The Development and Treatment of Personality Disorders

Written by HealthyPlace.com Staff Writer

online conference transcript

What is a personality disorder? How are different personality disorders diagnosed and what does the treatment of personality disorders consist of?

Our guest, Dr. Joni Mihura, a licensed psychologist and an assistant professor of psychology joined us to discuss why they develop, common traits among people who have personality disorders (awful time adjusting, self-esteem and depressive problems, feeling of rejection and abandonment, unstable sense of themselves, unstable feelings, unstable identity, distorted perceptions of what is happening, feel abandoned, relationships may be poor, acting out behaviors), symptoms of various personality disorders (audience members had a lot of questions about Borderline Personality Disorder, BPD), general treatment guidelines and the big question: When it comes to the treatment of people with personality disorders, what are the chances of significant improvement?

David Roberts is the HealthyPlace.com moderator.

The people in blue are audience members.

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David: Good Evening. I'm David Roberts. I'm the moderator for tonight's conference. I want to

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welcome everyone to HealthyPlace.com. Our topic tonight is "The Development and Treatment of Personality Disorders." Our guest is Dr. Joni Mihura, a licensed psychologist and an assistant professor at the University of Toledo, where she teaches psychology courses.

Her post-doc training consisted of specializing in women's trauma and psychological assessment. Dr. Mihura's current specialties are psychodynamic therapy and personality assessment. Besides teaching, she has a part-time private practice and she just received an award as a national American Psychoanalytic Association Fellow.

Good evening, Dr. Mihura, and welcome to HealthyPlace.com. We appreciate you being our guest tonight. Just so everyone knows where you are coming from, can you please explain "psychodynamic therapy" to us in layman's terms?

Dr. Mihura: Good evening to you too, David. I'm glad to be here tonight. You could say that psychodynamic therapy addresses the fears and maladaptive coping that people have in response to their needs.

David: Thank you. Now onto our topic. What is a personality disorder?

Dr. Mihura: By the DSM-IV (the diagnostic manual), a personality disorder is an inflexible, persistent pattern of inner experience or behavior that leads to significant distress or dysfunction. The 'significant distress or dysfunction' is what makes it a 'disorder.'

David: When you say "inner experience or behavior," what does that mean?

Dr. Mihura: Basically, thoughts and feelings make up the inner experience. The thoughts can include words or images.

David: So, you're saying these problems really create a problem in allowing the person to function "normally"?

Dr. Mihura: Yes, you're right. In allowing the person to function adaptively and to have good well-being.

David: What causes someone to develop a personality disorder?

Dr. Mihura: There are many ideas on that, but they basically could be summarized as contributions from genetics and environment. There is evidence that personality is somewhat genetically related. And our environment--our interactions with other people, trauma, the general adaptiveness and type of our environment growing up. So it is both genetics and environment.

That is a global answer, the particulars also depend on the disorder. We need an environment, too, that is adaptive for our human needs like safety and attachment to caregivers.

David: - Here are all the different types of personality disorders: Personality Disorders includes: Antisocial Personality Disorder, Avoidant Personality Disorder, Borderline Personality Disorder (BPD), Dependent Personality Disorder, Histrionic Personality Disorder, Narcissistic Personality Disorder, Obsessive-Compulsive Personality Disorder, Paranoid Personality Disorder, Schizoid Personality Disorder, Schizotypal Personality Disorder.

Here is more information about a specific personality disorder.

I know that each personality disorder has its own particular traits, but are there common traits among people who have personality disorders?

Dr. Mihura: That's a good question. Mainly, there are commonalities between clusters of personality disorders. The basic commonality they share is the general description that I gave. Concerning the commonalities between groups of personality disorders, for example, schizoid, schizotypal, and paranoid are considered in the 'odd or eccentric' group. They often don't have close relationships, and may not want them.

David: How about when it comes to taking responsibility for their own lives and feelings? Is that another commonality?

Dr. Mihura: Yes, there is something very related to that concerning the way that they see their problems. The types of behaviors they show are usually not what they consider to be the problem. They may, however, take responsibility for their lives in many other ways. Like, the obsessive compulsive may work a lot and be hyper-concerned with responsibility, but this person's relationships may be poor, because they do not take responsibility for the lack of emotional closeness that they may show.