Beyond the Stigma: Recovery From Personality Disorders

Yes, you can find treatment for a personality disorder. These are serious conditions, but they’re not monsters under the bed. Your personality is not broken.

Data shows that there are many effective ways to treat these mental health issues. In a rehab program for personality disorders, you’ll have access to a variety of therapies. Prepare for recovery by learning about your options.

Overcoming the Stigma Around Personality Disorders

As a group, personality disorders are generally misunderstood. ((Sheehan, Lindsay, et al. “The Stigma of Personality Disorders.” Current Psychiatry Reports, vol. 18, no. 1, Jan. 2016, p. 11. PubMed, https://doi.org/10.1007/s11920-015-0654-1.)) And unfortunately, it’s not just the public who carry ignorant views of these diagnoses. Some healthcare providers also have harmful ideas about personality disorders. As a result, stigma is often a barrier to treatment. ((Sheehan, Lindsay. “The Stigma of Personality Disorders.” Curr Psychiatry Rep (2016) 18: 11. BPD Community. https://www.bpdcommunity.com.au/static/uploads/files/2016-sheehan-the-stigma-of-pds-wfcdbbajayss.pdf))

For Amanda Wang, living with borderline personality disorder (BPD) was overwhelming: ((BPD Profile: Struggles, Breakdown & Breakthrough. www.youtube.com, https://www.youtube.com/watch?v=B3t8s2JvVHg. Accessed 11 Dec. 2022.))

“I felt like something was wrong with me. It would start out with something small and it would escalate to thinking that I was probably the worst person in the world and that I wasn’t good enough.”

And without unbiased professional advice, it can be hard to plan your recovery.

So it’s understandable if you’re hesitant to seek help. But facing your condition head-on can empower you to heal. In fact, long-term studies show that remission is common for people with personality disorders, ((Pickersgill, Martyn. “How Personality Became Treatable: The Mutual Constitution of Clinical and Mental Health Law.” Social Studies of Science, vol. 43, no. 1, Feb. 2013, pp. 30–53. PubMed Central, https://doi.org/10.1177/0306312712457722.)) even in the most severe cases. Specialized therapies reduce your symptoms, improve your quality of life, and make it easier to navigate the world.

Not all therapists are qualified to support your healing journey. And it might take a while to find the right provider. Set yourself up for success by researching ahead of time, so you know what to look for in a therapist.

Effective Treatments for Personality Disorders

People with personality disorders rarely start treatment ((Lawton, Erin M., and Thomas F. Oltmanns. “Personality Pathology and Mental Health Treatment Seeking in a Community Sample of Older Adults.” Personality and Mental Health, vol. 7, no. 3, Aug. 2013, p. 10.1002/pmh.1198. PubMed Central, https://doi.org/10.1002/pmh.1198.)) because of those issues alone. More often, patients first enter recovery for addiction or another mental health issue. In that case, you might get diagnosed with a personality disorder once you’re already in rehab.

Once you begin healing, consistency is the key to treatment. ((Pickersgill, Martyn. “How Personality Became Treatable: The Mutual Constitution of Clinical and Mental Health Law.” Social Studies of Science, vol. 43, no. 1, Feb. 2013, pp. 30–53. PubMed Central, https://doi.org/10.1177/0306312712457722.)) With talk therapy and medication, many people make slow, steady progress. Then, for some people, personality disorder symptoms simply vanish in middle age. ((Oltmanns, Thomas F., and Steve Balsis. “Personality Disorders in Later Life: Questions about the Measurement, Course, and Impact of Disorders.” Annual Review of Clinical Psychology, vol. 7, Apr. 2011, pp. 321–49. PubMed Central, https://doi.org/10.1146/annurev-clinpsy-090310-120435.))

To find the right type of therapy, you first need a formal evaluation from a therapist. They’ll assess the intensity of your emotions and your relationships, and ask about other symptoms. Then, with a diagnosis in hand, you and your care team can consider a range of treatment options.

Transference-Focused Psychotherapy Helps You Build Relationships

Transference-focused psychotherapy (TFP) helps you improve your relationships. ((Transference-Focused Psychotherapy Program | Columbia University Center for Psychoanalytic Training and Research. https://www.psychoanalysis.columbia.edu/train/psychotherapy-programs/transference-focused-psychotherapy-program. Accessed 11 Dec. 2022.)) Patients do this by practicing interpersonal skills with a therapist. In that dynamic, you can learn to relate to others’ emotions more easily. This empowers you to build stronger, more sustainable relationships. TFP can treat BPD ((Kernberg, Otto F., et al. “Transference Focused Psychotherapy: Overview and Update.” The International Journal of Psychoanalysis, vol. 89, no. 3, 2008, p. 601. www.academia.edu, https://www.academia.edu/330551/Transference_Focused_Psychotherapy_Overview_and_Update.)) and narcissistic personality disorder, among other conditions.

Most people attend about 2-3 sessions per week for 1-3 years, and get additional support outside of therapy. Your relationship with your therapist is central to this process. By observing the way you act toward them, they’ll learn how you approach other dynamics. Then, they can help you develop healthier behavioral patterns.

