What is Personality?

• A person's characteristic traits, coping styles, and ways of

interacting in the social environment emerge during
childhood and normally crystallize into established
patterns by the end of adolescence or early adulthood.
D E F E N S E These patterns constitute the individual’s personality.
MECHANISMS 7-
IN 04-
PERSONALITY
• The word personality itself stems from the Latin word
DISORDER
2021

persona, which refers to a theatrical mask worn by

performers in order to either project different roles or
disguise their identities.

• At its most basic, personality is the characteristic patterns

of thoughts, feelings, and behaviors that make a person
unique. It is believed that personality arises from within
the individual and remains fairly consistent throughout
life.
2
 W H AT A R E P E R S O N A L I T Y
DISORDERS?
Personality disorders are long-term patterns of behavior and
inner experiences that differs significantly from what is
expected. The pattern of experience and behavior begins by late
adolescence or early adulthood and causes distress or problems
in functioning.
DEFENSE
MECHANISMS
IN Cluster A- 7-04-2021
PERSONALITY
Paranoid and Schizoid Personality Disorder
DISORDER

Cluster B-
Dissocial, Emotionally Unstable, Histrionic Personality
Disorder and Narcissistic Personality Disorder

Cluster C-
Anankastic, Anxious (avoidant) and Dependent Personality
Disorder

3
 WHAT ARE DEFENSE
MECHANISMS?
Defense mechanisms are
DEFENSE
MECHANISMS
IN
unconscious psychological 7-
04-
PERSONALITY
DISORDER responses that protect people 2021

from feelings of anxiety, threats

to self-esteem, and things that
they don't want to think about or
deal with.

4
 TYPES
Distortion
Rationalization
Isolation
Dissociation
Regression
DEFENSE Splitting
MECHANISMS
IN Acting Out
PERSONALITY
DISORDER Passive Aggression
Denial
Projection
Intellectualization
Fantasy
Repression
Identification
Introjection
Withdrawal
5
 • Distortion
Distortion involves a person believing something to be true
when it is not.
Example- A person May believe that they failed a test
Because of difficult questions, not because they did not
prepare fully.

Rationalization
D•E F E N S E
MECHANISMS
Attempting to justify One's behavior by presenting reasons
IN 7-04-2021
PERSONALITY
that sound logical.
DISORDER

Example- A client treated for a drug addiction Claims an

inability To stop taking drugs because of a bad marriage
• Isolation
Separation of emotions From precipitating event or situation.
Example- A rape victim Talks about her rape without
showing any emotions

6
 • Dissociation
Person deals with emotional conflict or stress by splitting
off or repressing some part Of their personality Or
consciousness from their awareness.
Example- A person talks about a traumatic event and goes
into a trance.

• Regression
DEFENSE
Individual Going back to Ways of behaving That are
MECHANISMS
IN
Associated with safer, more carefree or happier time of
PERSONALITY
DISORDER
life.
Example- Due to pressure of college, Tom start sucking his
thumb.

• Splitting
Viewing of Self or others As either good or bad Without
considering the whole range of qualities.
Example- You think Your best friend is Absolutely
worthless Because he forgot a lunch date with you.
7
 • Acting Out
Behavioral outcome of conflict Between an Unconscious Need to
express anger and A conscious need to deny it.
Example- A College student who has an abusive father has
difficulty with men Teachers as well as men on authority.

• Passive Aggression
Passive-aggressiveness is thought to be a defense mechanism that
many people automatically use to protect themselves. This can be
D E F Ea N Sconscious
E or unconscious effort that is unique to each person.
MECHANISMS
I NHowever, underlying feelings of fear, mistrust, rejection, low self-
PERSONALITY
D I S O Resteem,
DER and insecurity are common among all.

• Denial
Refusal to Believe or accept an unpleasant reality
Example- A person Denies that they have an alcohol or substance
Use disorder because they can still function and go to work each
day.

8
 • Projection
This involves Individuals attributing their own Unacceptable
thoughts, Feelings And motives to another person.
Example- You might hate someone, But your super ego Tells you that
Such hatred is unacceptable. You can solve the problem by believing
that they hate you.

• Intellectualization
D E F E Intellectualization
NSE Works to reduce anxiety By thinking about events
MECHANISMS
I Nin a cold, clinical way.

Example- A person who has Just been diagnosed With a terminal

PERSONALITY
DISORDER
illness Might focus on learning everything About the disease in order
to Avoid distress and Remain distant From the reality Of the situation.

• Fantasy
Fantasy is a sort of Imagination Which can provide An escape from
Frustration By giving us imaginary satisfaction.
Example- Making up stories about how successful you are, Rather
than working on your success.

