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Understanding personality disordersThe difference between Normal and Abnormal

Christine Hammond, LMHC

Licensed Mental Health CounselorLifeWorks Group in Winter ParkM.S. in Counseling Psychology from Palm Beach Atlantic UniversityWorks with exhausted peopleRepairing, restoring, and rebuilding relationshipsPredominate occupation is attorneys and their familiesIndividual, couple, family and play therapyParent Coordinator and 50 other areas of trainingSpecializes in personality disorders, addictions, ADD/ADHD, OCD, co-dependency, developmental disorders, anxiety disorders, anger, stress, and depressionBackground:Author of The Exhausted Womans HandbookWriter of over 100 published articlesSpeaker/teacher for over 35 seminars/classesFrom projects in DC to country club to middle classTeacher, small business owner, corporate trainer, stockbrokerSurrounded by attorneys: Husband, Father, Brother, SisterMarried with three teenage children

Normal vs. Abnormal PersonalityNormal Personality Traits

Persistent patterns of perceiving, relating and thinking Consistent in most circumstancesConsistent viewpoint about self and othersObserved in a wide range of contextsAbnormal Personality Disorders

Personality traits which become inflexible and maladaptiveOmnipresentResistant to changeEarly onset in childhood or adolescenceCause significant functional deterioration

Standard Deviation

Diagnosis BackgroundDSM-VDiagnostic and Statistical Manual of Mental DisordersUniversal authority for diagnosis of psychiatric disordersDiagnostic criteria and codes used by all health care professionals and insurance companiesPublished by American Psychiatric Association (APA)5th edition published on May 18, 2013 with 300 disorders4th published in 2000 and 1994 with 297 disorders3rd published in 1987 and 1980 with 292 disorders2nd published in 1974 and 1968 with 182 disorders1st published in 1952 with 106 disordersAPAFounded in 1844Medical specialty society representing about 33,00 psychiatric physiciansNot the same as American Psychological Association (APA)Association of psychologists with more than 134,000 researchers, educators, clinicians, consultants and students

Why You Should Care

Understanding personality issues can: Save time in negotiating Better anticipate unspoken needs of clientsEliminate unnecessary frustrations during negotiationsConserve your energyPredict progress based on accurate personality assessmentImprove outcome results

Bonus:Better understanding of your personality traits, your family members, and co-workersRecognize when its them and not you

Course Objectives

Identify the difference between normal and abnormal personality traitsRecognize key personality types and respond accordinglyAppreciate different personality typesUnderstand how to communicate effectively with different personality typesRecognize key personality disorders and respond accordinglySuccessfully negotiate in spite of present personality disordersDetermine when to refer a client to a specialist

Normal PersonalityDifferences

DominantInfluentialSteadfast

ConscientiousDISC

Frasier

Goal:Get it done now

Motivation:Competitive

Major Strengths: DrivenDirectDemandingQuick decisionsLeadersPracticalIndependentNeed: To be in control

Fear:Being taken advantage of

Major Weaknesses:BullyImpatientEasily angeredUnfeelingInconsiderateSarcastic

Dominant

Goal:Lets have fun

Motivation:Popular

Major Strengths: Life of the partyTalkativeFriendlyConvincingEnthusiasticAdventurousCare-freeNeed: To be recognized

Fear:Being ignored

Major Weaknesses:Over commitmentIllogicalHates disapprovalImpulsiveLoudRestless

Influential

Goal:Keeping the peace

Motivation:Loyalty

Major Strengths: DependableReservedConservativeSensitivePatientStableReliableNeed: To feel needed

Fear:Offending others

Major Weaknesses:SelfishFearfulIndecisiveAvoids changeWont confrontStingySteadfast

Goal:Get it done right

Motivation:Perfectionist

Major Strengths: Detail orientedAnalyticalCautiousIdealisticSystematicTenaciousAvoids riskNeed: To do quality work

Fear:Being wrong

Major Weaknesses:MoodyI told you soImpracticalRigidLonerFears criticismConscientious

Famous Profiles

Positive OutlookNegative OutlookTaskOrientedPeopleOriented

Negotiating Questions

Negotiating Strategies

Lunch Anyone?