Schema-Focused Therapy Soothes Your Inner Child

In schema-focused therapy (ST), you learn how to comfort yourself. ((Tan, Yeow May, et al. “Schema Therapy for Borderline Personality Disorder: A Qualitative Study of Patients’ Perceptions.” PLoS ONE, vol. 13, no. 11, Nov. 2018, p. e0206039. PubMed Central, https://doi.org/10.1371/journal.pone.0206039.)) It’s based on the idea that personality disorders result from childhood trauma. Patients recover by soothing their inner child. ST is especially effective for people with BPD ((Dr. K. Thomaes, MD PhD. “Prediction and Outcome Study in PTSD and Personality disorder.” https://clinicaltrials.gov/ProvidedDocs/53/NCT03833453/Prot_SAP_000.pdf)) and anxious personality disorders, like avoidant personality disorder.

For example, many people with personality disorders were abandoned as children. ((Mahari, A. J. The Legacy of Abandonment In Borderline Personality Disorder. Phoenix Rising Publications, 2006.)) That trauma can cause an intense fear of abandonment in adulthood. ST teaches these patients how to manage that fear. You and your therapist might roleplay a conversation with a parent who abandoned you in the past. You’ll use specific coping skills to regulate your feelings, and still express yourself in a healthy way. This empowers patients to meet their own needs.

Dialectical Behavior Therapy Teaches Emotion Regulation

Dialectical behavior therapy (DBT) teaches you how to process intense emotions healthily. Research shows that DBT reduces symptoms of several personality disorders. ((May, Jennifer M., et al. “Dialectical Behavior Therapy as Treatment for Borderline Personality Disorder.” The Mental Health Clinician, vol. 6, no. 2, Mar. 2016, pp. 62–67. PubMed Central, https://doi.org/10.9740/mhc.2016.03.62.)) Specifically, it helps patients improve impulse control, mindfulness, and emotion regulation.

This is a very practical approach to personality disorder treatment. Treatment includes both individual and group sessions. You’ll go through assignments from a textbook, complete homework, and share what you learn. In some ways, DBT is more like a class than it is like group therapy.

DBT teaches you to accept yourself, ((Chapman, Alexander L. “Dialectical Behavior Therapy.” Psychiatry (Edgmont), vol. 3, no. 9, Sept. 2006, pp. 62–68. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2963469/.)) intense emotions and all. You can’t hate yourself into recovery. Instead, patients cultivate the desire to heal because they deserve to be well.

Mentalization-Based Therapy Lets You Understand Others’ Feelings

Mentalization is related to empathy. ((Schnell, Knut. “Functional relations of empathy and mentalizing: An fMRI study on the neural basis of cognitive empathy.” Elsevier. https://www.researchgate.net/profile/Brigitte-Konradt/publication/45799025_Schnell_K_Bluschke_S_Konradt_B_Walter_H_Functional_relations_of_empathy_and_mentalizing_an_fMRI_study_on_the_neural_basis_of_cognitive_empathy_Neuroimage_54_1743-1754/links/5d63dbb3299bf1f70b0dfece/Schnell-K-Bluschke-S-Konradt-B-Walter-H-Functional-relations-of-empathy-and-mentalizing-an-fMRI-study-on-the-neural-basis-of-cognitive-empathy-Neuroimage-54-1743-1754.pdf)) According to the American Psychological Association, mentalizing ((APA Dictionary of Psychology. https://dictionary.apa.org/. Accessed 11 Dec. 2022.)) is “the ability to understand one’s own and others’ mental states.” This lets you understand why people do what they do, and what effect those actions will have.

Mentalization based therapy (MBT) ((BATEMAN, ANTHONY, and PETER FONAGY. “Mentalization Based Treatment for Borderline Personality Disorder.” World Psychiatry, vol. 9, no. 1, Feb. 2010, pp. 11–15. PubMed Central, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2816926/.)) teaches people how to mentalize in a balanced way. Studies prove MBT can reduce the symptoms of BPD ((Vogt, Katharina Sophie, and Paul Norman. “Is Mentalization‐based Therapy Effective in Treating the Symptoms of Borderline Personality Disorder? A Systematic Review.” Psychology and Psychotherapy, vol. 92, no. 4, Dec. 2019, pp. 441–64. PubMed Central, https://doi.org/10.1111/papt.12194.)) and other mental health conditions. Empathy is especially hard for people with narcissistic personality disorders, ((Gabbard, Glen O., and Holly Crisp‐Han. “The Many Faces of Narcissism.” World Psychiatry, vol. 15, no. 2, June 2016, pp. 115–16. PubMed Central, https://doi.org/10.1002/wps.20323.)) so mentalization is an important skill to learn in treatment.

In MBT, patients practice mentalization during both group and 1:1 sessions. You might use specific events from your real life as examples. You’ll describe a situation—say, a recent argument with a friend. And your therapist will help you imagine how your friend might have felt. They’ll also help you identify and regulate your own feelings. These skills can improve your relationships with other people, and with yourself.

Medication Can Manage Symptoms

Currently, there are no medications specifically designed to treat personality disorders. ((“What are Personality Disorders?” American Psychiatric Association (APA). https://www.psychiatry.org/patients-families/personality-disorders/what-are-personality-disorders)) Despite this, your doctor might recommend a prescription to control your symptoms. Antidepressants and mood stabilizers are common treatments. But it’s important to note that personality disorders aren’t purely neurochemical. ((Ma, Guorong, et al. “Genetic and Neuroimaging Features of Personality Disorders: State of the Art.” Neuroscience Bulletin, vol. 32, no. 3, Apr. 2016, pp. 286–306. PubMed Central, https://doi.org/10.1007/s12264-016-0027-8.)) On the contrary, experts think some of them may have environmental causes. As a result, it’s unlikely that medication alone will “fix” your personality disorder. You might also need to make some major behavioral changes. These complex conditions can impact every aspect of your life.