9
 • Repression
Person deals with emotional conflict or Stress by forcing out any thoughts,
impulses, experiences or memory from conscious awareness.
Example- A victim of a car accident does not remember anything about the
accident

• Identification
A conscious or unconscious attempt to model oneself after a respected person.
Example- A student wants to be like a famous person so they begin to dress
and act like that person.
DEFENSE
MECHANISMS
IN
• Introjection
PERSONALITY
Taking on the qualities or attitudes of others without thought or examination.
DISORDER

Example- A person may take a political view of a famous admired actor.

• Withdrawal
It consists of retreating into oneself and pulling away from reality in order to
take refuge in the world of phantasy or sleep.
An easily observable example is an anxious or overstimulated baby that
protects itself by going to sleep.

10
 CLUSTER
DEFENSE
MECHANISMS
IN A 7-
04-
PERSONALITY 2021
DISORDER
PERSONALITY
DISORDER

11
 CLUSTER A
Paranoid
DEFENSE
MECHANISMS
Personality 7-
IN
PERSONALITY
DISORDER
Disorder 04-
2021

Schizoid
Personality
Disorder
12
 PARANOID PERSONALITY DISORDER
• ICD coding: F60.0 Paranoid Personality Disorder
• Paranoid Personality Disorder causes patterns of distrustful behavior.
People with this personality disorder often feels suspicious about the
DEFENSE
MECHANISMS motives of others or fear that others intend to harm them. The fearful, 7-04-2021
IN
PERSONALITY
DISORDER
distrustful perceptions that accompany PPD can make forming and
maintaining close relationships very difficult, affecting the person’s ability
to function at home, work, and school. When they perceive they’re being
persecuted, rejected, or slighted, they’re likely to respond with angry
outbursts, controlling behavior, or by deflecting the blame onto others.

13
 TRAITS
• Suspects, without Sufficient basis, That others are exploiting, harming or
deceiving him or her

DEFENSE
• Excessive sensitiveness to setbacks and rebuffs
MECHANISMS 7-
IN
•
PERSONALITY
Tendency to hold grudges 04-
2021
DISORDER

• Tendency to experience excessive self- importance

• Unjustified fear that a spouse or romantic partner is being unfaithful
• Is preoccupied with unjustified doubts about the loyalty or trustworthiness
of friends or associates.

14
 CAUSES
• The cause of PPD is unknown. However, researchers believe that a
combination of biological and environmental factors can lead to it. The
disorder is present more often in families with a history of Schizophrenia
DEFENSE
MECHANISMS and delusional disorder. Early childhood trauma can be a contributing
IN 7-04-2021
PERSONALITY
DISORDER
factor as well.

15
 ONSET
• This disorder often begins in childhood or early adolescence and appears
to be more common in men than in women. Studies estimate that PPD
affects between 2.3% - 4.4% of the general population.
DEFENSE
MECHANISMS 7-
IN 04-
PERSONALITY 2021
DISORDER

16
 DEFENSE MECHANISMS USED
• Projection- Projecting one's own negative features onto others fosters
suspicion.

DEFENSE
• Intellectualization-In intellectualization can also be seen as they block the
MECHANISMS
IN
emotional side and address only the facts. 7-04-2021
PERSONALITY
DISORDER

17
 TREATMENT
• Paranoid personality disorder is generally treated with psychotherapy.
With ongoing treatment and appropriate support, people with this
condition can manage their symptoms and function more effectively in
DEFENSE
MECHANISMS daily life. However, people who have PPD may not seek treatment for 7-
IN 04-
PERSONALITY
DISORDER
their condition, usually because they do not feel that they have a problem. 2021

• To those with PPD, their suspicions of others are justified and it is other
people who are the problem. Cognitive- behavioral therapy is often
effective in helping individuals adjust distorted thought patterns and
maladaptive behaviors. Cognitive behavior therapy (CBT) is a type of
psychotherapeutic treatment that helps patients understand the thoughts
and feelings that influence behaviors.
18
 SCHIZOID PERSONALITY DISORDER
• ICD coding: F60.1 Schizoid Personality Disorder
• Schizoid personality disorder is a chronic and pervasive condition
DEFENSE
characterized by social isolation and feelings of indifference toward other
MECHANISMS
IN
people. This type of personality disorder is believed to be relatively rare 7-04-2021

and tends to affect more men than women. People with schizoid
PERSONALITY
DISORDER

Personality disorder are also at risk of experiencing Depression.

