What is a Personality Disorder?

Briefly, a Personality Disorder is a condition of rigid patterning in the way an individual thinks, feels, and behaves. It is the ingrained, pervasive, habitual, set of thoughts, emotions, and actions. The "disorder" label is applied when traits solidify into predictable and inflexible patterns that limit a person's ability to respond appropriately and constructively to another and to the tasks of living. A disordered personality is manifest most often in failures in intimate relationships and career achievements. The individual's life does not work out as he intends. The people in his life are often perplexed and unhappy about their relationship. His difficulties are compounded by his almost complete lack of ability to self-observe, consequently he can grasp very little about how he needs to change to improve his life.

We relate everyday, in some capacity, to difficult people. This paper is an attempt to make available to you a few of diagnostic tools of the mental health field, in hopes you can better understand and work constructively with some of the problematic people in your life. Categorization of persons is one of those things the mind does to attempt to give predictability and order to the flow and chaos of living. There is no one who is "completely" a "Narcissist," or a "Borderline," or a "Schizoid," but some persons have these characteristics more than others. When we repeatedly have the same unhappy experiences in being with another-or when we discover people coming up again and again with the same disappointing experience in being with us-we may begin to wonder: Is there is a pattern here? The answer is "Yes!" At this moment of recognition a term such as Personality Disorder can be very useful. To know that others have seen and thought carefully about being with difficult people makes us less crazy and alone. Many persons have dysfunctional, inflexible, patterned styles. We gain more options for controlling our life if we are able to see persons the way they are, not "bad people," but caught, without insight and self-awareness, in repetitive thoughts, feelings and behaviors that poorly connect them with their fellows creatures and their world.

How this paper is intended. For this brief article, I'm going to focus on three Personality Disorders, which are most often represented in my experience with clients, friends, and family. I am not categorizing people so they can be dismissed or become diagnosed as "ill," so that you and I become the detached and "superior" non-diagnosed. Diagnosis is the observation of repeated behaviors and feelings that have become unsuccessful. The purpose of observing patterns is better to understand how to deal creatively and satisfactorily with each other. I am interested in promoting healthy detachment. This means that we recognize what we are dealing with in others, and in ourselves, and that we do not break ourselves upon the rigidity of our or another's patterns. This paper is not about condemnation or dismissal but about perspective and compassion and clearing the way for more constructive living, with less energy devoted to cracking through impregnable walls.

The Self-Absorbed Person (Narcissistic Personality)

Nicholas has spent a lifetime developing himself as a grand leader. Countless times he relates to all who will listen how sought-after he was by beautiful and fashionable women, how his friends were influential people, how he was a mover and shaker in the realm of high finance, how he was pursued for his "wisdom." Now in his fifties, he has become a self-appointed teacher and guide. He thrives on attention and always responds fulsomely when it is offered. But rarely is he able to give himself empathetically to the other person. He fancies himself a bountiful gift-giver, and, at first glance, this might seem to break his self-promotional mode-alas, it only illustrates it. He gives "thoughtful" gifts that are chosen with care to express what he anticipates the recipient would like. Sadly, he is rarely right, for he knows very little about the recipient, and chooses his gift according to what he likes and projects that it will please the recipient and elicit eager words of appreciation. He never offers a gift without several follow-up inquiries about how much the gift was enjoyed. He becomes impatient if the receiver has not hung his picture, or displayed his pen, or worn his jewelry. It becomes clear that the gift was about his own self-gratification in acting out a grandiose image of gift-giving acumen and largesse. He is puzzled that other persons are not more responsive to him, that he is routinely left out of social events, that his children arrange vacations without including him. Yet it doesn't occur to him to take initiative to include others in his plans.

The narcissistic person has three basic characteristics. He can be amazingly grandiose-believing he is smarter, more loved, more effective than realistic appraisal warrants. Underneath he is extremely sensitive to criticism and to any perceived or actual doubts and negative thoughts others might have about him. He can be marvelously attractive. When he has an audience that adores him he in his element, he shines. Further, and perhaps most telling and most difficult to live with, he is sorely lacking in empathy. He can be gracious or indifferent-whatever enhances his sense of self-importance. Our feelings run from wariness to repulsion, for we are (consciously or unconsciously) are painfully aware that he cares more about himself than he does us-or anyone else for that matter.

