Personality Disorder

The term Personality Disorder is a contentious one but essentially refers to a broad pattern of difficulties that are persistent over time, problematic (for both the person and often for relatives/friends) and pervasive (e.g. impact on a number of different areas of a person’s life for example sense of self, relationships, work etc).

We offer assessment and treatment for Personality Disorders in our clinics in Godalming (near Guildford), Surrey and Haywards Heath in West Sussex.

Types and Symptoms of Personality Disorders

A person with a paranoid personality disorder is extremely distrustful and suspicious. Other features include:

  • thinking other people are lying to them or trying to manipulate them
  • feeling they cannot really trust their friends and associates
  • worrying that any confidential information shared with others will be used against them
  • thinking there are hidden meanings in remarks most would regard as innocent
  • worrying that their spouse or partner is unfaithful, despite a lack of evidence

A point to note is that we can all experience at times traits of the above and this does not mean we have Paranoid Personality Disorder

A person with a schizotypal personality disorder is likely to have poor social skills and delusional thoughts, and behave in unusual ways. In some cases, people they may react oddly in conversations, not respond, or talk to themselves. They frequently misinterpret situations as being strange or having unusual meaning for them; paranormal and superstitious beliefs are not uncommon for these people. Other features include:

  • attaching undue and misguided significance to everyday events – such as thinking newspaper headlines are secret messages to them
    believing in special powers – such as telepathy or the ability to influence other people’s emotions and actions
  • unusual ways of speaking – such as long, rambling vague sentences or going off on a tangent
  • experiencing excessive anxiety in social situations – even if they have known a particular person or group of people for a long time
This is also be referred to as Emotionally Unstable Personality Disorder.
A person with borderline personality disorder typically experiences instability in different aspects of their lives including their emotions (which often fluctuate quickly and can be very intense), their sense of self (which is often very changeable) and their relationships (which can be volatile). They often feel worthless and defective and are often highly sensitive to rejection and abandonment. They might be quite impulsive and may have a history of self harm and suicidal thinking.
A person with narcissistic personality disorder often appears to view himself or herself as special although underneath this they have deep routed feelings of insecurity and worthlessness (which may be hard to see). They may act as if they have an inflated sense of their own importance and show an intense need for other people to look up to them.
Other features include:

    exaggerating their own achievements and abilities
  • thinking they are entitled to be treated better than other people
  • exploiting other people for their own personal gain
    lacking empathy for other people’s weaknesses
  • looking down on people they feel are “beneath” them, while feeling deeply envious of people they see as being “above” them
A person with dependent personality disorder often lacks a sense of autonomy and competence, believing they have no ability to be independent. They may show an excessive need for others to look after them and can be experienced by others as “clingy”. Other features include:

  • finding it difficult to make decisions without other people’s guidance
  • needing others to take responsibility over what should be their own important life choices
  • not being able to express disagreement with other people
    finding it difficult to start new activities due to a lack of confidence
  • going to extremes to obtain

  • support and comfort
    feeling helpless and uncomfortable when alone
  • urgently needing to start a new relationship once a previous relationship comes to an end
    having an unrealistic and constant fear they will be left alone to fend for themselves
Someone with a schizoid personality disorder may appear cold and detached, and avoid making close social contact with others. Other features include:

  • preferring to take part in activities that do not require interaction with others
  • having little desire to form close relationships, including sexual relationships
  • being uninterested when receiving criticism or praise
    having a limited ability to experience pleasure or joy
A person with an antisocial personality disorder sees other people as vulnerable and may intimidate or bully others without remorse. They often lack concern about the consequences of their actions.
Features include:

  • lack of concern, regret or remorse about other people’s distress
  • irresponsibility and disregard for normal social behaviour
  • difficulty in sustaining long-term relationships
    little ability to tolerate frustration and to control their anger
  • lack of guilt, or not learning from their mistakes
    blaming others for problems in their lives
A person with histrionic personality disorder often feels anxious about being ignored. As a result, they feel a compulsion (overwhelming urge) to be noticed and the centre of everyone’s attention. Features include:

  • displaying excessive emotion, yet appearing to lack real emotional sincerity
  • dressing provocatively and engaging in inappropriate flirting or sexually seductive behaviour
  • moving quickly from one emotional state to another
    being self-centred and caring little about other people
  • constantly seeking reassurance and approval from other people

Symptoms and signs may co-exist with borderline and narcissistic personality disorders.