• It is a condition in which people avoid social activities and consistently
shy away from interaction with others. They also have a limited range of
emotional expression. Person who have Schizoid personality disorder
Maybe seen as a loner or Dismissive of others, They may lack the desire
Or skill to form close relationships.
19
 TRAITS
• Few, if any, activities provide pleasure
• emotional coldness, detachment or flattened affectivity
DEFENSE • Limited capacity to express either warm ,tender feelings or anger towards
MECHANISMS 7-
IN
PERSONALITY
others 04-
2021
DISORDER

• Little or no desire to form close relationships with others

• Apparent indifference to either praise or criticism
• Indifference to social norms and expectations
• Little interest in having sexual experiences with another person

20
 CAUSES
• Little is known about the cause of schizoid personality disorder, but both
genetics and environment are suspected to play a role. Some mental health
professionals speculate that a bleak childhood where warmth and emotion
DEFENSE
MECHANISMS were absent contributes to the development of the disorder.
IN 7-04-2021
PERSONALITY
DISORDER

21
 ONSET
• Schizoid personality disorder usually begins in late adolescence or early
adulthood.

DEFENSE
MECHANISMS 7-
IN 04-
PERSONALITY 2021
DISORDER

22
 DEFENSE MECHANISMS USED
• Fantasy-A pathological reliance on fantasizing and preoccupation with
inner experience is often part of the schizoid withdrawal from the world.
Fantasy thus becomes a core component of the self in exile, though
DEFENSE
MECHANISMS fantasizing in schizoid individuals is far more complicated than a means of
IN 7-04-2021
PERSONALITY
DISORDER
facilitating withdrawal.
• Denial
• Withdrawal-Withdrawal can also be Seen in patients, where they remove
oneself either physically or emotionally from unwanted situation. The use
of withdrawal means the end of one's social life.

23
 TREATMENTS
• If you have schizoid personality disorder, you may prefer to go your own
way and avoid interacting with others, including doctors. You may be so
used to a life without emotional closeness that you're not sure you want to
DEFENSE
MECHANISMS
change or that you can. Options include: 7-
IN 04-

Talk Therapy (Psychotherapy)- Psychotherapy can be helpful. If you'd like

PERSONALITY 2021
DISORDER

to develop closer relationships, a modified form of cognitive behavioural

therapy may help you change the beliefs and behaviours that are problems.
Group Therapy- It also provide a support structure and improve your social
skills.

24
 CLUSTER
DEFENSE
MECHANISMS
IN
B
PERSONALITY
DISORDER PERSONALITY
DISORDERS

25
 CLUSTER B
Dissocial Personality
Disorder
SE MECHANISMS IN PERSONALITY
DISORDER
Emotionally Unstable 7-04-2021

Personality Disorder
Histrionic Personality
Disorder
Narcissistic
Personality Disorder

26
 ANTISOCIAL/DISSOCIAL PERSONALITY
DISORDER
• ICD coding: F60.2 Dissocial Personality Disorder
• Antisocial personality disorder (ASPD) describes individuals with a pervasive
pattern of disregard for, and violation of, the rights of others that begins in
DEFENSE
MECHANISMS
childhood or early adolescence and continues into adulthood. 7-
IN 04-
PERSONALITY
DISORDER
• The outstanding characteristic of people with antisocial personality disorder 2021

(ASPD) is their tendency to persistently disregard and violate the rights of others.
These people have a lifelong pattern of unsocialized and irresponsible behavior
with little regard for safety—either their own or that of others. These
characteristics bring them into repeated conflict with society, and a high
proportion end up becoming incarcerated.

27
 TRAITS
• lack of remorse or shame for harmful acts committed to others,
• poor judgment and failure to learn from experience,
DEFENSE • extreme egocentricity and incapacity for love,
MECHANISMS
IN 7-04-2021
PERSONALITY
DISORDER
• lack of emotional responsiveness to others,
• impulsivity,
• absence of “nervousness,”
• a combination of unreliability, untruthfulness, and insincerity.

28
 CAUSES OF DISSOCIAL/ANTISOCIAL
PERSONALITY DISORDERS
• The outstanding characteristic of people with antisocial personality
disorder (ASPD) is their tendency to persistently disregard and violate the
rights of others. They do this through a combination of deceitful,
DEFENSE
MECHANISMS aggressive, and antisocial behaviors. These people have a lifelong pattern 7-
IN 04-
PERSONALITY
DISORDER
of unsocialized and irresponsible behavior with little regard for safety— 2021

either their own or that of others. These characteristics bring them into
repeated conflict with society, and a high proportion end up becoming
incarcerated.

29
 ONSET
• Only individuals ages 18 or over can be diagnosed with ASPD. For the
diagnosis to be made, the person must have shown symptoms of conduct
disorder before age 15. After age 15, there must also be evidence of such
DEFENSE
MECHANISMS things as repeated unlawful behavior, deceitfulness, impulsivity,
IN 7-04-2021
PERSONALITY
DISORDER
aggressiveness, or consistent irresponsibility in work or financial matters.

