Personality Disorders and Pathological Traits

People often ask me about  personality disorders and  the pathological  traits  seen in them. I am going to describe  pathological traits that we see in Narcissistic,  Borderline  and Antisocial or Sociopathic personality disorders.

The DSM V has put them in a specific cluster of personality disorders because they often share pathological traits with each other.  There are ten personality disorders recognised and whereas they use to be listed separately from other mental illnesses, they are now classified on the same level.

We all have a personality, which influences how we see ourselves, how we see others, how we react to situations, obstacles, how we handle our emotions, but more importantly how we relate to other people!

When a personality becomes maladaptive to the functioning of an individual, by directly creating difficulties for him, hurt and upheaval in his family and entourage, or society, then it becomes “disordered”.

Personality traits that make up specific personality disorders are pervasive, in that they  are well established and have a consistency throughout someone’s life that are disruptive and harmful to those around him and or society.  They don’t appear overnight!

They are not caused by a medical condition, brain injury or substance abuse.  They are derived mainly from that person’s early relationships with parents and childhood environment  though some recent research implicates some genetic tendencies.

It is not unusual at all to see pathological personality traits in offspring of personality disorder parents, that I feel is directly influenced by a parent’s poor parenting.

In order to be diagnosed with a personality disorder, a person must meet certain criteria and display specific behavioral symptoms.  When someone has all of the criteria of a specific personality disorder then he has a full-blown spectrum of it.

When a person has several  pathological traits from different personality disorders, then he is diagnosed as a personality disorder with mixed traits, which can often be the case, especially in these three particular personality disorders.

Even if a person has a full-blown disorder, there is often some distinctive traits that can be found in others.  An example I like to use is that all sociopaths are narcissistic, but not all narcissists are sociopaths.

Likewise all Borderlines are Histrionic, ( attention seeking and emotional drama queens), but all histrionics are not borderline.

You can not change someone’s personality, so personality disorders are resistive to  psychotherapy.

The narcissist rarely seeks or stays in therapy, unless for depression, anxiety or dragged in by a spouse, because they are convinced nothing is wrong with them.

Sociopaths are not interested at all in therapy.  Clinicians may see them occasionally in court appointed treatment in correctional facilities, or sometimes in substance abuse programs as I did.

The borderlines  are what we see most often in the therapy rooms due to their intense mood instabilities and mangled relationships and I have had my share.

If the personality disorder patient can be engaged, then  you can teach them about alternative ways of reacting and encourage them to employ behaviors that won’t cause them  difficulties with others.

 In other words a successful treatment would compromise turning them into a “nicer” personality disorder, rather than changing their personality.

Additionally you can treat depressive and anxiety symptoms often seen in the borderline and narcissistic patients.

Of the ten personality disorders,  the sociopathic, borderline and narcissistic are the most difficult and abusive.  There are a lot of them out there in all walks of society and in all nationalities and  ethnic groups.

Let’s look at the Narcissistic Personality Disorder.  Above all, narcissists have an  overwhelming conviction of superiority, or a grandiose perception of themselves and they are not shy of letting you know it!

They see themselves as special, unique,  very gifted and  having more success and knowledge than others.

They may often brag about their intelligence or abilities as being superior to others, and  are quick to shoot down others who challenge them.  They come across as arrogant, snobs and a  know it all.

Woe to anyone who would dare to question or criticize, as they will provoke outbursts of anger, rage,  and insults as the narcissists consider themselves as infallible.

One of the biggest problems is that they lack empathy for others, though they may feign it in public when needed to impress others.

 They make blatant cruel and cutting remarks about others because they feel it is their right to point out others faults, weaknesses, and mistakes.

Because they seek constant recognition and admiration, they only want to be associated with the “best”, be it the most well known personalities or institutions.  They often name drop as a way of evoking jealousy in others and elevating their status.

They often think others are jealous of them because of their superior knowledge, or success, and will devalue others.

Their image is extremely important to them and craftily constructed and maintained to perfection. Prestige is sought at all costs.

They are so power hungry, that they will use cut throat tactics and manipulate others to get where they want to be.

They have a big sense of entitlement. They are convinced that you should accord them special treatment not given to ordinary folks.

Because of their sense of uniqueness, they can be above the laws of society as well and may be involved in sociopathic activity.

Borderline Personality Disorder traits are even more psychiatrically complex and invariably involve mood instabilities, inappropriate intense anger and chaos in relationships.

Peering into their psyche is like looking at an emotional roller coaster or like Mr. Toad’s wild ride into hell.

The borderline is one of the most difficult personalities to get along with.  To the outsider, there is no rhyme or reason to their very unpredictable mood instabilities , anger, chaotic lifestyle and abusive behavior.

I have had several in my practice and they are draining to treat as you must constantly walk on eggshells, as do people around them.

They are initially very engaging socially and demonstrate often a high degree of charisma. Once they have entrusted you into a relationship, their mantle of their persona becomes thin and the pathology springs out.

Those in relationships with them are constantly being caught off-guard by their malignant anger. Most of the time the victim of their malicious outbursts has no idea what they did to provoke them.

Their verbal attacks can be very vicious, along with chronic bullying to devalue and mutilate someone emotionally.  They can also be physically violent as well, hitting and destroying property.

