Defining Features Of Personality Disorders: Problematic Emotional Response Patterns

People with personality disorders exhibit characteristic, emotional response patterns that can become problematic.  Generally, each of the personality disorders has an emotional response pattern that is associated with that particular disorder. This inflexible pattern of emotional response often creates difficulty.  Some personality disorders are characterized by emotional sensitivity and a tendency to experience feelings with great intensity.  Other personality disorders are characterized by little or no emotional response, regardless of the circumstance or situation.  Yet another set of disorders are characterized by bouncing back and forth between these two extremes: from being overwhelmed with intense emotions one moment, to feeling numb and disconnected in the next.

Some theorists understand this aspect of personality disorders as a problem of emotional regulation; some disorders are characterized by a tendency to under-regulate emotions, whereas others tend to over-regulate emotions.  This differs from a healthy personality where we expect a full range of emotional intensity from controlled to fully expressive.  This range is dictated by the situation and circumstance.  Of course, people with healthy personalities will occasionally get overwhelmed with emotions, or can feel emotionally detached at times.  Similar to the distorted thinking patterns we discussed earlier, the problem for people with personality disorders is the extreme degree and persistence of their dys-regulated affect.

In addition, people with healthy personalities tend to understand when it is beneficial to express a particular emotion, and when it is best to restrict its expression.  In other words, people with healthy personalities have learned that there are times when it is wise and appropriate to fully express a particular emotion. At other times it is best to regulate or restrict its expression, or to dampen down its intensity.  Having decided just how much emotion is appropriate to display, they then display only the appropriate amount, knowing just how to do that.  As we have emphasized previously, a key feature of healthy personalities is flexibility. Healthy personalities have a flexible range of affective responses that properly consider the time, place, and circumstance.

Unfortunately, persons with personality disorders are not nearly as flexible. Depending upon the type of personality disorder, affective (emotional) features can range from being very constricted, indifferent, cold, and experiencing little pleasure in life; to rapidly changing and wildly fluctuating emotions, often expressed with great intensity and dramatic flair. In some personality disorders this lack of flexibility surrounding emotional expression leads to problems with chronic anger and irritability, problems with extreme anxiety, or a complete lack of empathy.

Examples of personality disorders with problematic emotional response patterns 

Just as we did before when we considered disordered thinking patterns, let's look at some examples of specific personality disorders to illustrate these problematic emotional response patterns, and the types of interpersonal problems that are created a result.

People with Schizoid Personality Disorder are at the over-regulated end of the affective spectrum and appear emotionally constricted and indifferent. They tend to experience little or no pleasure in things, seem indifferent to praise or criticism, and come across as detached, cold, and unexpressive. To other people, they seem unfeeling, unresponsive, and insensitive and are thus unlikely candidates for friendships of any sort. On the other side of the affective spectrum is the Histrionic Personality Disorder, which represents emotional under-regulation.  This disorder is characterized by an extremely reactive emotional pattern that shifts very rapidly. These people tend to be rather dramatic in their emotional expression to such an extent they seem to be disingenuous, shallow, and insincere.  Other people will often react to their intense emotional expression with discomfort, and regard the rapidly shifting emotions with a sense of disbelief or distrust. 

For persons with Avoidant Personality Disorders, the anxiety they experience in social situations and their fear of being inadequate, rejected, and ridiculed, dominates their emotional life and interferes with their ability to function. Their high level of anxiety causes them to avoid social situations such as parties and other social gatherings. Typically, people with Avoidant Personality Disorder have only a small number of close friends. Similarly, for people with Dependent Personality Disorder, anxiety dominates their affective experience. However, in contrast to those with Avoidant Personality Disorder who prefer to avoid relationships, people with a Dependent Personality Disorder are preoccupied with fears of being alone, fears of separation and abandonment, and fears of not being taken care of by others. Their anxiety over the possibility of losing important caregivers and their fear of being unable to take care of themselves can make it very difficult for them to stand up for themselves. Consequently, they may tolerate mistreatment, and avoid conflict at the expense of their dignity and self-respect.

