Specific approaches There are many different forms (modalities) of treatment used for<unk> s: * Individual psychotherapy has been a mainstay of treatment. There are long-term and short-term (brief) forms. * Family therapy, including couples therapy. * Group therapy for personality dysfunction is probably the second most used. * Psychological-education may be used as an addition. * Self-help groups may provide resources for<unk> s. * Psychiatric medications for treating symptoms of personality dysfunction or co-occurring conditions. * Milieu therapy, a kind of group-based residential approach, has a history of use in treating<unk> s, including therapeutic communities. * The practice of mindfulness that includes developing the ability to be nonjudgmentally aware of unpleasant emotions appears to be a promising clinical tool for managing different types of<unk> s. There are different specific theories or schools of therapy within many of these modalities. They may, for example, emphasize psychodynamic techniques, or cognitive or behavioral techniques. In clinical practice, many therapists use an 'eclectic' approach, taking elements of different schools as and when they seem to fit to an individual client. There is also often a focus on common themes that seem to be beneficial regardless of techniques, including attributes of the therapist (e.g. trustworthiness, competence, caring), processes afforded to the client (e.g. ability to express and confide difficulties and emotions), and the match between the two (e.g. aiming for mutual respect, trust and boundaries). + Response of Patients with<unk> s to biological and psychosocial treatments Cluster Evidence for brain dysfunction Response to biological treatments Response to psychosocial treatments A Evidence for relationship to schizophrenia; otherwise none known Schizotypal patients may improve on antipsychotic medication; otherwise not indicated Poor. Supportive psychotherapy may help B Evidence for relationship to bipolar disorder; otherwise none known Antidepressants, antipsychotics, or mood stabilizers may help for borderline personality; otherwise not indicated Poor in antisocial personality. Variable in borderline, narcissistic, and histrionic personalities C Evidence for relationship to generalized anxiety disorder; otherwise none known No direct response. Medications may help with comorbid anxiety and depression Most common treatment for these disorders. Response variable Challenges The management and treatment of<unk> s can be a challenging and controversial area, for by definition the difficulties have been enduring and affect multiple areas of functioning. This often involves interpersonal issues, and there can be difficulties in seeking and obtaining help from organizations in the first place, as well as with establishing and maintaining a specific therapeutic relationship. On the one hand, an individual may not consider themselves to have a mental health problem, while on the other, community mental health services may view individuals with<unk> s as too complex or difficult, and may directly or indirectly exclude individuals with such diagnoses or associated behaviors. The disruptiveness that people with<unk> s can create in an organisation makes these, arguably, the most challenging conditions to manage. Apart from all these issues, an individual may not consider their personality to be disordered or the cause of problems. This perspective may be caused by the patient's ignorance or lack of insight into their own condition, an ego-syntonic perception of the problems with their personality that prevents them from experiencing it as being in conflict with their goals and self-image, or by the simple fact that there is no distinct or objective boundary between 'normal' and 'abnormal' personalities. There is substantial social stigma and discrimination related to the diagnosis. The term<unk> ' encompasses a wide range of issues, each with a different level of severity or disability; thus,<unk> s can require fundamentally different approaches and understandings. To illustrate the scope of the matter, consider that while some disorders or individuals are characterized by continual social withdrawal and the shunning of relationships, others may cause fluctuations in forwardness. The extremes are worse still: at one extreme lie self-harm and self-neglect, while at another extreme some individuals may commit violence and crime. There can be other factors such as problematic substance use or dependency or behavioral addictions. Therapists in this area can become disheartened by lack of initial progress, or by apparent progress that then leads to setbacks. Clients may be perceived as negative, rejecting, demanding, aggressive or manipulative. This has been looked at in terms of both therapist and client; in terms of social skills, coping efforts, defense mechanisms, or deliberate strategies; and in terms of moral judgments or the need to consider underlying motivations for specific behaviors or conflicts. The vulnerabilities of a client, and indeed a therapist, may become lost behind actual or apparent strength and resilience. It is commonly stated that there is always a need to maintain appropriate professional personal boundaries, while allowing for emotional expression and therapeutic relationships. However, there can be difficulty acknowledging the different worlds and views that both the client and therapist may live with. A therapist may assume that the kinds of relationships and ways of interacting that make them feel safe and comfortable have the same effect on clients. As an example of one extreme, people who may have been exposed to hostility, deceptiveness, rejection, aggression or abuse in their lives, may in some cases be made confused, intimidated or suspicious by presentations of warmth, intimacy or positivity. On the other hand, reassurance, openness and clear communication are usually helpful and needed. It can take several months of sessions, and perhaps several stops and starts, to begin to develop a trusting relationship that can meaningfully address a client's issues.
Personality disorder
Obsessive–compulsive personality disorder
Tic disorder
Bipolar disorder
Social anxiety disorder
Dissociative identity disorder
Psychopathy
Schizotypal personality disorder  Schizotypal disorder  1