“Our Difficult Personalities”

“Our Difficult Personalities” represents a combination of our medical notes with the syllabus entitled “Understanding Character Flaws: Navigating Challenging Relationships with People at Home and at Work and authored by Joseph Shannon, PhD. Dr. Shannon. He is a practicing psychologist in Ohio who has special interest and knowledge in this area of psychology. He has graciously permitted the use of his well referenced work for our article. We truly thank him and appreciate his willingness, candor, and comradery.

It turns out that one in five of us (20%) has a personality so difficult to deal with that it is considered toxic. They usually appear normal (even super-normal) and are intelligent, well-educated, articulate, and attractive. Often, they possess exceptional talents and abilities, which enable them to hold many responsible and important positions. They can initiate and maintain intimate relationships, but usually sabotage them, and consistently behave in an irresponsible manner.

To better understand them, it is interesting to know that our personalities are made up of only three fundamental parts. These continuously interact with each other and define our unique individuality.

1. Thinking (thoughts) learning, which together are termed cognition.
2. Emotion(feelings)
3. Behavior (as the final common expression of our personality)

All three parts of our personality are composed of smaller packets termed personality traits. These are particular and defined patterns of personality, which combine in an almost limitless fashion to form an individual. Their uniqueness to the individual and their stability over time explain the recurrent patterns of behavior in all of us.

An impressive 638 personality traits have been identified by MIT (Massachusetts Institute of Technology) and divided into three groups. All are terms we use every day and are informative to review. Of the total:

1. Positive traits are possessed by 37% of us.
2. Negative traits are possessed by 46% of us.
3. Neutral traits are possessed by 18% of us.

Since we all normally possess a combination of personality traits, the issue then becomes which ones are present, the extent to which they manifest, the degree they differ from each other, and the inability to predict their presence within an individual.

When personality traits deviate markedly in an exaggerated, pervasive, and inflexible manner, and create significant stress and difficulty adapting for the individual two conditions may be present and diagnosable:

1. Character flaws
2. Personality disorders (the more severe of the two)

For the sake of completeness, three other psychiatric disorders may exhibit “toxic” behaviors but are not classified as personality disorders.

1. Depression (Unipolar, Bipolar, [types I &II])
2. Anxiety
3. PTSD (Post-Traumatic Stress Disorder)

All five groups of these individuals have a higher risk of coexisting (comorbid) major psychiatric (mental) disorders. They are often regarded as difficult people. In medical practice, they are often seen as unnecessarily and exceedingly demanding, as well as unwilling to follow treatment plans.

Ten personality disorders have been described.  Presented here in decreasing order are the seven toxic (noxious) types and their percent prevalence (present at any one time in the general population):

1. Narcissistic Personality Disorder (6-8%)
2. Borderline Personality Disorder (4-6%)
3. Antisocial (Sociopathic) Personality Disorder (4%)
4. Obsessive Compulsive Personality Disorder (2%)
5. Histrionic Personality Disorder (2%)
6. Paranoid Personality Disorder (1-2%)
7. Schizotypal Personality Disorder (1-2%)

Individuals with some disorders of personality are often unaware of their affliction and usually blame others for their problems they themselves create (project). When confronted with their toxic behaviors they often react defensively, only to retaliate later aggressively or passive aggressively.  Many have little or no empathy (feelings for others) for the ill feelings they cause to others.

All of these disorders may have their onset from puberty through early adulthood. They are underdiagnosed and therefore also go undertreated. This is unfortunate because treatment exists and is beneficial, especially if begun early.  Otherwise these individuals will suffer from lifelong, profound emotional dysfunction and destructive behaviors.

These individuals have atypical chemistry in certain areas of their brains, but their condition is not caused by another illness (medical, neurological, or hormonal).  Many causes have been postulated, including genetics, trauma, (emotional, physical, and sexual), poor parenting, gender, generation, culture, social class, religion, and political climate.  Often, like many things in medicine, a combination of two or more is present.

Additionally, these individuals are classified as potentially dangerousif they possess more than one of the following: (Yudofsky, 2005)

1. Are unaware of their problem
2. Have no desire to change
3. Behave in a manner that could result in future harm to you or themselves
4. Violate the law, possibly with your involvement
5. Their problem is not treatable or correctable

Narcissistic Personality Disorder shows the same common characteristics as the other personality disorders and, additionally, a grouping (cluster) of particular personality traits to the extreme, which further defines the disorder. Of the people with this disorder, males outnumber females by an average ratio of 4:1.  Individuals diagnosed often have a poor prognosis if they enter psychotherapy after the age of 40.

Simply stated, these individuals are all about themselves (I) and tend to make the same mistakes repeatedly since they lack true insight. Their greatest fear is to be embarrassed, shamed, or exposed as a failure or a fraud. They:

• Are extremely self-centered, self-absorbed, self-confined, and selfish considering themselves more interesting and special than anyone or anything and should only have to relate to others like themselves.
• Have a sense of grandiosity and an overwhelming sense of entitlement.
• Must be admired and envied and exaggerate their accomplishments, educational background, and other achievements in order to create and maintain an impressive public image.
• Must always have their way and more than everyone else.
• Believe no one or anything should get in their way in their pursuit of status or pleasure, and they often “do not play by the rules” because they are so special.
• Are prone to addictive disorders such as alcohol, drugs, sexual addiction, and over-work.

Additionally, a new subgroup of Malignant Narcissism has been identified.  These individuals suffer from:

• Paranoia
• Prominent antisocial or sociopathic traits
• Sadistic tendencies, such as deriving intense pleasure from afflicting pain on others

No known treatment (or therapy) is currently available for this form of narcissism.

Interacting with character-flawed and personality-disordered individuals is difficult and frustrating.  It is most important to always remember that the problems with the relationship originate with them and are not your fault.  Your highly conflicted feelings and reluctance to separate from them are varied, but this is in part due to their positive qualities and successes.

If desirable and possible, detach completely from the toxic individual and learn something beneficial about yourself and people with these disorders.  If separating completely is not possible, you must adapt your behavior, communication style, and expectations of them.  However, always remember that your hopes and efforts are not likely to change them.  Rather, your efforts should focus on:

• Setting boundaries and carrying out consequences when necessary.
• Resisting the desire to rescue them as well as getting involved with their psychodramas and seductive schemes. For instance, narcissists will place you on a pedestal and keep you there so long as you always affirm their greatness and never challenge their toxic beliefs.
• Always trying to treat these individuals with respect, kindness, and compassion.
• Speaking to them with empathy and prepare to avoid anger and conflict. Explain the purpose of the conversation and its benefits to them.  Get to the point quickly with facts and specifics and explain the negative effect it has on you and the relationship.  Listen closely, acknowledge their feelings and your own and ask for their opinion.  State where you have shared interests or goals, define options and a plan of action, accept their pros and cons, and attempt to implement it.  Express your positive feelings of thanks, admiration, and appreciation.

These are difficult tasks, but professionals are out there who can help.  Remember, it is all about developing a strong self-esteem.  You deserve to surround yourself and your family with other emotionally healthy, safe, respectful, and supportive people.

Interacting with others, even under the best of circumstances, will always have its difficulties and challenges. All of us have our good and bad days, however, identifying and managing individuals with difficult personalities is both necessary and beneficial if we are all going to communicate better.

Dr. Shannon’s well-referenced work is available in its entirety at: https://www.jwilsonshannon.com/