a common trait among people who suffer from personality disorders.

  • Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

  • Cognitive Dissonance - A psychological term for the discomfort that most people feel when they encounter information which contradicts their existing set of beliefs or values. People who suffer from personality disorders often experience cognitive dissonance when they are confronted with evidence that their actions have hurt others or have contradicted their stated morals.

  • Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

  • Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

  • Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

  • Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

  • Dissociation- A psychological term used to describe a mental departure from reality.

  • Engulfment - An unhealthy and overwhelming level of attention and dependency on another person, which comes from imagining or believing one exists only within the context of that relationship.

  • Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

  • Escape To Fantasy - Taking an imaginary excursion to a happier, more hopeful place.

  • False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

  • Favoritism - Favoritism is the practice of systematically giving positive, preferential treatment to one child, subordinate or associate among a family or group of peers.

  • Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

  • Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

  • Hoarding - Accumulating items to an extent that it becomes detrimental to quality of lifestyle, comfort, security or hygiene.

  • Holiday Triggers - Mood Swings in Personality-Disordered individuals are often triggered or amplified by emotional events such as family holidays, significant anniversaries and events which trigger emotional memories.

  • Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

  • Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

  • Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

  • Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

  • Impulsiveness - The tendency to act or speak based on current feelings rather than logical reasoning.

  • Invalidation - The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.

  • Lack of Conscience - Individuals who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.

  • Lack of Object Constancy - An inability to remember that people or objects are consistent, trustworthy and reliable, especially when they are out of your immediate field of vision.

  • Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

  • Manipulation - The practice of steering an individual into a desired behavior for the purpose of achieving a hidden personal goal.

  • Magical Thinking - Looking for supernatural connections between external events and one’s own thoughts, words and actions.

  • Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

  • Moments of Clarity - Spontaneous periods when a person with a Personality Disorder becomes more objective and tries to make amends.

  • Mood Swings - Unpredictable, rapid, dramatic emotional cycles which cannot be readily explained by changes in external circumstances.

  • Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

  • "Not My Fault" Syndrome - The practice of avoiding personal responsibility for one's own words and actions.

  • Objectification - The practice of treating a person or a group of people like an object.

  • Obsessive-Compulsive Behavior - An inflexible adherence to arbitrary rules and systems, or an illogical adherence to cleanliness and orderly structure.

  • Pathological Lying - Persistent deception by an individual to serve their own interests and needs with little or no regard to the needs and concerns of others. A pathological liar is a person who habitually lies to serve their own needs.

  • Perfectionism - The maladaptive practice of holding oneself or others to an unrealistic, unattainable or unsustainable standard of organization, order, or accomplishment in one particular area of living, while sometimes neglecting common standards of organization, order or accomplishment in other areas of living.

  • Projection - The act of attributing one's own feelings or traits to another person and imagining or believing that the other person has those same feelings or traits.

  • Proxy Recruitment - A way of controlling or abusing another person by manipulating other people into unwittingly backing “doing the dirty work”

  • Raging, Violence and Impulsive Aggression - Explosive verbal, physical or emotional elevations of a dispute. Rages threaten the security or safety of another individual and violate their personal boundaries.

  • Ranking and Comparing - Drawing unnecessary and inappropriate comparisons between individuals or groups.

  • Scapegoating - Singling out one child, employee or member of a group of peers for unmerited negative treatment or blame.

  • Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

  • Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

  • Self-Harm - Any form of deliberate, premeditated injury, such as cutting, poisoning or overdosing, inflicted on oneself.

  • Shaming - The difference between blaming and shaming is that in blaming someone tells you that you did something bad, in shaming someone tells you that you are something bad.

  • Silent Treatment - A passive-aggressive form of emotional abuse in which displeasure, disapproval and contempt is exhibited through nonverbal gestures while maintaining verbal silence.

  • Situational Ethics - A philosophy which promotes the idea that, when dealing with a crisis,the end justifies the means and that a rigid interpretation of rules and laws can be set aside if a greater good or lesser evil is served by doing so.

  • Splitting - The practice of regarding people and situations as either completely "good" or completely "bad".

