Therapist Unlimited Blog

Schizoid Personality Disorder is a condition characterized by excessive detachment from social relationships and a restricted range of expression of emotions in interpersonal settings.
This disorder is only diagnosed when these behaviours become persistent and very disabling or distressing.
The disorder should not be diagnosed if the distrust and suspiciousness occurs exclusively during the course of Schizophrenia, a Mood Disorder with Psychotic Features, or another Psychotic
 Disorder or if it is due to the direct physiological effects of a neurological (e.g., temporal lobe epilepsy) or other general medical condition.
Individuals with this disorder may have particular difficulty expressing anger, which contributes to the impression that they lack emotion.
  These individuals often react passively to adversity and have difficulty responding appropriately to important life events.
 Because of their lack of social skills and lack of desire for sexual experiences, individuals with this disorder have few friendships and often do not marry.
 Occupational functioning may be impaired, particularly if interpersonal involvement is required, but individuals with this disorder may do well when they work under conditions of social isolation.

Individuals suffering from Schizoid Personality Disorder have particular difficulty expressing anger, which contributes to the impression that they lack emotion.

Symptoms

A. Neither desires nor enjoys close relationships, including being part of a family.
B. Almost always chooses solitary activities.
C. Has little, if any, interest in having sexual experiences with another person.
D. Takes pleasure in few, if any, activities.
E. Lacks close friends or confidants other than first-degree relatives
F. Appears indifferent to the praise or criticism of others
G. Shows emotional coldness, detachment, or flattened affectivity

Treatments

Personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions.
Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.

Psychotherapy

While there are many suggested treatment approaches one could make for this disorder, none of them is likely to be easily effective. As with all personality disorders, the treatment of choice is individual psychotherapy. However, people with this disorder are unlikely to seek treatment unless they are under increased stress or pressure in their life. Treatment will usually be short-term in nature to help the individual solve the immediate crisis or problem. The patient will then likely terminate therapy. Goals of treatment most often are solution-focused using brief therapy approaches.
The development of rapport and a trusting therapeutic relationship will likely be a slow, gradual process that may not ever fully develop as in seeing people with other disorders. Because people who suffer from this disorder often maintain a social distance with people in their lives, even those close to them, the clinician should work to help ensure the client’s security in the therapeutic relationship. Acknowledging the client’s boundaries are important and the therapist should not look to confront the client on these types of issues.
Long-term psychotherapy should be avoided because of its poor treatment outcomes and the financial hardships inherent in lengthy therapy. Instead, psychotherapy should focus on simple treatment goals to alleviate current pressing concerns or stressors within the individual’s life. Cognitive-restructuring exercises may be appropriate for certain types of clear, irrational thoughts that are negatively influencing the patient’s behaviours. The therapeutic framework should be clearly defined at the onset. Stability and support are the keys to good treatment with someone who suffers from schizoid personality disorder. The therapist must be careful not to "smother" the client and be able to tolerate some possible "acting-out" behaviour.

Group Therapy

Group therapy may be an alternative treatment modality to examine, although it is usually not a good initial treatment choice. A person who suffers from this disorder who is assigned to group therapy at the onset of therapy will likely terminate treatment prematurely because he or she will be unable to tolerate the effects of being in a social group. If, however, the person is graduating from individual to group therapy, they may have enough minimal social skills and abilities to tolerate group therapy much better.
People who suffer from this disorder see little to no reason for social interactions and often will be quite quiet in group therapy, contributing little to others and offering little of themselves. This is to be expected and the individual who has schizoid personality disorder should not be pushed into participating more fully in the group until he or she is ready and on their own terms. Group leaders must be careful to help protect the individual from criticism from other group members for their lack of participation. Eventually, if the group can tolerate the initially silent member with this disorder, the individual may gradually participate more and more, although this process will be very slow and drawn out over months. Clinicians should be wary of too much isolation and introspection on the part of the patient. The goal is not to keep the individual in therapy as long as possible (although they may appreciate, if not fully utilize, therapy). As in group therapy, the individual who suffers from this disorder may engage in long periods of not talking and silence in session. These may be difficult to bear for the clinician.

Medications

Medication is usually not an issue for someone who suffers from this disorder, unless they also have an associated psychological disorder, such as major depression. Most patients show no additional improvement with the addition of an antidepressant medication, though, unless they are also suffering from suicidal ideation or a major depressive episode. Long-term treatment of this disorder with medication should be avoided; medication should be prescribed only for acute symptom relief. Additionally, prescription of medication may interfere with the effectiveness of certain psychotherapeutic approaches. Consideration of this effect should be taken into account when arriving at a treatment recommendation.

Self-Help

The medical profession often overlooks self-help methods for the treatment of this disorder because very few professionals are involved in them. The social network provided within a self-help support group can be a very important component of increased, higher life functioning and a decrease in an inability to function in the face of unexpected stressors. A supportive and non-invasive group can help a person who suffers from schizoid personality disorder-overcome fears of closeness and feelings of isolation. Many support groups exist within communities throughout the world that are devoted to helping individuals with this disorder share their commons experiences and feelings.
Patients can be encouraged to try out new coping skills and learn that social attachments to others don’t have to be fraught with fear or rejection. They can be an important part of expanding the individual’s skill set to develop new, healthier social relationships
 

Source: http://www.mentalhelp.net

Medical experts define paranoid personality disorder as the pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent.
This type of personality disorder could be traced in the beginning by early adulthood and present in a variety of contexts.
People with paranoid personality disorder have long-term, widespread and unwarranted suspicions that other people are hostile, threatening or demeaning.
These beliefs are steadfastly maintained in the absence of any real supporting evidence.
The disorder, whose name comes from the Greek word for "madness," is one of ten personality disorders described in the 2000 edition of the Diagnostic and Statistical Manual of Mental Disorders,(the fourth edition, text revision or DSM-IVTR), the standard guidebook used by mental health professionals to diagnose mental disorders.
Despite the pervasive suspicions they have of others, patients with Paranoid Personality Disorder are not delusional (except in rare, brief instances brought on by stress).
Most of the time, they are in touch with reality, except for their misinterpretation of others’ motives and intentions.
Paranoid Personality Disorder patients are not psychotic but their conviction that others are trying to "get them" or humiliate them in some way often leads to hostility and social isolation.

