Updated
8/14/14
What is a Personality
Disorder
 First and foremost, you have no idea if someone has a
PD unless you have an emotional relationship with them
or you see the individual in extreme cases where the
disorder is glaring at you; the Narcissist explodes in
anger when he is rejected when he asks his girlfriend to
marry him
 Character flaws that are permanently ingrained into a
person’s personality
 You don’t have to have a PD to end up with a person with
a Personality Disorder
 When emotionally attached to someone with a PD, it is
extremely difficult to break it off
 Unconsciously, you expect the “other person” to be
somewhere in there and don’t realize it was all an act to
hook you.
 They are not aware they have a problem
What Causes P.D.’s
 Predisposed to the Disorder
 Inability to bond with the mother
 Humans mirror their mothers when the are infants. If
mom doesn’t or can’t bond with the child, that child
stops maturing emotionally.
 Because the infant mirrors mom, whatever bad traits
she has will be put on the child. So a Borderline
mother has borderline children
 Think of people with personality disorders
(depending on the disorder) as a 3 to 6 year old child
in an adults body.
The opposite of a Personality
Disorder
 Being self-actualized
 Only occurs when a person works at becoming self
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actualized
Takes years to get there and you have to want to be
there
Most adults stop maturing when they don’t have to
grow up
Many adults have the maturity of a teenager and will
regress to behaving that way when they are under
duress
Ms. Libbon is an example of someone I would think
is “Self-actualized”
Self Actualized
 Think of the Dalai Lama.
 An individual who has actualized the full potential of the
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self.
To become everything that one is capable of becoming
They embrace reality and facts rather than denying truth.
They can accept their own human nature in the stoic
style, with all its shortcomings, they accept others for who
they are (they don’t have to like them, and they generally
lack prejudice.
Bottom line – they don’t stress when its not needed, they
focus on problem solving and they accept people the way
they are
Neurotic
 Neurotic is (in a sense) the opposite of a personality
disorder, but can still cause problems for individuals
 They / we worry about things they /we have no
control over
 Most everyone who isn’t character disordered, is
neurotic in some way
 Example; you are neurotic when everyone around
you who knows the situation tells you there is
nothing to worry about, yet you still worry and later
learn that there really was nothing to worry about.
 You’re first day of school and you come in late to class
and are terrified about everyone staring at you. The
reality is no one cares that you were late, and the only
people staring at you are those that find you
attractive…
The Neurotic
 They could be easy going or take be a little hard to deal
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with.
If they are too neurotic, they may have issues which may
hinder how effective they can be at their job, how people
view them as team members.
Someone who is very neurotic can be obsessed about
screwing up, so much they actually do screw up (choking
is being neurotic).
They can be insecure, which happens when they take too
much responsibility for their behavior and also feel they
are incompetent at managing themselves.
This puts them into a bind which is self-generated and
can consume them with worry.
Excessively neurotic people are distracted by worry,
which is bothering them constantly.
Personality Disorder
 Personality disorders cause serious
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problems with relationships and work.
They are stable traits – not single episodes.
Many people with personality disorders are “high
functioning” and they can be very successful in life
(think Charley Sheen).
Most people with these disorders lead unhappy lives
and also disrupt those close to them –
They can literally ruin other people’s lives and you
want to STAY AWAY FROM THEM!
More Personality Disorder
 They don’t see that they have serious problems
because they lack insight – they can’t understand
that they have obvious problems
 Very difficult to treat – they don’t change
 No matter what happens to them, its always because
of outside influences and they never take
reasonability of anything negative that happens
around or to them.
 You can tell them point blank that behavior a
certain behavior will cause them problems, and
they will ignore that information and come right
back and complain about how it was someone
else's fault.
How they might develop
 As a child, they experience intense horrible feelings
(fear, rage, out of control) and their psyche’s can’t
handle them and they develop defense mechanisms
that become ingrained in their psychological
makeup.
 They have a genetic predisposition that gets
triggered,
 They learn it from those around them
 They get rewarded for that kind of behavior (think
child stars that go crazy)
Neurotic versus Personality
Disorder
 The Neurotic says “Its my fault” and the
Personality Disorder says “Its your fault”
 The neurotic takes too much responsibility for
problems and try to fix them (co-dependant),
 While the P.D. will consciously or unconsciously
blame others for their situations and with the
world would stop screwing with them.
 Rules don’t apply to them
Codependent
 A person who is enmeshed in a dysfunctional
relationship and is usually an enabler which detracts
from their lives.
 EX: If I cared for a sick brother who was a drug addict
and kept making excuses for him to not change..
 A person is called codependent when they put up
with a person’s bad behavior and / or act in
excessive caretaking ways that have a negative
impact on their life.
 A wife that puts up with her husband’s drinking
 A parent who is constantly making excuses for their
How to tell if you know a P.D.
 Many of these people lead normal lives and you won’t
notice them until you have a relationship with them (get
to know them).
 They will blame outside influences for issues with their
behavior, including other people.
 These people cannot be trusted – they will turn on you.
 This is because they blame outside forces for their
problems.
 I’ve dealt with these people while interning – they can be
very affable if they can’t control you until they want
something from you or you block them from getting what
they want
My experience with them
 I was surprised that when I diagnosed them, it didn’t
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bother them at all…
One 25-year old Anti-social said “you nailed it, that is
me”
A 26-year old admitted that she had already been
diagnosed as a Borderline.
A narcissist just said “OK, I see that.”
They don’t change but the Borderline can grow out
of some aspects of it, and some can experience
some relief.
How to recognize, how they feel, how they might be caused
and how they are treated (if possible)
A very productive person with
many personality disorders.