30
 DEFENSE MECHANISMS USED
• Devaluation-It's used when a person attributes themselves, an object, or
another person as completely flawed, worthless, or as having exaggerated
negative qualities.
DEFENSE • Projection- An example of Projection is that of blaming others for his 7-
04-
MECHANISMS
situation.
2021
IN
PERSONALITY
DISORDER

31
 TREATMENT
• Antisocial personality disorder is difficult to treat, but for some people, treatment and
close follow-up over the long term may be beneficial. Look for medical and mental
health professionals with experience in treating antisocial personality disorder.
Treatment depends on each person's particular situation, their willingness to
DEFENSE
participate in treatment and the severity of symptoms.
MECHANISMS
IN 7-04-2021

• Psychotherapy
PERSONALITY
DISORDER

Psychotherapy, also called talk therapy, is sometimes used to treat antisocial

personality disorder. Therapy may include, for example, anger and violence
management, treatment for alcohol or substance misuse, and treatment for other mental
health conditions.
But psychotherapy is not always effective, especially if symptoms are severe and the
person can't admit that he or she contributes to serious problems.
32
• Medications
 EMOTIONALLY UNSTABLE/BORDERLINE
PERSONALITY DISORDER
• ICD coding: F60.3 Emotionally Unstable Personality Disorder
• Emotionally unstable personality disorder (EUPD) is the most common
DEFENSE
type of personality disorder. It is also known as borderline personality
MECHANISMS
IN
disorder. It usually causes you to experience intense and fluctuating 7-
04-

emotions, which can last for anywhere between a few hours and several
PERSONALITY 2021
DISORDER

days at a time. These emotions can range from extreme happiness,

euphoria and self-belief, to crushing feelings of sadness and worthlessness.
• The rapid and extreme changes in mood, as well as the negative feelings
EUPD creates in yourself and towards others, can make it difficult to
maintain stable personal relationships. EUPD can also cause you to have
suicidal thoughts or carry out self-harming behaviours. If you’re in this
situation, it’s crucial that you reach out for professional help, and open up 33

to a loved one, as soon as possible. Nobody will judge you and you will
 TRIATS
• Impulsivity
• Mood swings
• An overwhelming fear of abandonment
• Extreme anxiety and irritability
DEFENSE
Anger
M E C H A•N I S M S
IN 7-04-2021
PERSONALITY
•
DISORDER
Paranoia and being suspicious of other people
• Feeling empty, hopeless and worthless
• Suicidal thoughts
• Self-harm
• Having a pattern of unstable or shallow relationships
• Rapidly changing your opinions of other people
• Dissociation (feeling as though you have lost touch with reality)

34
 CAUSES
• Genetics-Genes you inherit from your parents may make you more vulnerable to developing EUPD. A study found that
if 1 identical twin had EUPD, there was a 2-in-3 chance that the other identical twin would also have BPD. However,
these results have to be treated with caution, and there's no evidence of a gene for EUPD.
• Problem with brain chemicals It's thought that many people with EUPD have something wrong with
the neurotransmitters in their brain, particularly serotonin. Neurotransmitters are "messenger chemicals" used by your
brain to transmit signals between brain cells. Altered levels of serotonin have been linked to depression, aggression
D E F E N and
S E difficulty controlling destructive urges.
MECHANISMS 7-
IN
• Problem with brain development Researchers have used MRI to study the brains of people with EUPD. MRI scans
PERSONALITY
04-
2021
use strong magnetic fields and radio waves to produce a detailed image of the inside of the body. The scans revealed
DISORDER

that in many people with EUPD, 3 parts of the brain were either smaller than expected or had unusual levels of activity.
These parts were:
the amygdala – which plays an important role in regulating emotions, especially the more "negative" emotions, such as
fear, aggression and anxiety
the hippocampus – which helps regulate behavior and self-control
the orbitofrontal cortex – which is involved in planning and decision making
Problems with these parts of the brain may well contribute to symptoms of EUPD.
35
 ONSET
• Usually begins by early adulthood. The condition seems to be worse in
young adulthood and may gradually get better with age.

DEFENSE
MECHANISMS
IN 7-04-2021
PERSONALITY
DISORDER

36
 DEFENSE MECHANISMS USED
• Idealization-a person with EUPD may shift from great admiration for a
loved one — idealization of that person — to an intense anger or dislike
towards that person — devaluation of that person.
DEFENSE
MECHANISMS
IN
• Splitting- Splitting can interfere with relationships and lead to intense and 7-
04-

self-destructive behaviors. A person who splits will typically frame people

PERSONALITY 2021
DISORDER

or events in terms that are absolute, with no middle ground for discussion.

