Personality disorders are known for being especially difficult to treat in a clinical setting and this is because you are trying to change someone’s personality. These disorders can not be diagnosed until the age of 18 so by the time that you begin trying to change a person’s personality, they have had that personality, that way of seeing the world and interacting within it, for 18 years.
Their ways of behaving have been practiced, perfected and reinforced in their brain. Many personality disorders involve manipulation, so the first time a person uses manipulation to get what they want, and it is successful, a groove is created in their brain. A groove that says “this is the way we do this, the way we get what we need”. Every time afterwards that they repeat this pattern, the groove is further reinforced, deepened and becomes the person’s default in how they interact. Trying to change this behavior at the age of 18, 30, 55, or 70-with that number of years invested into their groove-is very difficult.
However, to understand personality disorders you have to understand attachment. This is because every personality disorder is defined by dysfunction in relationships. Their way of interacting with others is not healthy.
Personality disorders are not treated with medication and are not hereditary because they are learned behaviors. No one is born as a narcissistic or borderline personality disordered person. These personality traits develop over time. The understanding that a person has about relationships and how they work is taught to them through the modeling that their parents provide.
Our first relationship in life, with primary caregivers, is foundational to our understanding of all relationships moving forward. It sets the expectations and norms for interactions with others. If your parents were cold and dismissing in regards to you, then you most likely will become cold and dismissing to others because that is what was modeled for you. Unless your do the hard work of changing the way that you interact with others by changing your understanding of relationships, this is how you will continue to interact.
If your parents did not meet your needs growing up and you had to manipulate others to get what you needed, then that is how you will continue to interact with others past childhood. If we can recognize manipulation in childhood as a child trying to have their needs met, albeit dysfunctionally and inappropriately, then we should be able to frame adults in the same way-as adults who did not have their needs met in childhood.
That does not mean that with our understanding and compassion we dismiss their manipulative behaviors. In the same way that we redirect a child who is manipulative and help them to find health and the ability to trust others, we set limits with the adult. We reinforce our healthy boundaries and firmly reinforce our limits. We control only ourselves, not the other person. So, we are responsible for our boundaries and limits. The other person is in control of their response to our limits. They can choose to respect them or not, that is their choice. We make our decisions about continuing the relationship based on their response to our boundaries. However, often people with personality disorders seek help when a relationship that they don’t want to lose is in jeopardy because their partner started placing boundaries….and this becomes the instigation and motivation for the hard work that change will require.
Did you know Dr. Christina Reese has partnered with Envision to deliver an on-demand course? Adult Attachment: Trauma-Informed Assessment and Treatment Interventions Across Diagnosis is a must for any mental health professional and you can enroll and watch it on your time here: https://envision-workshops.thinkific.com/courses/adult-attachment-dr-christina-reese
This blog was written by Christina Reese, LCPC, Ph.D. . Dr. Reese is a licensed clinical professional counselor in Maryland and Pennsylvania as well as a licensed clinical supervisor. She received her Master's Degree in community counseling from McDaniel College in Westminster, MD and her PhD in counselor education from George Washington University in Washington, D.C. Past work experiences include being director of a mental health clinic and the case manager of the Howard County Cold Weather Shelter, working with homeless individuals and families. additionally, Dr. Reese is very passionate about her work focusing on attachment and has extensive experience with adoptive families and children in foster care.
This blog was originally published on February 7, 2021 on Dr. Christina Reese's blog at https://felicitycounselingservices.com/f/the-link-between-attachment-trauma-and-personality-disorders