Symptoms

A. Suspects, without sufficient basis, that others are exploiting, harming, or deceiving him or her.
B. Is preoccupied with unjustified doubts about the loyalty or trustworthiness of friends or associates.
C. Is reluctant to confide in others because of unwarranted fear that the information will be used maliciously against him or her
D. Reads hidden demeaning or threatening meanings into benign remarks or events
E. Persistently bears grudges, i.e., is unforgiving of insults, injuries, or slights
F. Perceives attacks on his or her character or reputations that are not apparent to others and is quick to react angrily or to counterattack
G. Has recurrent suspicions, without justification, regarding fidelity of spouse or sexual partner.
 

Paranoid Personality Disorder has affected many people from different parts of the globe.

Treatments

Personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions.
Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.

Psychotherapy

As with most personality disorders, psychotherapy is the treatment of choice. Individuals with paranoid personality disorder, however, rarely present themselves for treatment. It should not be surprising, then, that there has been little outcome research to suggest which types of treatment are most effective with this disorder.
It is likely that a therapy that emphasizes a simple supportive, client-centered approach will be most effective. Rapport building with a person who has this disorder will be much more difficult than usual because of the paranoia associated with the disorder. Early termination, therefore, is common. As the therapy progresses, the patient will likely begin to trust the clinician more and more. The client then will likely begin disclosing some of his or her more bizarre paranoid ideation. The therapist must be careful to balance being objective in therapy concerning these thoughts, and of raising the suspicions of the client that he or she is not trusted. It is a difficult balance to maintain, even after a good working rapport has been established.
During times when the patient is acting upon his paranoid beliefs, the therapist’s loyalties and trust may be called into question. Care must be used not to challenge the client too firmly or risk the individual leaving therapy permanently. Control issues should be dealt with in much a similar manner, with great care. Since the paranoid beliefs are delusional and not based in reality, arguing them from a rational point of view is useless. Challenging the beliefs is also likely to result in more frustration on both the part of the therapist and client, too.
All clinicians and mental health personnel who are exposed to the individual who suffers from paranoid personality disorder should be more keenly aware of being straightforward with this individual. Subtle jokes are often lost on them and allusions to information about the client not received directly from the client’s mouth will raise a great deal of suspicion. Therapists should typically avoid trying to have the patient sign a release of information for information not essential to the current therapy. Items in life that usually would not give most people a second thought can easily become the focus of attention to this client, so care must be exercised in discussions with the client. An honest, concrete approach will likely gain the most results, focusing on current life difficulties, which has brought the client into therapy at this time. Clinicians should generally not inquire too deeply into the client’s life or history, unless it’s directly relevant to clinical treatment.
Long-term prognosis for this disorder is not good. Individuals who suffer from this disorder often remain afflicted with prominent symptoms of it throughout their lifetime. It is not uncommon to see such people in day treatment programs or state hospitals. Other modalities, such as family or group therapy, are not recommended.
 

Medications

Medications are usually contraindicated for this disorder, since they can arouse unnecessary suspicion that will usually result in noncompliance and treatment dropout. Medications that are prescribed for specific conditions should be done so for the briefest time period possible to bring the condition under management. An anti-anxiety agent, such as diazepam, is appropriate to prescribe if the client suffers from severe anxiety or agitation where it begins to interfere with normal, daily functioning. An anti-psychotic medication, such as thioridazine or haloperidol, may be appropriate if a patient decompensates into severe agitation or delusional thinking, which may result in self-harm or harm to others.

Self-Help

There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder. Such approaches would likely not be very effective because a person with this disorder is likely to be mistrustful and suspicious of others and their motivations.

Source: http://www.mentalhelp.net

Obsessive-Compulsive Personality Disorder pertains to those persons who are not open and flexible to their daily activities, interpersonal relationships and expectations.
Persons having this type of personality disorder are also concerned with too much orderliness, perfectionism and control of their lives and relationships.
This type of medical condition is hereditary and could be transmitted to any family members.
Based on research Obsessive-Compulsive Personality Disorder occurs more frequently to men than women.
The affected person is also easily gets angry when things go out of control.
Furthermore, anyone who is suffering from this type of personality disorder is someone who has difficulty expressing tender feelings, and rarely pays compliments.

Obsessive-Compulsive Personality Disorder is hereditary and could be transmitted to any family members.

Symptoms
 

A. Is preoccupied with details, rules, lists, order, organization, or schedules to the extent that the major point of the activity is lost
B. Shows perfectionism that interferes with task completion (e.g., is unable to complete a project because his or her own overly strict standards are not met)
C. Is excessively devoted to work and productivity to the exclusion of leisure activities and friendships (not accounted for by obvious economic necessity)
D. Is over conscientious, scrupulous, and inflexible about matters of morality, ethics, or values (not accounted for by cultural or religious identification)
E. Is unable to discard worn-out or worthless objects even when they have no sentimental value
F.  Is reluctant to delegate tasks or to work with others unless they submit to exactly his or her way of doing things
G. Adopts a miserly spending style toward both self and others; money is viewed as something to be hoarded for future catastrophes
H. Shows rigidity and stubbornness.

Treatments

The overwhelming preoccupation with orderliness, perfectionism and control of their lives and relationships means that most types of treatment are going to be, at best, difficult. Treatment options that do not fit within the client’s cognitive schema will likely be quickly rejected rather than attempted.
Individuals who suffer from this disorder have difficulty in incorporating new and changing information into their lives, so new learning takes place only over a great deal of time and  with as much effort on both the clinician’s and client’s part. Their ability to work with others is equally affected, since they see the world as black and white — their way of doing things and the wrong way of doing things. Naturally, this faulty logic will also be translated into their therapeutic relationship with the clinician and their treatment. It is therefore unlikely the clinician will have much success in using techniques or treatment modalities, which have not first been approved by the patient for use. Sometimes, simply stating the effectiveness of a given treatment for a specific problem citing relevant research studies may help the patient be more open to certain treatments. More often, though, this technique won’t be effective.
When this disorder is combined with the presentation of a medical illness, physicians should expect a logical and coherent presentation of troubling symptoms with little emotionality attached to their physical discomfort. Treatment is most effective when the nature of the disease process is first discussed with the individual, as well as typical and accepted treatments.
A physician in this instance is best sticking with the facts of the presenting problem and underlying disorder rather than offering vague impressions of their opinion.
Since the individual with this disorder tends to be meticulous and concerned with details, the treatment regimen — once accepted — will likely be adhered to rigorously, without incident.