As I was
growing up,
this
performer
was
probably the
most
The result of Personality
Disorders
High functioning individual who was tormented with
personality disorders
What might have been
displayed
 No one knows for sure except for doctors closest to
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him, but a Google search will give you these
“maybes” based on the behaviors seen in public
Avoidant (surgical masks)
Borderline (Empty and depressed)
Delusional (saw the thing differently that everyone
else)
Obsessive compulsive (many, many surgeries)
Narcissistic (self-loathing behaviors)
Character Disordered / Personality
Disorder
 Assumes too little responsibility with regard to
relating to the world around them
 A personality Disorder is a permanent pattern of a
world view and behavior that is a great deal different
than the expectations of their culture.
 They never change or adapt, and usually starts to
show itself in the early twenties.
 Some can’t function while others are said to be high
functioning and can seemingly live a very productive
life
Individual’s first 6 months of life
 EXTREMELY IMPORTANT
 The child and the world are one – there is no difference
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or boundary separating the two
Strong ties between parents and their child provide the
baby's first model for close relationships and foster a
sense of security and positive self-esteem
Parents' responsiveness to an infant's signals can affect
the child's social and cognitive development.
The mother and child start bonding immediately
according to the latest research.
A bonding hormone is produced in the hypothalamus
during childbirth breast-feeding
First 18 months
 Bonding with mom is critical – no bonding means the
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child will most probably end up with some personality /
social disorder ranging from a Sociopath to a Borderline
for example
Narcissistic defensive mechanisms develop during this
time
Very important programming time in an individual’s life
Sets up their whole make-up and personality in life
Genetics also plays a huge roll in this development
An individual can have a “pre-disposition” for a certain
disorder but the environment has to “kick-start” it for it to
develop
At 6 months
 Now there is no difference (in the child’s experience)
between the child and the primary care-giver
 The child will mirror the experiences of the PCG. If
that person experiences psychological pain, so will
the child
 This is when the child’s psychological make-up
becomes programmed for life (supposedly) – much
like programming a computer for the first time except
it is hard to re-program after it’s already set up.
st
1
two-years of life
 Whatever the primary caregiver’s problems are, they can
be passed on to the child at this stage in the
programming of their personalities.
 If PCG is “self-actualized” the child will be programmed to
develop into a self-actualized person.
 If the PCG is a raging alcoholic, this can also program
the child to develop this disorder
 With Borderline mothers, the chances that they will raise
a BPD child increase a great deal.
 But because there are so many other variables, this doesn’t
have to happen.
 People can be raised by dysfunctional PCG’s and still grow
up to be a self-actualized individuals
st
1
5-years of life
 Your brain learns and changes more than at any
other time in your life
 It physically changes (more folds are created) in a
very deliberate way – in fact, the folds can dictate
whether you have mental difficulties or not.
 Basically your first five years of life have an
enormous impact on your development as a human
being
Normal Person under stress
Personality Disordered under
stress
What does Psychotic mean?
 Breaking from reality; the inability to perceive reality
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accurately
a "loss of contact with reality.
People suffering from psychosis are said to be
psychotic.
They may think things are happening that really are
not happening like people are “after” them or
someone wants them dead.
If someone says to you “they are coming to get me”
and there is no evidence that this is happening, they
are said to be experiencing a “psychotic break”.
Delusional
 Having a believe about something despite indisputable
evidence to the contrary
 EX: I’m going to play professional football next season for
the San Diego Chargers
 I am 50-years old and I have a metal hip – major hip
surgery
 I have arthritis and can barely walk in the morning
 I believe I am going to play in the NFL even though there
is indisputable evidence telling me that is impossible
 For this class, there is a distinction between Psychotic
and Delusional
 Psychotic is a serious mental illness, and many people
can be delusional…. A parent believes their son will earn
a full football scholarship even though he is not very
athletic – the parent is delusional…
What is “Splitting” mean?
 Seeing someone as all good or all bad.
 When you are a little kid and you get mad at
someone you think they are a bad person for a little
while – then you get over it.
 A Borderline will idolize a person one day and then
hate them the next – the person is either all good or
all bad
 This happens to people that they have an emotional
investment in like a boss, boyfriend / girlfriend, a
relative or even a friend.
Magical thinking
 A symptom of some PDs: When a person thinks
that they can affect the physical world or alter it
in some way.
 Magical thinking is a common phase in child
development. Up until early school age children will
often link the outside world with their internal
consciousness, e.g. "It is raining because I am sad".
 Occurs in people with OCD, Clinical Depression,
Schizotypal PD, Borderline PD.
 It is unlike superstitions or culture based Prayer for
example; meaning that if you believe in Prayer, you
are not “thinking magically.”
Personality Disorders
 If you think you have one and it bothers you – that is
proof that your don’t; one of the things about people with
PD’s is that they cannot detect the PD in themselves. A
professional has to tell them they have the PD and
eventually they need to believe it.
 Personality that is maladaptive to change and a variety of
ways – they are stuck
 Characteristic ways of thinking, feeling and behaving
 You are stuck in a 9 feeling all the time – we can have
extreme emotions 7 or 8 but they come back down –
personality disordered people are stuck at high levels of
emotion – they have the same traits normal people do
but they are always high on the scale
Personality Disorders
 Avoidant Personality Disorder (They shy one)
 Schizoid Personality Disorder (The loner)
 Histrionic Personality disorder (The center of
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attention)
Narcissistic Personality Disorder (Loves
themselves?)
