Are All Troublesome Personalities “Disordered?”

If a person in their very nature is really difficult to deal with, does it necessarily mean they have a personality disorder? If it doesn’t, what does it take for a troubling personality to be considered truly disordered?

All of us have had the experience of dealing with someone whose very approach to life, whose way of looking at things and dealing with things, whose personality, is a source of consternation for us. Such folks can drive us a little crazy. We wish they would see things differently or do things differently but they seem to prefer a tack that makes living or dealing with them difficult or unpleasant. At times it can seem like no matter how hard we try to accommodate their peculiarities, it’s a constant battle to get along with them.

In my books In Sheep’s Clothing and Character Disturbance, I assert that personality and character disturbances exist along a continuum of both quality and degree. While this notion was once fairly controversial, as we’ve come to realize how many other conditions actually exist along a spectrum, it’s steadily becoming less so. Perhaps that’s partly because awareness of personality and character disturbances has been growing steadily over the past several years. (See “Growing Awareness of Personality and Character Disturbances”.)

All of us have a personality — a combination of our innate traits and learned ways of coping that come together to form our unique “style” of relating to others. Most of the time, our personality is not in itself the cause of any problems. In fact, having a distinctive personality is part of what makes life interesting. It would be an awfully boring world if everyone were inclined to see and do things in the very same way. But sometimes the very way a person approaches life and tends to deal with its concerns is in itself the reason for the person’s difficulties. From a technical standpoint, it’s when a person’s way of seeing and doing things is so inordinately inflexible, deviates so far from accepted norms, and/or is a source of great distress to the person or others, that it can rise to the level of a disorder.

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A person doesn’t have to have a personality disorder to rub folks the wrong way. Sometimes even fairly well adjusted personalities can clash with one another just because their ways are so divergent or incompatible. Free thinking creative types might not get along all that well with members of their product development team who have to have things neatly organized and well defined. Then there are those folks who may not be completely “disordered” in their general manner but who possess certain personality traits that really irritate or annoy, or that readily engender conflict. All of us know someone who would be no trouble at all to get along with if it weren’t for their quick temper, their impatience, their criticism and sarcasm, their stubbornness, or their penchant for overdramatizing. While folks with disturbing traits may not always be truly personality disordered, there are times when their various quirks are of sufficient intensity or intractability to rise to the level of a disorder even when they don’t meet any of the criteria for one of the “official” personality disorder classifications listed in the diagnostic manuals mental health clinicians use. When a person’s various traits come together in a manner that make their overall style of relating severely dysfunctional or the source of great distress to them or those around them, they can still be considered to have a personality disorder.

In many ways, having a personality disorder — at least the way it’s presently defined — doesn’t make a lot of sense. To have such a disorder, your way of seeing and doing things has got to be a problem. But who in their right mind would want to hang on to problematic ways of seeing and doing things? It’s paradoxically in the very nature of a personality disturbance or disorder for the person to be “comfortable” with and to “prefer” their particular ways despite how others might consider those ways problematic. (See “Self-Image: How We See Ourselves and Why It Matters”.) And why this is true is a matter of some theoretical debate. One thing is for sure, however, and that is that folks with significant personality disturbances or full blown disorders rarely think problems lie with them and their ways of seeing and doing things. Rather, they most often tend to think everyone else either is or has the problem, and things would be just fine if everyone else would see things their way.

Over the years, I’ve both evaluated and counseled hundreds of individuals who either had personality disturbances or had some type of relationship with someone who did. Not all of the time did those disturbances of personality rise to the level of a disorder, at least not by official standards. But that didn’t mean that their very ways of seeing and doing things weren’t a problem. In fact, in many instances, no matter what other diagnoses the person may have warranted or had received in the past — e.g., mood disorder, substance abuse disorder, anxiety, impulse control problems, etc. — it was evident that the root of problems really rested with their personality traits. For example, a person with an innate low tolerance for frustration, a tendency to be sensation seeking, and an inability to delay gratification might have been led by those very traits into a pattern of maladaptive substance use. (See “Sensation Seekers: When Boredom Intolerance Becomes Pathological”.) And, if those traits are not dealt with directly during the course of any professional intervention, it’s quite likely that even in the absence of continued substance abuse, other problematic coping behaviors might emerge. So I learned early on how important it is to pay attention to personality — even if someone can’t rightfully be deemed to have a personality disorder.

• character disturbance
• in practice
• personality disorders