If a person is obviously mentally ill or has a substance abuse problem, we usually have a pretty clear idea of what is wrong and how to go about getting help for them.. But toxic persons, or people with personality disorders, are usually not even aware that they have a problem. We may interact with them every day, and we may even be very close to them emotionally, even though they are often difficult to get along with because something about them is just -- well, different.
A word of caution: You Tube is flooded with descriptions of personality disorders, but since anyone can post to You Tube, there is no quality control whatsoever. Even people who may have published books on one or more personality disorders may tend to treat everyone the same, without due regard for individual differences. Like anything else on the Internet, such postings should not be taken as authoritative unless you trust the source!
The ancient Greeks used to tell the story of Narcissus -- a lad who was so good-looking that he fell in love with his own reflection in a pool of water, and spent so much time gazing at it that he eventually fell into the pool and drowned. People who are given a diagnosis of narcissistic personality disorder are often perceived as being selfish or conceited. They may often spend a great deal of time telling you how great they are, or boasting of their achievements or accomplishments.
Narcissists do not always act selfishly in the short term. They are often highly motivated to pursue long-term goals in order to prove their worth both to themselves and others. For this reason, narcissists often tend to gravitate to positions of leadership in business, government, education -- and yes, even churches.
Narcissists often cause a great deal of suffering, particularly when they happen to be employers, family members, or romantic partners. Yet there are ways of dealing with them. (Since no two personalities are exactly identical, however, you cannot stereotype them and treat them all exactly the same way.)
People who have been diagnosed with histrionic personality disorder may often be compared to an adult version of the “spoiled child” who will do anything to remain the center of attention. If histrionics are able to “show off” and remain the center of attention by doing a good job, they often accomplish a great deal. But if they feel that they are being ignored, or that the attention which they crave so deeply is denied them, they may become angry and disruptive in order to get it back again -- even if it’s unfavorable attention this time! ("I don't care what yor say about me," one publicity-hungry histrionic is reported to have said to a reporter for a scandal magazine. "Just be sure you spell my name right.!")
People with a diagnosis of antisocial personality disorder did not incorporate our society’s standards of right and wrong into their personalities as well as the rest of us have. They begin getting into trouble with the authorities by the time they are adolescents, and don’t grow out of it. As you might suppose, this pattern is much more common in men than in women.
Since personality disorders are so difficult to change, many such people keep going back and forth to jail from their teen years until middle age, when they seem to mellow out of their own accord. They make up the bulk of most prison populations, and often have a history of substance abuse or substance dependency. However, people with antisocial personality traits (I like to call them stealth antisocials) may be encountered almost anywhere, even at the highest levels of many organizations; and they may not be found out until their behavior gets them into trouble. (The discovery and apprehension of stealth antisocials in high-profile positions is the basis of many of the news stories we read about every day.)
To understand the person who qualifies for a diagnosis of borderline personality disorder, think back to some of the stormiest days of your own adolescence, or the adolescence of someone you know well. With an incompletely developed sense of self, the borderlines have no firm idea of who they are and where they are going. Their lives are often erratic, with frequent job changes and alterations in long term goals, and intense and unstable friendships and romantic involvements.
Because of their poorly developed sense of self, borderlines often have difficulty with so-called “boundary issues,” or the ability to distinguish between what is appropriate and what is inappropriate in a given situation. Some borderlines, in fact, may find it difficult to even talk to a person of the opposite sex for very long without acting as if they are falling in love with them. As would be expected, the romantic lives of borderlines tend to be especially intense and tumultuous. The manipulative abilities of people with borderline personality disorder often enable them to deceive those who do not understand the inner storms which produce such behavior, which frequently causes their sudden bouts of passion to be mistaken for genuine love.
Borderlines often engage in “splitting,” with either extremely positive or extremely negative feelings towards others, sometimes suddenly reversing from extreme friendliness to extreme rejection and vice-versa. This changeability frequently leads them to engage in behavior that is highly manipulative. This splitting may also be the reason why the interpersonal relationships of borderlines are often centered around real of imagined fears of abandonment. (One book on borderline personality disorder is entitled, I Hate You - Don’t Leave Me!) These tendencies to engage in splitting may also explain why borderlines also seem to have a strong ability to divide those around them into separate camps of friends and enemies.
Borderlines usually have very low self-esteem, and suicidal gestures, genuine attempts,
Obsessive-Compulsive Personality Disorder.
People who have been diagnosed with an obsessive-compulsive personality disorder may be popularly known as a “nit-picker” or “neat freak.” They may become so involved with orderliness, perfectionism, and control that efficiency suffers as a result. This culture tends to place a high value on preoccupation with detail in certain jobs. With proper training, people who have milder forms of obsessive-compulsive personality disorder may become excellent law clerks, college registrars, bank auditors, or personal physicians -- in which case, it may not be a personality disorder any more, unless it interferes with their functioning off the job!
Obsessive-compulsive personality disorder is closely related to another disorder with a similar name, obsessive-compulsive disorder, or OCD for short, which is similar in nature but more limited in scope. Obsessive-compulsive disorder refers to a pattern of continually recurring thoughts (obsessions), or behaviors which one is compelled to continually repeat, such as checking a door several times in a row to be sure that it is locked.