Borderline Personality Disorder (Chaotic
relationships)
Dependant Personality Disorder (They need)
Antisocial Personality Disorder (They manipulate)
Obsessive Compulsive Personality Disorder (They
Avoidant Personality
Disorder
Shy & Inadequate
Avoidant Personality
Disorder
 Extremely shy people – they stand out when you
see them because they are so very shy
 Avoidant personality disordered individuals have a
lifelong pattern of feeling very shy, inadequate, and
sensitive to rejection
 Cause problems with work and relationships
 Only form relationships with people that they believe
will not reject them (Pretty girl with loser guy)
Avoidant PD Symptoms
 Can’t stop thinking about their own inadequacies,
 Very easily hurt when criticized or disapproved of,
 Hold back too much in intimate relationships
 They avoid activities or jobs that involve contact with
others
 Very shy in social situations because they are afraid
they will do something wrong
 Exaggerate potential difficulties
 They see themselves as less than others
APD Treatment
 Antidepressants and psychotherapy as well as group
therapy
 They can improve with treatment
 Without help, they could end up alone and go into
total isolation
 Develop secondary issues like substance abuse and
develop a mood disorder
Schizoid Personality
Disorder
 Extremely withdrawn person
 Keeps their head down, won’t
acknowledge others are around
 My student (1st year teacher) would wait outside the room,
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never make eye-contact and would go straight to his / her
seat and sit down.
Behaved as if no one else was around – never turned
around to get papers being passed up,
Would not pass up her / his paper; just leave the exam on
the desk
Drive to school in the back seat of a small car
Earned a “B” in the class but NEVER participated
When playing “killer ball” would get hit and just shuffle off to
the side without showing emotion.
Outgoing and friendly
Schizoid Personality Disorder
(2)
 Takes pleasure in few, if any, activities
 Does not desire or enjoy close relationships, including
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family
Almost always chooses solitary activities
Little or no interest in sexual experiences with another
person
Lacks close relationships other than with immediate
relatives
Indifferent to praise or criticism
Shows emotional coldness, detachment or flattened
affect
Exhibits little observable change in mood
Schizoid Personality Disorder
(3)
 These people avoid social activities and consistently
shy away from interaction with others. They are
generally loners with a profound inability to connect
with others and form personal relationships.
 To others, they may appear aloof, dull or humorless,
and they're often ignored in social settings.
 The show a flattened or restricted range of emotions,
and can appear indifferent to what's going on around
them.
 However, their inner life can be rife with a deep
emotional need, sensitivity and confusion about the
world around them.
Possible Causes of Schizoid
PD
 Biologic theorists believe that chromosomal or
nervous system disorders are causes.
 Social theorists believe learned behavior responses
cause the disorders.
 Psychodynamic theorists use deficiencies in ego
development to explain causes.
The histrionic exaggerates their emotions
exponentially
Histrionic PD
 They greatly exaggerate their
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emotions,
Drama queens,
They try to be attractive in order to
seek attention
They will dress very provocatively
to attract attention
They NEED to be the center of
attention in group / social
situations
Histrionic Personality (2)
• Constantly seeking reassurance or approval
• Overly concerned with physical appearance
• They believe that relationships are more intimate
than they actually are
• Low tolerance for frustration or delayed
gratification
• Rapidly shifting emotional states that seem fake,
• They change opinions based on what others
think
Possible Causes of HPD
 Genetics and the environment they grew up in seem
to shape this kind of disorder
 It seems more in women and come men with
feminine personality traits
 Some people are rewarded with this type of behavior
“thinking actors” or reality TV.
 It seems to be passed down to their children
Treatment
 Psychotherapy and some meds are used such as
anti depressants
We are just looking at their behaviors –
maybe its just an act?
How do they get that way?
 Theory #1: The individual never connected to the
primary care-giver so the child believes that they are
all bad (not even mommy loves me therefore I am
loathed by the world) and they blame themselves for
not being able to make that connection.
 The reality is that the PCG was severely emotionally
impaired and couldn’t bond with the child
 The child must bond symbiotically with the PCG and
then separate in order to have any chance of
becoming a normal person
Normal Child Development
Future Narcissist
This is why the Narcissists “Hates” him or herself: Imagine if God, Mom and
every person on earth thought you were garbage and not worth anything…. That
is how the Narcissists feels deep down inside their unconscious… they hate
themselves and never develop a self; so they have to make up a self that they
believe everyone else will like / love / envy because there is no one really their –
without their narcissistic supply, they start freaking out with more anxiety than any
of us have ever experienced and they have to do something (get someone to
have sex with them for example) to feel wanted…
 Theory #2: They are made to feel “special” by the
primary care giver and believe they really are special
which wouldn’t hurt them, except they are divestated
when they are not treated as special (because they
are not special, just normal) and they live miserable
lives…
NARCISSTIC SUPPLY
 A term used to name the person(s) who satisfy the
Narcissist’s insatiable desire for praise or to
associate themselves with someone who they deem
“great” in the case of dependent narcissists
The Narcissist wants people
to think they are very special
Teenagers
 Teens score high on narcissism for several reasons,
 Very stressful time in their lives
 Uncertain about where they fit in life – so this is used
as a “Reaction Formation”
 This is where many of us ‘adults’ have the most
regrets when it comes do the end of our lives
because we treated others poorly due to our teenage
narcissism.
 Parents can contribute by protecting them from
health criticism
 If you want to screw a kid up for life, protect him and
spoil him during this time and they will probably never
recover
Narcissistic Personality
Disorder
 Main presentation is “I am better than everyone” but
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this is a reaction formation
They “project” thinking others are envious of them
They feel entitled – this is also a “teenager delusion”
Actors are more likely to score high on narcissist
inventories
They are very self-centered – you should do this for
me!
They exploit others for personal gain (they use
people)
They are always looking for a “better romantic
partner”
Narcissists & their mates
 Narcissists tend to go through a string of short-term
relationships that don’t last long and are usually
devoid of much intimacy (they don’t show
themselves).
 Even when they’re in a relationship, they always
seem to be on the lookout for other partners and
searching for a better deal.
 Whether that’s because of their heightened sexuality
or because they think multiple partners enhance
their self-image isn’t entirely clear.
 Borderline women and Narcissistic men do well
together (relatively speaking)
Research on Narcissism
 Normal narcissism peaks at about 15 or 17 and
then steadily declines as people get older – they
learn the “reality principle.”