37
 TREATMENT
• Dialectical behavior therapy (DBT) – this talking therapy helps you to address the
emotional challenges around EUPD. It focuses on the most crucial elements of BPD,
which are its tendency to make you emotionally vulnerable and the idea that you may
have had your emotions dismissed in the past. (DBT will teach you to accept your feelings as being
valid, while also allowing you to challenge them and substitute negative thought patterns for positive ones. Experiencing
the intense emotions of EUPD can be made more distressing if you’ve been taught that you’re wrong for having them.)
DEFENSE
7-04-2021

MECHANISMS
IN
• Mentalization-based therapy (MBT) – this is a psychotherapy we usually offer as part
PERSONALITY
DISORDER
of residential treatment, which helps you to identify and challenge your thoughts and
beliefs. It basically means to ‘think about thinking’. (The reason this is effective for treating EUPD
is because it can give you a greater understanding of why you may carry out impulsive behaviors (especially self-
harming), allowing you to think through what is driving these actions before you act on your impulses.)

38
 HISTRIONIC PERSONALITY DISORDER
• ICD coding F60.4
• Excessive attention-seeking behavior and emotionality are the key characteristics of
individuals with histrionic personality disorder. As you can see from the DSM-5 criteria box,
these individuals tend to feel unappreciated if they are not the center of attention; their lively,
D E F E N S E dramatic, and excessively extraverted styles often ensure that they can charm others into
MECHANISMS
IN attending to them. But these qualities do not lead to stable and satisfying relationships 7-
04-

D I S O R D E R because others tire of providing this level of attention. In craving stimulation and attention,
PERSONALITY 2021

their appearance and behavior are often quite theatrical and emotional as well as sexually
provocative (Freeman et al., 2005). They may attempt to control their partners through
seductive behavior and emotional manipulation, but they also show a good deal of
dependence.
• The prevalence of histrionic personality disorder in the general population is a little over 1
percent, although some believe rates of the disorder may be decreasing (Blashfield et al.,
2012; Torgersen, 2012). Some studies suggest that this disorder occurs more often in women
than in men (Lynam & Widiger, 2007; Widiger & Bornstein, 2001).
39
 TRAITS
1. Uncomfortable when not the center of attention
2. Seductive or provocative behavior
DEFENSE 3. Shifting and shallow emotions
MECHANISMS
IN 7-04-2021
PERSONALITY
DISORDER
4. Uses appearance to draw attention
5. Impressionistic and vague speech
6. Dramatic or exaggerated emotions
7. Suggestible (easily influenced by others)
8. Considers relationships more intimate than they are

40
 CAUSES
• While it is unknown what explicitly causes histrionic personality disorder,
it is likely a disorder that is multifactorial in its origin. Histrionic
personality disorder probably develops as a conglomeration of both
DEFENSE
MECHANISMS learned and inherited factors.[6] One hypothesis is that histrionic 7-
IN 04-
PERSONALITY
DISORDER
personality disorder may develop as a result of trauma experienced during 2021

childhood. Children may endure their trauma by coping with their

environment in ways that may ultimately lead to a personality disorder.
[2] Personality disorders in childhood may originate as an adaptation to
cope with a traumatic situation or traumatic environment.
• Very little systematic research has been conducted on histrionic personality
disorder, perhaps as a result of the difficulty researchers have had in
differentiating it from other personality disorders (Bornstein & Malka, 41

2009) and/or because many do not believe it is a valid diagnosis

 ONSET
• Histrionic personality disorder is usually diagnosed when a sufferer is in
their late teens or early twenties, when an individual's personality is
believed to have fully developed.
DEFENSE
MECHANISMS
IN 7-04-2021
PERSONALITY
DISORDER

42
 DEFENSE MECHANISMS USED
• Repression- Repression is the most basic defense mechanism. When
patients' thoughts produce anxiety or are unacceptable to them, they use
repression to bar the unacceptable thoughts or impulses from
DEFENSE
MECHANISMS consciousness. 7-
IN 04-

Dissociation-When patients with HPD use the defense mechanism of

PERSONALITY 2021
DISORDER•
dissociation, they may display two or more personalities. These two or
more personalities exist in one individual without integration. Patients
with less severe cases of HPD tend to employ displacement and
rationalization as defenses.

