What Does It Mean to Have a Personality Disorder?

“If your hands are covered in dirt, and you find little planted seedlings everywhere you go, then you might be the gardener,” a patient of mine once said.

Metaphors aside, my patient—who was not, in fact, employed as a gardener—was talking about recognizing his responsibility for the problems in his life. He held a high-status, high-paying job, but he continually argued with his supervisor and didn’t get along with many of his colleagues. After he’d been in therapy for some time, I’d gently suggested that the problem might not consist solely in the behavior of the other people in his life. That’s when my patient began to consider an alternative hypothesis: that there was something in his behavior and his personality that was causing him the same problems over and over again.

Maybe you’ve heard it said that if you have a personality, you also have a personality disorder. In my experience, there is no such thing as a “normal” character, because everyone has a unique, flawed, idiosyncratic way of seeing the world. And being diagnosed with a personality disorder (a “PD”) really isn’t as harsh of judgment as you might think. It suggests that your outlook is consistently affected by a particular, recognizable slant—be it perfectionism (as in obsessive-compulsive PD), the need for validation from others (narcissistic PD), or the desire to be cared for (dependent PD). There’s also the fear and social discomfort inherent in avoidant PD, or the “stable instability” of mood and interpersonal relationships of borderline PD. But there’s also a fairly broad range along which each personality falls, so that one person with, for example, histrionic PD won’t exactly resemble another.

And what does it feel like to have a personality disorder? It’s a lot like every other way in which people contribute to their own problems without noticing. Imagine yourself wearing sunglasses all afternoon, and into the evening, so that when you finally take them off, you realize that, for hours, you’d been looking at an increasingly brown-tinted version of the world without recognizing your altered perspective. A personality disorder, just like every other personality that doesn’t meet the criteria for ICD-10 diagnosis, will color the way you see the world, and in most cases, it’s imperceptible from the inside. Of course, because you can’t take off a personality, it’s not always easy to notice the biases you’re bringing to your relationships and social interactions.

Personality pathology is human nature. Each of us lives inside an elaborate illusion of perceiving the world with perfect accuracy, which none of us are really able to do. Our perspectives are limited physically by our senses and our bodies: we can’t experience aspects of the natural world or other people in any way that the equipment we’re built with cannot reach. (It’s hard to look at the back of your head in a mirror.) We’re limited even further by our brains, which tend to build rigid templates out of the imperfect relationships we grew up with; templates that guide the way we will relate to the people we meet later in life.

The difficulty of seeing one’s own biases—of recognizing one’s limitations or getting a picture of the invisible templates in one’s brain—is also one reason why it’s so difficult to communicate with anything like perfect clarity. After all, when other people speak to you, they're communicating through the screen of their assumptions about you and about how you’ll view them. You, of course, will take in their remarks through the filter of your own biases, and you’ll respond in kind. The connotations you hear might not be what your partner intended; likewise, your own communication is interpreted according to someone else’s unique internal perspective, not your own. All of this is to say that personality pathology doesn’t exist in a vacuum; it expresses itself within close relationships, unsettling all parties involved.

If you find that your typical way of interacting with others is causing you trouble or if you notice ongoing, difficult trends in many of your relationships, psychotherapy may be able to help you. The key to making meaningful changes is insight, at least to begin. A good therapist should be able to work through the multiple biases and assumptions inherent in seeing the world through your unique pair of eyes, including those that affect the conversations you’ll have with your therapist. If you see it that way, you’ll recognize that the therapist-patient relationship is the only one in which the relationship itself can be investigated, even as it takes place, or can even become a tool for insight and healing.

In the protected space psychotherapy offers, people with all kinds of personalities—or personality disorders—can take steps toward meaningful change.

To find a therapist, please visit the Psychology Today Therapy Directory.