 Narcissists often try to make a good first
impression; because of strong social skills that
make them appear charming
 Their empathy if fake and used to take
advantage of others
 When you talk to them, they keep bringing the
conversation back to themselves.
Possible Causes of Narcissistic
PD
1. An oversensitive temperament at birth (genetics)
2. Early childhood – ignored by the primary care-giver
a.
Reaction formation; they believe that they are of no value
to their care-givers, so they over-compensate by
becoming delusional and telling themselves they are
special (a defense mechanism)
3. Severe emotional abuse in childhood is also
common
Or…..
1.
2.
3.
Overindulgence and overvaluation by parents (spoiled;
my generation seems to do this with their kids)
Excessive admiration for perceived exceptional looks or
talents by adults:
Great athlete OR Gorgeous girl
1. Being praised without balanced criticism because
parent feels like they are not giving enough
Why is my generation like
that?
 Studies have shown that because we think we work too
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much “we must not be good parents” we overcompensate and give our kids too much attention. Our
parents did it better than we did because someone was
always home and we can’t do that.
Since we are not around to counsel and critique, we “feel
guilty” without knowing it and over compensate.
We feel deep inside that we got more than we deserved
when we were younger so we apologize thorough our
children and ruin then making us feel even worse
Our guilt forms kids that feel entitled which actually hurts
our intentions because we feel inadequate as parents
Bottom line – since we can’t be home and our parents did
such remarkable jobs we over-compensate for our
inadequacies and then hurts our kids.
Who are famous Narcissists
 Many dictators, criminals and celebrities had or
have narcissistic personalities.
 Hitler and Stalin
 Alec Baldwin, Sharon Stone, Elvis Presley,
William Shatner, Michael Jackson, OJ Simpson –
have been labeled as narcissists for their public
behaviors,
 (according to Wiki answers – just think of their
public personalities without labeling them as
narcissists – none of them that I know of have
been proven to be narcissists.
Differ from Anti social
 They are a lot a like but a narcissist has much more
access to a variety of feelings and they don’t usually
show conduct disorders as youths
 They also feel depressed where the anti social feels
entitled to things so they take them
Kate Middleton IS NOT a DN but I’m
using her as an example of a
behavior that a DN would do for
Narcissist Supply.
Lives vicariously through their mate
Think of someone who marries someone famous in
order to become famous
Professional Athletes wives can be Dependant
Narcissists and when their “famous person” is no longer
famous, they drop them because it lowers their selfvalue
Explaining the example
 Princess Kate is from a middle class family who’s
mother and father met while working for the airlines
 Princess Kate was a professional photographer and
did web page design according to Wikipedia and she
met the Prince William at University (the way they
say in over the pond)
 Princess Kate must “Curtsy” to everyone in the
Royal Family except when she is with her husband,
and then it depends upon the situation who is
involved but there is a “written hierarchy” as to where
Princess Kate is on the list of importancy
If she were a Dependent
Narcissist
 She would be a narcissist who, rather than bragging
about themselves all the time and embellishing their
accomplishments, marries someone who is very
important (in their minds or in the real world) and
lives vicariously through the other person.
 How to tell if you are with a Dependent Narcissist?
 They constantly brag about their Narcissistic Supply’s
achievements and wants to always be associated with
that person regardless if they are with them or not…
Dependent Narcissist
sometimes called “Craving Narcissists”
 This person is a Narcissist in that they hate themselves
or don’t have a self, but they marry someone that
elevates their Self-Image so they don’t feel so horrible
about themselves
 They want their mates way too much and are paranoid
they will lose them
 The will brag about their mates within a minute of first
meeting them
 They are attractive to normal people because they put
them on a pedestal and there is nothing you can do
wrong until you do
 Then Splitting comes into play and they try to ruin their
mates reputation anyway they can
 It is a way to elevate their self-value by belittling the person
who rejected them
Like 5-year olds
 Spouses find that shortly after marriage, they
discover that they are married to someone with the
emotional maturity of a 4 – 7-year old adult
 They fail to distinguish themselves from external
objects (their spouse)
 They are who they are because of who they are
married / related to
 They will take a lot of demeaning (unlike Narcissists)
from their spouse in order to keep their “Narcissistic
Supply”
Lindsay Lohan, Brandon Marshall and Megan Fox have all stated
publically they have battled Borderline Personality Disorder –
sometimes it is confused with bi-polar disorder
Chaotic Relationships
Borderlines will seek therapy
 BPD’s seek therapy because of their chaotic romantic
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relationships which become VERY intense very quickly.
The will “fall in love” very quickly, then hate you the
next day
One day they will believe they love you and the next
they will “know” that the relationship will never work
(this is called splitting).
They chase the relationship and once the object of their
affection returns the love, they reject them.
NOTE: While working with one BPD, I could predict
within days of her break-up / make-up cycle with a
police officer.
Chameleons with severe mood
swings
 They will literally change their looks and their
personalities to fit into the love-object’s world
I don’t mean to pick on her – I actually liked her in her comedy movies
when she was a kid – she seemed like a innocent little kid who was
exploited because of her talent and looks. She has gone though a lot and I
hope she pulls out of it.
Borderlines are on of the only personality disorders that change for the
better with time and she is still very young. That, coupled with her child
stardom contributed to her demise; I’m told she is intelligent, she is
obviously attractive and she is supposedly a talented actress and model
who is having a rough patch in her life right now, but she can pull out of it.
Psychological Pain
Borderlines
 They have such continual intense emotions that they
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cannot deal with them
The crave love but then the possibility of abandonment
pushes their partner away.
They might have had a great weekend and the Non BPD
feels like they are perfect for each other and the BPD will
start an argument
Valentine's day – The BPD is so afraid of being
abandoned that she sabotages the relationship the day
before so her boyfriend cannot disappoint her
Then she acts impulsively to mask the pain and makes
things worse by making out with some worthless pervert.
