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Ask a psychotherapist



Question: I read your last two columns about Borderline and Hysterical personality disorders. I think one of my friends from high school probably fits the borderline pattern and I've got this sister-in-law who sounds just like the hysterical person you talked about. Is this possible? What are the chances of having both these kinds of people in your life? Neither of them would ever consider going to therapy because they don't think there's anything wrong with them – it's always somebody else's fault. Like you say, they cause a lot of drama. Can you give any more pointers for dealing with them?

Answer: It's entirely possible to have more than one person in your life with features of either of these personality types. Such people can have annoying traits belonging to either the Borderline or Hysterical (Histrionic) spectrum or they may indeed have full-blown personality disorders. In either case, they can be very difficult to deal with especially if they believe that you have a problem, not them.

Borderline Personality Disorder is the most commonly diagnosed personality disorder. About 2 per cent of the population appears to have the full-blown disorder while many more have Borderline traits or styles. Hysterical (Histrionic) Personality Disorder is thought to exist in 2 to 3 per cent of the general population again with many others showing features of it in the form of traits or style.

You bring up an important difficulty in treating people with these traits: they often don't think that they need help and tend to externalize the blame for their behaviours onto others. A key in managing your interactions with them, therefore, is to refuse to take the blame for someone else's bad behaviour or poor choices. People with these personality features usually only come for help when their methods no longer work to get what they want from others. You would be helping both the other person/s and yourself by refusing to comply with unreasonable demands, resisting getting caught up in their emotional dramas and rejecting inappropriate blaming directed at you.

Easier said than done, you say? Indeed. People with either of these personality features can be highly manipulative. It's often extremely difficult to resist these manipulations particularly when they involve threats of self-harm or suicide if you don't comply. That is why it's best to seek professional support while making these important changes and recovering from the emotional damage that has likely been done to you in the course of your relationship with people at or near the “disorder” end of either of these personality spectrums.

People with these disorders often have other debilitating conditions such as Generalized Anxiety Disorder, substance abuse or eating disorders as well. All of these require treatment and it's sometimes one of these problems that propels people with either Borderline or Hysterical (Histrionic) Personality Disorder into treatment.

Alison Kerr, Ph.D.,

Psychotherapist can be reached at 905 936-2400 or at alikerr@xplornet.ca

 

 


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