Psychotherapy

As with most personality disorders, individuals seek treatment for items in their life that have become overwhelming to their existing coping skills.
These skills may be somewhat limited, in the first place, because of their disorder. While they may be generally effective enough in most instances to shield the client from stress and emotional difficulties, during times of increased stress, work pressure, family problems, etc. the underlying disorder will become more evident in day-to-day behaviours.
 As with most personality disorders, treatment is often focused on short-term symptom relief and the support of existing coping mechanisms while teaching new ones.
 Long-term or substantive work on personality change is usually beyond most clinician’s skill levels, and patient’s budgets.
 Obsessive-compulsive personality disorder is especially resistant to such changes, because of the basic makeup of this disorder.
Short-term therapy will most likely be beneficial when the patient’s current support system and coping skills are examined. Those skills that are not currently working could be reinforced with additional skill sets. Social relationships can also be examined, reinforcing strong, positive relationships while having the client re-examine negative or harmful relationships.
 One important aspect is to try to have the individual examine and properly identify their feeling states, rather than just intellectualizing or distancing themselves from their emotions.
This can be accomplished through a variety of techniques, such as feeling identification (e.g., the "feeling faces") at the onset of every therapy session.
 Homework might include writing feelings down in a journal, especially as they notice them. Proper identification and realization of feelings can bring about much change in and of itself.
Individuals suffering from obsessive-compulsive personality disorder often are not in touch with their emotional states as much as their thoughts.
Leading the client away from describing situations, events, and daily happenings and to talking about how such situations, events and daily happenings made them feel may be helpful.
 Sometimes the patient may complain he or she doesn’t remember or know how he or she felt at the time; the journal becomes a useful tool at this point.
Therapy with people who have this disorder can sometimes be trying, since they can see the world in a very "all-or-nothing" manner.
Beck’s cognitive therapy does not seem to be very effective in treatment, and cognitive approaches in general probably aren’t useful in this case.
Clinicians must be willing to undergo verbal attacks on their professionalism and knowledge; as such, scepticism about a therapist’s treatment approach from the client with this disorder can be expected. Clinicians should also be careful about engaging the client within these verbal attacks or intellectual discussions, as they continue to distance the patient from his or her feelings, and take the focus off the client and onto unrelated matters (e.g., a therapist’s professional training).
Most people who suffer from this personality disorder (and the different, but related, obsessive-compulsive disorder) lead relatively normal lives, may have a family, friends, and work regularly.
 Clinicians should be careful not to overgeneralize psychopathology and look to change aspects of the patient’s personality he or she is not ready or willing to change.
This means, in effect, that if the way they relate to others in their environment (which a clinician might characterize as a personality disorder) is working for them, a clinician should not seek to change it 180 degrees without the client’s purposeful consent. Therapy will most often be most effective when it focuses on correcting short-term difficulties currently being experienced.
 It will become increasingly less effective when the goal of therapy is complex, long-term personality change.
Although a group therapy, modality may be helpful and an effective treatment option, most people who suffer from this disorder will not be able to withstand the minimum social contact necessary to gain a healthy group dynamic. They may quickly become ostracized by the group for pointing out other people’s deficits and "wrong-headed" ways of doing things.

Hospitalization

Hospitalization is rarely needed for people who suffer from this disorder, unless an extreme or severe stressor or stressful life event occurs which increases the compulsive behaviours to an extent where regular daily activities are halted or present possible risks of harm to the patient.
 Hospitalization may also be needed when the obsessive thoughts do not allow the individual to conduct any usual activities, paralyzing them in bed or with their accompanying compulsive behaviours.

Medications

Medication for this disorder is generally not indicated unless the individual is also suffering from an associated psychological disorder such as anxiety or depression.
 

Self-Help

The medical profession often overlooks self-help methods for the treatment of this disorder because very few professionals are involved in them.
 Support groups, though, offer an excellent adjunct to continuing medication check-ups once a month, and a way to gain emotional and social support through the community.
These groups also allow others to ensure the client is doing well and promotes the client’s independence and stability.
 Many support groups exist within communities throughout the world that are devoted to helping individuals with this disorder share their commons experiences and feelings.
Such support groups are recommended to individuals suffering from this disorder, especially if they have found therapy unhelpful or too expensive.  

Source: http://www.mentalhelp.net

A better understanding of Narcissistic Personality Disorder

Medical experts define Narcissistic Personality Disorder are those persons who have too much love on their appearance and skills.
Patients suffering from this type of disorder want to project to themselves and others that they are perfect in almost every aspect of their lives.
Those persons suffering from this type personality disorder want to make it appear that they are perfect since they are actually insecure with their appearance and have a low self-esteem.
Based on study Narcissistic Personality Disorder is more common on men than women are which is why many male politicians, wealthy businessmen, movie producers, surgeons, and trial attorneys are having problems with this type of medical disorder.
The illusion of "greatness" they project to others is most commonly shattered by some substantial threat to their ego such as a physical illness, loss of a job, loss of a relationship, or depression when sensing that their lives are actually quite empty even though they may have acquired much material success.
This loss precipitates a panicky sensation that "my world is falling to pieces," and the patient feels that his/her life is unravelling.

Persons suffering from Narcissistic Personality Disorder love to project themselves as perfect to hide their insecurity within.

Symptoms

   A. Has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements).
   B. Is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love.
   C. Believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).
   D. Requires excessive admiration.
   E. Has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations.
   F. Is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends.
   G. Lacks empathy: is unwilling to recognize or identify with the feelings and needs of others.
   H. Is often envious of others or believes that others are envious of him or her.
   I. Shows arrogant, haughty behaviours or attitudes.

Treatments

Personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions.
Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.
 

Psychotherapy

Most psychiatrists will, as a practical matter, treat most of their severely narcissistic patients for symptoms related to crises and relatively external Axis I diagnoses, rather than in an effort to address the personality disorder itself. The therapist must be aware of the importance of narcissism in helping to sustain the patient’s self-image, of refraining from confronting the need for self-aggrandizement, and of helping the patient use his or her narcissistic characteristics to develop a self-image based upon genuine positive self-esteem rather than out of fears of inadequacy. Those patients who do not terminate treatment after symptom relief has been obtained may wish to receive help for some of the problems related to their personality disorder, such as interpersonal difficulties or depression.
If possible, long-term individual psychotherapy is the treatment of choice for those with narcissistic personality disorder because it helps to establish a strong therapeutic alliance between therapist and patient. Yet, even within this framework, expectations should focus on small changes in personality traits as opposed to expecting large changes as being possible.
Goals in therapy should focus on helping the patient develop some empathy for others by learning to appreciate other’s feelings and points of view, acknowledging his/her "specialness" while helping the patient learn how to put it into perspective, and helping the patient learn how to appropriately handle slights and rejections from others without feeling one’s sense of self as being extremely threatened. These goals can all be developed within the safety of a strong therapy relationship between therapists and patient so that when the patient’s vulnerabilities are exposed, the therapist can help the patient feel okay about these vulnerabilities while gently putting the patient’s exaggerated sense of self-importance back in perspective.
Group therapy for those with narcissistic personality disorder tends to be ineffectual. Usually in a therapy group, narcissists will tend to dominate the group or tire other group members with their list of accomplishments and grandeur. Because they do not respond well to critical feedback, narcissists are likely to drop out of group therapy once others start providing feedback about their behaviour. On the other hand, on the other hand, the other group members might drop out of the group because they get tired of the narcissists dominating the therapy.
 

