Personality problems and personality disorders

Personality is a very controversial concept that is discussed from different aspects in terms of philosophy, sociology and psychology. Personality is the physical, intellectual and spiritual characteristics that make people different from each other and manifest themselves in various environments, including their perspectives on themselves and those around them, the level of relationship they can establish with them, and their reactions. In short, we can say that the integrity of the individual’s unique characteristics is his personality. It is the pattern formed by specific attitudes and behaviors in daily life. These attitudes and behavior patterns have their own consistency and predictability.

These characteristics of personality are of a nature to protect one’s self. A personality problem or disorder is mentioned when these characteristics disrupt the person’s adaptation to the environment, disrupt his daily functionality, create a state of tension-anxiety, and become permanent, deviating from the expectations of the culture in which he lives. A personality problem is in a way a milder form of what is called a personality disorder.

It is observed that in people with personality disorder, behaviors and attitudes are embedded in the self, adopted by the self, and do not want to be changed. These people do not show flexibility to adapt to their environment, they do not care about the rules that are valid in order to be considered compatible in the society they live in. These symptoms started in childhood. With these attitudes and behaviors, he experiences significant incompatibility in society and in business life. Constant conflict and friction with the environment arises due to their attitudes. It is the people around them who are wrong in every behavior and attitude, and they think that those around them should conform to them. They do not take into account the difficulties they experience in their business and private relationships, and how their attitudes and behaviors affect others.

Negative life events and psychological traumas may occur due to personality problems, or a mental distress may be aggravated. Personality disorder perceiving oneself, others, and events; the relevance, variability, and intensity of his emotional responses; interpersonal functionality; It manifests itself in at least two of the four areas that we can classify as anger, excitement, control of excessive desires and impulses.

Prevalence rate of personality disorder % It varies between 10-20. It is seen 4-5 times more frequently in men than in women.

Although drug treatment can be applied for problems arising from personality, positive responses are received to a limited extent. The psychological treatment approach to these cases is sometimes inconclusive, and sometimes partial benefits are obtained. The desired response can only be obtained if the fight against personality problems is planned as a long-term education and improvement program that spans the whole life.

Personality disorders are divided into three clusters. These are: Cluster A personality disorders;Paranoid personality disorder, schizoid personality disorder, schizotypal personality disorder. Cluster B personality disorders;Borderline personality disorder, antisocial personality disorder, histrionic personality disorder, narcissistic personality disorder. Cluster C personality disorders;Avoidant personality disorder, dependent personality disorder, obsessive compulsive personality disorder, passive-aggressive personality disorder.

PARANOID PERSONALITY

The main feature of paranoid personality disorder is a persistent skepticism and distrust, interpreting the behavior of others as malicious. Such people avoid taking responsibility for their feelings and tend to throw them on others.

Main features insecurity; He suspects that some people around him have bad intentions about him, he is very attentive to the events around him and is always on the alert. He does not pour out his heart to anyone, he is skeptical. He doubts the honesty of others, even his own close ones, and is often jealous. They think that the words and actions against them have “hidden meanings”. They derive meanings from ordinary words or events as being humiliated or intimidated. Without considering the whole event, he eagerly looks for evidence of his suspicions in the details. If he feels insulted, he will retaliate many times over. He thinks that he is easily insulted or wronged because he is always dealing with his own priority and rights. Rigidity; seems rational, cold, logical, but resists evidence from others. He has difficulty in showing love or positive emotions, his humor side is not developed.