43
 TREATMENT
• In general, people with histrionic personality disorder do not believe they
need therapy. They also tend to exaggerate their feelings and to dislike
routine, which makes following a treatment plan difficult. However, they
might seek help if depression -- possibly associated with a loss or a failed
SE MECHANISMS IN PERSONALITY
7-04-2021
DISORDER
relationship -- or another problem caused by their actions causes them
distress.
• Psychotherapy (a type of counseling) is generally the treatment of choice
for histrionic personality disorder. The goal of treatment is to help the
individual uncover the motivations and fears associated with their thoughts
and behavior, and to help the person learn to relate to others in a more
positive way.
• Medication might sometimes be used as treatment for other conditions 44

that might also be present with this disorder, such

 NARCISSISTIC PERSONALITY DISORDER
• F60.81 Narcissistic Personality Disorder
• Narcissistic personality disorder (NPD) is one the group of cluster B
disorders that also includes antisocial, histrionic, and borderline. NPD
DEFENSE
MECHANISMS
IN
involves three elements: an inflated view of the self, a lack of warmth or 7-
04-

empathy in relationships, and the use of a variety of strategies for

PERSONALITY 2021
DISORDER

maintaining the inflated self-view.

• Individuals with narcissistic personality disorder show an exaggerated
sense of self-importance, a preoccupation with being admired, and a lack
of empathy for the feelings of others (Pincus & Lukowitsky, 2010;
Ronningstam, 2005, 2009, 2012). Numerous studies support the notion of
two subtypes of narcissism: grandiose and vulnerable narcissism
45
 TRAITS
• Grandiose sense of self-importance. ...
• Lives in a fantasy world that supports their delusions of grandeur. ...
• Needs constant praise and admiration. ...
SE MECHANISMS IN PERSONALITY
7-04-2021
DISORDER
• Sense of entitlement. ...
• Exploits others without guilt or shame. ...
• Frequently demeans, intimidates, bullies, or belittles others.

46
 CAUSES
• it's not known what causes narcissistic personality disorder. As with
personality development and with other mental health disorders, the cause
of narcissistic personality disorder is likely complex. Narcissistic
DEFENSE
MECHANISMS personality disorder may be linked to: 7-
IN 04-

Environment ― mismatches in parent-child relationships with either

PERSONALITY 2021
DISORDER •
excessive adoration or excessive criticism that is poorly attuned to the
child's experience
• Genetics ― inherited characteristics
• Neurobiology — the connection between the brain and behavior and
thinking

47
 ONSET
• Narcissistic personality disorder affects more males than females, and
it often begins in the teens or early adulthood. Keep in mind that,
although some children may show traits of narcissism, this may simply be
typical of their age and doesn't mean they'll go on to develop narcissistic
SE MECHANISMS IN PERSONALITY
7-04-2021
DISORDER
personality disorder.

48
 DEFENSE MECHANISMS USED

• Fantasy-Since reality doesn't support their grandiose view of themselves,

narcissists live in a fantasy world propped up by distortion, self-deception,
DEFENSE
MECHANISMS
IN
and magical thinking. They spin self-glorifying fantasies of unlimited 7-
04-

success, power, brilliance, attractiveness, and ideal love that make them
PERSONALITY 2021
DISORDER

feel special and in control.

• Dissociation-Narcissists dissociate (erase memories) a lot (are amnesiac)
because their contact with the world and with others is via a fictitious
construct: The False Self. Narcissists never experience reality directly but
through a distorting lens darkly

49
 TREATMENT
Treatment for narcissistic personality disorder is talk therapy (psychotherapy). Medications may be included in
your treatment if you have other mental health conditions.
• Psychotherapy
Narcissistic personality disorder treatment is centered around talk therapy, also called psychotherapy.
Psychotherapy can help you: Learn to relate better with others so your relationships are more intimate,
SE MECHANISMS IN P enjoyable
E R S O N A L I Tand
Y rewarding. Understand the causes of your emotions and what drives you to compete, to distrust 7-04-2021
DISORDER
others, and perhaps to despise yourself and others. Areas of change are directed at helping you accept
responsibility and learning to: Accept and maintain real personal relationships and collaboration with co-
workers. Recognize and accept your actual competence and potential so you can tolerate criticisms or failures