  • Stunted Emotional Growth - A difficulty, reluctance or inability to learn from mistakes, work on self-improvement or develop more effective coping strategies.

  • Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

Movies Portraying Schizotypal Personality Disorder Traits

Taxi Driver - Taxi Driver is a 1976 movie starring Robert de Niro about a troubled Vietnam veteran with schizotypal traits who works as a cab driver in New York City.

The Apostle - The Apostle is a 1997 drama written, directed and starring Robert Duvall, about an evangelical itinerant preacher with schizotypal trailts who commits a violent crime then moves to Louisiana in an attempt to build a new life.

STPD Support Groups & Links:

Psychforums STPD forum - Psychforums Site.

Schizotypal Forum - Freeforums Site

Schizoid Personality Disorder (SPD)

Schizoid personality disorder manifests itself as a chronic lack of emotion, lack of interest in relationships with others and a lack of motivation or ambition.

People who suffer from Schizoid personality disorder sometimes describe an inability to manufacture the kind of feelings they observe occurring naturally in others.

Despite the name similarity, Schizoid Personality Disorder is different from Schizophrenia and Schizotypal Personality Disorder. However, it does have an certain degree of comorbidity (or co-occurrence) with these disorders and with Avoidant Personality Disorder. Some individuals who suffer from Schizoid Personality Disorder have also been known to suffer from brief psychotic episodes.

Schizoid Personality Disorder (SPD) - The DSM Criteria

Schizoid Personality Disorder (SPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster A (odd or eccentric) Personality Disorder.

Schizoid Personality Disorder (SPD) is defined as:

A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Neither desires, nor enjoys, close relationships, including being part of a family.
  2. Almost always chooses solitary activities.
  3. Has little, if any, interest in having sexual experiences with another person.
  4. Takes pleasure in few, if any, activities.
  5. Lacks close friends or confidants, other than first-degree relatives.
  6. Appears indifferent to the praise or criticism of others.
  7. Shows emotional coldness, detachment, or flattened affectivity.

Does not occur exclusively during the course of schizophrenia, a mood disorder with psychotic features, another psychotic disorder or a pervasive developmental disorder and is not due to the direct physiological effects of a general medical condition.

A formal diagnosis of SPD requires a mental health professional to identify 4 out of the above 7 criteria as positive. Some people with SPD may exhibit all 7. Most will exhibit only a few.

Schizoid Personality Disorder Traits

The following list is a collection of some of the more commonly observed behaviors and traits of those who suffer from Schizoid Personality Disorder (SPD). Note that these are not intended to be used for diagnosis. People who suffer from SPD are all unique and so each person will display a different subset of traits. Also, note that everyone displays "schizoid" behaviors from time to time. Therefore, if a person exhibits one or some of these traits, that does not necessarily qualify them for a diagnosis of Schizoid Personality Disorder. See the DSM Criteria on this page for diagnostic criteria.

Click on the links on each trait for much more information about a particular trait or behavior and some ideas for coping with each.

  1. Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

  2. Belittling, Condescending and Patronizing - This kind of speech is a passive-aggressive approach to giving someone a verbal put-down while maintaining a facade of reasonableness or friendliness.

  3. Chronic Broken Promises - Repeatedly making and then breaking commitments and promises is a common trait among people who suffer from personality disorders.

  4. Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

  5. Cognitive Dissonance - A psychological term for the discomfort that most people feel when they encounter information which contradicts their existing set of beliefs or values. People who suffer from personality disorders often experience cognitive dissonance when they are confronted with evidence that their actions have hurt others or have contradicted their stated morals.

  6. Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

  7. "Control-Me" Syndrome - This describes a tendency which some people have to foster relationships with people who have a controlling narcissistic, antisocial or "acting-out" nature.

  8. Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

  9. Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

  10. Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

  11. Dissociation- A psychological term used to describe a mental departure from reality.

  12. Sense of Entitlement - An unrealistic, unmerited or inappropriate expectation of favorable living conditions and favorable treatment at the hands of others.

  13. Escape To Fantasy - Taking an imaginary excursion to a happier, more hopeful place.

  14. Feelings of Emptiness - An acute, chronic sense that daily life has little worth or significance, leading to an impulsive appetite for strong physical sensations and dramatic relationship experiences.

