Personality Disorders: Fact from Fiction


By Everest Brooks, LCSW, Fond du Lac County Department of Community Programs

As a psychotherapist, I have had experiences dealing with individuals who come to therapy to work on issues ranging from mild distress to chronic mental health issues.  Some of these individuals will recall having difficulties in many areas of their lives beginning before they reached adulthood.  They may feel that they are different or misunderstood.  They may be confused as to why they have difficulties fitting in or functioning within societal norms.  They may have had problems with relationships, employment, or even the law.  These may be signs that the individual has a disorder of the personality.

As humans, our personalities begin to form in infancy.  Our personalities, due to genetics and environment, continue to grow and evolve through adulthood.   Trauma can also play a factor in how we view the world and interact with it.  Individuals learn coping skills and defense mechanisms to deal with their circumstances that can become part of their temperament.  However, some of these traits can become self-defeating and lead to significant problems in obtaining life goals.  As such, maladaptive patterns of thought, functioning and behavior are known as personality disorders.

It is estimated that between 9 and 15 percent of the population have a diagnosable personality disorder.  However, individuals may have more than one disorder or another concurrent mental health issue.  Other people may have some traits of a disorder without meeting the full criteria needed for diagnosis. 

The DSM-5 groups personality disorders into 3 clusters or general types.

Cluster A: Paranoid, Schizoid, and Schizotypal disorders which are characterized by unusual and eccentric thoughts and behaviors. 

Cluster B: Antisocial, Borderline, Histrionic and Narcissistic personality disorders.  These types are recognized by impulsive, erratic, and overly-emotional traits. 

Cluster C:  Avoidant, Dependent, and Obsessive-Compulsive personalities which are identified by worry and fearfulness. 

Before treatment can begin, it is important that a valid diagnosis be made.  Mental health professionals base a personality disorder diagnosis on enduring patterns of moods, thoughts, and behaviors.  This can be supported by examination and testing, reviewing prior mental health records, talking with previous clinicians, or obtaining collateral information from friends and family.  Once a diagnosis has been made, a treatment plan can be developed.

Personality disorders are treatable. 

Treatment may include psychotherapy and/or medication.  Psychotherapy for personality disorders tends to focus on examining and challenging thoughts, feelings, and behaviors which are counter-productive.  By gaining insight and utilizing new coping skills, individuals can manage their symptoms and improve their quality of life.


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