and that can be dangerous for those around him.
http://www.geocities.com/Athens/Forum/6297/faq15.htmlPatients suffering from personality disorders have many things in common:
Most of them are insistent (except those suffering from the Schizoid or the Avoidant Personality Disorders). They demand treatment on a preferential and privileged basis. They complain about numerous symptoms. They never obey the physician or his treatment recommendations and instructions.
They regard themselves as unique, display a streak of grandiosity and a diminished capacity for empathy (the ability to appreciate and respect the needs and wishes of other people). They regard the physician as inferior to them, alienate him using umpteen techniques and bore him with their never-ending self-preoccupation.
They are manipulative and exploitative because they trust no one and usually cannot love or share. They are socially maladaptive and emotionally unstable.
Most personality disorders start out as problems in personal development which peak during adolescence and then become personality disorders. They stay on as enduring qualities of the individual. Personality disorders are stable and all-pervasive – not episodic.
They affect most of the areas of functioning of the patient: his career, his interpersonal relationships, his social functioning.
The typical patients is unhappy. He is depressed, suffers from auxiliary mood and anxiety disorders. He does not like himself, his character, his (deficient) functioning, or his (crippling) influence on others. But his defences are so strong, that he is aware only of the distress – and not of the reasons to it.
The patient with a personality disorder is vulnerable to and prone to suffer from a host of other psychiatric problems. It is as though his psychological immunological system has been disabled by his personality disorder and he falls prey to other variants of mental illness. So much energy is consumed by the disorder and by its corollaries (example: by obsessions-compulsions, or mood swings), that the patient is rendered defenceless.
Patients with personality disorders are alloplastic in their defences. They have an external locus of control. In other words: they tend to blame the outside world for their mishaps. In stressful situations, they try to pre-empt a (real or imaginary) threat, change the rules of the game, introduce new variables, or otherwise influence the world out there to conform to their needs. This is as opposed to autoplastic defences (internal locus of control) typical, for instance, of neurotics (who change their internal psychological processes in stressful situations).
The character problems, behavioural deficits and emotional deficiencies and lability encountered by patients with personality disorders are, mostly, ego-syntonic. This means that the patient does not, on the whole, find his personality traits or behaviour objectionable, unacceptable, disagreeable, or alien to his self. As opposed to that, neurotics are ego-dystonic: they do not like who they are and how they behave on a constant basis.
The personality-disordered are not psychotic. They have no hallucinations, delusions or thought disorders (except those who suffer from the Borderline Personality Disorder and who experience brief psychotic "microepisodes", mostly during treatment). They are also fully oriented, with clear senses (sensorium), good memory and a satisfactory general fund of knowledge.