Borderline Personality
Disorder
 The person will present with chaotic relationships –

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
breaking up and getting back together – very intense
relationships.
Pairs up well with the Narcissist because they will chase
him and feed his narcissistic. However, as soon as their
boyfriend / girlfriend returns the love, they will run.
Probably the best future as far as getting over the
disorder
Fears abandonment – chase – run relationships
Impulsive – self damaging – suicidal
Very promiscuous (some – not all)
Splitting is common
May also become psychotic at times
 People with BPD are often bright, witty,
funny, life of the party
Borderline Personality
Disorder
 Chameleons – they have no sense of selfso they become what their partner wants
them to become unconsciously – biker girl
to choir girl or whatever the partner looks for
unconsciously
 Females with Borderline can give off the
“vibe” that they are very sexual – even the
choir-girl borderline can give that
unconscious impression
 Erratic relationships stand out in this type of
disorder – on again, off again relationships
where you can time the break-up and the
“get-back-together” on a calendar
 Mother’s are borderlines – sexually abused
Marilyn Monrow
•Marilyn was said to be Borderline and
Bi-Polar
•Had affairs with both JFK & RFK which
is typical for BPD
•Killed herself of was killed which makes
perfect sense – she either did it
because of her depression or someone
else did it because she could not be
controlled or she was impulsive
Possible Causes of BPD
 Chemical imbalances in the brain and other
biological factors may be involved, such as heredity.
 Childhood trauma, such as abuse and neglect, have
also been cited as possible causes.
 Mom was a borderline and she mirrored her mother
as well has have a pre-disposition to the disorder
2000 – 2001 study
Columbia University and NY
State
 Showed that 1 in 5 young adults suffered from a
Personality disorder (20%)
 Half of young people (19 – 25) suffered some sort of
psychiatric condition
 The disorders include obsessive, anti-social and
paranoid behaviors that are not mere quirks but
actually interfere with ordinary functioning.
The problems
The deviation must manifest itself
pervasively as behavior that is inflexible,
maladaptive, or otherwise dysfunctional
across a broad range of personal and social
situations (i.e., not being limited to one
specific "triggering" stimulus or situation).
Cluster A (odd or eccentric
disorders)
Paranoid Personality Disorder
characterized by irrational suspicions and
mistrust of others.
Schizoid Personality Disorder
lack of interest in social relationships,
seeing no point in sharing time with others
Schizotypal Personality Disorder
characterized by odd behavior or thinking.
Cluster B (dramatic, emotional
or erratic disorders)
Anti social Personality Disorder: a pervasive disregard
for the law and the rights of others.
Borderline Personality Disorder: Extreme "black and white"
thinking, instability in relationships, self-image, identity and
behavior often leading to self-harm and impulsivity.
Borderline personality disorder is diagnosed in 3 times as
many females as males
Histrionic Personality Disorder Attention Seeking
Behavior:
inappropriately seductive behavior and shallow or
exaggerated emotions.
Narcissistic Personality Disorder : a pervasive pattern of
grandiosity and the need for admiration and a lack of
Cluster C (anxious or fearful
Disorders
Avoidant Personality Disorder
social inhibition, feelings of inadequacy, extreme
sensitivity to negative evaluation and avoidance of
social interaction.
Dependant Personality Disorder
pervasive psychological dependence on other
people.
Obsessive-compulsive Personality Disorder
(not the same as obsessive-compulsive
disorder:
characterized by rigid conformity to rules, moral
OCPD
 obsessive compulsive personality disorder.
 About 8 percent of young adults in both groups had
this illness, which can include an extreme
preoccupation with details, rules, orderliness and
perfectionism.
 12% in college kids
 All good students have a touch of "obsessional"
personality that helps them work hard to achieve.
But that's different from an obsessional disorder that
makes people inflexible and controlling and
interferes with their lives, he explained.
OCD versus OCPD
 Obsessive Compulsive Disorder and Obsessive Compulsive





Personality Disorder are related but not identical diagnoses.
OCD is considered an "Axis I" diagnosis while OCPD is an "Axis II"
diagnosis.
Axis I disorders are generally ones that come on in early adulthood
or later,
Axis II disorders (Personality disorders and Developmental
Disorders) are generally present from a fairly early age.
OCD is an anxiety disorder characterized by either Obsessions
(intrusive, repetitive thoughts that won't leave the mind and that
cause great anxiety) or Compulsions (repetitive behaviors that are
designed to reduce anxiety brought on by obsessions).
OCPD, on the other hand, is a personality style characterized by
a preoccupation with "orderliness, perfectionism and mental and
interpersonal control at the expense of flexibility, openness and
efficiency" (DSM IV). The two disorders can occur separately, or they
can co-occur. People with OCD are not necessarily perfectionists,
There is evidence that the individual's characteristic
and enduring patterns of inner experience and
behavior as a whole deviate markedly from the
culturally expected and accepted norms. Such
deviation must be manifest in two or more of the
following areas:
1) cognition (i.e., ways of perceiving and
interpreting things, people, and events; forming
attitudes and images of self and others);
2) affectivity (range, intensity, and
appropriateness of emotional arousal and
response);
3) control over impulses and gratification of
needs;
They can’t make even simple decisions on their own…
Dependent Personality
Disorder
 Person presents as very submissive and clingy as




well as having an inappropriate need to be taken
care of.
They have big problems with making everyday
decisions like color shirt to wear.
They need a lot of reassurance and advice from
others
They are submissive and allow another person to
control most all aspects of their lives
They will agree with things they really don’t agree
with such as capital punishment for example. They
are on a committee to prevent capital punishment
because they believe in it, but will agree with some
who asserts their will on them even thought they
Dependant on others
Dependent Personality Disorder
(2)
Think of the dependency a 3-year old has
on their mother’s. That’s pretty much how
someone with DPD “acts” like they need
someone else. They need someone that
much; even when it comes to what they are
going to wear of what they should do with
their lives.