What are you?DominantInfluentialSteadfastDISC

Conscientious

Abnormal PersonalityDisorders

DSM-V Definition of Personality Disorder Technical definition

Onset of disorder occurs in childhood or adolescence There is persistence of the behavior over time and in almost all situations Causes personal suffering, problems at work or problems with family or social relationshipsPractical definition

Makes others sufferDoesnt know or accept they have a disorderHas problems in relationships Thinks that others are the problemIncapable of maintaining stable work or affective relationships over timeMay have depressive symptoms or anxietyDoesnt respond to conventional treatments

Antisocial Personality (Sociopath)Technical Definition

Identity: Self-esteem derived from personal gain, power, or pleasureSelf-direction: Personal gratification directed with failure to conform to laws or ethicsEmpathy: Lack of concern for feelings, needs or suffering of othersIntimacy: Incapacity for intimate relationships Manipulativeness: Use of subterfuge to control othersDeceitfulness: Dishonesty and fraudulenceCallousness: Lack of remorse about ones actions, aggression, or sadismHostility: Frequent angry feelings, insults, or vengeful behaviorIrresponsibility: Failure to honor financial agreements or promisesImpulsivity: Acting on the spur of the moment without consideration of outcomesRisk taking: Engagement in dangerous, risky, and potentially self-damaging activities

Antisocial PersonalityHannibal from Silence of the Lambs

Antisocial PersonalityPractical Definition

No regard for moralityLies all the timeUses charm to manipulate Sense of superiority Recurring difficulties with all authorityRepeatedly violates the rights of others through intimidationHostility, aggression or violenceLack of empathy or remorse about causing harmDangerous behaviorsAbusive relationshipsIrresponsible work behaviorFailure to learn from the negative consequences

Antisocial Personality Negotiating Help

Because they are gifted liars, dont believe what they say. Actions speak louder than words.Dont waste your time being fake; they can smell a phony a mile away.Be direct, firm and calmly unwavering in your decisions.No emotion, they see this as weakness.Their stories of people they have harmed is an intimidation tactic, show no reaction.They threaten violence when backed into a corner, dont look away as they can smell fear.Dont underestimate them; alcohol/drugs can empower and physically strengthen them.Dont threaten back; it is a waste of time. If you say, Im going to call the police then do it.

Avoidant Personality Technical Definition

Identity: Low self-esteem, excessive feelings of shame or inadequacySelf-direction: Reluctance to pursue goals or take risksEmpathy: Preoccupation with criticism or rejectionIntimacy: Reluctance to get involved with people unless certain of being likedWithdrawal: Avoidance of social activity or contactIntimacy avoidance: Avoidance of close or romantic relationship and sexual relationshipsAnhedonia: Lack of enjoyment from lifes experiences or unable to take pleasure in things Anxiousness: Intense feelings of nervousness or panic often in reaction to social situations

Avoidant Personality JD Salinger from Salinger

Avoidant Personality Practical Definition

Hypersensitive torejectionPrefers social IsolationExtremeshynessAvoids physical contact Self-loathingMistrustsothersDistance in intimacySelf-criticalabout their problems Problems in occupational functioning

Avoidant Personality Negotiating Help

Be careful, they shut down easily and become self-loathing.Find an area of common interest to establish a bond of reassurance.Dont minimize their feelings or self-doubt.Dont try to make it better by saying something, listening is the most effective.They dont like conflict, so make the environment as non-confrontational as possible.Make sure you hear all of what they are saying as they frequently dont say all of what they mean.Many times they will think they have said something when they have not.They are awkward in social settings so expect it.They already know they are different so dont bother telling them.