The reason is that borderlines can quickly misinterpret your reaction, words, perceived lack of attention or loyalty.  Even very minor perceived slights can trigger an avalanche of violent anger and revenge.

This is due to ongoing negative projections they have. Projections are feelings that the borderline “projects” onto others, that actually stems from them, not from the person in question.

Having them in conjoint (marital) therapy can be a nightmare full of fireworks, threats, outbursts towards their spouse and even towards the therapist, who may not go along with their “reasoning” or behavior.

They are extremely needy, constantly wanting attention, always wanting you to meet all of their needs all the time or else you will be accused of abandoning them,  being disloyal, or disregarding their needs.

This comes from an inner emptiness they have that and fears of being abandoned.  Because of their chronic inappropriate anger and constant demands of others meeting their needs, they lose friendships  and relationships often.

There lifestyle is chaotic and filled with drama, that they constantly create with others.  They are very self-absorbed and constantly seeking attention.

Beside their anger problem, they are given towards splitting.    Splitting is a psychological term indicating  a black and white way of perception, where there isn’t any “gray” of good or bad.

Borderlines are famous for either over valuing you and putting you on a pedestal, or totally undervaluing you.    They can think you are the greatest one minute and then the next totally tear you down.  

Plus,  they often easily vacillate between the two extremes at any given time, if you fail to meet their expectations and needs.

This vacillation is a form of emotional manipulation and coercion and leaves others extremely confused, creates tension in relationships, and eventual distancing from the borderline to protect oneself from being humiliated or hurt.

They are master manipulators and also are given towards pitting others in a group or team setting in order to get their way.  Of  course this creates more drama, which they thrive on.

Many have a history of eating disorders, or substance abuse. and some are self mutilators.

They can also have a history of suicidal threats and gestures and can be dangerous to themselves.  They often have paranoid type perceptions of being unliked, unappreciated and being abandoned.

They are extremely impulsive and given to wide extremes of mood variations, that can at times mimic a bipolar.  As such they often can plunge into a severe depressive periods in need of antidepressant treatment and or mood stabilizers if the extremes meet the criteria of bipolar disorder.

Trying to maintain a relationship with a borderline is exhaustive due to the explosive  anger, drama, manipulation, emotional abuse and constant chaos they create in  relationships.

The Antisocial or Psychopathic Personality Disorder is the pathological extreme of narcissism that generally involves criminality. These people  have complete disregard for societal norms, morals, rules, and laws.

They often can be very charming, seductive and enlist trust through devious means.  Others go around being openly hostile, angry, belligerent and aggressive.

Most are very gifted liars and are true masters of deceit and deception.  They can also be very strategic and calculative in their efforts to harm and deceive others.

With the proliferation of the net and social media, they have free reign to fabricate illusions and lie with the intent to deceive.

They completely lack any empathy, and worse have no guilt or remorse for their harmful behavior.  They can steal, kill or exploit others without reticence or responsibility.

They generally think of themselves in a superior way because of their ability to go above the law and view their victims as weaklings and inferior in intelligence.

Because they lack any guilt and remorse they have a history of  recidivism  for criminal activity.

Antisocial behavior can be seen in childhood with progressive involvement in delinquency in their teens.  Harmful treatment of animals is likewise an early sign, as well as bullying, chronic lying and getting in fights with others.

Interpersonal relationship are vapid and primarily one-sided because they rarely form close bonds with people.  Familial abuse, rejection and abandonment is often seen in their childhoods, so there are problems with attachment and trusting others.

It is not unusual to see generations of sociopathic tendencies in families, as pathological behavior are modeled by successive generations and can even be “normalised” as a way of living, such as in mafiosi families.

By the same vein, children who grow up with a devious, calculating and deceptive  parent, who has succeeded in exploitive businesses affairs  or criminal behavior  may see nothing wrong in emulating their antisocial parent.

They  may not all be interested in killing you, but think nothing or robbing you of your savings, stealing your trust to gain money or power at your expense.

Many take pride and pleasure in being able to  deceive others with  their finely honed business plans, lies and deception geared solely for their gain.

Swindling you out of your trust and money makes them feel powerful and elite.  As Barnum T. Bailey said  ” there is a sucker born every minute” and they consider their victims as stupid for buying into their game.

Some have garnered a famous name  and are considered a revered guru or business mogul in their arenas. They are talented  wheelers and dealers in business and  financial affairs and bask in the limelight till they are caught in their deception.

There are many in all levels of society and in all fields from the petty criminal to a serial killer, mafia types, terrorists, even clergy, and all the way up to military leaders and heads of states.

The best you can do is to be aware and weary of individuals who have some of these pathological traits and avoid them at all costs.  Since most are highly skilled  con artists,  the trusting types who look for the good in everyone can often fall victims.

If you find yourself caught in a personal relationship with one, you probably already are suffering from their abuse.  Best you can do is to get professional help from a therapist in either how to extradite yourself from them or protect yourself as best you can from their ongoing pathology.

If you have fallen under the spell of one of these personality disorders, don’t think you are the only one, nor that it is your fault.  They do prey on the unsuspecting  and trusting types.

They are extremely convincing, charismatic, and skilled in manipulation.  That is their modus operandi for survival and for recruiting others into their cause and relationships.

My intent is to inform you so you can be more aware of these personality disorders and  pathological traits that inflict much harm on others and society.