 If they lose a person
that they were dependent on, they
will quickly find another.
 They constantly worry about being abandoned by the
person
 To be diagnosed, the person needs to have dependant
fears that are excessive & unrealistic.
 EG. An older man with cancer moves in with his son to care
for him. He is exhibiting dependency that is appropriate
given the circumstance.
They don’t care about anything but getting what they want
Anti-social Personality
Disorder
1. Since the age of fifteen there has been a disregard for and
violation of the right’s of others, those right’s considered
normal by the local culture, as indicated by at least three of
the following:
A. Repeated acts that could lead to arrest.
B. Conning for pleasure or profit, repeated lying, or the use of
aliases.
C. Failure to plan ahead or being impulsive.
D. Repeated assaults on others.
E. Reckless when it comes to their or others safety.
F. Poor work behavior or failure to honor financial obligations.
G. Rationalizing the pain they inflict on others.
2. At least eighteen years in age.
3. Evidence of a Conduct Disorder, with its onset before the
age of fifteen.
Jerk versus anti social
Style
Disorder
 Superficial charm & makes
 Lie and profit for enjoyment
friends easy
 Externally makes decisions
 Poor judgment, impulsive
behavior, don’t learn from
mistakes and are
competitive but poor losers
 Decisions rigid and inflexible
 Vindictive
 Impulsive
 Blame everything on others
 Externalize reasons for
behavior
 Others suffer and it doesn’t
bother them at all
Jerk versus anti social
Style
Disorder
 Lacks empathy or
 Lack any guilt, shame or
responsibility for their
actions
 Feels empty and seeks
excitement because they are
bored.
 Assume the worst in others
and is easily argumentative
and irritated
embarrassment for harm
they cause to others
 Impulsive and reckless when
it comes to dangers of
actions, sex, or substance
abuse
 Abusive when frustrated
Jerk versus Anti social
Style
Disorder
 Good at reading social
 Manipulates others to gratify
situations and is able to
persuade others to meet
their needs
 Assume everyone is like
them and it’s a dog eat dog
world so they are seldom
honest or open
their desires
 No real loyalty but can come
across that way (Mafia)
 Get others before they get
you
 People get what they
deserve and they are cold
Jerk versus Anti-social
Style
Disorder
 Irresponsible with money at
 Spend money carelessly, fail
times but can support
themselves and may even
be quite successful
to honor obligations, can’t
maintain stable work do to
discipline issues
If you believed she did do it,
antisocial personality disorder
might explain it
Anti-social Personality
Disorder
Conscience
Antisocial Personality
Disorder
 About 20% of the population has these “tendencies”
and only 2 ½% or really dangerous.
 Egocentricity, callousness, impulsiveness,
conscience defect, exaggerated sexuality, excessive
boasting, risk taking, antagonistic, deprecating
attitude toward the opposite sex, and lack of bonding
with a mate. Although egocentricity and selfishness
are the norm. Sociopaths may believe they are
contributing to society and could be politicians,
CEOs of companies and the like
What you see in APD
 He or she speaks only in very broad generalities.
“They say...” “Everybody thinks...” “Everyone knows...”
and such expressions are in continual use, particularly
when imparting rumor.
 Such a person deals mainly in bad news, critical or
hostile remarks, invalidation and general
suppression.
 “Gossip” or “bearer of evil tidings” or “rumormonger” once
described such persons
 The antisocial personality alters, to worsen,
communication when he or she relays a message or
news. Good news is stopped and only bad news, often
What you see in APD (2)
 A characteristic, and one of the sad things about an




antisocial personality, is that it does not respond to
treatment or reform.
Surrounding such a personality we find cowed or ill
associates or friends who, when not driven actually
insane, are yet behaving in a crippled manner in life,
failing, not succeeding.
Such people make trouble for others.
The antisocial personality habitually selects the
wrong target.
If a tire is flat from driving over nails, he or she curses a
companion or a non-causative source of the trouble. If
the radio next door is too loud, he or she kicks the cat. If
A is the obvious cause, the antisocial personality
inevitably blames B or C or D.
What you see in APD (3)
 The antisocial becomes surrounded
with incomplete projects.
 Many antisocial persons will freely
confess to the most alarming
crimes when forced to do so, but
will have no faintest sense of
responsibility for them.
 They have no sense of correct
causation and particularly cannot feel
any sense of remorse or shame
High Functioning Anti-social PD
 Sarah Thompson, M.D. has stated in writing that she
believes President Clinton as she wrote [“My
opinion? Mr. Clinton clearly meets the criteria as
described in Sections A and B], Anti-social
Personality Disorder.
 I have no idea if the former President has anti-social
personality disorder or not ; the point is that
someone with Anti-social Personality Disorder could
be “high functioning” enough to be the CEO or
President. Just because someone is successful
does not mean that they are NOT mentally ill.
More anti-social (2)
 No conscience so they have no trouble hurting
others
 Childhood marked by torturing and killing of
small animals
 Love to play with fire – pyromaniac
 Getting into trouble as kids (they wouldn’t last
very long at BMHS unless they really wanted to
stay for some self-serving purpose)
Anti-social characters
Tony Soprano in
the Sopranos
Sharon Stone’s
character in Basic
Instinct
Psychopaths
 Common personality characteristics of psychopaths
are: glib and charm, grandiose sense of self-worth,
pathological lying, conning and manipulation, lack of
remorse, promiscuous behavior, and criminal
versatility – great salesmen – probably most could
pass a polygraph test because they believe their
own lies
The Psychopath (Hannibal
Lector)
The psychopath is hotheaded, manipulative,
irresponsible, self-centered,
shallow, lacking in empathy
or anxiety, and likely to
commit more types of crimes
than other offenders. They
are also more violent, more
likely to recidivate, and less
likely to respond to
treatment. They like to
James Bond
The Sociopath
 They will have a moral code specific to that context: they
might not lie, exploit, or manipulate within the group.