Borderline PersonalityTechnical Definition

Identity: Unstable self-image with excessive self-criticismSelf-direction: Instability in goals or career plansEmpathy: Prone to feel slighted or insulted even when not trueIntimacy: Relationships marked by mistrust, neediness, and preoccupation with real or imagined abandonmentEmotional liability: Unstable emotional experiences and frequent mood changesAnxiousness: Intense feelings of panic, feeling fearful, fears of falling apart or losing controlSeparation Insecurity: Fears of rejection or separation from significant othersDepressivity: Miserable, hopeless, thoughts of suicide and suicidal behaviorImpulsivity: Acting on a momentary basis without a plan or consideration of outcomesRisk Taking: Engagement in dangerous, risky and self-damaging activitiesHostility: Anger or irritability in response to minor slights and insults

Borderline PersonalitySusanna from Girl, Interrupted

Borderline PersonalityPractical Definition

Impulsive and risky behavior such as unsafe sex or gambling sprees Threatens and often does self-harming behavior Wide mood swingsShort but intense episodes of anxiety or depressionInappropriate anger sometimes escalating into physical fightsDifficulty controlling emotions Suicide attemptsFeels misunderstood, neglected, alone, empty or hopelessFears being aloneFeelings of self-hate

Borderline PersonalityNegotiating Help

One minute you are their best friend and the next you are the enemy, dont trust either.Establish and maintain firm unwavering boundaries, they constantly push the envelope.If you find yourself wanting to rescue them, they are most likely a borderline.They often play the victim to get others involved, dont.They frequently have a black cloud of destruction overhead; it is not your responsibility.Remember the moon hung over the opposing person, now look where they are.Because they are emotionally driven, use emotions to convince them, dont use logic.Distraction works when all else fails.

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Narcissistic PersonalityTechnical Definition

Identity: Exaggerated self-appraisalSelf-direction: Personal standards are unreasonably high, sees oneself as exceptionalEmpathy: Impaired ability to identify with the feelings or needs of others, excessively attuned to reaction of othersIntimacy: Relationship largely superficial and exist to serve self-esteem regulationGrandiosity: Feelings of entitlement, belief that one is better than others, condescending toward othersAttention Seeking: Excessive attempts to attract and be the focus of attention of others

Narcissistic PersonalityRon from Anchorman: The Legend of Ron Burgundy

Narcissist PersonalityPractical Definition

Believes they better than othersFantasizes about power, success and attractivenessExaggerates achievements Expects constant praise and admirationBelieves they are special No empathy for othersExpects others to go along with ideas and plansTakes advantage of othersExpresses disdain for those they feel are inferiorBelieves that others are jealous of themTrouble with relationshipsSets unrealistic goalsEasily offended

Narcissistic PersonalityNegotiating Help

Use sandwich method: compliment, confront, compliment. Dont do it too frequently.Agree with them whenever you can, dont look for ways to disagree.Be straight forward and short in explanations, too long gives too much time for attack.Expect immediate decisions and dont question their judgment.Find ways to praise them without being patronizing.Look them in the eye when talking and give them all of your attention.Even when they are gloating, find something to admire.Dont talk too much about yourself or others; focus the conversation on them and then you will get what you want.Find ways to help them feel special.

Obsessive Compulsive PersonalityTechnical Definition

Identity: Sense of self derived from work or productivitySelf-direction: Rigid, unreasonably high, and inflexible internal standards of behaviorEmpathy: Difficulty understanding the ideas, feelings, or behaviors of othersIntimacy: Relationships seen as secondary to work and productivityRigid perfectionism: Insistence on everything being flawless, perfect, without errors; believing there is only one right way to do things; difficulty changing ideas or viewpoints; preoccupation with details, organization, and orderPerseveration: Continuance of the same behavior despite repeated failures

Obsessive Compulsive PersonalityMonica from Friends

Obsessive Compulsive PersonalityPractical Definition

Over-devotion to work or hobbyNot ableto throw things away, even when the objects have no valueLack of flexibility in opinionsLack of generosity, money is hoarded for catastrophesDoesnt like to delegate to others because they wont do it rightNot very affectionatePreoccupation with details, rules, and lists even for enjoyable activitiesPerfectionist standards interfering with task completionOverly conscientiousStubborn