In severe cases, there is paranoid (suspicious) personality disorder. People with Paranoid Personality Disorder They suspect, without an ethereal basis, that others are exploiting them, deceiving them, or harming them. He has unwarranted doubts about the loyalty or trustworthiness of friends or co-workers. He does not want to give secrets to others because he is afraid that what he says will be used against him with bad intentions. He infers meanings from ordinary words, gestures, facial expressions, or events, in the form of being humiliated or intimidated. He tends to explain the events around him and the world with unrealistic conspiracies. There is a belligerent and stubborn attitude about personal rights that does not fit the real conditions. He constantly harbors grudges, does not forgive dishonorable behaviors, injustices and ignoring himself. In a way that is incomprehensible to others, he judges that his character or reputation has been attacked and reacts abruptly with anger or counterattack. He often has unjustified suspicions about the infidelity of his wife/husband or sexual partner.

How should individuals with paranoid personality be approached?

First of all, if there is a paranoid personality in front of us, we should avoid targeting his personality and his ego, and direct our criticism to mistakes in his behavior and thinking. If we confront his personality, not his behavior, we will confirm his suspicion. We should clearly state our reasons and intentions towards these people, and try not to leave open doors for doubt. We need to be careful about having others around to ensure we are there during conversations and events that they may misinterpret. We should follow the formal rules meticulously and should not make any mistakes. He can easily use the rules that we do not comply with against us, or he may become suspicious because of this. We should avoid religious and political discussions, because of his disagreement on these issues, he can easily develop hostility towards us or attribute his suspicions to this separation.

SCHIZOID PERSONALITY

They often paint an image that is obscure, unrelated, and self-living. Formality, emotional coldness and distance are observed in relations with others. They are unresponsive to criticism or praise of others. In particular, excessive preoccupation with daydreaming and introspection is observed. They choose only one type of activity that can be performed alone. They are satisfied with their situation and find their lifestyle adequate. He has no sincere friends outside his family circle. They are not easily attached to one another. They do not feel comfortable when they are with others and avoid eye contact. They do not show emotional ups and downs. They may have strange behavior and related areas.

How should such individuals be treated?

Schizoid personality is one of the personality structures most resistant to drug-free correction approaches. They open up a little over time when they are directed to activities that interest them. Sometimes they can be confused with simple types of schizophrenia.

Respect their desire to be alone. Suggest jobs that match your qualifications. Deal with your inner world. Appreciate them for their quiet qualities. Do not ask him to express his intense excitement. Don’t overwhelm him by talking too much. But don’t let it sink into loneliness either. Do not have social expectations from them, do not ask them to be sociable and open, do not expect to change from today to tomorrow as in other personality disorders.

Schizotypal personality disorder

These people show many oddities and unusualness in their behavior, thought, affect, speech and appearance. Ideas of reference (that others talk about, laugh about themselves); bizarre beliefs or magical thinking that influence behavior and are not in line with cultural values ​​(for example, superstition, prophecy, telepathy, or sixth sense); unusual perceptual experiences, these may include illusions of seeing his own body, face, arm, foot differently, seeing strange ways; bizarre thinking and speech (for example, vague, peripheral, figurative, or overly verbose); skepticism or paranoid thinking; inappropriate or limited affect; strangely unusual or very peculiar behavior or appearance; Absence of close friends or confidants other than first-degree relatives. If they do get married, they get divorced pretty soon, as they remain superficial and on the sidelines in their relationship. They do not belong to a group that is suitable for their socio-cultural level in the society, or they are contrary people who are at the far end of this group.

Individuals with this disorder immediately attract attention with their strange behavior. Such persons may also occasionally develop psychotic episodes (bouts of mental illness). Then it is approached in the same way as mental illness is approached. There are also individuals with schizotypal personality disorder who continue their work and even succeed. There are also those who have spent a lifetime without ever going to a psychiatrist. However, seeing a specialist from time to time increases their adjustment.

BORDERLINE PERSONALITY DISORDER

In this personality disorder, pervasive and persistent imbalance in the individual’s sense of identity, relationships, and affect is evident. These people show deep insecurity and imbalance in their sexual, occupational and social identities. A solid sense of identity has not developed. The person’s self-image, goals, and choices are unclear or distorted. They constantly feel emptiness. The tendency to enter into intense and unstable relationships in order not to be alone can cause recurrent emotional crises in the person. This tendency can lead to excessive efforts to avoid abandonment and recurrent suicidal threats or self-harming behaviors.

