Weatherly's Woes - Personality Disorders

PERSONALITY DISORDERS

Personality Disorders are inflexible and pervasive patterns of personality that make everyday life very difficult. They’re jerks, basically. These patterns begin in the patient’s youth, and never go away. There are 10 Personality Disorders, grouped into 3 clusters. All personality disorders share…

(a) NO INSIGHT and (b) CAN’T BE TREATED!! (with one sorta exception).

Cluster A is Absurd

Paranoid - on Alert

Schizoid - Aloof

Schizotypal - Alien

Cluster B is Bad Boys

Antisocial - Barbaric

Borderline - Broken heart, Bumpy emotions or Borderline

Histrionic - show-Biz

Narcissist - Boastful

Cluster C is not Calm (they’re anxious)

Avoidant - Cowardly

Obsessive-Compulsive - Careful

Dependent - Clingy

For each Disorder, I give a description, a stereotypical example and advice for how to interact with them. That advice is important since PDs are ego-syntonic and impossible to treat, so what we can learn instead is how to interact with them.

The Cluster A disorders share a lot of similarities with Schizophrenia. In fact, each one of these disorders incorporates a single element of Schizophrenia. Another way of saying it is that Schizophrenia is like a combination of all the Cluster A disorders.

Paranoid - Suspicious and distrustful. Pretty self explanatory. Be honest, clear and nonthreatening.

Russell Crowe, A Beautiful Mind

April Ludgate, Parks and Rec

Schizoid - NOT interested in other humans. Choses to be solitary. Chilly disposition. Might be asexual. “Schizoids avoid others.” You won’t see them, because they don’t seek medical attention.

Schizotypal - these guys are eccentric. They have the “magical thinking” that is characteristic of Schizophrenia. Might see themselves as clairvoyant. They have odd patterns of speech, weird clothes and ideas of reference (the TV is talking to me), but they’re fully functional. Not much to say, they seem entertaining tbh

Willy Wonka

The Cluster B disorders feature very loud personality types. They’re bold, brash and they stand out from the crowd.

The Jokes

Antisocial - Wild criminals basically. Sociopaths. No regard for human life. Without a conscience. Below the age of 18, we call it Conduct Disorder. This patient will probably come to you as a prisoner from jail.

Borderline - Emotionally crazy. Unstable, impulsive, parasuicidal, can’t stand abandonment, shallow and have rapidly fluctuating moods (over minutes). Occasional mini-psychotic episodes (on the border between depression and psychosis)! They lack direction in life -- always trying to find meaning, but always coming up short. They see life in “black and white” terms. It’s the only PD amenable to treatment (Dialectical Behavioral Therapy). Keep their room free of needles and sharps, because they are at a high risk for suicidal gestures

Dennis Reynolds, It's Always Sunny

Regina George, Mean Girls

Histrionic - Attention seeking. Theatrical. The center of attention. Wildly dressed with flashy colors. Hypersexual. Very susceptible to peer pressure. They may thrive in high school, but as they get older and their appearance becomes less appealing, they tend to degenerate. Cry a lot. Common in females. Set firm boundaries

Narcissist - Mean. Self-centered. Ingrained feeling of superiority and entitlement, but they constantly crave praise. They dress with the right name brands, but they don’t wear tie-dye sequin cowboy hats like the Histrionics do. They’re haughty on the outside, but fragile egos on the inside. Common in males. They might scoff at the DO on your name tag. Give them clear instructions, and insist that they follow your rules. Be authoritative.

Donald Trump

The Cluster C disorders all share an underlying anxiety. They are nervous, weak, shy or timid.

Napolean Dynamite

Avoidant - they want friends, but don’t know how to make them. Very low self-esteem. They end up all alone. Compare with Schizoid PD, who don’t want friends to begin with, and Social Anxiety Disorder, who possess insight into their interpersonal problems. They’re terrified of making any decisions, so make sure that you don’t pressure them into doing anything. Give them space. Let them choose.

Obsessive Compulsive - type A personalities. Rigid and stubborn, they’re main concern is order and perfection, at the expense of efficacy. Importantly, they do NOT have any of the ritualistic behaviors (e.g., must turn off the light switch 10 times) characteristic of OCD. They make awesome patients. They’re clean, organized and follow your advice to a T.

Jack Byrnes, Meet the Parents

Buster Bluth, Arrested Development

Dependent - Submissive and clingy personalities. They jump from relationship to relationship. Unfortunate because they are vulnerable to abusive relationships. If you have even the tiniest inclination that there is an abusive relationship, please isolate them. The abuser (violent boyfriend) may provide the history for the patient (timid battered girlfriend). On the other hand, a dependent patient may try to depend on you, so set firm boundaries.