Hospitalization

The hospitalization of patients with severe Narcissistic Personality occurs frequently. For some, such as those who are quite impulsive or self-destructive, or who have poor reality testing, this is the result of Axis I symptoms that are overlaid upon the personality disorder. Hospitalizations should be brief, and the treatment specific to the particular symptom involved.
Another group of patients for whom hospitalization is indicated, provided long-term residential treatment is available, are those who have poor motivation for outpatient treatment, chronic destructive acting out, and chaotic life-styles. An inpatient program can offer an intensive milieu, which includes individual psychotherapy, family involvement, and a specialized residential environment. The structure is physically and emotionally secures enough to sustain the patient with severe ego weakness throughout the course of expressive, conflict-solving psychotherapy. The ultimate goals are of affecting a more integrated, cohesive self-concept that is less vulnerable to slights, criticisms, rejections, or general blows to self-esteem.

Source: http://www.mentalhelp.net

Medical experts define Histrionic Personality Disorder as those people who have intense, unstable emotions and distorted self-images.
Persons who are suffering from histrionic personality disorder usually depend their self-esteem on the approval of others and do not arise from a true feeling of self-worth.
Patients who have this type of personality disorder have an overwhelming desire to be noticed, and often behave dramatically or inappropriately to get attention.
The word histrionic in itself means “dramatic or theatrical.”
This type of disorder is also more common in women than in men and usually is detected in early adulthood.
 

Symptoms
 

A. Is uncomfortable in situations in which he or she is not the center of attention.
B. Interaction with others is often characterized by inappropriate sexually seductive or provocative behaviour.
C. Displays rapidly shifting and shallow expression of emotions.
D. Consistently uses physical appearance to draw attention to self.
E. Has a style of speech that is excessively impressionistic and lacking in detail.
F. Shows self-dramatization, theatricality and exaggerated expression of emotion.
G. Is suggestible, that is, easily influenced by others or circumstances.
H. Considers relationships more intimate than they actually are.

 Persons suffering from Histrionic Personality Disorder usually loved to be notice at all times.

 Treatments
 

Personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions.
Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.
 

Psychotherapy
 

As with most personality disorders, people present for treatment only when stress or some other situational factor within their lives has made their ability to function and cope effectively impossible. They are, however (unlike other people who suffer from personality disorders), much quicker to seek treatment and exaggerate their symptoms and difficulties in functioning. Because they also tend to be more emotionally needy, they are often reluctant to terminate therapy.
Psychotherapy, as with most personality disorders, is the treatment of choice. Group and family therapy approaches are generally not recommended, since the individual who suffers from this disorder often draws attention to themselves and exaggerates every action and reaction. People with this disorder often come across as "fake" or shallow in their interpersonal relationships with others. Patients often express all of their feelings with the same depth of emotion, unaware of the subtleties of their own emotional states and of the vast range available to them.
Therapy should generally be supportive and good rapport will usually be easily established with the patient early on. Clinicians may often find themselves placed in a "rescuer" role, in which the therapist will be asked to constantly reassure and rescue the client from daily problems. Every problem is usually expressed in a dramatic fashion. Many times the therapist will be perceived as sexually attractive to the patient. Boundary issues in relationships and a clear delineation of the therapeutic framework are relevant and important aspects of therapy.
Approaches that take advantage of matter-of-fact and realistic assessment of situations and problems can also be important. Solution-focused therapy is often appropriate with this client. Most therapy approaches should not be focused on the long-term, personality change of the individual, but rather short-term alleviation of difficulties within the person’s life. Few people could afford the time or cost required to "cure" someone of this disorder. This should be explicitly stated up-front at the onset of therapy to dismiss any thoughts the client may have of a "magical" cure for this disorder.
Suicidal behaviour is often apparent in a person who suffers from histrionic personality disorder. Suicidality should be assessed on a regular basis and suicidal threats should not be ignored or dismissed. Suicide sometimes occurs when all that was intended was a gesture, so all such thoughts and plans should be taken with the same seriousness as with any other disorder. A suicide contract should be established to specify under what conditions the therapist might be contacted in case the client feels like hurting him or herself. Self-mutilation behaviour may also be present in this disorder and should be taken seriously as an issue of importance to discuss within therapy.
Therapists will find that taking a somewhat skeptical stance within therapy to be useful, due to the usual exaggeration of events and problems by the patient. By following a line of reasoning to its logical conclusion, the client can usually discover the unrealistic expectations and fears associated with many behaviours and thoughts. Since many people who have histrionic personality disorder will emphasize attractiveness ("style over substance") in their lives and relationships, discussing alternatives and trying out new behaviours may be helpful. The therapist can also help by pointing out, in session, when the client is using shallow criteria in which to judge another. The patient should eventually look to be able to do these themselves throughout their lives.
Insight- and cognitive-oriented approaches are generally largely ineffective in treatment of this disorder and should be avoided. People with this disorder are often incapable of examining unconscious motivations and their own thoughts to a degree where it is helpful. While these approaches can be a part of a larger treatment plan, they should not be the focus. Helping the client to examine interactions from a more objective point of view and emphasizing alternative explanations for behaviour is likely to be more effective. Examining and clarifying a client’s emotions are also important components of therapy.
Clinicians will often experience reactions to treating this disorder, because of the dramatic nature of the patient. Because of this possibility, therapists should be more attuned to their own feelings within the therapy setting and ensure that they are treating the patient fairly and with respect. As with Borderline Personality Disorder, individuals with histrionic personality disorder often find themselves discriminated against by mental health professionals because of the symptoms of their disorder. Clinicians and patients should be aware of this possible discrimination.

Medications
 

As with most personality disorders, medications are not indicated except for the treatment of associated disorders such as anxiety or depression. Care should be given when prescribing medications to someone who suffers from histrionic personality disorder, though, because of the potential for using the medication to contribute to self-destructive or otherwise harmful behaviours.