  15. Hoarding - Accumulating items to an extent that it becomes detrimental to quality of lifestyle, comfort, security or hygiene.

  16. Identity Disturbance - A psychological term used to describe a distorted or inconsistent self-view

  17. Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

  18. Invalidation - The creation or promotion of an environment which encourages an individual to believe that their thoughts, beliefs, values or physical presence are inferior, flawed, problematic or worthless.

  19. Lack of Conscience - Individuals who suffer from Personality Disorders are often preoccupied with their own agendas, sometimes to the exclusion of the needs and concerns of others. This is sometimes interpreted by others as a lack of moral conscience.

  20. Low Self-Esteem - A common name for a negatively-distorted self-view which is inconsistent with reality.

  21. Masking - Covering up one's own natural outward appearance, mannerisms and speech in dramatic and inconsistent ways depending on the situation.

  22. Neglect - A passive form of abuse in which the physical or emotional needs of a dependent are disregarded or ignored by the person responsible for them.

  23. "Not My Fault" Syndrome - The practice of avoiding personal responsibility for one's own words and actions.

  24. Objectification - The practice of treating a person or a group of people like an object.

  25. Pathological Lying - Persistent deception by an individual to serve their own interests and needs with little or no regard to the needs and concerns of others. A pathological liar is a person who habitually lies to serve their own needs.

  26. Projection - The act of attributing one's own feelings or traits to another person and imagining or believing that the other person has those same feelings or traits.

  27. Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

  28. Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

  29. Stunted Emotional Growth - A difficulty, reluctance or inability to learn from mistakes, work on self-improvement or develop more effective coping strategies.

  30. Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

Movies Portraying Schizoid Personality Disorder Traits

The Remains of the Day - The Remains of the Day is a 1993 Columbia Pictures Release, starring Anthony Hopkins & Emma Thompson which portrays the life of a head butler in an English Manor who manifests some of the traits of schizoid personality disorder.

The English Patient - The English Patient is a 1996 Miramax movie which portrays the life of a wounded World War II pilot who demonstrates schizoid traits and his relationship with his caretaker nurse.

SPD Support Groups & Links:

Schizoids.net - A support forum for schizoid people.

Paranoid Personality Disorder (PPD)

Paranoid Personality Disorder (PPD)

Introduction

Paranoid personality disorder is a serious mental health condition in which the sufferer has a chronic mistrust of friends, strangers and authority figures.

PPD sufferers often have a heightened sensitivity to the actions and words of others, and often combine confirmation bias with dissociation to form a world view which confirms their belief that they are in imminent danger.

Because of their world view, people who suffer from PPD have a tendency to isolate themselves and may become hostile to people who threaten this isolation, such as family members, partners and friends.

Paranoid Personality Disorder (PPD) - The DSM Criteria

Paranoid Personality Disorder (PPD) is listed in the American Psychiatric Association’s Diagnostic & Statistical Manual (DSM) as a Cluster A (odd or eccentric) Personality Disorder.

Paranoid Personality Disorder (PPD) is defined as:

a pervasive distrust and suspicion of others such that their motives are interpreted as malevolent, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:

  1. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
  2. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
  3. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her.
  4. Reads benign remarks or events as threatening or demeaning.
  5. Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights.
  6. Perceives attacks on his or her character or reputation that are not apparent to others and is quick to react angrily or to counterattack.
  7. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.

The traits, behaviors and characteristics:

  1. Do not occur exclusively during the course of a mood disorder accompanied by psychotic features nor other psychotic disorders.
  2. Are not due to the direct physiological effects of a general medical condition.

A formal diagnosis of PPD requires a mental health professional to identify 4 out of the above 7 criteria as positive. Some people with PPD may exhibit all 7. Most will exhibit only a few. 

Nobody’s perfect. Even normal healthy people will experience or exhibit a few of the above criteria from time to time. This does not make a person PPD.

Understanding the clinical criteria for Paranoid Personality Disorder (PPD) is helpful but learning how to cope with having a loved-one who suffers from PPD is quite different.