The Borderline Personality Disorder provides an example of the affective pattern of experiencing both emotional extremes; from highly intense and dys-regulated emotions, to the extreme opposite-- feelings of numbness and detachment. Persons with Borderline Personality Disorder tend to be highly sensitive and react with great emotional intensity. They have powerful feelings in the context of interpersonal relationships particularly when difficulties and conflict cause them to feel intensely anxious, angry, or down. During interpersonal conflicts they become easily overwhelmed with the intensity of their emotions, and may have a hard time calming down once they are upset. At other times, people with Borderline Personality Disorder can rapidly shift to the polar opposite and suddenly feel completely disconnected, numb, empty, and detached. Many people with Borderline Personality Disorder end up injuring or harming themselves in reaction to this emptiness and the accompanying feelings of numbness. Other people tend to react with fear or anger to their rapidly shifting emotional states and their self-injurious behavior. This only serves to escalate interpersonal conflict. Therefore, interpersonal relationship difficulties and conflicts are a common consequence of the intense, rapidly fluctuating emotions associated with this disorder.

For most of us, an emotion is connected to an urge to "do something". For instance, when we get angry, we may have an urge to verbally or even physically attack the other person with whom we feel angry. When we feel anxious, we may have an impulse to run away or avoid the situation that is frightening us. Healthy people do not typically act upon these impulses if the action associated with the impulse is not situationally appropriate. However, for people with Borderline Personality Disorder, emotions may become so intense that it becomes difficult for them to avoid acting on these impulsive urges; regardless of the whether it is wise or healthy to do so. For example, a diagnostic criterion for Borderline Personality Disorder is outbursts of intense anger that often result in yelling, throwing things, or even hitting other people. It is not simply the intensity of the emotion that causes these dangerous outbursts. Most of us at one time or another have experienced some form of intense anger, or even rage. Rather, problems occur when intense emotion is coupled with a lack of impulse control.  As we will see in the next section, this issue of self-control is another defining feature of personality disorders.

Comments
  • Hareesha SG

    Can we remove personality disorders permanently after experencing one year?

    I think treatment is not workout to adult, it may be possible to only children or adolocence.

  • Anonymous-1

    I ve had BPD all my life with many comorbidities. My major symptom has been scopophobia which I shared with my mother who was a holocaust victim$ I had infantile trauma during WWII as an infant, and although I have lived with other dysfunctional aspects of BPD, scopophobia has been the most obvious and disabling symptom.(When I was young it was misdiagnosed((probably)) as paranoid schizophrenia..

  • Anonymous-2

    I WAS DIAGNOSED AT AGE 43 AFTER A LONG AND SAD ROAD-- I HAD NO INSURANCE AND HAD TO RESEARCH AND FIND MEDICATIONS FROM OTHERS---I USE CYMBALTA AND HAVE HAD MIRACULOUS RESULTS--I NO LONGER HATE MYSELF OR THINK IM UGLY OR FORM DOOMED RELATIONSHIPS--I AM IN COLLEGE NOW AFTER SPENDING THE LAST 20 YEARS OF MY LIFE COWERING IN MY HOME--I AM ALIVE FOR THE FIRST TIME IN MY LIFE AND I AM WRITING THIS IN HOPES THAT SOMEONE ELSE WILL HAVE THE SAME RESULTS--LOVE-BORDERLINE AND DOING FINE

  • noclue

    is there any help website for ocd patients.. pls help

  • Anonymous-3

    why is misdiagnosis so prevalent, eg autistic featuers mistaken for bpd types and vice versa?

  • Anonymous-4

    in reference to the blog linking scopophobia to borderline and comorbid conditions, i have experienced the very same thing, including misdiagnosis, and the mother's like symtoms. I found it incredible to read it, and was it not for the fact that the blog was dated august 2010, i would have thought i had written it myself.

