Personality is simply the way we cope with life.  It's a set of traits, beliefs and behaviors that help us survive our social environment.  A disorder means that the same traits, beliefs and behaviors no longer help the individual thrive in a social environment, in fact, it starts to backfire.  Since our personality is part genes and part environment, the exact cause is not clearly known.  There are no medications to treat personality disorders, in fact, most of the medications that are prescribed instead are for symptoms of personality disorders such as anxiety, depression and so forth.  Various therapy models have been tried to treat it, however, there has been nothing conclusive since it's one of the most difficult disorders to treat.  However, treatment such as CBT and Schema Therapy show better results than most.  These two models focus mostly on the emotional origins, beliefs and behaviors by identifying the exact and earliest emotional traumas, beliefs and behaviors and offering modification to each area.  The process is deep and lengthy and with schema therapy it's a lot faster than most, simply because it identifies these early traumas and beliefs through a survey questionnaire that is performed before the first meeting.  Once identification is established, the treatment begins by first becoming aware of each specific problem, and learning specific tools to change it.  That's easier said than done, however, if there's a will there's a way.  The difficulty usually lay in the length of time that these traits have been carved in the brain in what is known as neural networks.  To change means to create new neural networks.  That is usually established by practicing new beliefs and behaviors until they become as solid as the old neural networks.  In other words, going against the original neural networks.

The duration period for CBT is between 12-16 weeks, however, for something as chronic as a personality disorder, schema therapy duration period varies, but it's a minimum of 6 months to 1 year.  The treatment takes several phases.

Phase I is about identifying the problem areas.

Phase II is the awareness phase, and this is the longest phase.  

Phase III is catching one's self in the midst of being aware of the problem areas and making a conscious choice on whether to act on the old pattern or choose the new one.

Phase IV is when the individual's awareness causes enough pain, due to the repetition of the same consequences, and finally consciously choosing a different more effective way to respond to the situation.

Phase V is the final phase where the therapist and the individual review everything that's been learned and monitoring the progress that's been made including responses that didn't work and why.  

Since personality disorders mainly interfere in social relationships and cause pain to the individual and the people around them, the relationship with the therapist is of the utmost importance.  Conflicts can easily arise between individuals and therapists since it's really no different than any other social situation or relationship.  The key is to keep in mind that the therapist is there to help and TRUST becomes the key instrument to make this work.  Conflicts in sessions need to be brought up, discussed and resolved, since this is a small representation of what happens outside in the real world.  Once we are successful to overcome these conflicts, it's then easier to start to transfer these results to other social settings.  This area in therapy is a very sensitive and a critical one.  If it's not successfully worked on and resolved, this will lead to much more frustrations and resistant to seek help and change.  This is why many therapists prefer not to work with individuals with personality disorders, and that's also why there's a pattern of continuously changing therapists once conflicts arise and not resolved.  Please note that no one consciously wants these conflicts to happen, since these conflicts are caused by the unconscious parts of the brain that keeps repeating the same patterns learned over and over again.  The goal here is not to allow the brain to keep taking over by hijacking how we feel, think and behave.  It is the mind, which is the consciousness, to overcome these old patterns and make the final determination on how to respond.  

If you have further questions and inquiries, please feel free to contact me and I am more than happy to talk to you and answer all your questions.  Consultation is free and to get to know me is very important to establish trust and a healthy therapeutic relationship. 

For more information, please call:

Gabi L. Deak, LCSW

(310) 666-3097

or email us at:
gabi.deak@cbstclinic.com

Personality Disorders