Self-Help
 

There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder. Such approaches would likely not be very effective because a person with this disorder is likely to be very dramatic in their interactions with others, coming across as "artificial" or shallow.
As with many of the other personality disorders, encouraging those with Histrionic personality disorder to learn self-help tools such as stress and anxiety reducing techniques may aid them in managing some of their crisis-oriented feelings. Learning stress management skills such as deep breathing and consistent exercise may help someone with Histrionic personality disorder to cope better during stressful times.
 

Sources: http://www.mentalhelp.net, http://www.psychologytoday.com, and http://my.clevelandclinic.org.

Dependent Personality Disorders is clinically defined as the long-standing need for the person to be taken care of and a fear of being abandoned or separated from important individuals in his or her life.
This pervasive fear leads to "clinging behaviour" and usually manifests itself by early adulthood.
Individuals with dependent personality disorder are also usually quite needy for attention, valuation, and social contact.
Clients with this disorder usually do not present in a dramatic fashion, but will often make repeated requests for attention to their complaints, whether these complaints are about their lifestyle, social relationships, lack of meaning in life, medical, or education.

Symptoms

A.Needs advice and reassurance before making any decisions.
B. Needs others to assume responsibility for most major areas of his or her life.
C. Has difficulty expressing disagreement with others because of fear of loss of support or approval.
D. Has difficulty initiating projects or doing things on his or her own (because of a lack of self-      confidence in judgment or abilities rather than a lack of motivation or energy).
E. Goes to excessive lengths to obtain nurturance and support from others, to the point of volunteering to do things that are unpleasant
F. Feels uncomfortable or helpless when alone because of exaggerated fears of being unable to care for himself or herself.
G. Urgently seeks another relationship as a source of care and support when a close relationship ends.
H. Is unrealistically preoccupied with fears of being left to take care of himself or herself.

Persons suffering from dependent personality disorder needs constant attention and love and usually afraid of being left abandoned by his or her special someone, family and friends.

Treatment

People who suffer from this disorder are often outwardly compliant with clinicians’ suggestion for treatment, and will usually be passive in their overall treatment, no matter what form it takes. However, real gains in therapy may not be made easily, because the client’s compliance (due to the disorder) is often only surface-deep. While the individual may be one of the easiest to see week after week or month after month in therapy, they may also be one of the most difficult because of their strong need for constant reassurance and support. Dependency upon the clinician specifically and therapy in general should be carefully monitored and avoided. Psychiatrists and physicians should be aware that individuals with dependent personality disorder would often present with a number of physical or somatic complaints. While appropriate medications need to be prescribed for these as necessary, the clinician should carefully monitor medication intake and maintenance to ensure the patient is not abusing it. Physical complaints should not be minimized or dismissed, as is often the case with someone who suffers from this disorder, but they must not also be encouraged.
 A simple, matter-of-fact approach works best in this case.
Clinicians in general should be wary of the therapeutic relationship with a person suffering from dependent personality disorder.
The needs of the individual can be great and overwhelming at times, and the patient will often try to test the limits of the therapeutic frame for therapy.
Burnout among therapists treating this disorder is common, because of the client’s demands for constant reassurance and attention, especially between therapy sessions.
 A clear explanation at the onset of therapy about how treatment is to be conducted, including a discussion of appropriate times and needs for contacting the clinician in-between sessions,  is vitally important. While rapport and a close, therapeutic relationship must be established, the boundaries in therapy must also be constantly and clearly delineated.
Personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions.
Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.

Psychotherapy

As with all personality disorders, psychotherapy is the treatment of choice.
 Treatment is likely to be sought by individuals suffering from this disorder when stress or other complications within their life have led to decreased efficiency in life functioning.
 As with all other personality disorders as well, they may present with a clear Axis I diagnosis and the personality disorder may only become apparent after a few sessions of therapy.
The most effective psychotherapeutic approach is one, which is focused on solutions to specific life problems the patient is presently experiencing. Long-term therapy, while ideal for many personality disorders, is contra-indicated in this instance since it reinforces a dependent relationship upon the therapist.
 While some form of dependency will exist no matter the length of therapy, the shorter the better in this case.
 Termination issues will likely be of extreme importance and will virtually be a litmus test of how effective the therapy has been. If the individual cannot end therapy successfully and move on to become more self-reliant, it should not be seen as a therapeutic failure. Rather, the individual was not likely seeking life-changing therapy in the first instance but instead solution-focused therapy.
Examining the client’s faulty cognitions and related emotions (of lack of self-confidence, autonomy versus dependency, etc.) can be an important component of therapy.
 Assertiveness training and other behavioural approaches have been shown to be most effective in helping treat individuals with this disorder.
Group therapy can also be helpful, although care should be utilized to ensure that the patient does not use groups to enhance existing or new dependent relationships.
Challenging dependent relationships the client has with others that may be unhealthy for the client should generally be avoided at the onset of therapy.
 As therapy progresses, these challenges can occur but must be done carefully; restraint must be used if the individual is not ready to give up these unhealthy relationships.
Termination of therapy with a person who has this disorder is an extremely important issue to consider. While termination should always be a joint decision between the clinician and the client, people with this disorder often don’t know "how much is enough" therapy. The therapist, therefore, may need to prod the patient toward ending therapy.
 As the end of therapy approaches, the patient is likely to re-experience feelings of insecurity, lack of self-confidence, increased anxiety and perhaps even depression. This can be typical of individuals with this disorder terminating therapy and should be treated appropriately. The clinician should not allow the patient to use these new symptoms, though, as a way of prolonging the current therapy. The goal is to end a relationship at an agreed-upon time and way. The client should be reinforced for the positive gains made in therapy and encouraged to explore their newfound autonomy or improved management of their anxious feelings.

Medications

As with all personality disorders, medications should only be prescribed for associated disorders suffered by the individual.
Sedative drug abuse and overdose is common in this population and should be prescribed with additional caution.
 Anti-anxiety agents and antidepressants should be prescribed only when there is a clear Axis I diagnosis in conjunction with the personality disorder.
 Physicians should resist the temptation to over-prescribe to someone with this disorder, because they often present with multiple physical complaints or anxiety.
The anxiety in this instance is clearly situationally related and medication may actually interfere with effective psychotherapeutic treatment.
Giving any individual with a personality or mental disorder a placebo drug for its perceived value by the patient is ethically questionable.
 Doctors rarely have needed to prescribe a vitamin or other non-psychoactive substance unless a patient’s medical condition clearly indicates it.
 When such a prescription is made, it should be made with the clear understanding what it is being prescribed for.
 Any indirect suggestion that such a medication will help an individual overcome their feelings of insecurity; inadequacy, need for dependence, etc. should be avoided.
 A medication should not be prescribed because of its "magical" effects, and medications that are more expensive should not be prescribed over less-expensive medications just because they are “newer." Prescriptions should always be written for a specific medication because of the research suggesting its effectiveness with the patient’s specific medical complaint or diagnosed mental disorder and avoidance of intolerable side effects.

