Can People With Cluster B Personality Disorders Change?

Disir

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Sep 30, 2011
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Of the 10 personality disorders described in the DSM-5-TR, four are in Cluster B: borderline, narcissistic, antisocial, and histrionic. Some are considered more amenable to treatment now, but their “enduring patterns” still make them more difficult to treat than substance use disorders, for example, which many with personality disorders (PD) also have. Since the DSM indicates that more than 10 percent of adults may have a personality disorder and 4.5 percent have a Cluster B disorder, many people wonder whether they can change. This post briefly introduces this important subject.

I have worked with 2 of the four with the formal diagnosis. Yes, they can change but they have to be willing to 1) recognize it and 2) engage in therapy. It does require work. There seems to be this push to categorize it as a mental illness. It's a learned behavior. You don't agree with that? That's fine. Take that up with your insurance and see how that works out. It is also why there is no medication for it. Borderline personality disorder has to do with attachment and it is one of the most painful things to witness someone deal with.
 
Of the 10 personality disorders described in the DSM-5-TR, four are in Cluster B: borderline, narcissistic, antisocial, and histrionic. Some are considered more amenable to treatment now, but their “enduring patterns” still make them more difficult to treat than substance use disorders, for example, which many with personality disorders (PD) also have. Since the DSM indicates that more than 10 percent of adults may have a personality disorder and 4.5 percent have a Cluster B disorder, many people wonder whether they can change. This post briefly introduces this important subject.

I have worked with 2 of the four with the formal diagnosis. Yes, they can change but they have to be willing to 1) recognize it and 2) engage in therapy. It does require work. There seems to be this push to categorize it as a mental illness. It's a learned behavior. You don't agree with that? That's fine. Take that up with your insurance and see how that works out. It is also why there is no medication for it. Borderline personality disorder has to do with attachment and it is one of the most painful things to witness someone deal with.

The data shows it is very, very difficult to change cluster B personality disorders. Often age is the best cure, particularly for antisocial or borderline. I have seen improvement in my practice, but it takes a lot of work and a lot of patience.
 
The data shows it is very, very difficult to change cluster B personality disorders. Often age is the best cure, particularly for antisocial or borderline. I have seen improvement in my practice, but it takes a lot of work and a lot of patience.
I have not met someone with an official diagnosis for antisocial. I do know that BPD requires an individual to put in effort and they need to be held accountable in order for there to be any success. IF age is the answer then it seems that it is almost impossible to stop a parent from gifting the same to their children. How is that circumvented?
 
I have not met someone with an official diagnosis for antisocial. I do know that BPD requires an individual to put in effort and they need to be held accountable in order for there to be any success. IF age is the answer then it seems that it is almost impossible to stop a parent from gifting the same to their children. How is that circumvented?

My first year residency in graduate school was in a medium/maximum security prison. I saw a lot of antisocial personality disorder.

There is a correlation between BPD and the same in their offspring. As I recall about a 20-30% higher probability than the general population.

I always visualized people with BPD as a fragmented personality structure. You would see them in one session upbeat, hair, make-up, clothes done well. A week later you might see disheveled, depressed, and anxious. You never knew who would show up. I tried to work on building consistency of behavioral response (i.e. bringing together the fragments to make a whole). Integration of the personality structure. Easier said than done.

Positive visualization can help. "What is your idealized self. Described it to me. How do we make that picture a reality?"
 
The one thing I find intriguing is the way that so many people with histrionic personality disorders manage to find USMB.

I remind myself, though, that I am here, and it is only normal that they would want to bask in my magnificence.
 
The one thing I find intriguing is the way that so many people with histrionic personality disorders manage to find USMB.

I remind myself, though, that I am here, and it is only normal that they would want to bask in my magnificence.
That's interesting. Can you describe those with the histrionic personality disorders?
 
The one thing I find intriguing is the way that so many people with histrionic personality disorders manage to find USMB.

I remind myself, though, that I am here, and it is only normal that they would want to bask in my magnificence.

Well said. I too, have found everyone here at USMB thinks I am wonderful. Ah, the curse of being so special, but what can I do? :D
 
That's interesting. Can you describe those with the histrionic personality disorders?
They are quite easy to spot in this forum. They post emotionally fuled diatribes filled with hyperbole, and express obsessive fears over an imaginary beast that frightens them terribly, which they call "Trumpster"
 
Well said. I too, have found everyone here at USMB thinks I am wonderful. Ah, the curse of being so special, but what can I do? :D
Like you, I am a most generous and magnanimous individual, and all I require of those attracted to my magnetic charm is that they acknowledge this fact.

I wouldn't want a repeat an incident like the last time a member of my inner circle disagreed with me in some small way.
 
Hmmmm.........I'm in the fuck off category and I may not be well liked but I have been not liked by far better.
 

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