1 What do we mean when we talk about ‘personality disorder’? We all have personalities – the collection of qualities and personal characteristics that make us distinctive as people. We all also make assessments of other people’s personalities: we might describe one person as an extrovert, or another as shy.
BACKGROUND Each person’s personality has a number of different qualities or ‘traits’; these may sometimes seem contrasting or contradictory: a person can be cautious with respect to money, but impulsive when it comes to making relationships; they might be very serious and dutiful at work, but humourous and warm with friends. We all have parts of our personalities that cause us problems in some situations. For example, someone who generally copes well in life might be inclined to be irritable and suspicious when they meet someone new, or feel anxious when alone. What is the difference between having aspects of your personality which can sometimes cause problems, and having a personality disorder? <strong>The</strong> three ‘P’s’ For someone’s personality difficulties to be considered a ‘disorder’, those difficulties must be Problematic, Persistent and Pervasive. Think about ‘the three Ps’: • For someone to be given a diagnosis of personality disorder, the individual’s personality characteristics need to be outside the norm for the society in which they live, to be a source of unhappiness to that person and/or to others, and/or to severely limit them in their lives. Those characteristics are problematic. • Personality disorders are chronic conditions, meaning that the problematic characteristics continue over a long period of time, they usually emerge in adolescence or early adulthood, they are relatively stable and can continue into later life. <strong>The</strong> characteristics are persistent. • <strong>The</strong>se problematic characteristics result in distress or difficulties in a number of different aspects of someone’s life, such as intimate, family and social relationships, how someone experiences the world around them, their relationship to themselves (that is, their inner world), and in any employment or occupation that the person takes part in . <strong>The</strong>y can also affect the way in which the individual relates to potential sources of help. <strong>The</strong>y are present in most if not all aspects of the person’s life. In other words, they are pervasive. Diagnosing ‘personality disorder’ is a task for a skilled and trained professional. Labelling someone as having a personality disorder may have serious implications for them, and some people may be very upset by or disagree with the diagnosis. If someone is formally diagnosed as having a personality disorder, this diagnosis should be discussed with them in a careful and sensitive way. (For helpful tips see Chapter 2, Why is the diagnosis so controversial?). Because of the dangers of casual or careless labelling, we would discourage you from labelling your clients as having a personality disorder unless you are professionally trained to do so. It is much more useful to think about them as having complex needs, or personality difficulties, and to think about what those are, and how they affect the person. 9
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