In object relations, they are unstable and inconsistent, with a tendency to both sublimate and devalue. There are tense and inconsistent interpersonal relationships that oscillate between the extremes of over-magnifying, praising, and downplaying people. Also, frequent self-harming behaviors (speeding, excessive spending, uncontrolled sex, substance abuse, cutting oneself, excessive smoking, binge eating). During stressful periods, temporary heavy personality disintegration or doubting everything around can be seen.

It is one of the most difficult personality disorders to manage and manage. Aggression is more directed towards the person himself. In cases of aggression, regardless of whether it is a girl or a boy, there is a knife-blade throwing at the arm and chest. The goal here is to get some kind of satisfaction from pain.

It is important to maintain relationships with such people. When communicating with them, their wishes should be taken into account. Efforts should be made to gain their trust, but this should not be done by compromising their every wish. They should be encouraged to engage in activities suitable for their personality and values, to acquire skills, and to help them find orientations that will somehow strengthen their ties with life and add meaning to their lives. Families with such individuals should first try to make their life colorless and boring, at least within the family, and to support the positive efforts of the individual with personality disorder. If the early childhood traumatic experiences of such personalities are known, the family can contribute to providing support by sharing this with their physician.

Emotional mechanisms underlying emotional outbursts, crises and self-destructive behaviors should be discussed with them, and they should be supported to keep their emotions under control. While discussing his problems, both criticism of his every move and excessive accusations should be avoided. When self-harming urges arise, the ability to cope with non-harming activities such as taking cold showers, playing sports, punching a punching bag or dancing should be ensured. On the basis of thought, the habits of seeing anything they are inclined to either completely white or completely black should be tried to be changed by discussing over many examples. Changing these patterns, wrong conditioning, requires long-term effort. If the problem has been overcome without accident (or with minor accidents) until reaching a certain age, the person can start to cling to life and get used to it, the situation will settle down relatively.

ANTISOCIAL PERSONALITY DISORDER (Sociopathy-Psychopathy)

This personality disorder appears as a pervasive pattern of disregard for and attacking the rights of others, beginning in childhood or early adolescence and continuing into adulthood. Severe psychopathic personalities not only pose a serious danger to the society they live in but they are also a complete nuisance for their immediate surroundings. This disorder basically presents with a cluster of symptoms in the form of a strict indifference to the rights and feelings of others. Deceiving others and acting irresponsibly are their way of life. In these people, a stubborn opposition and irresponsibility are observed against social values, rules and obligations. Due to the low threshold of frustration, the tendency to aggression including verbal or physical violence has increased. During their childhood, they showed verbal/de facto violent behavior towards their friends and animals. There is an inability to feel guilty and not learn/learn useful lessons from negative experiences, especially punishment. These people are insensitive to the suffering of people who have been harmed by their ‘unscrupulous’ wrongdoings. It is evident to blame others for their mistakes and to make excuses for their behavior that creates problems in society. They constantly exhibit attitudes and behaviors that will get them in trouble and lead to their arrest or even punishment. It is observed that he cannot keep up with the moral and etiquette rules of the society he is in. He constantly lies, acts dishonestly, circumvents others, deceives. They think they have the right to get ‘that thing’ no matter what they want. His wishes come first. Deceives or deceives others for his own priorities, interests, and pleasures. In his eyes, other people are ‘stupid’ and deserve to be deceived. Impulsivity becomes the basic behavior; He always acts as he thinks, without thinking about the harm he can do to himself and those around him. A constant irresponsibility is observed, which manifests itself as not being able to continue a job he started or not fulfilling his financial obligations (rent, tax, insurance premium, salary, etc.), using the money he should spend for the household in unnecessary places.

