What is a Personality Disorder?
A personality disorder is not a temporary condition, but a set of stable types of behavior that characterize a person's lifestyle and their way of relating to themselves and others. These are deeply rooted patterns manifesting as rigid responses to a wide range of personal and social situations.
The word "Persona" means mask. A disorder is diagnosed when certain character traits become so strong and one-sided that they lead to rigid, dysfunctional behavior in all areas of life.
Main Criteria and Severity Levels
Specialists use three main signs for diagnosis:
- Totality: pathological traits manifest in almost all spheres of functioning.
- Stability: the pattern is chronic, long-standing, and not merely episodic.
- Social Maladaptation: the disorder leads to a significant decline in professional and social productivity.
Severity levels range from personality difficulties (accentuation), where problems are not constant, to severe disorders that pose a significant risk to oneself or others. A key feature is egosyntonia: individuals perceive their behavior and feelings as a natural part of themselves rather than a problem, often viewing their suffering as caused by external factors.
Analysis of Key Personality Types:
Paranoid Type: The World as a Threat
A paranoid personality tends to be very egocentric and distrustful, often interpreting neutral or friendly actions as being directed against them.
Origin: Often formed due to rigid boundaries in childhood and a denial of the child's autonomy.. Diagnostic Questions:
- Do you often have to keep an eye out to stop people from using you or hurting you?
- Do you spend a lot of time wondering if you can trust your friends or colleagues?
- Do you often detect hidden threats or insults in things people say or do?
- Are you the kind of person who holds grudges or takes a long time to forgive people?
Schizoid Type: The Fortress of Solitude
This type is expressed through emotional coldness and detachment. They appear as "loners," indifferent to the emotions of others, praise, or criticism.
Origin: Thought to result from early trauma involving neglect and a lack of affection, leading the child to conclude that personal relationships are unreliable or dangerous.
Diagnostic Questions:
- Do you almost always rather do things alone than with other people?
- Is it NOT important to you whether you have any close relationships?
- Does it NOT matter to you what people think of you?
- Do you find that nothing makes you very happy or very sad?
Dissocial Type: Living Outside the Rules
Characterized by a gross discrepancy between behavior and prevailing social norms, and a callous indifference to the feelings of others.
Origin: Often linked to childhood trauma (abuse), lack of care, and genetic predisposition (related to the MAO-A enzyme).
Diagnostic Questions (behavior before age 15):
- Did you bully or threaten other kids?
- Did you deliberately torture animals or people, causing physical pain?
- Did you often skip school or run away from home overnight?
Conclusions and Insights
- Goal of Therapy: To compensate for maladaptive manifestations and reduce subjective stress, rather than completely changing the personality.
- Therapeutic Stance: Absolute honesty is vital with paranoid clients. With dissocial individuals, empathy is ineffective; one must speak the language of their self-interest and personal gain.
- Insight: Fear is what feeds the dissocial personality. Asking the question "what do you need from me right now?" can help pause a psychopathic attack by appealing to the rational part of the brain.
For successful work with such conditions, it is critical to transition from egosyntonia (when behavior is perceived as a normal part of oneself) to egodystonia (the realization that this behavior hinders and causes suffering). The MriyaRun project offers professional tools for this:
- Psychological Diaries: The "Conversation with Myself: Hear, Understand, and Heal" workbook helps track recurring problems that a person usually does not associate with their own behavior.
- Metaphoric Associative Cards (MAC): A set of 50 cards based on the myth of Psyche and Eros allows for the safe exploration of archetypal images and the "shadow" aspects of the personality. This is particularly useful for schizoid and paranoid types who often avoid direct discussion of feelings, as the act of speaking about them can be painful for them.