Thus, they exhibit psychopathic behaviors in certain
contexts but not all.
 They are able to kill and not get nervous at all. They can
be tortured and hold up well.
 This would be very much like James Bond.
 For an “agent” to be able to do what James Bond or even
Jason Bourne in the Bourne Ultimatum, you would have
to be a Sociopath.
Casey Anthony
Sociopath
or
Psychopath
The Difference
Psychopath: They are conning, manipulative
narcissistic liar and user as a psychopath, as long as
he or she is completely lacking in remorse or
empathy.
The sociopath, however, is capable of guilt, caring,
building relationships, etc., but only within a certain
context. He or she will have loyalties to a specific
group but not to society at large.
Anti-social Personality
 This disorder can also allow people to function
extremely well in their lives / careers.
 James Bond would fit the bill of anti-social
Personality disorder because he can kill a person
and it doesn’t bother him – he shows no fear (typical
of ASPD)which allows him to take chances without
getting nervous.
 Assassins, soldiers, people who torcher others for
the CIA for example would benefit from being antisocial PD.
 Matt Damon had this to say about Bond: "He's
repulsive. Bond is an imperialist, misogynist,
sociopath who goes around bedding women and
swilling martinis and killing people.” Is he
correct?????
Compulsive PD
 Restrained, conscientious, respectful
 Very rigid, conventional, respectful
 Very angry underneath – grew up with
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very disciplined environment
Really fears disapproval
Very moral – perfectionist – if you
move something they freak out
Might be great workers -Tell Justin / john story sight switch
From the
movie Dragnet
Obsessive-compulsive
Personality Disorder
 Preoccupation with orderliness, perfectionism, and
mental & personal control at the expense of flexibility,
openness and efficiency.
 Attempt to maintain a sense of control through attention
to rules, trivial details, procedures, lists, schedules or
form to the extent that the major point of the activity is
lost.
 Time is poorly used, they pay attention to such detail that
they never get a project done.
 Conscientious, inflexible about matters of morality, ethics
or values and have a very strict standard of performance.
Howard Hughes
Study on Diagnosing PDs in
movies
 The study consisted of psychology students
watching various movies and trying to diagnose
personality disorders with limited understanding
(Like us)
 Patrick Bateman in American Psycho played by
Christian Bale
 Aileen Wuornos in Monster, played by Charlize
Therone
 Suzanne Stone in To Die for, played by Nicole
American Psycho
 name: Patrick Bateman

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
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
diagnosis: Schizophrenia,
Bipolar disorder Type I,
Homicidal ideation (possible suicidal ideation),
anxiety (OCD and generalized anxiety disorder with
intermittent panic attacks and an occasionally
present eating disorder),
a questionable but present diagnosis of sociopathy,
substance abuse,
sex addiction.
Film Monster played by Charlize
Therone
In the film "Monster", Aileen is a prostitute who falls in love with a young lesbian
woman. Shortly after a man rapes her and tries to kill her, but she succeeds in killing
him instead, and after that starts to kill men whom she contacts as a prostitute. Please
note that the Aileen Wuornos described in this paragraph is the Aileen of the film as
seen by the raters in this study – not the real character.
Diagnosed with Borderline Personality Disorder and
Antisocial Personality Disorder
Film: To Die For Nicole
Kidman
Suzanne Stone in the film "To Die For" is a young woman who wants to be on television at any cost. She marries a young man, but
soon begins to have affairs with TV producers to accomplish her main goal: to become a news-reporter at a major TV station.
When her husband tries to persuade her to settle down and have children, she decides to have him killed instead, taking
advantage of three troubled youths, whom she has met while trying to make a TV production. SS was seen as a prototypical
narcissistic person by the raters: on average, she satisfied 8 of 9 criteria for narcissistic personality disorder, some histrionic
personality disorder criteria, and relatively few others.
Would be diagnosed with Narcissistic
Personality Disorder
Dissociative Identity Disorder
AKA Multiple Personality
Disorder
 A severe condition in which two or more distinct
identities, or personality states, are present in—and
alternately take control of—an individual.
 These people usually suffered severe physical,
psychological, or sexual abuse during childhood.
They have learned to dissociate themselves from
such stressful events by selectively forgetting them,
which reduces the anxiety they feel.
 The name was changed in 1994 to reflect a better
understanding of the condition—namely, that it is
characterized by a fragmentation, or splintering, of
identity rather than by a proliferation, or growth, of
separate identities.
All About Eve
 Eve White – Quiet, sad, shy
 Eve Black – Happy, flirty, bit of an airhead
 Jane – older, more mature.
 Can talk to all of them but needs to go through Eve
White
How it happens
 These children have often been kept in such
extraordinary terrifying and confusing circumstances
that I am more amazed that they survive
psychologically at all than I am that they manage to
preserve themselves by a desperate redrawing of
their boundaries.
 What they do, when confronted with overwhelming
conflict and pain, is this: They "leave." They create a
boundary so that the horror doesn't happen to them;
it either happens to no one, or to some other self,
better able to sustain its organization under such an
onslaught--at least that's what they say they did, as
best they recall.
DID / MPD
 reflects a failure to integrate various aspects of identity,




memory and consciousness in a single multidimensional self.
Usually, a primary identity carries the individual's given name
and is passive, dependent, guilty and depressed.
When in control, each personality state, or alter, may be
experienced as if it has a distinct history, self-image and
identity.