There is so much emotionlessness that it can be called unscrupulous. They do not feel remorse for the harm they cause to those around them. Even if they have regrets, they are superficial and temporary.

Conduct disorder falls into four categories: aggression towards people or animals, damage to property, fraud or theft, or serious breaking of rules. Symptoms of this disorder usually begin at a young age. Running away from home, spending the night out, making irresponsible vagrant friends like himself, lying, stealing money from home, early smoking and subsequent drug use, burglaries and other petty crimes, sadistic tendencies, beatings, beatings It occurs with severe behavioral disorders such as killing, torturing and killing animals.

Parents or relatives of children or young people showing psychopathic signs should continue their dialogue with them under all circumstances. Cutting off communication with them, allowing them to leave the house at an early stage, accelerates negative developments. Positive advice should be given, trying to understand it, avoiding long sermons. Try to be friends with him. This is often difficult or impossible, but try and it will somehow respond if there is some positive potential in it. Avoid verbal and physical violence. Do not give severe punishments that are not appropriate for their age, this will increase their anger towards you. Remember that he is vengeful and there is a lot of vengeance. In more difficult and detailed situations about how you should behave, you should consult experts. Do not show that you are afraid of him, such people go against those who are afraid. Don’t compromise, don’t be a slave to it, don’t let it squander your wealth. Ask for the help of your family and those around you, whom you are afraid of. As a last resort, protect yourself by legal means. To teach her sense of responsibility, give her the opportunity to pay for her misbehavior from childhood. Don’t just cover up your crime. Even if you are with him when he has legal problems, you will prepare the ground for him to turn to the next crime by compensating the damage he has done every time. (You can benefit from my book titled ‘Distracted Distracted Children’, which has been published before and focuses on children with ADHD as a sample of troubled children.)

It can sometimes be beneficial to direct them to relaxing activities such as sports, hobbies, painting and music, where they will direct their energies. In many cases, this disorder may subside to some extent as age progresses.

Histrionic (Player) Personality

Histrionic personality disorder desires and efforts to attract attention, a tendency to magnify events, to dramatize events, and even to tell false stories; exaggerated emotional responses and body and facial movements; It has features such as quick response. They try to be ostentatious and attractive. They tend to be self-centered and self-centered. They quickly become friends, but quickly feel rejected. In general, artificiality, playfulness, superficiality dominate the relations. While most of them basically have deep sexual fears and limitations, outwardly they are like the opposite. Some may exhibit seductive behavior. They are naive, suggestive, and dependent in interpersonal relationships. They show a hunger for compassion and love; but they cannot establish mature, balanced relationships.

In the past, such people were called hysterical personalities. Since Hippocrates, the habit of calling people or attitudes ‘hysterical’ has been established in medicine and psychiatry. Since such features were mostly seen in women at that time, Hippocrates thought that it was caused by the uterus and used the word ‘hysteria’ meaning womb. However, this personality has nothing to do with the uterus. Therefore, in recent years, the concept of hysterics has been replaced by the concept of histrionic. Histrio means player in Greek.

Paying attention to each of their “normal” behaviors can help them correct their behavior. When you are with them, it is necessary to be prepared to be reduced from the level of heroism to the level of misery or vice versa. When you communicate, you should keep your distance and express what you want to say clearly.

Narcissistic Personality Disorder

These personality traits often coexist with Borderline Personality traits. These people exaggerate their achievements and abilities, and they overestimate themselves physically and spiritually and see themselves as superior. They expect constant appreciation, attention and approval from their environment and believe that they deserve a special place wherever they go. These intense narcissistic expectations can lead to frequent disappointments and hurts. They can maintain their self-esteem only with the interest, admiration and approval from outside. They always expect praise. For this reason, their appearance and behavior are always aimed at obtaining them. Self-esteem drops quickly when their expectations are not met. There may be resentments, anxiety and depression.