Generally, in popular talk, the term "narcissist" is a very judgmental word, like "stupid" or "selfish." It connotes a person full of self-importance who doesn't have room for the other person in his thoughts or feelings. This is the person who thinks only of himself, whose bottom line is what he wants and who can never be counted on for a genuinely altruistic act. This is the person who never really "gets it" that what he is doing is driving others away. Often the narcissist will be hooked up with friends or lovers who are ready to take disproportionate responsibility for friction in the relationship. When the narcissist says "it's your fault," the co-dependent tends to want to find some way to agree that indeed it really is-keeping the dysfunctional relationship going for a long time.

Sometimes we can become very close to narcissistic people. We can seem to be loved and cared for by them. More likely, what is happening is that we have come within their ego boundaries, we are included in their sense-of-self, and thus we believe we are important to them. Actually, we are extensions-as long as we "behave ourselves" in ways gratifying to them-of their narcissistic self-love. And if our presence becomes irritant or irrelevant to them, then they will leave us, often with contempt and/or rage.

These are the obvious external characteristics of the narcissist. His inner life is a negative image of the outer. He is a desperately fragile self. Instead of feeling proud and strong, as a narcissist postures himself to be when he is in his "act," he actually feels small and vulnerable. He feels little hopefulness about himself. He is one to pity and from whom to protect oneself. He is self-absorbed because it takes practically all his energy to hold himself together and self-promote, that he does not have enough energy left over to engage actively with others and the world. When he is criticized or believes he has done something unacceptable, he experiences the criticism as an attack upon his core self. He feels he has only two choices-to acquiesce, therefore confirming that he is powerless and worthless, or to respond with all his raging power to damage (kill?) the source of attack. He spends what power he has guarding his vulnerable citadel of self.

The Unstable Person (Borderline Personality)

Leslie lives a volatile, frantic, and emotionally painful life. She had two marriages that ended in acrimonious divorces, each time having felt that her husbands were was the most marvelous persons ever to grace the earth, followed shortly after by feelings of disillusion and fiery anger. Ed, her first husband sought refuge from her demands in sports. She became so hurt and angry that she threatened to leave him one time too many-and he left her. James, her second, escaped her smothering attention into the arms of his secretary. Leslie dealt with this by driving her car into a tree. Eventually Leslie became enthusiastic about a new love interest. Early in their courting he failed to phone her right after a first date to tell her how wonderful it had been being with her. She went into a pout and it took two weeks of solicitous attention to bring her back into being willing to see him again. This dynamic repeated itself till he gave up.

Her friendships are no more successful that her marriages. For almost two years, she and Jennifer met at each other's homes several times a week for coffee. This was a warmly anticipated part of her day, and they shared literary and spiritual values and long hours of satisfying conversation. But Jennifer's husband's schedule changed, and he became less available to care for their children. Jennifer's time for coffee was sliced in half. Leslie took this change as a deeply personal rejection. She felt "betrayed" by Jennifer. "Didn't she care for me at all?" agonized Leslie. And Leslie so dramatically expressed her hurt with accusations and screams that her relationship with Jennifer never recovered.

The fundamental characteristic of the Borderline is that of instability. She is given the label, "Borderline," because her inner turmoil and outer behavior can sometimes shift into psychotic-like experience. She can become reality disoriented and have episodes which are so extreme as to cause herself harm-even threatening, or acting out, suicide. She can be bright and optimistic one moment, and the slightest bit of information that does not fit her expectations can cast her into intense despair and /or rage. She alternates between over-idealization and extreme devaluing of the other. Her moods are wildly variable. She carries narcissistic rage to its fullest expression. She may be extremely sarcastic, or bitter, or revengeful. Continually, she is living with the fear of loss and abandonment. She often believes that abandonment means that she is unworthy or bad. More than half of borderline persons have been physically or sexually abused and they are hyper-reactive to any hint of repetition. She can be marvelously appealing, for when she is gratified by a relationship, she is powerfully drawn to a person, flattering him or her with her idealizations and entering quickly into advanced intimacies. But, within a short period, she will begin to find that what her new friend or lover is giving her is not caring or sensitive enough, and stormy fights, often followed by break-ups, ensue. Her mood of happiness is fragile and ephemeral. The least interruption, an incidental slight, even inadvertent negative glances can upset her equilibrium and cause huge emotional pain. She is unable to live in the middle. She cannot tolerate ambiguity. Life is black or white.