50
 DEFENSE
MECHANISMS
CLUSTER C
PERSONALITY
IN
PERSONALITY
DISORDER

DISORDER

51
 CLUSTER C
Anankastic
DEFENSE
Personality
MECHANISMS
IN
PERSONALITY
Disorder 7-
04-
2021
DISORDER

Avoidant ( Anxious
) Personality
Disorder
Dependent
Personality
Disorder
52
 ANANKASTIC PERSONALITY DISORDER
• ICD coding: F60.5 Anankastic Personality Disorder
• Obsessive compulsive personality disorder is a personality disorder that's characterized by Extreme
perfectionism, order and neatness. People with obsessive compulsive personality disorder will also feel a
need to impose their own standards on their outside environment.
• Obsessions are persistent and recurrent intrusive thoughts, images, or impulses that are experienced as
disturbing, inappropriate, and uncontrollable.
SE MECHANISMS IN PERSONALITY
7-04-2021
DISORDER
• People who have such obsessions actively try to resist or suppress them or to neutralize them with some other
thought or action. Compulsions involve overt repetitive behaviors that are performed as lengthy rituals (such
as hand washing, checking, putting things in order over and over again). Compulsions may also involve more
covert mental rituals (such as counting, praying, or saying certain words silently over and over again).
• A person with OCD usually feels driven to perform this compulsive, ritualistic behavior in response to an
obsession, and there are often very rigid rules regarding exactly how the compulsive behavior should be
performed. The compulsive behaviors are performed with the goal of preventing or reducing distress or
preventing some dreaded event or situation. OCD is often one of the most disabling mental disorders in that it
leads to a lower quality of life and a great deal of functional impairment.

53
 TRAITS
• They find it hard to express their feelings.
• They have difficulty forming in maintaining close relationships with
others.
DEFENSE
•
MECHANISMS They are hard working, but their obsession with perfection can make 7-
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them inefficient. 2021

• They often feel righteous, indignant and angry.

• They often face social isolation.
• Experience anxiety that occurs with depression.

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 CAUSE
• The exact cause of OCPD is unknown. Like many aspects of OCPD, the
causes have yet to be determined. OCPD may be caused by a combination of
genetics and childhood experiences.
• In some case studies, adults can recall experiencing OCPD from a very early
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age. They may have felt that they needed to be a perfect or perfectly
obedient child. This need to follow the rules then carries over into
adulthood.

55
 ONSET
• OCD often begins in childhood while OCPD usually starts in the teen
years or early 20s. People with either OCPD or OCD are high achievers
and feel a sense of urgency about their actions.
DEFENSE
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DISORDER

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 DEFENSE MECHANISMS USED
• Repression
• Isolation
• Intellectualisation
DISORDER • Withdrawal
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 TREATMENT
• Cognitive Behavioural Therapy
Cognitive Behavioural Therapy (CBT) is a common type of mental health counselling. During CBT, you
meet with a mental health professional on a structured schedule. These regular sessions involve working
with your counsellor to talk through any anxiety, stress, or depression. A mental health counsellor may
encourage you to put less emphasis on work and more emphasis on recreation, family, and other
interpersonal relationships.
DEFENSE
•
IN
Medication
MECHANISMS 7-
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Your doctor may consider prescribing a selective serotonin reuptake inhibitor (SSRI) to decrease some
DISORDER

anxiety surrounding the obsessive-compulsive cycle. If you’re prescribed an SSRI, you may also benefit from
support groups and regular treatment from a psychiatrist. Long-term prescription use isn’t usually
recommended for OCPD.
• Relaxation training
Relaxation training involves specific breathing and relaxation techniques that can help decrease your sense of
stress and urgency. These symptoms are common in OCPD. Examples of recommended relaxation practices
include yoga, tai chi, and Pilates.

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 ANXIOUS (AVOIDANT) PERSONALITY
DISORDER
• ICD coding: F60.6 Anxious (avoidant) Personality Disorder
• People with avoidant personality disorder avoid social situations due to fear of rejection and
being judged by others. However, because most people with this condition want to develop
relations, they may be more likely to respond to the work of psychotherapy.
• Individuals with avoidant personality disorder show extreme social inhibition and introversion,
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leading to lifelong patterns of limited social relationships and reluctance to enter into social
interactions. Because of their hypersensitivity to, and fear of, criticism and disapproval, they do
not seek out other people, yet they desire affection and are often lonely and bored.
• Unlike schizoid personalities, people with avoidant personality disorder do not enjoy their
aloneness. Avoidant individuals want contact with other people. However, their inability to relate
comfortably to other people causes them acute anxiety. They are painfully self-conscious in
social settings and highly critical of themselves. Not surprisingly, avoidant personality disorder
is often associated with depression.

59
 TRAITS
• Avoidant personality disorder symptoms include a variety of behaviors,
such as:
• Avoiding work, social, or school activities for fear of criticism or rejection.
DEFENSE
MECHANISMS
IN
It may feel as if you are frequently unwelcome in social situations, even 7-
04-

when that is not the case. This is because people with avoidant personality
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DISORDER

disorder have a low threshold for criticism and often imagine themselves
to be inferior to others.
• Low self-esteem
• Self-isolation

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 CAUSE
• The exact cause of avoidant personality disorder is not known. However, it
is believed that both genetics and environment play a role. It is believed that
avoidant personality disorder may be passed down in families through genes
but this has not yet been proven. Environmental factors, particularly in
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childhood, do play an important role. Shyness, often normal in young
children, lasts into adolescents and adulthood in those with avoidant
personality disorder. Those with the disorder often report past experiences of
parental or peer rejection, which can impact a person’s self-esteem and sense
of worth.

