Psychedelic Therapy for Personality Disorders

Personality Disorders

Each of us has a personality, or an ego structure: a set of traits, likes and dislikes, talents, curiosities, and weaknesses. Ideally, our personality forms around an authentic center of self. However, when personalities are formed around core and complex traumas, it can become organized in such a way as to invite consistent pain and conflict to the individual and their community. 

Personality disorders are the most common of all psychiatric diagnoses comprising 40-60% of all psychiatric patients. 

65-90% of people seeking treatment for substance use have at least one personality disorder. 

Childhood trauma, particularly early childhood trauma, are among the greatest risk factors for the development of a personality disorder. 

Personality disorders (PDs) are organized into three clusters in the DSM based on shared features.

Cluster A Personality Disorders

Characterized by eccentric or peculiar behavior, those with personality diagnoses in cluster A experience relational distress due to strange or detached behavior. 

• Paranoid Personality Disorder

Those with paranoid PD live in a world of constant persecution and fear. They are incredibly wary of deception and have difficulty trusting anyone. They often have strong and consistent fantasies of surveillance and persecution, like someone is out to get them. 

• Schizoid Personality Disorder

Characterized by social isolation and indifference towards interpersonal relationships, those with schizoid PD often have a rich inner life that takes priority over the outer. Though they appear withdrawn or cold, they often enjoy their own company but have difficulty relating to others. 

• Schizotypal Personality Disorder

Characterized by odd behavior, speech, and thought patterns, people with a schizotypal PD diagnosis have difficulty in forming accurate depictions of reality. They experience difficulty in practical affairs and forming relationships. 

Cluster B Personality Disorders

Cluster B personality disorders are characterized by dramatic or erratic behavior. People with these diagnoses experience very intense emotions and are organized around them, or are impulsive, theatrical, or dismissive of others, as well as social rules and boundaries. 

• Antisocial Personality Disorder

Unlike other PDs, antisocial personality disorder can sometimes be detected pre-adolescence (most people with other PDs aren’t diagnosed until adolescence or adulthood). People with this diagnosis have a disregard for social norms and behaviors, spend a great deal of time alone, and have a lack of remorse for others. 

• Borderline Personality Disorder

Characterized by instability in interpersonal relationships and self-image, impulsivity, and strong and swinging emotions. People with borderline PD are incredibly demanding and challenging in interpersonal relationships, and struggle voraciously to feel safe and loved. They are often impacted by early childhood trauma. 

• Histrionic Personality Disorder

People with histrionic personality disorder are intensely dramatic and employ theatrical behaviors to attract attention and assistance. They experience difficulty in interpersonal relationships, particularly romantic and professional. 

• Narcissistic Personality Disorder

People with narcissistic PD have generally experienced core or complex trauma in which they create an aggrandized self to stay separate from it. They are characterized by intense drive to achievement, extreme self-centeredness, aggrandizing of self to obscure fragility, as well as lack of empathy and respect for others.  

Cluster C Personality Disorders

Cluster C diagnoses are characterized by anxiety. Personality traits are solidified as ways to ward off and avoid anxiety. 

• Avoidant Personality Disorder

Extreme social anxiety and social inhibition are hallmarks of this PD. They are often ruled by fears of perceived inadequacy and criticism from others. 

• Dependent Personality Disorder

Dominated by fears of being alone, those with dependent PD put themselves into positions to be taken care of by others. 

• Obsessive-Compulsive Personality Disorder

Characterized by preoccupations with orderliness, cleanliness, perfection, and control in intrapersonal and interpersonal relationships. People with obsessive-compulsive PD experience tremendous anxiety when feeling out of control. It is not to be confused with obsessive-compulsive disorder.