I am a trauma specialized therapist that often treats clients that have been diagnosed or strongly self- identify with one of 3 common types of personality disorders. There is so much misunderstood about these experiences and personal presentations. And also so much information out there on the web and social media trying to help us understand them.
But what is the truth?
What reflects people’s reality?
What is it really like having Borderline Personality Disorder?
Having a sister that does?
A dating partner?
This blog will cover the three types of personality disorders that I see most often in my practice. We will go through myths about each of the three, what is real and how to heal, move forward.
Types of Personality Disorders: Borderline Personality Disorder (BPD)
What is BPD? Or what we call Borderline Personality Disorder?
There are so many misconceptions out there that lead to both getting in the way of treatment for people who have one of 3 types of personality disorders and them leading perfectly normal lives, which they can and do all the time!
Some common myths are that only teenage girls have Borderline Personality Disorder and this is identified through self-harm behaviour. There is some truth in this, but it is simply not in line with all the facts. Borderline Personality Disorder is often identified in teens as this is the developmental stage in which feelings become more complex and intense and they are experiencing a lot of firsts in love and relationships. This is true of all teens. It is a vulnerable time when they are just figuring out how to handle all these feelings and experiences.
So imagine if we add a trauma history, emerging personality disorder and/or a challenging time such as a parent’s divorce into this? It is not uncommon for trauma symptoms and related characteristics to be diagnosed as Borderline Personality Disorder, there is a lot of overlap. And there are teens that self-harm and do not have BPD. Self-harm is a very powerful way to deal with intense affect, although not a healthy/safe way.
Borderline personality disorder (BPD) is a mental illness characterized by intense and unstable moods, impulsive behaviors, fear of abandonment, and inconsistent self-image.
Sounds like a lot of teens right? Here’s the issue: Borderline Personality Disorder does not go away as we finish maturing and begin our 20’s. It is pervasive and needs proper treatment to manage. We don’t hear much about older people with BPD as it is possible to learn affect regulation and have healthy relationships and families.
Hopeful right?
I also hear it is only girls/women that have BPD. That is not true either. Personal presentations are as varied as gender presentations with boys/men as often more criminal, angry and violent in nature, largely due to socialization. They can get treatment and the right help too.
Many clients I see do not self-harm or have not in many years. I also see clients that self-harm due to a trauma history and do not have any of the other characteristics we call BPD.
While it is pervasive and seems hopeless, with failed relationships and angry/upset past friends/partners, it is absolutely possible to be a healthy, happy person living with Borderline Personality Disorder, including healthy relationships.
Some of my clients also feel when they tell a newer partner about this diagnosis they get demonized and it hurts. These are sensitive, lovely people that have a super power of connecting deeply and may make you feel seen in a way you may never have experienced before. They can own their stuff, heal and get treatment like all of us. They can be some of your favourite people, they are simply often afraid of losing you and the connection you have.
Types of Personality Disorders: Histrionic Personality Disorder (HPD)
Histrionic Personality Disorder is characterized by attention-seeking behaviour with a need to seek approval, and are uncomfortable without this approval in their lives and relationships. People assume this is a dramatic, disingenuous person that is hard to take seriously. But there are many presentations and ways of trying to get attention that are more subtle and take time to even see them as histrionic in nature.
A person may use serious health scares and conditions to get this attention. They may ask your opinion on their behaviour, decisions and appearance frequently. They may get upset if you do not offer this approval in the way they need. They may be the most stunningly beautiful, well-groomed person you know that seduces you every time. They may be the most successful person you know as well.
And, of course, this presentation will depend on where they are in their healing journey, how much insight they have into their triggers and related approval needs.
Types of Personality Disorders: Narcissistic Personality Disorder (NPD)
Narcissistic Personality Disorder is characterized by a pattern of exaggerated self-importance, an excessive need for admiration, as well as a diminished ability to empathize with others.
I feel this is often something that presents in my office as a client identifies this in a friend, parent or ex-partner. The most commonly seen characteristic is that an afflicted person feels they are special (in a good or bad way ex: I am doomed and my life is harder than other peoples), may dominate a room with their concerns and are too in their own stuff to be able to access empathy for others. While empathy is an important piece, it is also not a full picture and is necessary but not sufficient to warrant a diagnosis. A person with Narcissistic Personality Disorder can be covert and subtle as well.
The key piece is actually a narcissistic wound in which a person actually hates themselves, carries huge shame that they are less than and cover it with a false cover of self-importance and/or victimization. They need you to buy into them as wonderful or they will not be able to sustain the relationship in which you see their normal, human flaws.
They want you to see the mask, not the real vulnerable side. Hard not to empathize with that softer view, right? They are terrified you will see their core self and not love them as this was their childhood experience. And if you see their core, vulnerable parts and leave, you are rejecting them in instead the mask they present too, right? Most of this is unconscious of course, this is about understanding to begin healing.
Treatment for 3 Types of Personality Disorders
All people that have a personality disorder are capable of being healthy and having healthy relationships. It is just harder and needs a holistic, varied approach to treat. All of these disorders have complex causal factors that include a genetic component as well as a personal relational and/or trauma history, they are attachment disorders.
A holistic approach to treatment is needed in order to learn to have your best life. You may want to try medication to support a healthy emotional life. You will likely need to take a Dialectical Behavioural Therapy group to learn affect regulation and meet like sufferers.
You may want to try insight therapy to better learn what your needs are and heal the wounds that have led to your disorder and your way of attaching to others. Healing our wounds can turn down the intensity of the feelings and experiences in being close to people. You can then bring your needs in a way that feels healthy and another person may be able to meet, rather than in a way that they get upset with you and create distance.
I have found a relational component is needed in the therapeutic relationship so you can use the therapist’s experience of you and your feelings in being in such an intimate, although professional, relationship to work out attachment wounds in vivo, in real time. It is a wonderful way to try on new ways of expressing feelings and needs, with a therapist not expecting you to do it perfectly.
Attachment can be healed and the engine that fuels your affective presentation turned down, having less weight. Meditation, exercise and other forms of self-care can calm your central nervous system. Couple and family counselling can help build and maintain healthy relationships, and include follow up to process the hard things you may hear from your loved ones.
Make mindfulness practices a regular part of your life.
Ensure your self-care is optimal.
You can have the life you want.
Lisa S.
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