A Concise Guide to Personality Disorders

by Joel Paris, American Psychological Association

This book reviews what we know and what we don’t know about PDs, and what this implies for clinical practice.

Clients with personality disorders (PDs) present special challenges to clinicians. Nonetheless, successful treatment is possible, and a rapidly growing research base can inform diagnosis and intervention.  A Concise Guide to Personality Disorders  integrates a large body of research findings into a concise, highly practical approach to managing difficult clients. Rather than advocating a single method of treatment, Joel Paris promotes an integration of all evidence-based psychotherapies, as well as effective case management. The evidence base for pharmacotherapy is reviewed as well. Focusing particularly on borderline, antisocial, and narcissistic PDs, the author also reviews other PD categories. His extensive experience and clinical wisdom illuminate the discussion, demonstrating how to work productively and empathically with these clients.

Genres: Psychology, Medicine

195 pages, Hardcover

First published April 13, 2015

About the author

Dr Paris is Professor, Department of Psychiatry, McGill University, and Research Associate, Department of Psychiatry, Jewish General Hospital. He obtained his psychiatric training at McGill. His research interests include: developmental factors in personality disorders (especially borderline personality), culture and personality.
Current projects: risk factors for borderline personality disorder in children the biological correlates of borderline personality disorder.

Reviews

[Petra X · Rating 4 out of 5]

The problem with being diagnosed with a personality disorder is much the same, with one exception, as being diagnosed with a psychosomatic disorder as in It's All in Your Head: True Stories of Imaginary Illness where other reviewers and also commenters on my review don't want to accept such a diagnosis.

People think if it is in your head, you will have to accept that you are mad, crazy and that the doctor knows it and that other people, your workmates, your family and your friends, will look at you differently and probably treat you as 'less' for not being normal. Everyone wants their issues to relate to a pathological origin which can be treated with a pill.

This is why so many people who have personality or psychosomatic disorders go on suffering, they aren't diagnosed. Their GP gives them pills, anti-depressants, tranquillizers, anything, but although symptoms might be masked, they can't be cured chemically if no physical base for them exists. Should the GP recognise the intractability of their symptoms and send them off to a psychiatrist or they find themselves in an emergency ward, or worst of all, sectioned, denial is the likely result by the patient.

The exception is borderline personality disorder. As with most personality disorders, not everyone thinks this exists. Some people think BP people are nasty, manipulative individuals who are nice when it suits them and have little or no control over their temper when they can get away with it. They are the most disliked of psychiatric patients. They don't follow treatment regimes or even turn up for appointments if it doesn't suit them, they throw tantrums, they accuse doctors of not really believing them, they demand total attention and give little back. And then they use their diagnosis as an 'excuse' for when they have behaved appallingly.

My "bi-polar" friendI have a friend who is on pills for bi-polar disorder. She isn't bi-polar, she is neurotic. She resorts to tears and making her hands shake when she can't cope or is upset. It isn't conscious I'm sure, she is genuinely unhappy but the stratagem works. Everyone does what they can to make her feel better and she can say it is a treatable, chemical disorder and she needs to have her meds adjusted rather than she is neurotic, has a personality disorder. And that she might be happier if with real treatment, like CBT, she could cope with things and people she didn't like in a more practical and less emotional way. (She is an executive and got down-graded for the tears and shaking rather than getting on the phone and sorting things out as the person (whom she now hates) who got the job does).

There is hope for people with personality disorders. They all tend to lessen with age as people change to have a more mellow life, and they can all be treated with various forms of behavioural therapy, if the person will only acknowledge the diagnosis and embrace the possibility of change through their own actions rather than medications.

The best thing of all, the most hopeful thing for society would to be change the way disorders of the mind are viewed, not as being crazy but as genuine in every way as diseases with physical origins.
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Notes on reading I'm finding this very heavy-going, I can usually read anything no matter how technical but I have my limits:
"However, a dimensional model has also been proposed for the World Health Organization (WHO), which will be publishing the 11th edition of the International Classification of Diseases (ICD–11 ) by 2017. This system (Tyrer, Crawford, Mulder, & the ICD–11 Working Group for the Revision of Classification of Personality Disorders, 2011) has one great advantage: It is rather simple. Clinicians would be asked to rate patients on a scale of 5 points: no PD, personality difficulty, PD, complex PD, and severe PD. There would be no specific categories, although clinicians would also be asked to score patients on five trait domains: asocial, dissocial (i.e., antisocial), anankastic (i.e., obsessional), anxious–dependent, and emotionally unstable."

In summary the book was ....

A desert is ...
Martinis can be ....
If you aren't wet you are ...
Hang you clothes out so they can ...
He stole all her money, he bled her ...
She was scared, her heart beat faster and her mouth was ...

[Mark · Rating 3 out of 5]

This is a brief guide to personality disorders (PD)as the title says. The research in this is a general reference with a man=in focus on PDs that has more research backing it. PDs that have more research include borderline personality disorder (BPD) and antisocial personality disorder (ASPD). ut the main focus out of the ten PDs seems to be BPD. Granted is that it probably have more research coming to it considering how the disorder manifests with more frequent trips to the hospital or people with BPD interact with the mental illness personal. Most of the other PDs that it is in one chapter. I feel that the book could have gone into more depth into those disorders as well as BPD.

Overall the ability to read the text is simple and clear. It does use the current DSM (the fifth as of publishing this review) and the book also makes clear the current an experimental ways of seeing personalities. It is a short read so it is not overwhelming

[Nichi · Rating 4 out of 5]

The book is very readable. I skimmed parts and then reread with more focus on parts and found both the skimming and closer reading valuable. The prose is very accessible but the content remains nontrivial. The two main complaints I have are that it at times is a bit too concise, and, relatedly, really only focuses on BPD. Of the ten PDs in the DSM-V, only three get chapters, the rest thrown into a catch-all chapter in which several don't even get their own section. That which is present, though, is excellent.