Obsessive Compulsive PersonalityNegotiating Help

When they are right, say the words, You are right. They love that.They have a tendency to repeat the same point over and over, dont change your opinion.They are hyper-logical so use logical not emotional arguments.Always ask for their opinion and dont assume you already know the answer.Your time with them will go long because they talk so much, anticipate it.Use the phrase, Let me think about that when you dont want to keep talking about the subject.Resist the temptation to join them in an anxious obsessive moment.

Schizotypal PersonalityTechnical Definition

Identity: Confused boundaries between self and othersSelf-direction: Incoherent goals, no clear set of standardsEmpathy: Difficulty understanding impact of behavior on othersIntimacy: Mistrust and anxiety with close relationshipsEccentricity: Odd, unusual, or bizarre behavior and appearanceCognitive and perceptual dysregulation: Odd or unusual thought processes, over-elaborate speechUnusual beliefs and experiences: Unusual experiences of realityRestricted affectivity: Little reaction to emotional situations, indifference or coldnessWithdrawal: Preference for being aloneSuspiciousness: Expectations of signs of interpersonal harm

Schizotypal PersonalityPheobe from Friends

Schizotypal PersonalityPractical Definition

Loner lacking close friends Feels external events have personal meaningPeculiar, eccentric or unusual thinking, beliefs or behaviorDresses in peculiar waysBelief in special powersPhantom pains Excessive social anxietyRambling oddly and endlessly during conversationsSuspicious or paranoid ideas Doubts the loyalty of othersFlat emotions

Schizotypal PersonalityNegotiating Help

Dont follow them down the rabbit trail, stay focused on the topic.Dont try to apply logic to random comments; it only frustrates you, not them.Emotional reasoning wont work either because their emotions dont make sense with the circumstances.They will agree with you even when they dont.Put everything in writing for future reference.Expect to re-explain over and over.Be patient, show no emotion. They shut down when confronted.Questions should be simple almost child-like.

Personality Disorder Trait SpecifiedTechnical Definition

Negative Affectivity Includes anger, fear, guilt, contempt, disgust, and nervousnessDetachment Inability to connectAntagonism - Hostility resulting in resistance, opposition, or contentiousnessDisinhibition vs. Compulsivity - Disregard for social conventions, impulsivity, and poor risk assessment vs. performing an act repetitively without it leading to reward or pleasurePsychoticism - Aggressiveness and interpersonal hostility

Personality traitdomains

Schizoid PersonalityTechnical DefinitionSocial withdrawalIntimacy avoidance Restricted affectivity blunted affectAnhedonia absence of pleasure or the ability to experience itNegotiating HelpWont talk much so dont expect a lot of feedbackWont go to lunchWill seem odd or indifferentEmotional reasoning wont work, logic willVery comfortable being alone so dont engage during awkward silenceDont take silence to mean agreementGive time to make decisionsPractical Definition

Prefers being alone Little desire for sexual relationshipsUnable to experience pleasureComes off as dull or coldFeels unmotivated

Schizoid PersonalityHead Butler from Remains of the Day

Dependent Personality

CharacteristicsSubmissivenessAnxiousnessSeparation insecurity fear of loss

Negotiating HelpBecause they seek approval, expect they will try to seek your approval even for the little things. Be reassuring with a dependent and dont push them away. They are very sensitive to criticism and feel it is rejection.You are doing the right thing is comforting to say if they have to confront someone else or stand up for themselves.Even small decisions require your approval, so give it without anger, resentment, bitterness, sarcasm, or minimizing.If you take the time to validate their feelings they will be on your side for life. Dont belittle them and refrain from sarcasm.

