Difficult People: personality disorders

Any time you feel exhausted after interacting...

How does one define "difficult" when referring to another human? In my "intro to counseling" class, my professor said that any time you feel exhausted after interacting with someone, you are likely dealing with a personality disorder. This isn't a term most people are familiar with, but in the mental health world, we use it frequently to describe a personality type. This observation can bring with it, a myriad of stereotypes- derogatory or otherwise. As defined by Mayo Clinic, a personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and to people. This causes significant problems and limitations in relationships, social encounters, work and school. There are many personality disorders out there, but I'm going to go over a few that have been recurring themes in my interpersonal relationships over the years. I'm willing to bet that a few of these will sound familiar to you too. 

I love you, go away...

  • Borderline Personality Disorder: I'm going to say that this is the most common one out there. The hallmark of this disorder is the extreme fear of abandonment, real or imagined. This can be met with intense (to say the least) behavior designed to avoid this uncomfortable feeling. People with borderline personality disorder have difficulty regulating their thoughts and emotions. Black and white thinking is present.  It's the "I love you, go away" person. Like anything else, there is a spectrum of severity. Additionally, this problem is more likely to emerge during adolescence and can be a lifelong struggle. Self-injurious gestures like cutting or suicidal ideation/attempts may be a factor. Dialectical behavioral therapy is the most successful method of treatment. 
  • Narcissistic Personality Disorder: When I say this, people get the picture of someone that has human remains in their crawl space. While that can be the case, the majority of true narcissists can be very charismatic and relatively "normal" people. In fact, therapists rarely see narcissists in their office because by definition, narcissists believe that they are perfect in every way.  Narcissistic personality disorder is mainly a problem for the people that are in the narcissist's life: family, spouse, children, they all struggle for their own sanity under the narcissists flat affect and manipulative hand. Per psychcentral.com, Narcissistic personality disorder is a disorder that is characterized by a long-standing pattern of grandiosity (either in fantasy or actual behavior), an overwhelming need for admiration, and usually a complete lack of empathy toward others. People with this disorder often believe they are of primary importance in everybody's life or to anyone they meet. I would reemphasize "lack of empathy." With these folks, you can be bleeding to death in front of them and they will say, "no you're not." Psychotherapy is the main treatment for this disorder, but as you can imagine, these peeps aren't lining up to confess their imperfections to a professional. 
  • Histrionic personality disorder: with this disorder, people (often women) are overly attention seeking, highly sexualized, and perceive relationships to be closer than they really are. They often feel most comfortable when they are the center of attention. When this is challenged, the individual may become highly agitated. Drama queens. Another hallmark for this disorder is that they are highly suggestible in order to connect to others. "Oh my gosh! You love spelunking too? It's my favorite!" Yet, they have never been spelunking. Like all personality disorders, people may be genetically predisposed. If your parent has a personality disorder, you are at risk to develop one yourself. This is due to the predisposition, but also observation of highly emotional behavior and poor coping skills. Treatment for histrionic personality is primarily psychotherapy and (at times) medication. 

Flashcards with names of people I knew on them...

After reading all of that, I would bet you a nickle that you started listing off people in your head that fit one of these descriptors: an old friend, an ex, a boss...the list is endless. I've been there. I remember when I got my first DSM IV-TR (diagnostic guide for mental disorders) in 2000, it was heaven for me. I started dog-earing pages, and for all my exams- I created flashcards with names of people I knew on them. Is that wrong? I totally rocked those tests. Here's the deal. There's a bit of a controversy in the world of mental health. Do diagnoses' like these help or harm people? In some cases, a label may give someone free reign to act poorly because "they can't help it." In other cases, it helps people understand why things are so much harder for them. It gives context and hope for treatment. At the end of the day it's about insurance companies being billed for service, because you have to put a name to a problem. That's the world we live in. Yuck.

A classic from my high school days about personality disorders. Ah, grunge...

Don't engage...

So what do you do? You've read this and you're thinking, "Yes! That's why so-and-so acts that way!" What can you do about it when you're wrapped up in drama, outbursts, or emotionally hijacked by difficult people? I saw a counselor in my 20's when I was going through a life transition. He gave me the best advice I could have ever gotten regarding an interpersonal relationship of this nature. Don't engage. People will bait you, waiting for a reaction. This is reinforcement for poor behavior. Don't engage. Create boundaries. While they are saying "I can't believe you! You're the most _____ I've ever met! How dare you abandon me like this!" Say "ok" and leave it. Don't engage. It can be excruciating, but reevaluating your relationships may be a good move. If you're stuck in a soul-sucking cycle of saving someone, or sticking around because you don't want someone to hurt themselves, it's bad news bears. Don't engage. While difficult people will continue to manifest in this world, we cannot control or fix them. We only have control over our reaction to them. Distance yourself if you can, and please...don't take it personally. They're just difficult.