Personality Disorders

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Personality Disorders Treatment and Support

Personality disorders (PDs) are lifelong patterns of thinking and behavior that significantly differ from cultural norms and cause distress or impairment. In PD, your usual way of relating to others and handling emotions becomes rigid and maladaptive. For example, borderline personality disorder may cause intense fear of abandonment, mood swings, unstable self-image and impulsive self-harm behaviors. Other PDs include paranoid (mistrustful and suspicious), narcissistic (grandiose and entitled), antisocial (disregard for others’ rights), avoidant (social inhibition and sensitivity), and others. Although people with PD usually believe their behavior is “just who they are,” these patterns often lead to troubled relationships, job instability, and emotional pain.

According to Mayo Clinic, a personality disorder means “people have a lifelong pattern of seeing themselves and reacting to others in ways that cause problems”, often finding it hard to understand emotions and tolerating distress. PDs typically begin in adolescence or early adulthood. For instance, someone with PD might only seek help after experiencing repeated job losses or relationship breakdowns. In Pakistan’s family-centered culture, behaviors like emotional intensity or mistrust can cause significant family strain. Treatment is possible, but patients often delay help until problems escalate.

Symptoms of Personality Disorders

Symptoms vary by PD type but commonly include:

Rigid Thoughts and Beliefs: A person with PD often holds fixed ideas about themselves and others. For example, one might permanently believe “I am unlovable,” or see others as always out to get them.
Emotional Instability or Numbing: Emotions can be extreme (e.g., intense anger, fear, loneliness) or blunted. Someone might react to a minor criticism with rage, or might rarely show emotions at all.
Behavioral Patterns: Repetitive behaviors like self-sabotage in relationships, self-harm (cutting or suicidal threats), compulsive perfectionism, extreme jealousy, or reckless behavior (substance abuse, gambling) are common.
Interpersonal Difficulties: Trust issues, fear of abandonment or intimacy, need for constant reassurance, or needing others to fill one’s emotional void are seen in many PDs. For example, borderline PD often involves rapid shifts from idealizing someone to suddenly feeling they are betraying you.

Psychotherapy: Talk therapy is the mainstay. Different therapies fit different PDs. For example: Dialectical Behavior Therapy (DBT): Especially effective for borderline PD. DBT teaches skills in emotion regulation, distress tolerance, interpersonal effectiveness and mindfulness. Studies show DBT can reduce self-harm, anger outbursts, substance misuse and depressive symptoms in BPD patients.
PsychotherapyCognitive Behavioral Therapy (CBT): Helps identify and modify rigid thought patterns common in PD. For example, a CBT therapist might challenge an avoidant patient’s belief “I will embarrass myself” by gradual exposure to social situations.
Schema Therapy: Integrates CBT with other techniques to address deeply rooted themes (schemas) in PD.
Family Therapy: Involves relatives to improve communication and understanding. This is useful in Pakistan where family dynamics are key.

Improved Emotional Regulation: You can learn to manage intense emotions and reduce impulsive actions. For example, DBT helps replace self-harm with safer coping techniques, dramatically reducing crisis episodes.
Better Relationships: Therapy focuses on communication skills and understanding others’ perspectives. Over time, you may build healthier connections and lessen conflicts at home or work.
Increased Self-awareness: Many patients learn to recognize their negative thought patterns and gradually “re-wire” them. Understanding why you act a certain way is a powerful step toward change.
Enhanced Functioning: As symptoms ease, you can hold a job more steadily and feel more confident in social and work settings.

About US

Dr. Naeem Aftab’s Approach

Dr. Aftab brings warmth and patience to therapy, crucial for PD treatment. Key aspects of his care include:

Collaborative Goal Setting: He works with you to set manageable goals (e.g., reducing anger outbursts, improving family communication) and tracks progress.
Skill-Building: He may teach practical skills (like coping exercises for anxiety or role-play social scenarios) during sessions. He might also provide worksheets or “homework” between sessions to reinforce learning.
Long-Term Support: Personality change takes time. Dr. Aftab schedules regular follow-ups (often weekly or bi-weekly) for months or years. If needed, he continues care for as long as it is beneficial.
Holistic Care: He looks for any co-occurring issues (like depression, substance use, or trauma) that often accompany PDs, addressing them as part of the treatment plan.

FAQs

Frequently Asked Questions

Can personality disorders be changed?

While personality disorders are enduring patterns, therapy can lead to significant changes. Many people with PD learn to manage their symptoms and develop healthier behaviors over time. Think of it as “unlearning” old habits and replacing them with new ones. It often takes months to years of therapy, but progress is possible.

What is Dialectical Behavior Therapy (DBT)?

DBT is a specific therapy for intense emotional problems, especially borderline PD. It teaches skills in 4 areas: mindfulness, distress tolerance, emotion regulation, and interpersonal effectiveness. For example, if you tend to get extremely angry, DBT teaches you ways to calm down without hurting yourself or others. Studies show DBT reduces self-harm and improves mood in borderline PD.

Do I need medication?

There is no medication for PD itself, but if you have co-occurring depression, anxiety or severe mood swings, medication may help. Dr. Aftab will discuss the risks and benefits; many patients find that therapy is the mainstay, while meds are used as needed for specific symptoms.

Is online therapy possible for personality disorders?

Yes, regular talk therapy can often be done via secure video. For skills training (like DBT group sessions), some aspects may be online as well. However, initial evaluations or crisis support might be better in person. Dr. Aftab offers both options and will determine together what works best for you.

How long does treatment take?

Personality disorders are long-standing, so therapy is typically long-term. You might see benefits in a few months, but real change often takes a year or more. Be patient and keep at it. Dr. Aftab provides encouragement throughout the journey.

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Appointment & Contact

Scheduling an appointment with Dr. Naeem Aftab is easy and confidential. Use the contact information below or our online portal (calendar integration coming soon) to secure a session.