People who carry a diagnosis of avoidant personality disorder have had such unpleasant social interactions in the past that with the possible exception of one or two close relatives or special friends, they have come to fear all human contact. Avoidants are frequently not merely shy about most social situations, they are genuinely phobic about them. Their avoidance is often centered around a core belief that if people really got to know them, it would immediately become obvious how incompetent and worthless they really are, and the immediate result would be scorn, rejection, and loss of employment. People with an avoidant personality disorder often tend to gravitate to solitary occupations -- researchers, librarians, or forest rangers, for example; and they may be attracted by certain monastic orders. (Of course, not everyone in these types of occupations could be diagnosed with an avoidant personality disorder!)
A central theme in the life of people who have been diagnosed with a dependent personality disorder is a need to be looked after and taken care of, often accompanied by excessive fears of real or imagined abandonment. Ironically, some people who qualify for a diagnosis of DPD may behave in exactly opposite fashion. Those with milder forms of this disorder may attempt to satisfy their underlying dependency needs by becoming so efficient and thorough that they make themselves indispensable. Others, whose disorder is more severe, become highly dependent on instructions from above, and are reluctant to show any initiative in carrying out their responsibilities for fear that they will have made the wrong decision.
People who have been diagnoses with paranoid personality disorder tend to see the activities of other people as ill-intentioned -- even when the opposite is true. Compliments may be seen as attempts to gain undue influence through flattery, and offers of help may be seen as evidence that the person to whom the help is offered is viewed as incompetent. The resulting suspiciousness and hostility may tend to bring about the negative attitudes and behaviors which the person with a paranoid personality disorder believes were always there. (The saying goes, “Just because you’re paranoid, it doesn’t mean they aren’t out to get you!”)
The person who has been diagnosed with schizoid personality disorder is an extreme loner or a “cold fish” who just isn’t interested in being around people. Such people are often found in the most solitary jobs which others might tend to shy away from. Because of their extreme lack of social skills, they should not be expected to change simply by inviting them to parties or by introducing them to a wide circle of people.
People who have been diagnosed with schizotypal personality disorder typically have bizarre notions of cause and effect, and may practice unusual rituals of their own devising, either to make things happen or to prevent them from happening, similar to those who have been diagnosed with schizophrenia. Their everyday speech patterns and favorite topics of converstation are usually regarded by those around them as being somewhat bizarre, although not totally “crazy” in the popular sense of the term. They may also take a keen interest in cults and in the paranormal. Although certainly not everyone who is interested in such topics has a schizotypal personality disorder, the true schizotypal still tends to stand out because of bizarre thought patterns.
Although the American Psychiatric Association no longer officially lists this as a separate personality disorder, people with passive aggressive tendencies try to disrupt things by sabotaging the success of their employers, their family, or their friends without appearing do so deliberately, because they feel that their own needs for recognition, status, or achievement are not being met, or that other people are more successful than they are. Passive aggressive people may risk an occasional confrontation if it helps them to get their frustrations out, but they can usually gauge their actions carefully enough to avoid losing their jobs or their families.
If they are not frankly and firmly confronted about their behavior, their passive-aggressive patterns may become worse over time as they continue to follow their own “hidden agendas” and they feel that their actions are being accepted or condoned. They may single out for special treatment vulnerable individuals or groups who will not or cannot “fight back,” and their behavior may degenerate into outright bullying. Then, when the inevitable day of reckoning does arrive, the consequences may be much more serious -- both for the victims and for the organization -- than if the problem had been immediately and forcefully dealt with.
In order to qualify for any of the foregoing diagnoses of personality disorder, the disorder must be seen to cause people significant distress in their social, intellectual, or occupational functioning, regardless of whether or not they are aware of this fact. Temperamental but highly successful movie stars, for example, whose demanding and self-centered behavior would interfere with their adjustment in another setting, would probably not qualify for a diagnosis of narcissistic personality disorder as long as they can "get away with it." Similarly, people who live alone in a remote location miles from the nearest neighbor would not qualify for a diagnosis of avoidant personality disorder as long as they are able to function well their current situation, regardless of how intensely they may dislike having social contact with their fellow human beings.
People with personality disorders are not likely to seek professional assistance, because they are frequently inclined to blame their troubles on everyone but themselves. When they do seek help, it is usually because they are forced to do so (often in conjunction with an assault or a suicide attempt, or because a family member insists on it). They tend to remain as long as they are "hurting," or as long as they are forced to stay. When they are no longer hurting and are in a position to stop, they discontinue treatment.
A final word of caution: as stated previously, an actual diagnosis of a personality disorder should only be made by an appropriately trained mental health professional. One of the easiest and most powerful ways to insult people is to let them know that you suspect them of having a personality disorder! While avoiding making such a diagnosis yourself unless you are properly trained to do so, and not communicating your suspicions to the individuals concerned, knowing how to recognize the major symptoms of a personality disorder will place you in a much better position to deal with such people on a daily basis, and to seek professional assistance in order to better cope with them if you need to do so.