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Mental Disorders

Examples of Personality Disorders With Distorted Thinking Patterns

Simone Hoermann, Ph.D., Corinne E. Zupanick, Psy.D. & Mark Dombeck, Ph.D.

Let's look at some examples of specific personality disorders to help illustrate these dysfunctional thinking patterns and the types of interpersonal problems that are created as a result.

For instance, persons with Paranoid Personality Disorders exhibit suspicious thinking and therefore have difficulty trusting other people. They may misinterpret what other people say or do as intentional attempts to attack them, hurt them, or take advantage of them. In turn, they end up holding grudges and may act in ways that are overly defensive, hostile, or even aggressive. You can imagine this thought pattern will cause a lot of anxiety for the person who is paranoid, and that this type guardedness, defensiveness, and hostility is very unpleasant for the other people around them. Obviously, this type of distrust makes close relationships nearly impossible.

People with an Avoidant Personality Disorder tend to think they are completely flawed and inferior to others. Persons with an Avoidant Personality Disorder are unable to recognize both their good and bad qualities. Their extremely negative self-image convinces them that other people see them in the same way (as flawed and inferior). Thus, they are certain no one will like them, and expect others will ridicule them. This leads them to avoid social situations because they anticipate these encounters will be painful and unpleasant experiences. Because of these thoughts, it is unlikely they will have any fun at parties or other social events and so they miss opportunities to have a fulfilling social life. Professionally, they might avoid social situations or avoid public speaking and hence miss out on professional and networking opportunities that usually benefit career development and advancement.

People with Schizotypal Personality Disorders exhibit odd beliefs. They might be extremely superstitious and have unusual beliefs in magic or the supernatural. Other people often find such a person odd and eccentric, and may feel uncomfortable being around someone who holds such strange and unusual ideas. People with Schizotypal Personality Disorder sense they are quite different from others and are often aware that other people seem uncomfortable around them. As a result, they have chronic feelings of just not "fitting in."

People with Narcissistic Personality Disorder exhibit distorted thinking when they go back and forth between over-idealizing themselves, and then completely devaluing themselves. In addition, they have a tendency to over-estimate the importance or significance of their abilities and talents. Persons with a Narcissistic Personality Disorder frequently have fantasies of having unlimited power, success, or special talents. These over-idealized beliefs about themselves can cause them to behave in ways that are arrogant, ruthless, and entitled.  Such behavior frequently causes a lot of conflict with others.  For example, a person with a Narcissistic Personality Disorder may ignore the social custom of waiting in a queue to purchase a ticket.  Instead, they will march to the front of the queue, believing they are more important than the other people in line and are therefore entitled to special treatment.  Of course, the people waiting politely in the queue do not respond well and conflict erupts.  Eventually, the person with Narcissistic Personality Disorder is likely to run into a situation in which they realize they have some normal, human limitations.  When this occurs, they are likely to find it extraordinarily difficult to cope with this realization.  Any inkling of failure is hard for them to tolerate. The sudden realization of ordinary human limitations typically leads them to completely debase themselves, shifting from the over-idealized fantasy of unlimited success and special powers, to a devastating and paralyzing sense of complete worthlessness, shame, and defeat.

The pattern of black-or-white thinking is quite common in those with Borderline Personality Disorder. Things tend to be "all or nothing", "black or white", "all good, or all bad." This way of viewing the world can create a lot of emotional suffering and is particularly devastating in relationships. Other people are seen as either "all good" meaning they are perfectly loving and available to meet their needs at all times, or they are "all bad" meaning they are malicious and hateful, with no shades of grey in between. Sometimes, their view of another person can shift in just a few seconds from "that person is completely wonderful" to "that person is horrible." Take the example of a woman thinking that her partner is the most caring and loving person in the world. Of course, no one can achieve such a perfect ideal all the time so when her partner does one unloving or thoughtless act, such as forgetting their anniversary, the immediate conclusion becomes "He doesn't love me. He is so mean and horrible." Sometimes, it doesn't stop there, because "If he doesn't love me, he must hate me." It is easy to understand that this pattern of interpreting relationships creates great distress and will provoke an intense emotional reaction in people who think like this. Subsequently, their partners may be quite baffled and distressed by these extreme ways of thinking.  In such cases, conflict is likely to be frequent.

It is important to note that even healthy, well-adjusted people without a personality disorder can also occasionally fall prey to some of the distorted thinking that we just described as characteristic of personality disorders. In fact, distorted thinking is quite common when people are feeling very distressed, depressed, or anxious. Again, recall that personality disorders are a variant form of normal, healthy personality so the difference is in the frequency, degree, and persistence of the distortion. For people with personality disorders the degree of their distortion is more extreme and occurs with greater frequency than for those people without a personality disorder. Additionally, people with personality disorders find it much more difficult to become aware of, and to challenge their distorted thinking.

As we have seen from these examples, distorted thinking patterns can impact both how a person feels, and how they behave. Recall, a person must exhibit at least two of the four core features that are characteristic of personality disorders before they will qualify for a diagnosis. This means someone who exhibits distorted thinking patterns would also have to exhibit at least one more characteristic before it is appropriate for them to receive a personality disorder diagnosis. This leads us to the second core feature of personality disorders: problematic affective (emotional) response patterns.