Practical DefinitionIndecisiveness Acts passive and helplessOversensitivity to criticismAvoids disagreeing with others Tolerates mistreatment and abuse Places needs of caregivers above ownNaive

Dependent PersonalityRoss from FriendsBecause they seek approval, expect they will try to seek your approval.Be reassuring, dont push away.You are doing the right thing is very comforting.Even small decisions require approval, give it.Validate their feelings and they will be on your side.Dont ever belittle them, refrain from sarcasm.

Histrionic Personality

CharacteristicsEmotional crying uncontrollablyManipulativeAttention seeking

Negotiating HelpYou look nice today is a safe way to give needed attention.Allow them to be the center of attention.Minimize conflict, they will shut down if frustrated.Dont play into drama moments, firm boundaries are necessary.Dont get emotional, they have a sixth sense about emotion and will play on it.Be very careful because they make rash decisions, they might agree now but wont later.Practical DefinitionDresses provocatively Acts very dramaticallyGullible Low tolerance for frustrationMakes rash decisionsThreatens or attempts suicide

Histrionic PersonalityScarlett OHara from Gone with the WindYou look nice today is a safe way to give needed attention.Allow them to be the center of attention.Minimize conflict, they will shut down if frustrated.Dont play into drama moments, firm boundaries are necessary.Dont get emotional, they have a sixth sense about emotion and will play on it.Be very careful because they make rash decisions, they might agree now but wont later.

Paranoid Personality

CharacteristicsDistrust and suspiciousnessIntimacy avoidanceHostilityUnusual beliefs and experiences

Negotiating HelpAlthough they are highly logical, dont try to logically reason their paranoid thoughts away.Paranoid beliefs are rooted in childhood and have nothing to do with present circumstances no matter what they say.They record everything including their own home, so expect it.Choose your words carefully as they read far more meaning into them then intended.All it takes is one comment and they will shut you out forever.Practical DefinitionBelieves others are using themReluctant to confide in others Unforgiving and holds grudgesTakes criticism poorlyReacts with anger, retaliatesCold, distant, controlling, and jealousBelieves they are always right

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Paranoid PersonalityJerry from Conspiracy TheoryAlthough they are highly logical, dont try to logically reason their paranoid thoughts away.Paranoid beliefs are rooted in childhood and have nothing to do with present circumstances no matter what they say.They record everything including their own home, so expect it.Choose your words carefully as they read far more meaning into them then intended.All it takes is one comment and they will shut you out forever.

Depressive Personality

CharacteristicsDepressivityAnxiousnessAnhedonia - absence of pleasure or the ability to experience itNegotiating HelpDont minimize their feelings of inadequacy, reassure them.Do a small act of encouragement or show gratefulness.If one thing goes wrong, it all comes crashing down, dont overreact.They spiral easily so keep things as smooth as possible.They arent able to look on the bright side so dont expect it.Listen to their worries without criticism.Practical DefinitionFeels dejected, gloomy, and worthlessSelf-criticaland derogatory Is negativistic, critical and judgmental toward othersPessimisticFeelsguiltyorremorseful

Depressive PersonalityAll three main characters from The HoursDont minimize their feelings of inadequacy, reassure them.Do a small act of encouragement or show gratefulness.If one thing goes wrong, it all comes crashing down, dont overreact.They spiral easily so keep things as smooth as possible.They arent able to look on the bright side so dont expect it.Listen to their worries without criticism.

Passive Aggressive Personality

CharacteristicsHostilityDepressivityNegotiating HelpThey will be very angry and you will not know it till they stab you in the back.This is not about maturity but their behavior is immature.Will eventually comply but will be late.Sabotages intentionally when angry, this is your clue that something is wrong.Hates outward signs of anger and shuts down when others are aggressive.Practical DefinitionActs sullenAvoids responsibility by claiming forgetfulnessInefficient on purposeBlames othersComplainsFeels resentmentHas unexpressed anger ProcrastinatesResists suggestions

Passive Aggressive PersonalityEmma from Bride Wars

ConclusionsCheat sheets