The Borderline style carries its own self-perpetuating dynamic. She has a built-in defense against allowing herself to have experiences through which she might learn that she can be loved and not left. When she begins to get close to a person, since her experience has always been that no one is really dependable, the more connected she becomes, the more she is scared that she will ultimately lose that person's love. Consequently, she does something-anything-to break the intimacy before it becomes so powerful that she feels it will be unbearable to lose it. Most commonly she blames the breakup on the behavior of the other. This makes sense in her world, in which no one is dependable; for her, it is only a matter of time till her partner does something real, or perceived to be real, that sabotages the assurance she needs. Hence she acts to head off, or at least reduce the intensity, of the anticipated abandonment.

The Out-of-Touch Person (Schizoid Personality)

Alexander has no friends other than his wife, siblings, mother, father, and his two children. His life is work, eat, sleep, TV, and some occasional moments with his son and daughter. Marsha, his wife, continually asks him to participate in family activities. He promises, but almost always he is too tired, or too busy. Further he is annoyed at her for asking him to be more into family activities than he wishes-which is virtually not at all. It appears that what he wants to do is retreat to his study, pour over his books, and chat online with car restoration enthusiasts throughout the world. When his wife threatens to take the children and leave him, he reacts strongly; he doesn't want to be left alone. It greatly matters to him to remain in proximity to them, for they provide the infrastructure for his life. However, he needs only limited connection with them or anyone. His family needs to depend on a relationship with him that is vital and cooperative and reciprocal. Unfortunately he has little to offer. What turns them on simply does not invigorate him. Leave him alone and let him work and rest, surrounded by the familiar comfort of family and home, and he is satisfied. All the fuss about his being more involved, he sees as the unreasonable and hysterical intrusion of a overly demanding wife.

The Schizoid Personality is an individual whose emotional life is under wraps, if it can be found at all. His affect is flat. He has a pervasive mode of detachment. He is remote and lacks sensitivity to emotional nuances. For the most part, he would rather be alone than in another's company. He does not have many, if any, friends, and his social interactions are mostly confined to a spouse and immediate relatives. In a social context he is passive and his range of emotions is limited. Praise and criticism show little effect on him. Often he is not very interested in sex or in any expressive activity. For an emotionally alive person, being in relationship with him is frustrating and unsatisfying. Efforts to bring him into active engagement and emotional resonance are inevitably doomed to failure, even when he is "willing" to attempt to be more emotionally attuned and expressive. He simply has a limited capacity for such experience.

Living-With These Difficult People

Thought quite different in the particular expressions of their dysfunctional styles, Personality Disorders have such common traits that general guidelines may be set that apply to living with all. Here are my suggestions:

These "FOLKs R US." Personality styles are not discrete categories. We human beings are all part of a grand continuum. The world is not divided between Personality Disorders (Them) and Regular Folk (Us). We all qualify in some degree as disordered personalities. We all have regular patterns of thinking, feeling, and behavior which are partially or completely out of our awareness, which cause trouble for others in their relationship to us, and consequently make our lives as well as theirs less fulfilled, happy, or constructive. As you read this paper, remember that the bell tolls for thee as well as thine.

Get real about your experience.

Let yourself know that if it walks like a duck, looks like a duck, quacks like a duck, and smells like a duck, chances are it is a duck. If a person in your life shows repeated patterns of self-absorption, interprets almost everything in terms of how it affects him, becomes deeply injured when he feels that he has been criticized or slighted, takes a lot more interest in himself than in you, he just might quality as Narcissistic Personality Disorder. Whether or not you wish to evoke a psychiatric category, you may find it useful to see that you are living with someone who has a cluster of noxious behaviors that continue to repeat themselves-regardless of how much you wish he were different, and how much you attempt to motivate him to change.

Understand how Personality Disorders work.

Remember that a Personality Disorder has behaviors, thought patterns, and emotions that are so entrenched in an individual's system of being that he hardly knows that anything is out of whack within himself. He senses only that something is uncomfortable, that life is not working with the joy and satisfaction that he believes it "should," that people are often displeased with him. He has little idea how what he is doing contributes to the problem. And it will be extremely difficult for him to learn. Efforts to change the person by getting him to see the error of his ways are almost always doomed to failure. But learning to be aware of the dynamics or predictability of disordered behavior will enhance your power to control you life in the environment you choose.

Mobilize your most important asset.