  • Mark Williams

    CYCLE OF ABUSE

    Although the cycle of abuse would actually begin with a summons, the threat was omnipresent and constant. A messenger boy could appear virtually anywhere at any time to deliver to any adult present, one or more small squares of mimeographed paper from either the principal's office (on pink paper) if it was a school matter, or the dean's office (on yellow paper) for all other matters. Long after the mimeograph process had become obsolete virtually everywhere else, just the sickening smell of that printing fluid would trigger the terror, and as I would hear my name called, the horror would begin again.

    The summons would state no charges just the day and time that I was to report to the appropriate office to be disciplined. If the principal's allegations included a 'farm offense,' I would be sent by him to the dean's office (a practice that earned the principal, [name removed], the nickname, “Puppet [removed]”). Perhaps it was policy, but only [name removed], the dean actually took boys to and from the farm, and the principal's referral to his office removed all doubt as to the punishment, leaving only the length of the sentence as yet to be determined.

    After presenting the summons to the dean's receptionist, I would be made to sit and wait (typically for a couple of hours) until any and all other boys were seen first. This was yet another foreboding sign that a trip to the farm was all but certain. When the last boy in the room closed the dean's big office door behind him and left the building, my heart would pound so hard with anticipation that I could hardly stand it, until my name was finally called.

    I really can't (or won't?) remember much about opening and then closing that huge office door so painstakingly gently, albeit in a panic to be 'prompt,' and awaiting the dean's command, directing me to walk across that enormous room and stand before him at his desk. I do recall vividly that he could snap his fingers really loudly, and the slightest hint of dissent in just my body language, might prompt him to do so. I would cringe at hearing that loud “snap!” and at the same time he would shout, “double!” or “triple!” referring to increases in the length of the sentence. This guy was a former student, notorious even then as a 'troublemaker,' and outspokenly proud of it. It was a well known fact that he had been promoted to the position of Dean of High School Boys from his former job as stockroom clerk in the commissary. He coined his own nickname: “the mean dean,” and openly claimed that he smoked a pipe solely for the purpose of striking terror in us at the very scent of his presence. It worked all too well.

    He would typically begin by referring to various parts of a 'report' that he held up, although I was never to know anything more about it than the parts he claimed to be reading aloud. The fact that it could have been written by anyone as far back as a month ago might have made it all absurd, but the stark reality of the terror was undeniable and gave the whole situation a surreal quality.

    The reprimand would typically culminate in charges of “insubordination,” along with accusations of deliberate wickedness, perpetrated to tarnish the school's good name, and intended to insult the dean and the staff personally. I was allowed absolutely no defense and only spoke when coerced to agree that I was indeed horrible. Suffice it to say that other than the beatings themselves, this humiliating phase of the cycle was the most hurtful.

    I would ultimately be given a sentence ranging from two weeks to three months at hard labor and instructed by the dean to return to my assigned building. I was then to put some clothes in my laundry bag ( assigned laundry # W-707), and to be at the front door in what was typically about half the time it should reasonably take (and of course, I was reprimanded again for being late). I was then to be taken in the dean's big black car to the 'boy's punishment farm,' way out on the corner of the property. I would be ordered to sit next to the dean in the front seat because, as he often stated, “I'm nobody's goddamn chauffeur!” We traveled in utter silence.

    The number of boys at the farm fluctuated often of course, but was rarely fewer than three or four, or greater than a dozen, although I had been out there alone more than once, which was even more frightening.

    Hard labor at the farm consisted primarily of digging landfills and turning over acres of farmland using long-handled spades, and mowing large orchards with hand mowers. It often included working in the campus laundry, shoveling snow in the winter, and any other distasteful job that needed doing from time to time. It began at sunrise, so we would have breakfast and perform all related chores while it was still dark outside. With the exception of a half hour for lunch and noontime chores, the work went non-stop until dark, at which time we would be required to shower, then prepare for the evening meal.