They use and even exploit others to glorify, see and show themselves superior. He uses his friendships only for the sake of self-glorification. He is not too affected by the feelings of others. They cannot empathize with the feelings, thoughts and needs of others.

How should such people be treated?

Show that you appreciate him in every situation where he acts sincerely and speaks sincerely. Explain other people’s reactions to him. Strictly follow etiquette and patterns of polite behavior towards him and others when together. Make only compelling criticisms and be very clear. Do not highlight your own achievements and privileges.

Do not systematically oppose him, but criticize his actions that must be criticized. (Criticize his behavior, not his personality.) Be wary of his use of you. Never do good deeds that you don’t want to repeat, you will only get worse when you don’t. Don’t always be the one who makes concessions to keep your relationship going.

AVOID PERSONALITY DISORDER

These are people who are afraid of being negatively evaluated in society, are shy, shy, watch themselves too much and wonder how they are seen. He is very afraid of being criticized or ridiculed, he is afraid of being ridiculed. Avoids contact with people without trusting the other person. He stays away from situations where he might get into trouble or get hurt. Their social and work lives may be affected by this situation. These people have low self-confidence and underestimate their abilities and achievements. Because of fear of failure, they often take on an insignificant role or take on tasks below their abilities.

The avoidant personality and social phobia are often confused and often coexist.

We should avoid making fun of him and avoid angry expressions while reacting for his wrong attitudes and behaviors in public. As with other personality disorders and problems, a lifelong patient struggle must be taken to overcome this deficiency. For this, exercises should be done in social environments. The person should gradually go over their fears in the form of environments that will cause mild to more intense anxiety. Although these exercises may cause distress in the person at first, being in these environments will create relief as they will gain a habit over time.

DEPENDENT PERSONALITY DISORDER

People with this personality cannot do even the smallest job without consulting someone, especially their parents. These people, who cannot make decisions, take initiatives, take action, or take responsibility on their own, become helpless like a child in the face of the natural expectations of adulthood. They leave the important decisions to someone else to make. They expect their relatives to make a decision and take initiative in every job where they are in a dilemma. They have difficulty in starting an initiative, rather they prefer to follow developments. They do not like to be alone, to do business alone. They constantly worry about the deterioration of their relationship. They say yes to everything so as not to offend anyone. If what they say is disapproved or criticized, they become very affected and worried. In fact, we observe these attitudes and behaviors in young children. These are people who are overprotected in their childhood, whose wishes are fulfilled immediately, and whose autonomy and initiative abilities are restricted and brought up. These people are helpless like a child in the face of the natural expectations of adulthood.

If they are not accompanied by people who take care of them, give, protect, support and make decisions, they become very insecure, anxious and depressed. Does not expect to take responsibility, autonomous decision making, entrepreneurship; they can adapt in protective workplaces that provide supervision and support.

How should we treat them?

Don’t focus on their success, support their initiative. If he asks you for a suggestion, get his personal opinion before answering. Tell him about your own weaknesses and indecisions, and don’t be afraid to ask him for advice and help. Encourage him to increase his activities. Explain that you can do some things without it, that does not mean leaving it. Even if he asks you urgently, do not make a decision for him, and do not come to his aid in any situation where he is in trouble. Do not criticize their attempts, even if they fail. Don’t leave him completely to learn to live on his own. Do not let him come under your control by doing some work or presenting you gifts. Don’t let it stay in your sphere of influence.

obsessive personality disorder (obsessive personality)

There is an expectation of extreme order, rigor and perfection in everything. Extreme attention to detail, regulations, regulations, and sequencing. There is an inability to make decisions due to features defined by folk idioms such as excessive indecision, procrastination, constantly weighing the positive and negative aspects of events, splitting hairs, scrutinizing. Due to these extreme meticulousness features, obsessive slowness is seen as not being able to do a job on time. They are accused of laziness because of the inability to start and finish any work due to perfectionism.

