Psychotherapy, ACT, CBT, DBT…what does it all mean and what are personality disorders?
The DSM-V defines Personality Disorders (PD) as the set of psychological traits and mechanisms within a person that influence his or her interactions and adaptations to the environment (including intrapsychic, physical and social environments). PDs are defined by an enduring pattern of inner experience and behavior that deviates from the expectations of the individual’s culture. These patterns manifested in two or more of the following areas: cognition (i.e: ways of perceiving and interpreting self, other people and events), affectivity (i.e the range, intensity, lability, and appropriateness of emotional response), interpersonal functioning and/or impulse control
The patterns of symptoms that make up Personality Disorders are pervasive across a broad range of personal and social situations that impair or causes distress to an individual at social, occupational or other areas of functioning. Like any diagnosable mental disorder, the symptoms have to affect an individual to the point where it impairs their daily affairs, and clinicians will look at the disorder in context to the individual’s life. The patterns found in PD symptoms are consistent and long term, usually beginning at adolescence or early adulthood.
The DSM-V defines PDs into three clusters. Cluster A personality disorders are characterized by odd, eccentric thinking or behavior. They include paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder. Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder. Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.
There are various types of therapy that are utilized in treating various personality disorders. Therapy is a general term for the application of techniques used to improve a person’s mental or physical well-being. Various types of therapy, along with medication, can be used on an individualized basis depending on what works to treat the symptoms of the disorder as well as what best helps the individual.
Let’s say you need to cross the street. Somehow it has become inexplicably flooded and your passage to the other side is blocked. Instead of standing there pondering about how the street became flooded and where all that water came from in the first place, you could just skip that step and instead work out a solution to get you to the other side. Cognitive-behavioral theorists prefer to immediately focus on a solution that works on getting an individual “to the other side” rather than focusing on the origins of the behavior that needs to be changed, repaired, or corrected. Dialectical behavior therapy (DBT) was developed to treat those with suicidal thoughts and actions. This type of therapy validates current thought patterns while coaching the patient to change unhealthy behaviors. It uses mindfulness which helps individuals work to accept their difficulties while at the same time taking steps to address the problems. DBT typically involves two therapy sessions each week; an individual psychotherapy session and a weekly group session where four specific skills are taught: interpersonal effectiveness, distress tolerance/reality acceptance skills, emotion regulation, and mindfulness.
Acceptance and commitment therapy (ACT) was developed as a mindfulness approach, this type of therapy works to accept thoughts and emotions, without judgement, distance who you are from what you think, such as changing, “I am an anxious person,” to “I am feeling anxious because of my current situation.” You are also expected to make a commitment to change unhealthy behaviors. While similar to DBT, the exercises and techniques used during therapy sessions are different.
Psychotherapy, also known as talk-therapy, is not just “talking about your problems”; it is working toward solutions, some therapy may involve homework, such as tracking your moods, writing about your thoughts, or participating in social activities that have caused anxiety in the past. You might be encouraged to look at things in a different way or learn new ways to react to events or people.
In understanding exactly what constitutes a personality disorder, and understanding treatment options for not only personality disorders we open doors for understanding mental illness. By making strides to learn about various mental health concerns, and the means for treatment we are broadening our understanding, and broadening our impact in discussions on mental health and stigma.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
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Guide, Health, and Eileen Bailey. “Different Types of Therapies: CBT, DBT, ACT – Talk Therapy – Anxiety | HealthCentral.” HealthCentral.com – Trusted, Reliable and Up To Date Health Information. Healthcentral, 23 Mar. 2017. Web.
“Psychotherapy: How it Works and How it Can Help.” Depression and Bipolar Support Alliance. N.p., n.d. Web.