WOMEN’S SPECIALIST PSYCHOTHERAPIST Private Online Therapy · Worldwide · Brisbane-Based Client resources. What is a personality disorder?
Some people seem to create the same problems everywhere they go, and never see their part in it. A personality disorder is one explanation. Here’s what it actually means, why it’s so hard to talk about, and why ordinary conversations so often fail.
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PART 1WHAT IT IS
Personality is who you are. A disorder is when it gets stuck.
Your personality is your usual way of thinking, feeling, seeing yourself and relating to others. Everyone’s personality has strengths and rough edges, and most of us can flex when life asks us to.
A personality disorder is when those patterns are so rigid and extreme that they cause ongoing distress or harm, to the person, to the people around them, or both. The patterns usually start in adolescence or early adulthood, last for years, and show up across most areas of life: home, work, friendships and love.
Studies around the world suggest roughly one adult in ten meets the criteria for at least one personality disorder. Most are never diagnosed.
The four areas a personality disorder affects
- How they thinkHow they see themselves, other people and events. Often rigid, and hard to shift with evidence.
- How they feelThe range, intensity and stability of their emotions. Too much, too little, or too changeable.
- How they relatePatterns in relationships that repeat with partner after partner, boss after boss.
- How they manage impulsesToo little control (impulsive, reckless) or too much (rigid, over-controlled).
WHAT DR GREGORY LESTER TEACHES
Why it’s always someone else’s fault.
I’ve trained with Dr Gregory Lester, and I consider him the leading expert in this field. His way of explaining personality disorders shapes this whole series.
A symptom, or a characteristic? Dr Lester draws a clear line between most mental health conditions and personality disorders. Anxiety or depression are symptomatic: they feel like something happening to you, and you want them gone. A personality disorder is characteristic: it’s part of who the person is. So it rarely feels like a problem to them. It feels like the way the world is.
Why they think it’s everybody else. If your way of seeing things feels like simple reality, then when things go wrong, the only explanation left is other people. That’s why people with personality disorders so rarely ask for help for the disorder itself. They ask for help with what it causes: the breakup, the job loss, the depression.
The agenda that doesn’t change. Dr Lester teaches that each personality disorder is organised around a core agenda, a need that drives behaviour across every situation. The agenda for borderline personality disorder is different from the agenda for narcissistic or obsessive-compulsive personality disorder, and once you can see it, behaviour that seemed random starts to make sense.
Why ordinary talking doesn’t work. Explaining, reasoning and pointing out evidence work when someone is open to seeing things differently. When the pattern is part of who they are, logic bounces off. More words often lead to more conflict. That’s why the advice in this series is about how you respond, not about finding the perfect argument.
The drama. Personality disorders tend to create dramas, and pull the people nearby into them. Much of Dr Lester’s training is about how to recognise those dramas early and avoid being drawn in, which is exactly what you’ll find on each page in this series. One of the clearest ways to see the pattern is the drama triangle.
PART 2HOW IT’S DIAGNOSED
Ten types, in three clusters.
Most Australian clinicians use the American diagnostic manual, DSM-5-TR, which describes ten personality disorders grouped into three clusters. The World Health Organization’s system, ICD-11, now describes personality disorder by severity and by trait, rather than by type. Both are used, and they describe the same patterns in different ways.
A personality disorder can only be diagnosed by a psychiatrist or psychologist, after a careful assessment. It usually isn’t diagnosed before 18, because personality is still forming.
Cluster AOdd or eccentric
Distrust, detachment and unusual thinking. People with these patterns often keep their distance.
Cluster BDramatic, emotional or erratic
Intense emotions, impulsiveness and turbulent relationships. These are the patterns most likely to create drama for the people around them.
Antisocial · Borderline (BPD) · Histrionic · Narcissistic (NPD)
Cluster CAnxious or fearful
Fear, worry and a need for control or reassurance. These patterns often look like anxiety from the outside.
WHERE IT COMES FROM
Temperament, plus experience.
There’s no single cause. Personality disorders usually grow from a mix of inherited temperament and early experience, especially the quality of early relationships. Trauma, neglect, abuse, inconsistent care, or growing up where feelings weren’t safe all raise the risk. Many people with personality disorders were deeply hurt long before they hurt anyone else.
That explains the pattern. It doesn’t excuse harm, and it doesn’t make it your job to absorb it.
PART 3CAN IT CHANGE?
Yes, when the person wants it to.
For many years, personality disorders were thought to be untreatable. That’s no longer the view. Some, like borderline personality disorder, respond very well to specialised therapy. Others are harder to shift, but change is possible when the person is motivated.
That last part is the catch. Treatment depends on the person seeing a reason to change, which is why so much depends on how the people around them raise it.
WORRIED ABOUT SOMEONE YOU LOVE?
Start here before you say anything.
If you suspect your partner, parent, adult child, sibling or friend has a personality disorder, how you raise it matters enormously. The wrong approach can turn into a drama that lasts for months. The right one can open a door.
WHERE I COME IN
They need their own help. You deserve yours.
If you’ve been living alongside someone with these patterns, it often takes a toll you don’t notice until you’re exhausted: walking on eggshells, doubting your memory, losing your own needs. I help women recover from that impact, settle their nervous system and rebuild their sense of self.
I help women who are experiencing abuse from someone with a personality disorder, and women who need help managing a relationship with someone who has one. These relationships often bring a great deal of anxiety, trauma and drama into your life. I don’t diagnose or treat personality disorders. My work is with you: resolving the impact on your nervous system, your confidence and your sense of self, and helping you step out of the drama for good.
You don’t need a referral or Mental Health Treatment Plan to see me. I’m a private practice, so you can book a private 15-minute consultation directly. If I’m not the right fit for what you need, I’ll tell you honestly, and point you to who is.
You can’t change their personality. You can change how much of your life it runs.
THE PERSONALITY DISORDERS SERIES
Read about each type.
What is a personality disorder? · The 10 types at a glance · Do you suspect someone you love has a personality disorder?
WHERE THIS INFORMATION COMES FROM
Sources.
This page draws on Australian health services, the diagnostic manual clinicians use (DSM-5-TR), and Dr Gregory Lester’s training on personality disorders.
- Personality disordershealthdirect AustraliaWhat personality disorders are, the main types, and where to get help in Australia.
- Project Air Strategy for Personality DisordersUniversity of WollongongAustralian information, guidelines and family and carer resources for personality disorders.
- SANESANE AustraliaInformation, peer support and counselling for people affected by complex mental health issues, including personality disorders.
- Gregory Lester, PhD: speaker profilePESIDr Lester’s background, including his 2,000+ personality disorder trainings and his role as an original research site for the DSM-5 personality disorders revision.
YOUR NEXT STEP · BRISBANE AND WORLDWIDE
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