These people are overly prescriptive and stubborn. They insist that everything be done according to their own rules and expectations. They are intolerant when someone doesn’t fully comply with these rules. Their reactions can be extreme. Due to their excessive sense of responsibility, they show rigidity and conservatism in moral and aesthetic values. They are conscientious and meticulous in extreme dimensions. There is excessive prescriptiveness, elaboration, logicism in his speech and relations. He is formalistic, cold and troubled in expressing his feelings.

If the features we have mentioned are not too extreme, these people are usually successful in business environments and are kept. Due to the same characteristics, they are also useful in their families and close circles. But they are usually boring outside of work life. They are not easily happy. It is as if they were formed as a result of a reaction against tendencies such as indifference, laxity and laziness, which are common in societies. The order and discipline in societies seem to be the work of these personalities.

How to approach such people?

Never make fun of his weird obsessions. Let them know that you like their orderliness and rigor. But do not praise him for his achievements due to his obsessive personality. Take firm stand when it interferes with your life and goes too far in interfering with what you are doing. Make him feel the need to relax from time to time. Don’t let it affect you with its thought system and drag it into its own vicious circle.

It is distinguished from obsessive-compulsive neurosis by the absence of typical thought obsessions (obsessions) and movement compulsions (compulsions). They may show signs of obsession and compulsion when their responsibilities increase, the workload increases, or under heavy stress.

PASSIVE-AGGRESSIVE (PASSIVE-AGGRESSIVE) PERSONALITY

It is a diagnosis that is not included in the personality disorder cluster. These people often show passive resistance to the wishes of others in their private life or work area. The feelings of anger, grudge and aggression are expressed through indirect and passive resistance to the people in the position of their superiors. These people show stubborn and undetected resistance to what is expected of them. These passive resistances are most evident in the family and work environment. When they are asked to deliver their work a little faster and on time, these people postpone the requested work and prolong it with various excuses. The more they are confronted, the more this stubborn procrastination and procrastination tends to increase. They are offended, sulking, quarreling with their superiors and tugging at them. They try to explain their behavior with forgetfulness and other superficial excuses. Silence, anger and resentment are important manifestations of passive resistance. With these attitudes, they arouse intolerance and are criticized in the family and at work. He complains that he is not understood or wanted, and believes that he has been treated unfairly.

How to treat such people?

Be kind to these people. Get his opinion whenever possible. Help her express herself. But remind him that everything has a rule.

Do not ignore his opposition to you. Don’t criticize him in his parenting style. Don’t let it drag you into a game of mutual retaliation.

TREATMENT IN PERSONALITY DISORDER:

People with personality disorders usually do not seek treatment. Those with antisocial personality traits are often referred to a psychiatrist for an evaluation and rarely for treatment because of committing a crime. Those who realize the basic disorder in their personality and apply to change are rare.

However, people who often get into trouble, are unsuccessful and unhappy, or have symptoms of another disorder (such as addiction to alcohol, neurotic symptoms, sexual problems, family discord) can apply to a physician. In fact, the treatment of personality disorder is very difficult and in most cases impossible.

Objectives in the therapy of personality disorder;

Alleviating the crises that it will experience from time to time,

Correcting the imbalance and inconsistency in their behavior,

Obtaining a behavior pattern compatible with the society in which they live,

To assist in spiritual self-development.

During crises, inpatient treatment may be required in order to prevent destructive behaviors towards himself (suicide) and his environment.

By correcting the imbalance and inconsistency in their behavior, it is aimed to strengthen the impulse control and decrease the self-harming and impulsive behaviors.

Therapy is organized in order to achieve social learning and to feel empathy (empathy) towards the people in front of him in order to obtain a behavior pattern that is compatible with the society he lives in.

Although drug therapy is not very effective in personality disorders, it is used for some purposes (such as anger, anxiety, mood swings and prevention of harm to himself and his environment).

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