Defining Features Of Personality Disorders: Impulse Control Problems

People with personality disorders tend to exhibit problems with impulse control. These problems can manifest as either over-controlled or under-controlled impulses. (Under-controlled impulse control is commonly called a "lack of impulse control".  In the same manner that people with personality disorders may have problems with over- or under-controlled affective (emotional) regulation, they also tend to have problems regulating their impulses. Here, too, we can think of impulse regulation along a continuum ranging from over-control to under-control, with healthy personalities falling somewhere in the middle between these two extreme poles.

Consider the issue of self-control and the need for a healthy balance between overcontrol and under-control.  On the one hand, we need to control our impulses and to consider the consequences of acting upon an impulse.  Having considered the consequences, we then decide how to act accordingly. We determine whether to allow ourselves to indulge the impulse, or whether to inhibit it.   The inhibition of certain impulses enables us to behave in ways that are both responsible and socially acceptable. Therefore, in some circumstances the inhibition of our impulses serves to promote our success in both relationships and in the workplace.  Two areas of particular concern are aggressive and sexual impulses. If we were to act on our every aggressive or sexual impulse, we would easily get ourselves into a great deal of trouble. On the other hand, the over-control of impulses leads to its own set of problems. A certain amount of carefully considered risk-taking is necessary to reap the benefits of creative expression, rewarding relationships, and successful problem-solving. Some amount of risk-taking is part of the excitement, fun, and spontaneity associated with an enjoyable life. With too much impulse control, we end up feeling restricted, bored, and dull; with too little we can get ourselves into a great deal of trouble. Clearly, a balance between these two extreme poles of over- and under-control would represent a healthy personality.

The challenge to strike the right balance of impulse control affects everyone from time-to-time, including people with healthy personalities. We all have had occasions where we behaved irresponsibly, or unwisely chose to act upon an impulse. At other times, we may have been too controlled, failing to take a risk that would have ultimately benefitted us. Once again, flexibility enables healthy personalities to achieve the proper balance of impulse control most of the time. People with personality disorders are distinguished by the rigidity of their pattern of over- or under-control, and the severity and persistence of their impulse control problems. Rigid and persistent over-control of impulse can manifest itself as inhibition, reluctance to do anything that involves any type of uncertainty or risk, reluctance to start new things or try new activities, and over-conscientiousness or scrupulousness. Rigid and persistent under-control can manifest itself as recklessness and a disregard for rights and needs of other people. This pattern can lead to troublesome or dangerous problems such as drug use, dangerous or risky sexual liaisons, over-spending, assault, or self-injury.

Examples of personality disorders with impulse control problems 

Now let's look at some examples of specific personality disorders to illustrate these problems of over- or under-control of impulses.

On the over-controlled side of the continuum is the Avoidant Personality Disorder. People with this disorder are afraid to try new things for fear of embarrassment, and fear of ridicule. They hold back when they are with other people and can come across as stiff and constricted. They lack spontaneity as every action must be considered for its potential to result in embarrassment or ridicule. Subsequently, people with this disorder end up missing out on some of life's unplanned but enriching adventures. Similarly, people with Obsessive-Compulsive Personality Disorder also tend to over-control their impulses. Overly worried about rules and regulations, they can be very scrupulous, and tend to be excessively focused on conscientiousness, morals, and ethics. Preoccupied with lists, and a rigid sense of right and wrong, they rivet their attention toward the smallest details and become unable to complete a task; i.e., they become so distracted by so many small details that they can't see the forest for the trees.

On the other side of the continuum are problems with under-control, or more commonly stated, a lack of impulse control.  This lack of impulse control can manifest itself as failure to plan ahead or to think about the long-term consequences. Lack of impulse control is evidenced by such things as impulsive spending; risky sexual behavior; combative and assaultive behaviors; substance abuse; recklessness and excessive risk-taking; gambling; and binge eating.  The Antisocial Personality Disorder provides a prime example of these problems with impulse control. Persons with this disorder don't really plan ahead and this type of reckless disregard can cause them to engage in risky behavior merely because it feels good in that one moment. They do not consider the consequences of their behavior, nor its effect on other people or themselves. This is how they end up breaking the law, getting themselves into trouble, and hurting others.

People with Borderline Personality Disorder can have similar problems. As mentioned previously, for someone with Borderline Personality Disorder, the inability to regulate their intense emotions when coupled with poor impulse control can lead to dire consequences. An emotion can become so intense that it becomes very difficult to avoid acting upon the immediate impulse or the urge to do something. Powerful negative emotions such as anger, coupled with a lack of impulse control, will often have disastrous results such as assault or self-injury. Some impulsive behaviors such as alcohol or other drug use, risky sex, and binge eating can also function as coping mechanisms for people with Borderline Personality Disorder. These behaviors may represent ineffective attempts to cope with intense and difficult emotions. These behaviors are dysfunctional because while the behavior may enable the person feel relieved and better in the moment, it ultimately has harmful long-term consequences.

As we have emphasized throughout, these first three core features of personality disorders 1) problems with disordered thinking, 2) problems with affective regulation (feeling), and 3) problems with impulse control (behavior) all have a profound and negative impact upon interpersonal relationships. As a result, the fourth core feature of personality disorders, which we are about to discuss, is considered the most significant and defining feature of all personality disorders.

Comments
  • LINDA

    Hi there, i believe my Daughter has BPD but to make things worse she also has a low IQ of 69.

    She is 34 yrs old and lives with her grandparents in Melbourne.