Self-Help

The medical profession often overlooks self-help methods for the treatment of this disorder because very few professionals are involved in them.
 Suggesting such, a support group later in treatment, to help put some of their new skill sets to use in a group setting, may be helpful.
 Many support groups exist within communities throughout the world that are devoted to helping individuals with this disorder share their commons experiences and feelings.
Individuals should likely avoid using a support group as the only means of treatment for this disorder, since it is likely to encourage additional dependent relationships.

Source: http://www.mentalhelp.net
 

Borderline Personality Disorder pertains to those persons who suffer labile interpersonal relationship characterized by instability.
Persons suffering from this type of medical disorder are viewed by many as "delusional" or those people who have a hard time distinguishing reality from their own misperceptions of the world and their surrounding environment.

This type of behaviour might be viewed as negative for many but experts explains it as  related to their emotions overwhelming regular  cognitive functioning, which is likely to create many conflicts with others.
Borderline Personality Disorder also pertains to persons having fears of being abandoned by others in relationships, which oftentimes lead these persons to engage in many extreme and confusing behaviours of over-possessiveness or being unavailable, which ultimately makes their partner leave them in the end.
 

Here are some common symptoms of Borderline Personality Disorder:

A.  Frantic efforts to avoid real or imagined abandonment.
B.  A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.
C.  Identity disturbance: markedly and persistently unstable self-image or sense of self.
D. Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating).
E. Recurrent suicidal behaviour, gestures, or threats, or self-mutilating behaviour.
F. Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days).
G. Chronic feelings of emptiness.
H. Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights).
 I.   Transient, stress-related paranoid ideation or severe dissociative symptoms.

Persons suffering from Borderline Personality Disorder need immediate treatment and understanding from their lover, family and friends.

Treatment

Psychotherapy is nearly always the treatment of choice for this disorder; medications may be used to help stabilize mood swings.
Controversy surrounds overmedicating people with this disorder.

Psychotherapy

Like with all personality disorders, psychotherapy is the treatment of choice in helping people overcome this problem.
 While medications can usually help some symptoms of the disorder, they cannot help the patient learn new coping skills, emotion regulation, or any of the other important changes in a person’s life.
An initially important aspect of psychotherapy is usually contracting with the person to ensure that they do not commit suicide.
Suicidality should be carefully assessed and monitored throughout the entire course of treatment. If suicidal feelings are severe, medication and hospitalization should be seriously considered.
The most successful and effective psychotherapeutic approach to date has been Marsha Linehan’s Dialectical Behaviour Therapy.
Research conducted on this treatment have shown it to be more effective than most other psychotherapeutic and medical approaches to helping a person to better cope with this disorder.
 It seeks to teach the client how to learn to better take control of their lives, their emotions, and themselves through self-knowledge, emotion regulation, and cognitive restructuring.
A comprehensive approach is most often conducted within a group setting. Because the skill set learned is new and complex, it is not an appropriate therapy for those who may have difficulty learning new concepts.
Like all personality disorders, borderline personality disorder is intrinsically difficult to treat. Personality disorders, by definition, are long-standing ways of coping with the world, social and personal relationships, handling stress and emotions, etc. that often do not work, especially when a person is under increased stress or performance demands in their lives.
Treatment, therefore, is also likely to be somewhat lengthy in duration, typically lasting at least a year for most.
Other psychological treatments, which have been used to lesser effectiveness, to treat this disorder include those that focus on social learning theory and conflict resolution.
These types of solution-focused therapies, though, often neglect the core problem of people who suffer from this disorder — difficulty in expressing appropriate emotions (and emotional attachments) to significant people in their lives due to faulty cognitions.
Providing a structured therapeutic setting is important no matter which therapy type is undertaken. Because people with this disorder often try and "test the limits" of the therapist or professional when in treatment, proper and well-defined boundaries of your relationship with the client need to be carefully explained at the onset of therapy.
 Clinicians need to be especially aware of their own feelings toward the patient, when the client may display behaviour that is deemed "inappropriate." Individuals with borderline personality disorder are often unfairly discriminated against within the broad range of mental health professionals because they are seen as "trouble-makers."

Hospitalization

Hospitalization is often a concern with people who suffer from borderline personality disorder because they so often visit hospital emergency rooms and are sometimes seen on inpatient units because of severe depression.
People with this disorder often present in crisis at their local community mental health center, to their therapist, or at the hospital emergency room.
While an emergency room is an immediate source of crisis intervention for the patient, it is a costly treatment and regular visits to the E.R. should be discouraged.
Instead, patients should be encouraged to find additional social support within their community (including self-help support groups), contact a crisis hotline, or contact their therapist or treating physician directly.
Emergency room personnel should be careful not to treat the person with borderline personality disorder in blind conjunction with another set of therapists or doctors who are treating the patient for the same problem at another facility. Every attempt should be made to contact the client’s attending physician or primary therapist as soon as possible, even before the administration of medication that may be contraindicated by the primary treatment provider. Crisis management of the immediate problem is usually the key component to effective treatment of this disorder when it presents in a hospital emergency room, with discharge to the patient’s usual care provider.
Inpatient treatment often takes the form of medication in conjunction with psychotherapy sessions in groups or individually.
 This is an appropriate treatment option if the person is experiencing extreme difficulties in living and daily functioning.
 It is, however, relatively rare to be hospitalized in the U.S. for this disorder. Long-term care of the person suffering from borderline personality disorder within a hospital setting is nearly never appropriate. The typical inpatient stay for someone with borderline personality disorder in the U.S. is about 3 to 4 weeks, depending upon the person’s insurance.
Since this treatment is so expensive, it is getting more difficult to obtain. Results of such treatment are also mixed.
While it is an excellent way of helping stabilize the client, it is usually too short a time to attain significant changes within the individual’s personality makeup.
Good inpatient care facilities for this disorder should be highly structured environments, which seek to expand the individual’s independence.
Partial hospitalization or a day treatment program is often all that is needed for people who suffer from borderline personality disorder.
 This allows the individual to gain support and structure from a safe environment for a short time, or during the day, and returning home in the evening. In times of increased stress or difficulty coping with specific situations, this type of treatment is more appropriate and healthier for most people than full inpatient hospitalization.