The alters‘ (other personality) characteristics—including name,
reported age and gender, vocabulary, general knowledge, and
predominant mood—contrast with those of the primary identity.
Certain circumstances or stressors can cause a particular alter
to emerge.
The various identities may deny knowledge of one another, be
critical of one another or appear to be in open conflict.
Causes of DID
 Severe physical and sexual abuse, especially during
childhood
 May also have post-traumatic symptoms
(nightmares, flashbacks, and startle responses) or
Post-Traumatic Stress Disorder.
 DID is more common among close biological
relatives of persons who also have the disorder than
in the general population.
 Treatment: Attempt to integrate all the personalities
into one.
Dissociative Identity Disorder
 Multiple personality disorder is a severe mental
disorder in which a person displays two or more
distinct identities. There can be as many as 100
personalities or more, although most patients display
about 10 to 15 different personalities.
 Each takes control over the patient's behavior for a
period of time, usually adopting a unique name,
voice, movement style, and life history.
The Real-life Sybil
 Sybil Dorsett was a 22-year-old college student who
had amnesia*. She also had terrible headaches and
sometimes could not see, as if she were blind.
Sybil showed other personalities.
 It was as if there were more than one person inside
Sybil's body.
 One personality, who called herself Vicky, said she
was from Paris. Another personality, called Peggy
Lou, was a tough woman who showed no fear. As
time passed, Sybil displayed more personalities: a
writer, a flirt, a pianist, a mother, and even an infant
and two men.
Real-life Sybil (2)
 each personality acted and sounded different from
the Sybil Dorsett she first had met.
 Each personality even described his or her physical
features in different ways.
 One said that she had blue eyes, while another said
that he had brown.
 Almost everything, from details about hair color to
gestures, changed as Sybil switched from one
personality to another. In all, Sybil displayed 16
different identities.
Sybil (3)
 There can be as many as 100 personalities or more,
although most patients display about 10 to 15
different personalities.
 Each takes control over the patient's behavior for a
period of time, usually adopting a unique name,
voice, movement style, and life history.
Possible Causes of D.I.D.
 The exact cause of multiple personality disorder is
unknown, but often patients with the disorder have
experienced child abuse.
 This was the case for Sybil, whose mother caused
exceptional trauma* for her when she was young.
 Doctors see multiple personality disorder as an
attempt to cope with particularly traumatic events in
a person's life.
 For example, a child might deal with extreme
physical or sexual abuse by hiding memories of the
abuse and displaying other personalities.
What they experience at 1st
 The first symptoms usually involve amnesia.
 Like Sybil, people with the disorder often start to
realize that there are abnormally long periods of time
that they cannot remember.
 For example, they might "wake up" in a different
place or in different clothes, and recall nothing that
explains the changes.
 This amnesia can lead them to suspect that
something is very wrong.
Conversion Disorder
 Psychological disorder coverts to a physiological
disorder
 Paralyzed from the waist down
 Dissociative Fugue
An Obsession
 Anxious and cannot stop thinking about something
even though it is unpleasant.
A compulsion
 A repetitive Action – going back to check to see if
you locked the door even though you’ve checked
twice already
 Washing your hands uncontrollably
Bipolar Disorder
 Also known as Manic depression
 Dramatic mood swings; frantic Action & Deep




Despair
One day you’re depressed and can’t get out of bed
The next day you feel great and full of energy but
others thing what you are doing is out of control or
even dangerous
Manic is elation, confusion, racing thoughts, a lot of
energy.
Depression is feeling of deep sadness that doesn’t
Medicines Used to Treat
 Lithium, the first mood-stabilizing medication approved by
the U.S. Food and Drug Administration (FDA) for
treatment of mania, is often very effective in controlling
mania and preventing the recurrence of both manic and
depressive episodes.
 Anticonvulsant medications, such as valproate
(Depakote®) or carbamazepine (Tegretol®), also can have
mood-stabilizing effects and may be especially useful for
difficult-to-treat bipolar episodes.
 Valproate was FDA-approved in 1995 for treatment of
mania. Newer anticonvulsant medications, including
lamotrigine (Lamictal®), gabapentin (Neurontin®), and
topiramate (Topamax®), are being studied to determine
how well they work in stabilizing mood cycles.
Agoraphobia
 Extreme fear of being in a public place
Dissociative Reaction
 A person loses identity or memory (amnesia)
 Dissociative Fugue – a person travels a distance
from their living area and then can’t remember who
they are or anything about themselves; not even
their name in most cases.
Schizophrenia
 Chronic severe and disabling brain disorder (over 1% of the








population
causes people to have hallucinations, delusions, and other
confusing thoughts and behaviors, which distort their view of
reality.
Loss of contact with reality (psychotic)
Paranoid-type schizophrenia can gave hallucinations and or
delusions
These people often times show deteriorated brain tissue
Diagnosed in late teens, early 20’s
Sometimes hear voices others don’t hear,
believe that others are broadcasting their thoughts to the
world, or become convinced that others are plotting to harm
them.
These experiences can make them fearful and withdrawn and
cause difficulties when they try to have relationships with
Illusion versus Hallucination versus
Delusion
 Illusion: A misperception of an external stimulus
 It looked like the magician sawed the pretty lady in half
 Hallucination: you hear or see something that is not there
 I see my dead relative and she is talking to me about my
hygiene
 Abraham Lincoln is at the foot of my bed telling me what a
great guy I am and that I should grow a beard
 Delusion: you think something that isn’t true
 I think I can fly so I just off the bridge and fall like a brick
into the ocean
 I think I’m the greatest quarterback who ever played the
game
The DSM-IV
 Diagnostic & Statistical Manual of Mental Disorders
 Assumes that what most people do is normal
 The “bible” of psychology / psychiatry
 Has about 1000 pages and almost 300 disorders
 5 revisions since 1952 (US Army related material)