June 9, 2005

During adolescence, individuals form their behavioural patterns, and any wrong development can lead to personality disorders. These are governed by the person’s upbringing, stress during childhood, brain damage and levels of serotonin, writes Zainab Mahmood

The study of human mind and behaviour patterns reveals that adolescence is the stage where young adults begin to assert their individual differences. Upbringing, exposure, standards of acceptable behaviour set by families and societal norms form the foundation of the child’s psyche which then evolves into the young adult’s personality.

Most parents are unable to recognize their children’s behavioural symptoms as indicative of a deep-rooted personality disorder and therefore do not deal with the problem effectively.

Personality disorder refers to behaviours that do not fit into any other obvious diagnostic category, but the person nevertheless has difficulty coping with life and where that behaviour persistently causes distress to themselves or others.

It is assumed that there are a number of possible causes for personality disorders, including abuse, inadequate parenting and trauma. Neurological and genetic factors such as brain damage or low levels of serotonin may also play a part.

If someone has a personality disorder they may also have other mental health problems such as depression, anxiety, panic or eating disorders, deliberate self-harm, substance abuse and manic depression.

Personality disorders manifest themselves in many different ways. Avoidant personality disease (APD) is characterized by a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation.

Young adults who meet criteria for APD are extremely shy, inhibited in new situations and fearful of disapproval and social rejection. They are unwilling to get involved with people unless certain of being liked and show restraint within intimate relationships because of the fear of being ridiculed. They tend to be preoccupied with being criticized or rejected in social situations and demonstrate feelings of inadequacy. They see themselves as socially inept, personally unappealing or inferior to others and are unusually reluctant to take personal risks.

APD is closely linked to a person’s temperament. Approximately 10 per cent of toddlers have been found to be habitually fearful and withdrawn when exposed to new people and situations. This trait appears to stabilize over time, but if it continues as the child grows it can develop into APD.

At home, in school/college individuals with an avoidant personality often deny the existence of problems or difficult situations as they are unable to tackle them head on. Even in relationships with parents, siblings and peers they shy away from confrontation and are neither argumentative nor aggressive by nature.

The most effective way for parents, teachers and counsellors to deal with APD suffering individuals is to peel away at their avoidance tactics one by one. Straightforward discussions with the individual will not be effective. Comparing them to others, ridiculing them or using aggression will only make matters worse.

Such situations have to be delicately handled as saying or doing the wrong thing can often push them further into their shell. It is best to help them face small issues, coming up with solutions and seeing them through. Correcting their thought and behaviour patterns will help them see the problem as a challenge they can meet.

Another personality disorder which afflicts many young adults around the world is dependant personality disorder (DPD). Before a person can be diagnosed with this controversial condition, they must meet the following criteria. Individuals with DPD encourage or allow others to make important life decisions for them. They have a limited ability to make every-day decisions unless given excessive reassurance and advice from parents, siblings or peers.

They refrain from making demands on people, especially those people who play an important part in their life and by doing so becoming compliant and subordinate to other peoples’ whims. They often harbour feelings of helplessness and discomfort when alone and are continually anxious about being abandoned by loved ones as they are afraid of being left to fend for themselves.

In a young person, laziness and teenage-apathy can make it hard to determine whether it is a passing phase or a personality disorder, but if these traits show themselves consistently, there is definitely a problem. People with DPD can often be mistaken as indolent, as their constant compliance with others’ instructions and strategies can seem harmless at the beginning. But this can have a negative impact on their social and intimate relationships and make them needy, depending on others for guidance, permission and approval.

It can destroy their self image to the point where they can put themselves in harm’s way by granting authority to others over their lives. For example, in abusive relationships the victim is so dependant on the perpetrator for taking care of them that they are unable to break from the vicious cycle.

People with DPD can be extremely vulnerable as many situations and individuals can take advantage of their personalities. Some parents go so far as to inculcate dependency in their child, without realizing that they are sowing the seeds for a dysfunctional adult who will be unable to steer his life in the direction he wants.

People with DPD are afraid to deal with consequences and be answerable for their choices, therefore parents and teachers must not compensate when the individual is stuck. By repeatedly refusing to spoonfeed them, parents and teacher’s can send a clear message that they cannot depend on others and so they will eventually have to take the first step towards making a decision.

Emotionally unstable personality disorder (EUPD) is another controversial disease. At present there is no consensus as to its causes or treatment. It has two kinds; ‘impulsive type’ and ‘borderline type’.

They both share the following characteristics; there is a marked tendency to act impulsively without considering the consequences of their actions, such as engaging in promiscuity and substance abuse, they show an inability to plan ahead. They may experience severe doubts about their self image, aims and sexual preferences.

It is common to experience a strong and debilitating sense of emptiness and this can lead to self-harm and suicide threats. They are also liable to become involved in intense but unstable relationships which can cause them to have continual emotional crises.

The added angst of teenage years can further complicate young people with emotionally unstable personality traits. There is no use in asserting boundaries and punishing impulsive careless behaviour as it could lead to violence or self-harm. The best tactic in such situations is for parents or teachers to calmly converse with the sufferer.

Addressing the root of this behaviour is more important than correcting the patterns. There are unstable thought processes which contribute to this kind of behaviour and they must be clarified in a calm and controlled environment where the individual does not feel threatened or trapped.

Listening to the individual’s outbursts and feelings often having to read between the lines for what they are actually trying to express is a good way of finding out why they feel emotionally unstable. The fault may lie in domestic or school environments where negative situations may have arisen. The individual internalizes everything that he feels.

Making them realize that they do not have to face these demons alone can be instrumental. As there is a vacuum which has developed within these individuals, they tend to form intense relationships with people they trust and can often become dependant and obsessive, further complicating matters.

Individuals with EUPD need to be encouraged to seek guidance and help to tackle crises and to learn how to react appropriately to situations without feeling frustrated and powerless. Regaining emotional stability can help them regain control over their lives.

Narcissistic personality disorder (NPD) is another unique disorder in which a person has a grandiose self-importance, preoccupation with fantasies of unlimited success, a driven desire for attention and admiration, an intolerance of criticism, and disturbed self-centered inter-personal relations. They are often referred to as being conceited and generally have a low self-esteem, as well.

They act selfishly and make demands on others with a sense of entitlement. Often spoilt children and those given excessive leeway especially during adolescence can develop this disorder and if it persists into adulthood it can be severely dilapidating.

Young narcissistic adults tend to be ostracized and shunned by peers and colleagues. They often have trouble expressing their real opinions and emotions and build a reputation for fakeness, insincerity and rarely develop consistent relationships with people.

In some cases they are able to take someone into confidence, letting the narcissistic front down but with majority of the people around them they act as if they are the focal point of the universe. More often than not, parents are to blame for this, as at times due to an unstable home environment (separation, divorce or death in the family) or a health or physical disability in the child at some stage may have led to over-compensation, teaching the child that whatever they want they can get, without question.

It is often difficult to realize what kind of damage can be caused by certain parental controls and tactics, and at other times being over-cautious and analytical can be harmful. Therefore, it is best to provide a balanced set of rules and boundaries for young adults, allowing them to carve out their own paths, providing guidance and encouragement when necessary.

Majority of the personality traits mentioned above exist in all of us, but keeping some on a leash while letting others lie dormant is necessary for us to grow into sane and well-adjusted adults.

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