Medications

As with all, the Personality Disorders there are no medications specifically prescribed to treat Borderline personality disorder.
However, some medications may be helpful to alleviate some of the associated disorders of anxiety, depression, and/or sometimes-psychotic symptoms.
It is, however, clear that low doses of high potency neuroleptics (e.g., haloperidol) may be helpful for disorganized thinking and some psychotic symptoms.
Depression in some cases is amenable to neuroleptics. Neuroleptics are particularly recommended for the psychotic symptoms mentioned above, and for patients who show anger, which must be controlled. Dosages should generally be low and the medication should never be given without adequate psychosocial intervention."
Antidepressant and anti-anxiety agents may be appropriate during particular times in the patient’s treatment, as appropriate.
For example, if a client presents with severe suicidal ideation and intent, the clinician may want to seriously consider the prescription of an appropriate antidepressant medication to help combat the ideation. Medication of this type should be avoided for long-term use, though, since most anxiety and depression is directly related to short-term, situational factors that will quickly come and go in the individual’s life.

Self-Help

The medical profession often overlooks self-help methods for the treatment of this disorder because very few professionals are involved in them.
 Encouraging the individual with borderline personality disorder to gain additional social support, however, is an important aspect of treatment.
 Many support groups exist within communities throughout the world that are devoted to helping individuals with this disorder share their commons experiences and feelings.
Patients can be encouraged to try out new coping skills and emotion regulation with people they meet within support groups.
They can be an important part of expanding the individual’s skill set and develop new, healthier social relationships.
Patients should also be encouraged to learn stress and anxiety reducing techniques as well as increased coping skills.
By learning how to utilize some of these tools on their own, they may be able to cope more effectively on their own possibly preventing situational crises from developing.
Even incorporating a consistent exercise regimen may help someone with this personality disorder regulate his/her emotional mood swings or release anger, thereby helping to produce more stability in the person’s life.

Source: http://www.mentalhelp.net

Avoidant Personality Disorder is defined as the long-standing and complex pattern of feelings of inadequacy, extreme sensitivity to what other people think about them, and social inhibition.

It typically manifests itself by early adulthood and is associated with perceived or actual rejection by parents or peers during childhood.

Whether the feeling of rejection is due to the extreme interpersonal monitoring attributed to people with the disorder is still disputed.

Persons suffering from this type of personality disorder are usually loners and report feeling a sense of alienation from society.

Common Symptoms

A.  Avoids occupational activities that involve significant interpersonal contact, because of fears of criticism, disapproval, or rejection.

B.  Unwilling to get involved with people unless certain of being liked.

C. Shows restraint within intimate relationships because of the fear of being shamed or ridiculed.

D. Preoccupied with being criticized or rejected in social situations.

E. Inhibited new interpersonal situations because of feelings of inadequacy.

F. Views self as socially inept, personally unappealing, or inferior to others.

G. Unusually reluctant to take personal risks or to engage in any new activities because they may prove embarrassing.

 Persons who are usually a loner or someone who love to be alone are probably suffering from Avoidant Personality Disorder.

Treatment

It is said that personality disorders are typically some of the most challenging mental disorders to treat, since they are, by definition, an integral part of what defines an individual and their self-perceptions.

Treatment most often focuses on increasing coping skills and interpersonal relationship skills through psychotherapy.

Psychotherapy

As with most personality disorders, the treatment of choice is psychotherapy. While individual therapy is usually the preferred modality, group therapy can be useful if the client can agree to attend enough sessions.

 Because of the basic components of this disorder, though, it is often difficult to have the individual attend group therapy early on in the therapeutic process.

It is a modality to consider as the patient approaches termination of individual treatment, if additional therapy seems necessary and beneficial to the client.

Individuals who suffer from this disorder typically have poor self-esteem and issues surrounding any type of social interactions.

They often see only the negative in life and have difficulty in looking at situations and interactions in an objective manner.

This can also interfere with their self-report when they present for an initial evaluation, which can lead to important life history and medical information being missed (because the patient deems it and him or herself too unimportant to bother).

It is necessary to take a more detailed evaluation than usual, while doing so in a relatively unobtrusive fashion.

The clinician should be sensitive to nonverbal cues of the client during this session, to evaluate when information is being withheld.

This is essential to making a differential diagnosis with similar-looking but vitally different disorders, such as someone who suffers from schizoid or borderline personality disorder.

As with other personality disorders, the individual is not likely to present him or herself to therapy unless something has gone wrong in their life with which their dysfunctional personality style cannot adequately cope.

As with other personality disorders, psychotherapy is usually most effective when it is relatively short-term and oriented toward finding solutions to specific life problems.

While self-esteem issues will undoubtedly present themselves in treatment, serious self-enhancement is unlikely.

 The negative self-valuation is a life-long, pervasive cognition not conducive to regular methods of increasing one’s self-esteem.

As with all therapy, a solid therapeutic relationship founded with good rapport and listening to the client is important to the therapist’s effectiveness.

 The therapeutic relationship in itself is used as a place where the client learns how to feel comfortable and safe in other social relationships. Forming initial rapport is likely to be more difficult with someone who has this disorder, since early termination is often an issue. Once rapport is formed, though, therapy is usually quite stable, unless issues are brought up that are extremely difficult for the client to deal with. Therefore, the clinician in exploring new material during the session should use care.

Termination of therapy is an important issue as well because a successful ending to therapy and the therapeutic relationship reinforces the possibility of new relationships.

Medications

As with all personality disorders medications should only be prescribed for specific and acute Axis I diagnoses or problems suffered by the individual.

Anti-anxiety agents and antidepressants should be prescribed only when there is a clear Axis I diagnosis in conjunction with the personality disorder.

Physicians should resist the temptation to over-prescribe to someone with this disorder, because they often present with complaints of anxiety in social situations or a feeling of disconnectedness with their feelings.

The anxiety in this instance is clearly situationally related and medication may actually interfere with effective psychotherapeutic treatment.

Self-Help

There are not any self-help support groups or communities that we are aware of that would be conducive to someone suffering from this disorder.

 Such approaches would likely not be very effective because a person with this disorder is likely to avoid attending such sessions, due to increased anxiety and difficulty interacting socially.

However, learning relaxation and stress management techniques, especially stress inoculation techniques would be helpful for someone with Avoidant personality disorder.

 By learning relaxation and other stress reducing tools, the person is more able to cope during times of stress and manage one’s own anxiety levels.