    Any help out there for her ??????

    thanks Linda

  • lucy

    a donde podriamos acudir en colombia, para el tratamiento de TLP??? agradecemos la orientacion,

  • Anonymous-1

    Hi, Linda. Methylphenidate or dextroamphetamine are known to help, Generally only a psychiatrist can subcribe them, a stimulant will help alot

  • rupert

    i believe i have a pd reason being when i consume alcohol i want to fight everyone i get aggressive my anger is very high.i disrespect anyone thats near me or who i am talking to at that time,then the next hour im fine apologizing to them.am i going crazy or what? or is it just past reflections of my past and therefor anger that i have to give out is being released from previous problems in my life,i can control this sometimes but then again sometimes its uncontrollable,do i need help?

  • Anonymous-2

    Rupert I doubt you have a personality disorder..it sounds like you have more of drinking problem...Look up the AA sites and take a brief questionnare...one of the factors is that your personality changes when you drink...If you had a personality disorder you would act like that alcohol or no alcohol...Hope this helps.

  • Anonymous-3

    I know my daughter had BPD. For the 3rd time since she turned 18, I am no longer in her life through actions on her own part. She had late onset of puberty, (age 17), and when she turned 18 her personality, morals, everything seemed to take a complete turn and now she is who she is. Of course I am concerned about what causes BPD. I was a very nuturing stay at home soccer mom. Meals had all the food groups, family sat down to dinner, the whole beaver cleaver setup. However, I did divorce the biological father and he was a negative role model for a while until he got into AA. My daughter needs help and I dont know what to do. I cannot allow her to cause me any more emotional pain and stress through her actions but she has 4 children by 3 different fathers who I am not allowed to see. Now I hear from close sources that she is having an affair with a married man that happens to be her co-habitating partners best friend. The reason why he agreed? Because during sex, my daughter likes to be cut and hurt :( This is the first I have heard of this, altho my she did confess to me once that she used to cut herself. No one can give her enough attention ever and she is impossible to satisfy for more than a day at a time. Any suggestions how I might get help for her?

  • missy t

    so for 13 years they have been telling me i am bi poler and way over druging me but i always hated what the meds did to me. i have many sucide attemps i was a cutter. flip off the handle mad at the drop of a dime. and i am always meanest to the people i love but i soo never want them to leave my life. bleh the list could go on. but now instead of bi poler i am bpd? im so lost and really dont know what to do with this new info.

  • GLORIA MEDINA

    Hoy mi hijo tiene 30 anos y desde los 4 anos se le detecto, el recibio terapias ahora vivimos en USA y ayer me dieron los resultados de las evaluaciones que le hicieran en este pais y me recomendaron que reciba terapias para aprender a sociabilizar, lamentablemente el idioma le impide sociabilizar y en donde tambien resulto que le falta bastante apoyo es en cuanto a las matematicas osea me recomendaron que pida un guardianship por que podrian haber personas que podrian aprovecharse de su dinero.

    Today my son is 30 and from 4 years is detected, the received therapies are now living in USA and yesterday told the results of the assessments made in this country you and I recommended that he receive therapy to learn to socialize, unfortunately language prevents you from socializing and where it also appears that support is quite lacking in terms of bone mathematics recommended me to request that a guardianship could be people who could benefit from your money.

  • Anonymous-4

    there is highly successful retreat center in tennessee for women with bipolar disorder. It saved my daughter's life but is extremely expensive. It is called Brookhaven Retreat Center. Take a second mortgage on your home if you have to send her there.

  • linda

    son has cognitive delays, is 26 and this year just flipped, thought he was bipolar but after reading this article realize he has bpd. the drs had him on zyprexa then he gained forty lbs, but seemed tired and not there..then they took him off and he did fine for four months then flared up again..back on zyprexa now they changed it to a new drug that has horrible reviews.geodon 20mg...so we decided not to give him the drug....serious withdrawls...so says patients....but we have decided to see another dr. and get second opinion based on this article...he needs therapy...but he also gets very depressed....but he has cognitive delays so he isnt the average patient....

  • Anonymous-5

    I think that it is important to note that personality disorders can and often do co-exist with other mental illnesses...

  • Anonymous-6

    I was diagnosed with BDP 4 years ago. My Dr prescribed Cyprilex 20mg 2 times a day and this did a world of difference, I am now down to 5 mg once or twice a day depending on my day. Most times I forget my meds and am okay but I know when I have a bad time and need to take it again. This happens less and less now that I am 40 yrs old. They say the symptoms begin to lessen with age and I believe this to be true. I also went to dialectic behavioral therapy and talk to a therapist who is specifically trained in the field of BPD. Having a strong network of friends and family who accept you for who you are and understand the disorder helps me too, as they learn to understand what I have and learn more about it they can help me and make me strong on those bad days. I now have a successful small business, and have a wonderful job I love and a great family. There is hope out there. There are some great books on BPD like Borderline personality disorder: How to live with this condition it has an apple and a ruler on the front is a wonderful book. The other one was How to live with someone you love with BPD helped my partner to understand my condition a great deal. Hope this helps a bit

  • Shirley Keck

    My daughter was molested by her cousin at 3, CPS then put him in my home against my wishes a year later and he molested her again. Ayear and a half later I got very ill I am a single mother my friend gave my children to CPS where they were abused. By 3rd grad she was said to have ADHD a few years later I became ill with blood clots and lost them again to CPS. This time she was in six placements, five abusive because of behavior problems and now changed to PTSD. Due to behavior at school CPS forced me to sign her over for residential care or loose both children. She has been there over 2 years the last 6 or 8 months worse.AWOL's up to 43 hours,threats to kill herself,destruction,one minute she likes you the next hates you doesn't know why,bored,eating binges,impulse issuse's,cutting,self hatred,anger.I believe she has BPD and needs med change and different therapy can't get anyone to listen to me.Can you help?I don't want my baby to die !

  • Anna Maria Vestin

    I am an expert in Colombia on Borderline personality disorder. Soy psicologa experta en trastornos limites de personalidad.