Mental Health and Disturbed Personality

By Julie Le Franc, Psychoanalytic Psychotherapist and Psychologist



       Have we ever looked to determine the nature and types of behaviour and qualities that determine a person’s personality?  Consider for a moment what such a list could include:  introverted/extroverted, irresponsible, sociable, harsh, callous, frugal, envious, cautious, fearful, immoral, creative, immature, extravagant, flamboyant, deceitful…..the list is virtually endless.

       Personality may be thought of as a pattern of thinking, feeling or behaving which is consistent across time and situations.  A scientific approach has evolved to bring order to an overwhelming picture, with personalities grouped into types to enable clinicians to recognize various personality processes as outlined in the DSM-IV.


Cluster A:              1 Paranoid, 2 Schizoid, 3 Schizotypal

Cluster B:              4 Antisocial, 5 Borderline, 6 Histrionic, 7 Narcissistic

Cluster C:              8 Avoidant, 9 Dependent, 10 Obsessive,

                                    11Personality Disorder Not Otherwise Specified.

       Theories on what makes someone the person they are suggest genetic, temperamental, psychological and social or physical damage, such as brain damage.  Analytic diagnosticians believe that character structure of any person cannot be understood without an appreciation of two distinct and interacting dimensions: the developmental level of personality formation and defensive style within that level (Williams, 1994).  Therefore, I believe that understanding a person’s developmental level and their earliest years are crucial to understanding the person, their difficulties and psychopathology.

       Patients with personality traits often have troubled lives, and generally show inflexibility and maladaptive patterns of behavior that impair their functioning in relationships, work and play.  In fact, long-standing traits can disrupt their lives and poor coping skills can cause them a great deal of stress.

       Treating any personality disorder can be difficult and a number of diverse therapeutic approaches are used, ranging from psychotherapy, supportive psychotherapy focusing on the person’s strengths to enable realistic changes and to limit any self-destructive behavior, behavioral techniques that include assertiveness training and problem-solving techniques, cognitive therapy approach for management and for depression.  Medication treatment is sometimes important for depression, anxiety, psychotic behavior or symptom relief.

       In conclusion, it is therefore necessary to look at a person’s whole life pattern when treating a disease condition.  A full understanding of their history is vital to bring about change.



       McWilliams, Nancy (1994).  Psychoanalytic Diagnosis:  Understanding personality structure in the clinical process.  New York: The Guildford Press.