The treatment of personality disorders consists mainly of psychotherapy and pharmacotherapy. They can be supported by training in social skills and coping with unhe althy emotions. The effect of the therapy is the development by a person with a personality disorder of new, constructive ways of communication, perception of himself and the world. The therapy is also a chance for a fuller participation in social life (family, work) and the elimination of the feeling of alienation and mismatch.

Treatment of personality disordersis the pursuit of changing the established ways of acting, thinking and perceiving the world, caused by changes in the psyche. They make life difficult for a person with a personality disorder on a daily basis because they differ from socially accepted behaviors. They make her have problems in dealing with other people and it is difficult for her with herself.

The methods of treatment used are psychotherapy and pharmacotherapy (as psychotherapy support, because the administration of drugs reduces the severity of the symptoms of the disorder, but does not cure its causes). The effects of therapy depend on the severity of the symptoms of the disorder and the time from which they occur. The first step before starting treatment is to meet a psychiatrist or psychologist who, after an interview and possible tests, makes a diagnosis. Then, with the support of a specialist, the patient decides which therapy to choose-individual or group.

Important! Remember that not every behavior that is criticized, misunderstood, or makes you feel worse is a symptom of a personality disorder.

Treatment of personality disorders: psychotherapy

Individual short-term psychotherapy (up to 10 sessions) does not work for the treatment of personality disorders. Problems of this type require more meetings and in-depth work with the patient. Mutual trust and active participation of both parties in the therapeutic process are very important in the treatment process. The most effective (40-64%) islong-term psychotherapy(over 10 sessions). Giving the possibility of insight, that is, learning about the mechanisms of the psyche, often unconscious, which could have caused the disorder. Then you can work effectively to bring about healing changes in the personality structure.

Another method of treating personality disorders is group psychotherapy(group size should not exceed 10-12 people). Then also work on harmful behaviors, thoughts and relationships, but it is done together with other group members and one or two therapists. Meeting together is not only talking about your experiences, learning new, he althy ways of reacting. They also give you the opportunity to confront and become aware of how what you do and say affects and interacts with other people. Meetings take place in safe conditions, in the environment of people they know, in an atmosphere of trust and non-judgment. The relationships that arise between the participants of the group are also a very important element in the therapy of personality disorders.

The following are most often used in the treatment of personality disorders:

  • psychodynamic psychotherapy- is based on the assumption that it is internal, unconscious mechanisms that guide human life. During the meetings, the therapist primarily listens, helps to bring out memories, and encourages sharing emotions, ideas or dreams.

Transference-focused therapy (TFP) is derived from modern psychodynamic psychotherapy. Its creator and promoter is Otto Kernberg. In TFP, the relationship created between the patient and the therapist enables the former to recreate the relationships present in his life (partnerships, professional, with friends). The therapist helps the patient to understand and integrate all aspects of the relationship, including the embarrassing and difficult ones - feelings, thoughts, motivation, so that later he can perceive himself and the environment in a coherent and uniform manner. Transference Focused Therapy has a particular focus on treating patients with borderline and narcissistic personality disorder.

  • modified approaches derived from cognitive-behavioral therapy (e.g. cognitive, cognitive-analytical, dialectical-behavioral) - its basis is the assumption that action is driven by the way you think about yourself and your role in the world. In this approach, the therapist is an expert and helps to understand the problem, participates in changing this way of thinking (cognitive aspect) and then behavior (behavioral aspect).

The Dialectical Behavioral Therapy, developed by Marsha Linehan, is based on cognitive behavioral therapy. Its basis is mindfulness, that is focusing on "here and now", accepting what is happening with positive and negative consequences, ending the fight with yourself and the environment. Dialectics, in turn, is to help understand what is happening in the patient's life by reconciling opposites and synthesizing them, showing functionality indysfunction, cause-effect relationships. The therapist is more of a partner who, if necessary, encourages additional contacts so that the patient remains in therapy and effectively implements new, he althier behaviors and thoughts. This type of therapy is particularly helpful in the treatment of borderline personality disorders, also with behaviors that threaten the patient's life and he alth, as well as eating disorders or, for example, opiate addiction.

