Personality Disorders: Causes, Treatment, and Help

Reader’s Question

I was reading the blog “Are You Dating a Loser” by Dr. Carver and I was interested in knowing the causes of that personality. Why is it that the “loser” reacts in such a manner? Is it their self-esteem? I just don’t understand what aspect of the individual contributes to these actions. The article is leaning towards the victim, knowing the features of the “loser” and how to get away from them. My question to you is on the other hand: What can you, as a psychologist, suggest to the loser in order to help him/her better their personality and way of being. What would be a general insight to give to the “loser” in order for them to understand why he/she is a “loser” and what can the victim do to help him/her develop a stronger and much happier relationship with his/her significant other and with the rest of society?

Our Consulting Clinical Psychologist’s Reply

The “Loser” is actually a “personality disorder” in mental health terms (see my introduction to personality disorders on this website). Of the ten recognized personality disorders, some are known to be linked to genetics (Schizotypal, Schizoid, and Paranoid). Genetics/heredity also seems to play a role in the development of Obsessive-Compulsive Personality. Family history and environment appears directly linked to Antisocial and Histrionic personalities while a history of sexual abuse if often found in Borderline Personality Disorder.

As I mention in my article on Personality Disorders, they are very difficult to treat because:

• they don’t feel they have a problem,
• they’ve always felt/behaved this way and see no problem,
• they blame others for their difficulties, and
• what began as behaviors in their children develop into a lifestyle as an adult.

For those interested in help, treatment is available. Therapy/counseling is helpful in recognizing maladaptive attitudes and beliefs, as well as building coping skills. Some specific therapies are recommended for certain personality disorders — such as Dialectical Behavior Therapy for Borderline Personality. In the community, disorders (medical or psychiatric) that produce distress often prompt treatment. In this theme, we do have distress-reducing treatments that include interventions, medications, and combinations of programs. Medications often are helpful in reducing the agitation, violent thoughts/behavior, poor impulse control, and tension found in Personality Disorders.

Insight-oriented treatments are available as well as those that are behavior-based. Insight programs are typically less successful than behaviorally based. For example, the use of a parole/probation and drug screen system (with threat of incarceration) is more successful at controlling drug abuse or violent behavior than insight programs. The theory assumes that when our behavior changes, we hopefully gain insight into why our old behavior was bad and our new behavior works better.

I’d recommend reviewing some of the Ask the Psychologist responses on Personality Disorders. I’ve frequently addressed treatment, identification, and having a Personality Disorder in the family or as a sweetheart.