One of the most effective ways we have found to deal with that is to get support from people who understand what it feels like to be in a relationship or be a family member of someone who suffers from a personality disorder and have learned how to cope. You can find people like that at our Support Forum.

PPD Characteristics & Traits

Alienation - The act of cutting off or interfering with an individual's relationships with others.

"Always" and "Never" Statements - "Always" and "Never" Statements are declarations containing the words "always" or "never". They are commonly used but rarely true.

Anger - People who suffer from personality disorders often feel a sense of unresolved anger and a heightened or exaggerated perception that they have been wronged, invalidated, neglected or abused.

Avoidance - The practice of withdrawing from relationships with other people as a defensive measure to reduce the risk of rejection, accountability, criticism or exposure.

Blaming - The practice of identifying a person or people responsible for creating a problem, rather than identifying ways of dealing with the problem.

Catastrophizing - The habit of automatically assuming a "worst case scenario" and inappropriately characterizing minor or moderate problems or issues as catastrophic events.

Chaos Manufacture - Unnecessarily creating or maintaining an environment of risk, destruction, confusion or mess.

Circular Conversations - Arguments which go on almost endlessly, repeating the same patterns with no resolution.

Cognitive Dissonance - A psychological term for the discomfort that most people feel when they encounter information which contradicts their existing set of beliefs or values. 

Confirmation Bias - The tendency to pay more attention to things which reinforce your beliefs than to things which contradict them.

Denial - Believing or imagining that some painful or traumatic circumstance, event or memory does not exist or did not happen.

Dependency - An inappropriate and chronic reliance by an adult individual on another individual for their health, subsistence, decision making or personal and emotional well-being.

Depression - People who suffer from personality disorders are often also diagnosed with symptoms of depression.

Dissociation- A psychological term used to describe a mental departure from reality.

False Accusations - Patterns of unwarranted or exaggerated criticism directed towards someone else.

Fear of Abandonment - An irrational belief that one is imminent danger of being personally rejected, discarded or replaced.

Relationship Hyper Vigilance - Maintaining an unhealthy level of interest in the behaviors, comments, thoughts and interests of others.

Hysteria - An inappropriate over-reaction to bad news or disappointments, which diverts attention away from the real problem and towards the person who is having the reaction.

Imposed Isolation - When abuse results in a person becoming isolated from their support network, including friends and family.

No-Win Scenarios - When you are manipulated into choosing between two bad options

Panic Attacks - Short intense episodes of fear or anxiety, often accompanied by physical symptoms, such as hyperventilating, shaking, sweating and chills.

Selective Memory and Selective Amnesia - The use of memory, or a lack of memory, which is selective to the point of reinforcing a bias, belief or desired outcome.

Selective Competence - Demonstrating different levels of intelligence, memory, resourcefulness, strength or competence depending on the situation or environment.

Self-Victimization - Casting oneself in the role of a victim.

Thought Policing - Any process of trying to question, control, or unduly influence another person's thoughts or feelings.

Triggering -Small, insignificant or minor actions, statements or events that produce a dramatic or inappropriate response.

Tunnel Vision - The habit or tendency to only see or focus on a single priority while neglecting or ignoring other important priorities.

PPD Causes and Treatment

The precise cause of PPD is unknown. PPD has been linked to schizophrenia in some studies which has led to a theory that its causes may be genetic in nature. Some nurturing element has also been associated to PPD.

Because of the nature of the disorder, it is often very difficult to persuade people who suffer from paranoid personality disorder to trust a mental health professional. In general, a combined regime of antidepressant or antipsychotic medication and psychotherapy are prescribed.

Movies Portraying Paranoid Personality Disorder Traits

The Caine Mutiny - The Caine Mutiny is a 1954 World War II drama which portrays the paranoia of a fictitious naval officer Phillip Queeg, played by Humphrey Bogart.

The Treasure of the Sierra Madre - The Treasure of the Sierra Madre tells the story of 3 American prospectors searching for gold in Mexico. One of the prospectors, Fred Dobbs, played by Humphrey Bogart, exhibits paranoid traits.

PPD Support Groups & Links:

Psychforums PPD forum - Psychforums Site.