Getting started with therapy for personality disorders

Everyone has their own personality, meaning their own way of thinking, feeling, and behaving. It’s this unique combination of characteristics that defines a person and helps explain their behavior. While you may develop some new personality traits over time, the essence of your personality will mostly remain the same.

But for people with personality disorders, their thoughts and behaviors are often inflexible — which can cause problems with relationships, work, and social functioning. For example, people with obsessive-compulsive personality disorder (OCPD) are often extremely stubborn and tend to prioritize work over important relationships. And borderline personality disorder (BPD) involves a deep fear of abandonment and trouble regulating emotions, such as anger. 

It’s not always easy to admit that you’re showing signs of a personality disorder, but meeting with a mental health professional is an opportunity to manage symptoms, address harmful thought and behavior patterns, and improve your quality of life. 

Do you need therapy for a personality disorder?

Personality disorders influence the way a person thinks about themself and the world around them. National data suggest that approximately 9% of U.S. adults have a personality disorder. Most people will first experience symptoms as a teen or young adult, but it’s possible to notice signs as early as childhood. 

There are 10 different personality disorders, and many people with a personality disorder will meet the criteria for more than one. Some of the most common personality disorder symptoms include: 

• Anxiety and worry
• Feelings of hopelessness and worthlessness
• Anger issues
• Feeling disconnected from others
• An inability to feel or name emotions
• Odd or unpredictable behavior
• Trouble maintaining close relationships with others
• Difficulty understanding other people’s feelings and intentions

Generally speaking, it’s a good idea to consider therapy if you are:

• Experiencing persistent feelings of sadness, anger, confusion, or emptiness
• Experiencing fear, paranoia, or antisocial tendencies
• Struggling to control your behavior 
• Having relationship issues 
• Having problems at work or school
• Dealing with low self-esteem or identity issues 

Four types of therapy to consider for personality disorders

There’s no guaranteed way to prevent a personality disorder, but it’s possible to manage symptoms with the right treatment and support. Talk therapy is an effective treatment option for long-term management of personality disorders. 

Different personality disorders require different types of care, but some of the most common treatment options include: 

1. Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) is a type of talk therapy that focuses on the connection between your thoughts, feelings, and behaviors. It’s considered an effective treatment for personality disorders because it can help people reframe unhelpful thoughts and behaviors.

For example, CBT can teach a person with avoidant personality disorder (AVPD) to challenge negative beliefs — like feelings of inferiority — while learning healthier coping methods and reducing distressing symptoms. 

2. Dialectical behavior therapy

Dialectical behavior therapy (DBT) was originally developed to treat borderline personality disorder but is now used for other personality disorders and mental health conditions as well. 

DBT helps people focus on mindfulness, distress tolerance, emotional regulation, and building more balanced relationships. The goal is to show people how to accept difficult feelings while learning to make positive changes in their lives. DBT can also help you manage any co-occurring depression, anxiety, or suicidal ideation*. 

*The 988 Suicide and Crisis Lifeline offers 24/7 confidential support through trained crisis counselors. If you or someone you care about is experiencing emotional distress, self-harm, or a suicidal crisis, please call or text 988. For life-threatening emergencies or immediate assistance, call 911.

3. Schema therapy

Although less studied, schema therapy is also considered an effective treatment for personality disorders. Schemas are deeply ingrained patterns of thinking that develop over time and influence the way people view themselves and others. 

With schema therapy, people can learn to replace harmful schemas with healthier ways of thinking, feeling, and behaving. It can be especially helpful for conditions that cause emotional struggles, like narcissistic personality disorder (NPD) and dependent personality disorder (DPD).

4. Transference-focused psychotherapy

Transference is when a person projects their feelings or expectations about someone onto their therapist. And while that may sound odd, it’s considered an effective form of treatment for conditions like borderline personality disorder and narcissistic personality disorder. 

With transference-focused psychotherapy (TFP), you can learn more about your emotional responses and how to focus on the present moment.

How to get started on your therapy journey

It’s not always easy for someone with a personality disorder to recognize that they need professional support. That said, starting therapy as soon as possible is the best way to minimize the condition’s impact on your life. Unmanaged personality disorders are associated with higher rates of divorce, unemployment, substance use, and homelessness. 

If you decide to start therapy, one of the first steps is to find the right provider to help you meet your goals. It’s important to choose a provider with experience treating personality disorders and availability that fits your schedule. More than that, you want someone who you trust and feel comfortable confiding in during sessions. For some people, this might mean finding a therapist of a certain race, sexual orientation, gender expression, or cultural background.

Once you begin therapy, there are a few tips to help you make the most of your sessions. 

• Set therapy goals. People start therapy for different reasons. For example, maybe your goal is to manage distressing symptoms or understand harmful behaviors. If you haven’t set a specific treatment goal, your therapist can help you reflect on why you started therapy and what you’d like to achieve. 
• Commit to the process. People with personality disorders can be quick to drop out of therapy or clam up when the conversation gets tough, but committing to the process is necessary for true change. People with AVPD, DPD, and OCPD may benefit from short-term therapy (less than a year), but most personality disorders are likely to require longer treatment.
• Be open and honest. The foundation of any successful client-therapist relationship is honesty and a willingness to learn and grow. This may be especially difficult for people with schizoid and schizotypal personality disorders, as these conditions can significantly impair your ability to connect with others. 
• Assess progress with your therapist. People with personality disorders may not see a problem with their behavior, but therapy is most effective when it’s a collaborative process between you and your therapist. To see the best results, it’s important to acknowledge unhealthy habits, regularly assess your progress, and be honest about any challenges or setbacks. 

Find care with Rula

If you or someone in your life is showing signs of a personality disorder, know that help is available. Starting therapy can empower people with personality disorders to learn how to effectively manage harmful thoughts and behaviors. 

Rula’s therapist-matching program makes it easier to find a mental health professional, like a therapist or psychiatric provider, who’s the right fit for your specific needs. With Rula, you can have access to personalized, collaborative care as soon as tomorrow.

Get started with Rula today