Source: http://www.mentalhelp.net

Based on internet research this type of personality disorder is characterized by a long-standing pattern of a disregard for other people’s rights, often crossing the line and violating those rights.
This pattern of behaviour has occurred since age 15 (although only adults 18 years or older can be diagnosed with this disorder). To better understand this type of character flaw here are some of its common symptoms:
Failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are grounds for arrest,  deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure,  impulsivity or failure to plan ahead,  irritability and aggressiveness, as indicated by repeated physical fights or assaults,  reckless disregard for safety of self or others, consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honor financial obligations and  lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
If you notice any of these signs, it would be best that you immediately consult a medical practitioner to deal with this condition.

Anti-Social Personality Disorder is a problem shared by many people in this planet.
 

Treatment

A. Psychotherapy

As with most personality disorders, individuals with this disorder rarely seek treatment on their own, without being mandated to therapy by a court or significant other.
Court referrals for assessment and treatment for this disorder are likely the most common referral source.
A careful and thorough assessment will ensure that the person has antisocial personality disorder.
This can often be confused with simple criminal activity (all criminals do not have this disorder), adult antisocial behaviour, and other activities that do not justify the personality disorder diagnosis.
As with a thorough assessment of any suspected personality disorder, formal psychological testing should be considered invaluable.
Because many people who suffer from this disorder will be mandated to therapy, sometimes in a forensic or jail setting, motivation on the patient’s part may be difficult to find.
In a confined setting, it may be nearly impossible and therapy should then focus on alternative life issues, such as goals for when they are released from custody, improvement in social or family relationships, learning new coping skills, etc.
 In an outpatient setting, the focus of therapy can also be on these types of issues, but a part of the therapy should be devoted to discussing the antisocial behaviour and feelings (or lack thereof).
Common in the population who suffer from antisocial personality disorder is the lack of connections between feelings and behaviours.
 Helping the client draw, those lines between the two may be beneficial.
Threats are never an appropriate motivating factor in any sort of treatment, and least of all with this disorder. If the only way to motivate the patient is to threaten to report their noncompliance with therapy to the courts or warden, it is highly unlikely the clinician will make any type of gains within therapy anyway.
 It is appropriate, however, to try to help the individual with this disorder find good reasons that they may want to work on this problem further. For instance, ensuring that they not meet the court system again, be incarcerated, have to submit themselves to additional psychological examinations, etc.
Effective psychotherapy treatment for this disorder is limited. It is likely, though, that intensive, psychoanalytic approaches are inappropriate for this population. Approaches that reinforce appropriate behaviours and attempting to make connections between the person’s actions and their feelings are more beneficial. Helping the patient to gain greater accessibility to his/her emotions and to identify them are usually key aspects of treatment of this disorder. In addition, since these patients often have had little or no significant emotionally rewarding relationships in their lives, the therapeutic relationship can be one of the first ones. This can be very scary for the client, initially, and it may become intolerable. A close therapeutic relationship can only occur when a good and solid rapport has been established with the client and he or she can trust the therapist implicitly.

B. Hospitalization

Rarely is inpatient care appropriate or necessary for this personality disorder. Like most personality disorders, most people will go through their lives with little realization of the difficulty they have.
In this case, though, the person is more likely to be seen as a criminal and have a history of difficulties with the law. Loss of freedom may be more of a motivating factor than in other personality disorders, so some specialized treatment facilities have started to treat people with this disorder.
One such program we have read about is the Patuxent Institute, located in Jessup, Maryland in the U.S. This hospital utilizes a strict behavioural approach of placing patients on a token economy based upon their treatment progress.
This is a relatively new and radical approach to this sort of disorder and little research has been conducted to confirm its long-term effectiveness.
As with any treatment, the focus on feelings and connecting antisocial behaviour to appropriate feeling states is appropriate.
Since inpatient, programs tend to be more intensive and expensive they are rarely sought out by the patient themselves. Community follow-up and support, either by the hospital or professionals, or with the use of self-help support groups, is imperative to maintaining treatment gains.

C. Medications

Medical doctors will typically use psychiatric medications to treat mood and disordered behaviour symptoms (e.g., depression, poor sleep), and disorganized thought processes (looseness of thought) that are associated with the Personality Disorders.

D. Self-Help

The medical profession often overlooks self-help methods for the treatment of this disorder because very few professionals are involved in them.
 Groups can be especially helpful for people with this disorder, if they are tailored specifically for antisocial personality disorder. Individuals with this disorder typically feel more at ease in discussing their feelings and behaviours in front of their peers in this type of supportive modality.
 Leaders of such self-help support groups, though, must be wary of individuals who come to group just to brag about their exploits and who may seek to use the group inappropriately.
 Usually a group can be very helpful and beneficial to most people with this disorder, once they overcome their initial fears and hesitation to join such a group.
 Many support groups exist within communities throughout the world, which are devoted to helping individuals with this disorder share their common experiences and feelings.
Trust brings up the issue of confidentiality since often the patient with antisocial personality disorder is mandated to therapy.
 This means that the clinician may have to occasionally report on the patient’s progress in therapy. While this can usually be done in a very general way, which reveals no significant details of the content of therapy, it is still an important issue for the client.
 He or she may be suspicious and distrustful of the clinician at first, since it will be unclear as to who has the highest priority — the patient or the court. This fear can only be alleviated with an honest disclosure as to what the therapist will reveal to the courts, and with time, as the client learns that what he says in the therapy session does not become common knowledge. The limitations of therapy should be discussed with the patient up-front, in a clear and matter-of-fact manner, so there are no misunderstandings later.
The content of therapy should focus on the patient’s emotions (or lack thereof). As the individual learns to experience various emotional states, one of the first may be depression. The client will likely be unfamiliar with the feelings associated with depression, and so it is beneficial for the clinician to be supportive and empathetic to the individual during this time. Reinforcing any emotions, outside of anger or frustration, is usually beneficial. Experiencing intense affect is usually a sign of progress in therapy.
Staying on "safe issues," and discussing more real-life concerns, while one way of treating this disorder, is not likely to be as effective in long term behavioural change as an approach emphasizing the discovery and labelling of appropriate emotional states.
People who have antisocial personality disorder often have trouble with authority figures.
The therapist should usually take a neutral stance in this matter, since it is a firmly held belief by the client. The clinician should avoid arguments and taking sides on authority issues and those who hold authority over the client. Their moral and ethical makeup may leave a lot to be desired as well. While this may be an appropriate topic for discussion in therapy, it will also likely be one of little progress.

Source: http://www.mentalhelp.net