Sometimes you are able to bring some measure of change in the behavior of a disordered person. Your best leverage, your best bet, for prompting change is your disapproval and your threat to withdraw. Summon your "very tough love." Don't be shy. Most disordered persons want to please, they want peace, and they do need people in their lives. Like everybody, they want love, often more so. This, quite possibly, makes them way you enough to give change a try. Only when Henry saw that Clara would not give up being angry with him about his forgetting anniversaries and birthdays and mealtimes, did he begin to pay attention to changing his haphazard patterns. His behavior was "all right with him." Henry never seemed to realize that special occasions were important, but he did figure out that they were important to Clara because of the vigorous ways she let him know it. Because he did not want to lose the relationship, he began the Herculean task of working on himself. A Palm Pilot helped. Further, when he remembered and attended, Clara responded with appreciation and affection.

Brace for disappointment.

Having given your best efforts to effect change, sometimes you will succeed, often you will not. A narcissist will often fail to give you the attention and empathy you crave. A borderline can be counted on for wide mood swings and alternate times of being enthusiastic about her relationship with you and devastated or enraged by it. A schizoid lives largely to himself, and you are going to be lonely a good bit of the time; there's not much blood in that turnip. A disordered personality is rarely going to change because you want him to, because you insist that he does, because you beg, demand, plead, cajole, threaten, guilt-make, entice, manipulate. If you are expecting change beyond what is possible, you will in all likelihood be disappointed. It is crucial that you be prepared for your loss, so you will not lose yourself in the process.

Learn acceptance.

As you will rarely receive what you think you want when you hook up with a Personality Disorder-parent, child, spouse, lover, sibling, or friend it's wise to build alternative strategies. One of the most hopeful is to develop acceptance. Lepers can be cured with modern science, but leopards still have the same spots. A narcissist is going to be self-absorbed, a borderline emotionally unstable, and a schizoid detached. Learn to live with it. Find the right stuff in yourself to make it OK, or know you are buying a lifetime of frustration. Quit bloodying your head against the Disordered Wall. You don't have to divorce your spouse, or never speak to your mother, or refuse the phone calls of a childhood friend who always "talks your ear off." You can begin to decrease your expectations about what you can receive from their persons. You can then begin to pay attention to the qualities your disordered relationships have that make you want to stay connected with them and enhance your connection in any way you can. Relax about behaviors that you are unsuccessful in changing and make your life work without these unattainable connections. You need to be clear whether you can get along well without your significant person becoming what you want him to be. You need to learn to satisfy yourself without his changing. If you can do this, and if you can insulate yourself from the negative fall-out of his behaviors, then you are set to have the possibility of a fruitful and happy life in your relationship.

Cultivate completeness in yourself.

There is a part over which you do have control: yourself. Confront your own patterns. How much have you counted on the other person being loving, or thoughtful, or active with you in what you also are interested in? How much have you counted on the other person making you complete-like The Missing Piece? If it is beyond his or her ability or inclination to do so, then you need to develop alternative ways of living, or you are going to have a very deprived life. Though many compensate for their disappointment with whining, martyrdom, self-indulgent and self-destructive diversions, these generally are not nearly as much fun or as rewarding as finding positive ways to build your own sense of self and empower constructive engagement.

Develop compassion.

Nobody makes himself or herself into a personality disorder because it makes life more enjoyable. Negative styles happen! Some of us are not given the same breaks that others have. Today we understand that not just biology and environment shape us, but also viruses and other illnesses that come in our early years. However we become what we are-and that is another topic-we are all what we are right now. In a deep sense everybody does the best he or she can. Think of compassion as a sort of creative detachment. It begins with the ability not to take personally much of the difficult behavior of others. It frees us not to take our hurts from others' neglect and aggression too seriously. It clears the mind to help us plan actions that are constructive. It makes us feel good, for compassion is closely related to the basic experience of joy.

Prepare for a partial or full break.

Sometimes it is simply too hard to make a life in close contact with another whom you find too detached, unstable, or self-absorbed. In this situation you may need to find your courage to do your inner work to be able to make a break-to reconfigure or to leave your relationship. Yes, many situations can be made to work. Many times persons with very difficult-to-live-with patterns can become suitable partners, if you can realistically reshape your expectations and invest your life force in those aspects of your relationship which have actual potential for satisfaction. But, sometimes it is just not worth it. The returns don't come close to the effort. The disappointment and the emotional pain are so great that you spend all your energy trying to get back in balance, a balance that is fleeting at best, but for the most part never comes. It can be time when honoring yourself means making the move to end-and begin again.

Robert Caldwell, M. Div., LCPC, practices individual, couple, and group psychotherapy in Bethesda, MD. He can be reached at 301-652-6180 or email, "rbrtdciii@aol.com". His website is "www.wholeliving.com/counseling".