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 ONSET
• Avoidant personality disorder is not usually diagnosed in
individuals younger than 18 years; however, most patients
DEFENSE
report an onset in childhood or adolescence, and many report
MECHANISMS
IN
PERSONALITY
continued social anxiety throughout their lives. 7-
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 DEFENSE MECHANISMS USED
• Withdrawal
• Denial

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63
 TREATMENT
• Talk Therapy
Talk therapy for avoidant personality disorder may include cognitive behavioural
therapy(CBT), psychodynamic therapy, and schema therapy. Group therapy and social
skills training may also be helpful.
DEFENSE
MECHANISMS 7-
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CBT is helpful for learning how to change unhelpful thinking patterns, while
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DISORDER
2021

psychodynamic therapy is aimed at being aware of how past experiences, pain, and
conflict may be contributing to current symptoms.
• Schema Therapy
Schema therapy for avoidant personality disorder is an integrative approach that builds
on CBT as well as many other therapeutic techniques. It has a focus on the therapeutic
relationship between therapist and client, and a goal of improving daily functioning
and gaining insight for change based on understanding and re-engineering of early life 64

experiences.
 • Medication
While there are currently no medications specifically approved for treating avoidant personality disorder, if a
person has other related disorders such as depression or anxiety, medication may be prescribed to help with those
symptoms.
For example, antidepressant medication can be helpful for improving mood and anhedonia, decreasing anxiety
symptoms, and may also reduce sensitivity to rejection.
Treating personality disorders is difficult, because people with these disorders have deep-rooted patterns of
thinking and behaviour that have existed for many years. However, people with avoidant personality disorder tend
SE M E C H A N I S M S I to
N Pbe
E R good
S O N A Lcandidates
ITY for treatment because their disorder causes them significant distress, and most want to
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DISORDER
develop relationships. This desire can be a motivating factor for people with avoidant personality disorder to
follow their treatment plans.
Medication—such as an antidepressant or anti-anxiety drug—might be used to help manage the anxiety felt by
people with this disorder. For the best results, however, medication therapy should be done in combination with
psychotherapy. Treatment for people with this disorder is most effective when family members are involved and
supportive

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 DEPENDENT PERSONALITY DISORDER
• ICD coding: F60.7 Dependent Personality Disorder
• Dependent personality disorder (DPD) is a type of anxious personality disorder.
People with DPD often feel helpless, submissive or incapable of taking care of
DEFENSE themselves. They may have trouble making simple decisions. But, with help,
MECHANISMS 7-
IN someone with a dependent personality can learn self-confidence and self-reliance. 04-
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DISORDER
• Individuals with dependent personality disorder show an extreme need to be taken
care of, which leads to clinging and submissive behavior. They also show acute fear
at the possibility of separation or sometimes of simply having to be alone because
they see themselves as inept (Bornstein et al., 2015; Widiger & Bornstein, 2001).
Such individuals usually build their lives around other people and subordinate their
own needs and views to keep these people involved with them.

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 TRAITS
• Difficulty being alone.
• Fear of abandonment and a sense of helplessness when relationships end.
• Oversensitivity to criticism.
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• Pessimism and lack of self-confidence.
• Trouble making everyday decisions.
• Avoidance of personal responsibility.

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 CAUSE
• Although the exact cause of DPD is not known, it most likely involves a
combination of biological, developmental, temperamental, and
psychological factors. Mostly found in people with abusive relationships,
DEFENSE
MECHANISMS childhood trauma, family history, some cultural and religious or family 7-
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behaviour. 2021

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 ONSET
• Dependent personality disorder usually starts during childhood.

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 DEFENSE MECHANISMS USED
• Introjection
• Identification
• Repression
DEFENSE
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 TREATMENT
• Cognitive Behavioral Therapy

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71
 REFERENCES
www.verywellmind.com, Abnormal Psychology by James N. Butcher
www.verywellmind.com, Abnormal Psychology by James N. Butcher, www.
psychiatry.org, DSM- V, ICD- 10, www.healthline.com,
DEFENSE
MECHANISMS myclevelandclinic.org 7-
IN 04-

https://my.clevelandclinic.org/health/diseases/9657-antisocial-personality-
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disorder
https://www.priorygroup.com/mental-health/personality-disorder-
treatment/emotionally-unstable-personality-disorder-eupd
https://www.medicalnewstoday.com/articles/320508#outlook
https://www.nhs.uk/mental-health/conditions/borderline-personality-
disorder/causes/ 72

https://www.ncbi.nlm.nih.gov/books/NBK542325/