The above-mentioned therapies allow the therapist to be more direct and active, which is very important when the disorder gets worse or when thoughts and attempts at suicide and self-harm appear.

Worth knowing

Differences between a psychologist, psychiatrist and psychotherapist

Psychologist graduated from university studies in psychology. He diagnoses and conducts tests, gives opinions, provides psychological counseling, and educates.

A psychiatrist graduated from medical studies and specializes in psychiatry. He diagnoses, conducts pharmacotherapy, issues prescriptions, sick leaves and referrals to the hospital. He can conduct psychotherapy if he graduated from psychotherapeutic school.

The psychotherapist has a master's degree (e.g. psychology, pedagogy, sociology, medicine) and graduated or graduated from psychotherapy school, which is confirmed by an exam and a psychotherapist's certificate.

Psychologist, psychiatrist, psychotherapist and coach - who to contact with your problems?

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Treatment of personality disorders: pharmacotherapy

Pharmacotherapy is usually used periodically, when particularly troublesome symptoms of the disorder appear. It is primarily used to calm emotions, regulate mood, reduce the level of anxiety and symptoms of depression. It helps to overcome crises and improve your well-being. Pharmacotherapy may be combined with long-term psychotherapy when the personality disorder is severe. However, when used as a single form of treatment, it does not eliminate the personality disorder.

An example of the use of pharmacology in the treatment of personality disorders is antipsychotic treatment, which helps to reduce suspicion towards others and is also used in the treatment of personality disorders such as schizoid or paranoia, when auditory hallucinations or paranoia appear. Drugs from the group of mood stabilizers are used to reduce impulsiveness and aggression.

In pharmacotherapy of personality disorders drugs from different groups are used, but they are selected individually. Because the individual symptoms of the disorder, although having the same name, may differ in their source or degreeseverity. For example:

  • drugs from the group of neuroleptics have an antipsychotic effect, and additionally, they can - depending on the symptoms accompanying the disorder - calm down (during motor agitation) or activate (influencing the psychomotor drive, counteract the negative symptoms of the disorder) or have a positive effect on a depressed mood,
  • antidepressants, in addition to their antidepressant effect, support the treatment of anxiety and anxiety attacks; social phobia accompanied by stress and fear of making contacts and social relationships; pain therapies as well as post-traumatic stress disorders,
  • the role of anxiolytic drugs is to eliminate or reduce single psychopathological symptoms. They have an anxiolytic, hypnotic, mood-boosting, hypnotic and sedative effects.

Treatment of personality disorders: other methods

Social skills training, the basis of which is learning, among others, is helpful in the treatment of personality disorders:

  • modeling new behaviors,
  • ways to deal with difficult emotions (e.g. anger),
  • ability to respond adequately to the situation (e.g. in a conversation),
  • building self-esteem,
  • communication rules.

These kinds of tools are used in individual, group and supportive therapy.

Supportive psychotherapy

Supportive psychotherapy is designed to help the patient to function better, but it does not change the personality and defense mechanisms, i.e. those that protect the ego. The supportive therapist gives understanding and help, emphasizes the positive qualities of the patient and the role of trusting oneself. It helps to maintain the results achieved during long-term therapy, to recognize subsequent patterns of action that make life difficult, and to shift the threshold of tolerance to difficult experiences, i.e. triggers of unhe althy behaviors or ways of thinking. This means that the patient learns his consecutive signals (emotional, mood changes, thought patterns) that previously triggered unhe althy behaviors, works through them and creates new, constructive ones. Supportive psychotherapy is also chosen by those people who do not have sufficient motivation to undertake long-term therapy, and the situation is so difficult for them that they need help.

Category:

Psychiatry