This page sets out some basic information on personality disorders, including how I work with them.
(This page is under revision as at 05 October 2022.)
What are personality disorders?
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In common with many therapists these days, I regard ‘personality disorders’ as the result of your previous experience. I don’t ask: What is wrong with you? I ask: What happened to you?
For someone to be considering a diagnosis of personality disorder, whatever happened to you has had a big impact on you. Often this is in your childhood or adolescence. This may be some form of trauma. But here too, the label ‘trauma’ is not the most important thing.
You are not your diagnosis!
For me, personality disorder is a label for a bunch of things – feelings, thoughts and behaviours – that you are experiencing in yourself and in relation to other people. These things have just about enough in common with other people that they get labelled as one or other of the personality disorders. At the same time, they are very personal to you. And so is the way they formed in the first place.
You may choose to adopt the label given to you – or not. Either way, you are not a label! I am meeting you, the person. It doesn’t matter to me whether the label is there or not. You are experiencing yourself and your relationships as you do, whether or not you label yourself that way. Your feelings about the label may change as you explore wat it means to you.
Do you need a diagnosis before you see me?
You don’t need to have been diagnosed with a personality disorder to talk to me about it! You will probably be in one of the following situations:
- You have received a confirmed diagnosis from a psychologist or psychiatrist
- Someone has suggested that this is an appropriate diagnosis for you. They may or may not be qualified to do so.
- You may be thinking about seeking a formal diagnosis
- You have diagnosed yourself as having a personality disorder (self-diagnosis)
Most times the suggestion of there being a personality disorder will have come from a medical professional, but increasingly, people are accessing information about personality disorders and asking whether it applies to them. In any of these situations, I will discuss with you what such a diagnosis means to you. But only if you want to!
How I work with personality disorders
As a psychotherapist, my starting point is different to that of a medical professional.
Will I give you a diagnosis?
No, I don’t offer you a diagnosis or prescribe medication. It is not my place to do either, nor am I qualified to do so. Nor is it my place to advise you whether you can or should seek a diagnosis. That is up to you!
My approach to a diagnosis is the same as for any other medical or psychiatric diagnosis.
Firstly, as a psychotherapist, I do not work to a ‘medical model’. The first thing you may notice is that I don’t give you my opinion. My role is to help you you discover yourself and to make the changes in your self and your life that you want to make. In this case, that may mean exploring how you feel about having a diagnosis and whether you think it is right for you.
Making things better
If you have been reading about personality disorders, I will also be interested to know what aspects of any given personality disorder you feel do and don’t apply to you.
Here are some more points about how I work with personality disorders
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How do you feel about a diagnosis of ‘personality disorder’?
I will also be interested what it is about such a condition that you feel applies to you. There are several reasons for this.
Firstly, you may relate to some aspects of what you have been diagnosed this way and not others.
Secondly, what the diagnosis makes you feel about yourself is important. For example, you may feel it gives you some understanding of what you have struggled with in life for a long time. That may give you some hope that things can improve. Or you might feel worse about someone can apply this label to you. These things are very personal. We can explore what a diagnosis means for you and how you feel about having or seeking one. Quite possibly you have mixed feelings or are not sure yet. We can talk about that if you think it would be helpful.
How do you feel about yourself and your relationships?
Apart from what you feel about the label, I will be curious as to how you feel about yourself and how you experience relationships and the world more generally. Why? Because this is the stuff of therapy. And it’s when you’re having difficulties here that people start talking about you having a personality disorder.
This conversation brings more details of what is happening in yourself or your life. It helps us get underneath the ‘disorder’ label, so that we get to the more useful detail that is unique to you!
Your feelings about the medical profession and therapists
There is one set of relationships that sometimes has additional power for people who struggle to maintain fruitful relationships. That is relationships with the medical and therapy professions.
It is part of life to feel affected by society and by ‘the system’, whether its your employer and colleagues, the government, the police, the courts, the benefits system. the media or whoever. This includes health professionals and therapists. Sometimes we feel safe and cared for. At other times we may feel scared or angry. If you tend to have intense feelings in life generally, it’s quite possible that you will have such feelings towards people working in mental health services too. If I am your therapist, that may include me!
Learning to deal with these feelings is very much part of therapy. Sometimes you may question, is is me or is it them? Sometimes you will feel sure! It is good that you talk about all of this in therapy.
You can read elsewhere on this website how people with personality disorders are sometimes pathologised, stigmatised and treated with hostility, even by the medical staff who are there to help them. This is far from true everywhere, but it does happen. If you feel that has happened to you, it is okay to talk about that too.
Articles about personality disorders on this site
Please click here for a list of items on this site tagged with ‘Personality Disorder’. These include
Personality Disorders in the Media
Borderline Personality Disorders in the Huffington Post UK
The reclassification of personality disorders
Resources
Mind’s page on personality disorders
The Consensus Statement for People with Complex Mental Health Difficulties who are diagnosed with a Personality Disorder (external link, updated on 29 September 2022). This 2018 document is agreed upon by Mind, The British Psychological Society and several other relevant bodies with many more contributors. It is based on the premise that the label of ‘Personality Disorder’ is controversial and needs to change. It also notes that people given that label are likely to have experienced past trauma.