A person with avoidant personality disorder appears painfully shy, is socially inhibited, feels inadequate and is extremely sensitive to rejection. Unlike people with schizoid personality disorders, they desire close relationships with others, but often lack the confidence and ability to form them.
A person with obsessive compulsive personality disorder is anxious about issues that seem out of control or “messy”. They are preoccupied with orderliness and ways to control their environment, and may come across to others as a “control freak”.
Other features include:

  • having an excessive interest in lists, timetables and rules
  • being so concerned with completing a task perfectly that they have problems completing it (perfectionism)
  • being a workaholic
  • having very rigid views about issues such as morality, ethics and how a person should behave in daily life
  • hoarding items that seem to have no monetary or sentimental value
  • being unable to delegate tasks to other people
  • disliking spending money, as they think it is always better to save for a “rainy day”

This personality disorder differs from obsessive compulsive disorder (OCD), a related mental health condition, in several important ways:

  • People with OCD are aware that their behaviour is problematic and are anxious about it.
  • Most people with obsessive compulsive personality disorder think their behaviour is perfectly acceptable and have no desire to change it.
  • Some people with OCD are compelled to carry out rituals, such as having to touch every second lamppost as they walk down the street. This is not usually the case with people with obsessive compulsive personality disorder.
  • People with OCD may feel compelled to make lists or organise items in their house, but feel anxious about doing so.
  • People with obsessive compulsive personality disorder find relief from anxiety when doing such tasks and may become irritated when prevented from doing so.

Recovering from Personality Disorders



The most effective way of managing the difficulties associated with Personality Disorder is psychological therapy. This normally lasts at least six months, often longer, depending on the severity of the difficulties and other co-existing problems.
 
Psychological Treatments for Personality Disorders include:

Dialectical Behaviour Therapy

Dialectical Behaviour Therapy (DBT) has proved successful in helping people reduce impulsive self-harming behaviours, especially in BPD. DBT is designed to help you balance emotional instability, manage distress and build healthy stable relationships. It focuses on behavior change through building new skills and thus assumes that many of the difficulties that people with BPD experience are due to skills deficits, although some people may have skills but might struggle to implement them especially in times of stress.

The psychologists working at The Psychology Company are trained and experienced DBT practitioners however as DBT combines group and individual work we are not currently able to offer the full package of DBT but our individual work can be informed by DBT principles and skills.

Schema Therapy

Schema Therapy has a strong and growing research base that shows it can be helpful in creating lasting change for people with longstanding and complex difficulties that are typical of personality disorder. Schema Therapy has been shown to be helpful for people with BPD but also the other personality Disorders. Compared to DBT, Schema Therapy works more with the origins of the difficulties and helps people to make sense of what can be experienced as changeable/confusing thoughts, feelings and behavior. Behavior change is seen to come after emotional change so this schema therapy can be more emotionally focused than some other therapeutic approaches.

Dr Olivia Thrift is an Advanced Certified Schema Therapist and Supervisor (the highest level of certification currently possible) and Justine Pulver is currently undertaking the certification process but has undertaken extensive schema training and supervision over the last several years.

Assessment & Treatment



We offer assessment and treatment for Personality Disorders in our clinics in Godalming (near Guildford), Surrey and Haywards Heath in West Sussex.
If you would like to arrange an initial confidential telephone conversation for you or someone you know, please get in touch.

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