Personality formation refers to the process whereby an individual develops stable and enduring patterns of thinking, feeling, and behaving. Personality disorders are intricate conditions shaped by the interplay of unconscious conflicts and early life experiences. A psychodynamic lens reveals core concepts such as the influence of the unconscious mind and the impact of early developmental experiences. There are many different types of personality disorders. They all have different symptoms and influence everyday life in a different ways. There is, however, one thing they have in common; if the symptoms are severe enough, the individual suffering from the disorder may have trouble sustaining work or forming positive relationships with others.
Personality disorders are relatively common, around 9-13% of the global population may experience a personality disorder
Despite the high prevalence rates, many individuals with personality disorders do not seek treatment, often due to stigma, lack of awareness, or difficulties recognising their own symptoms.
Types of Personality Disorders
Narcisstic Personality Disorder (NPD)
NPD depicts a pervasive pattern of grandiosity, need for admiration, along with a lack of empathy. People with narcissistic personalities battle an internal conflict of shame and envy as their two main emotions. They can experience shame as a sense of being seen as wrong or bad if they perceive others to be seeing them negatively. Although being narcissistic can lead to great success as they are prone to using idealisation and devaluation as a defensive strategy to improve their own self-worth, they may try to devalue (bring down) others to idealise (build-up) themselves, and vice versa when they feel inadequate.
Othello Syndrome (Delusional Disorder) is a pathological Jealousy type of mental disorder that is quoted in the DSM-5. People who have delusional disorder may show strong obsession towards their other half or care enough to get upset. Extreme jealousy, Inability to control impulses, stalking them, finding fault with them, even verbal and physical abuse are all symptoms of Delusion Disorder. Othello Syndrome can be a very distressing disorder for the person suffering from it and their partner as well. It greatly impacts the couple’s quality of life and causes high tensions in the relationship, which is unhealthy for the long term.
Obsessive-Compulsive Personality Disorder
OCD is one of the most common personality disorders in the community. It is characterised by a constant preoccupation with details, scheduling, organisation and/or rules. A focus on perfectionist goals and ‘productivity’ highly influences the enjoyment of everyday life and one’s relationships with others. Obsessive-Compulsive personalities will make grand efforts in setting rules and conventions to ensure they feel ‘in control’. Expressions of affection are perceived to be immature, and a sense of embarrassment would be felt if they accidentally behaved childishly.
HPD is a type of dramatic/emotional personality disorder characterised by a pattern of excessive emotionality and attention-seeking behaviours, often presenting by early adulthood. Individuals with HPD may come across as overly dramatic, erratic, and emotional, often with attention-seeking tendencies. HPD affects approximately 2-3% of the population and shares some overlap with Borderline Personality Disorder (BPD; another type of dramatic/emotional personality disorder), making it difficult to differentiate between the two.
Dependent Personality Disorder
Dependent Personality Disorder is when people have excessive dependent needs towards others. They find it difficult to leave “exploitative” or “abusive” relationships. People with dependent personality disorders define themselves in the context of their relationships with others. They also seek security and reassurance from others, and it is more common between women than in a man. The symptoms could be a pervasive pattern of dependent and submissive behaviour; cannot make decisions without an excessive amount of advice and reassurance from others; pessimism, self-doubt, passivity and fears of expressing sexual and aggressive feelings all typify the behaviour; an abusive, unfaithful, or alcoholic spouse may be tolerated for long periods to avoid disturbing the sense of attachment.
Borderline Personality Disorder (BPD)
BP is a complex mental health disorder that can severely affect how a person sees themselves, relates to others, and makes sense of the world around them. It is marked by an ongoing pattern of intense mood swings, unstable self-image, feelings of emptiness, difficulties managing anger, and impulsive, reckless behaviours. BPD Typically manifesting in mid to late teens or early adulthood, such symptoms can be extremely emotionally distressing for both the patient and their loved ones. People with BDP are often terrified of the thought of rejection or abandonment and as a result, may make frantic efforts towards avoiding this. Unstable and intense interpersonal relationships are also common.
The link between all personality disorders
Most personality disorders often stem from adverse childhood experiences, including unstable relationships with caregivers, infidelity among parents, rigid upbringing, overprotective or authoritarian parenting, childhood abuse, and insecure attachment patterns. Children subjected to such negative experiences may struggle with normal psychological development, carrying these behaviors into adulthood. Beyond childhood trauma, exposure to various traumas like abuse, neglect, or witnessing violence can contribute to personality disorders. Difficulty confronting and overcoming such experiences may lead individuals to adopt maladaptive behaviors into adulthood. Research also suggests that the origins of personality disorders may involve a complex interplay of genetic, neurological, and environmental factors, encompassing social, cultural, and achievement-related influences.
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Personality disorders can be a life-long challenge for both patients and people around them, with early diagnosis and appropriate treatment it is possible to recover.