    After supper and chores we would have the required fifteen minutes of 'bible study', timed as usual by the whistle, still clearly audible that far away (probably more than a mile) from the campus. We would sit in mandatory silence, 'reading' the bible or catechism until the second whistle blew. At the farm this imposed silence didn't mean very much, as there was no television or radio and we were not allowed to go outdoors, nor to wear shoes, nor to speak above a whisper except to adults.

    We usually congregated around two large wooden tables on the closed-in front porch. The tops of the tables were covered with the carved names of former inmates, along with the number of times each boy had been sentenced to this place. Although I was approaching the record, having been sentenced twenty two times in nine years, I have never in my life seen fit to vandalize property no matter whose it was, and to me that record was an unmitigated source of shame that I certainly didn't want on permanent display.

    The proctor was a grossly obese, illiterate man with a huge scar down one cheek which was rumored to be from the kick of an improperly held shotgun. On Friday around noon, his paycheck would come in the mail and he would drive in to the local town to cash it. He would be gone until well after the evening meal, only to return in a drunken stupor, shouting obscenities and stumbling all over himself. He would prop open the basement door with a brick and stumble down the stairs, swearing at the top of his lungs and threatening to “beat you 'til you $#!+, then beat you for $#!+ing!” Unfortunately he wasn't exaggerating one bit.

    At some point he would call out the name of one of us boys, who would be sitting around the tables on the front porch. The room would get deadly silent as we all turned our attentions to the boy in question. He would then have to go down the long hall to the open basement door and descend the stairs, whereupon the yelling got louder and more personally insulting.

    The old man claimed to have some sort of system of marks against various boys, written in a small notebook that he carried, implying that the beatings were the consequence of too many marks. But it was common knowledge that he was illiterate, and the book had been pilfered many times and was known to be completely blank. There were even cases of homework pages folded to look like love letters and deliberately 'dropped' by one of us, all the better to ridicule the ignorant hypocrite.

    So although the names he called from week to week were seemingly random, they were invariably those from the same group of boys that he just liked to abuse usually the smaller and more easily intimidated ones. Unfortunately, that included myself and, inasmuch as he detested 'smart guys,' my name was almost always called. Consider that with an average sentence of more than a month, times twenty two sentences, I must have been beaten well over a hundred times, starting when I was nine years old.

    I cannot recall which made me sicker the agonizing anticipation (during which we all struggled to endure the sounds of one boy after another screaming for mercy), or the sound of my own name, indicating that this outrageous horror was about to get much, much worse.

    Upon hearing my name, I would suddenly become the focus of everyone in the room, then be coerced to hurry down the stairs and onto the rough concrete of the basement floor. I would be forced to strip naked and extend one wrist, by which to be trapped in the grip of this sadistic son of a bitch (I still have scars on both wrists). In one hand he wielded a club made of a length of two by four, with one end whittled down and taped as a makeshift handle. He would corner me until he could grab my wrist with his other hand, and then his rage would explode!

    He would begin hitting me pretty much anywhere he could, as it was impossible for me to do anything but recoil from the blows, many of which also knocked me down. So, trapped by the wrist and tumbling head over heels on the concrete floor, I would go around and around, moving only by involuntary reactions to the blows. And by this time, the screaming (mine) and the obscene shouting (his) were a deafening constant. And before my body could even react to one blow, there was another, and another, and another. And as repeated blows were struck in the same places, the rapidly increasing soreness maximized sensitivity to the pain to the point of unbearable, at which point I began losing bladder and bowel control. This would fuel his rage and my humiliation to a horrific intensity. At those moments I was aware only of being such a failure as a human being, as to deserve being in ultimate pain, trapped by its source, and knowingly helpless to do anything whatsoever but react inadequately to it. Finally I felt the all too familiar, bittersweet feeling of passing out.