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Personality Disorder Service- Myth Busting

There are a number of myths relating to personality disorder than can contribute to the stigma surrounding the diagnosis. Some of them are discussed below.

Myth 1: Personality disorder is untreatable

For a long time, personality disorder was viewed as untreatable. Silk (2008) has suggested that this is still an attitude prevalent amongst therapists despite evidence to the contrary.

Facts: Psychological treatments have been shown to be effective for personality disorder. These include Dialectical Behaviour Therapy and Mentalisation Based Therapy. NICE have also published guidelines for the care of individuals with Borderline Personality Disorder and Antisocial Personality Disorder.

The strongest effects on behaviour are on the recurrence of self-harm, which is often reduced significantly.

Drug treatments including low doses of antipsychotic drugs, both typical and atypical neuroleptics, and antidepressants, particularly the SSRI's such as fluoxetine and paroxetine are also sometimes used with such individuals for other symptoms they may have.

Myth 2: A diagnosis of personality disorder stays with you for life

Facts: Personality disorder is an extreme deviation from the way the average person, within a cultural context, perceives, feels and relates to others. They are long-established, inflexible patterns, enduring since adolescence and are independent of social context. However, once new adaptive and functional behaviours are learnt, the personality disorder label may no longer apply.

Myth 3: Individuals with a diagnosis of personality disorder are manipulative

Research has suggested that a commonly held attitude is that individuals with Personality Disorder are "manipulative" or "attention seeking". The simple addition of the diagnostic label within a clinical vignette led psychiatrists to view the patient as more manipulative, difficult to manage, unlikely to evoke sympathy, and more attention seeking than a patient with the same behavioural description without the diagnosis (Lewis & Appleby, 1988). Staff nurses also felt that clients with a PD diagnosis were more in control of their behaviour than clients with a diagnosis of depression, or schizophrenia, and this was associated with less sympathy, and less optimism among nursing staff (Markham & Trower, 2003).

Facts: It is now accepted that unsympathetic treatment can make things worse

Myth 4: Individuals with a diagnosis of personality disorder all behave in the same way

Facts: Rarely do real people match "pure types" and overlap of PD types is not uncommon.Two people with same diagnosis can be very different. 2 BPD clients may meet 5 out of 9 criteria with potentially only 1 symptom that overlaps. 

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