All of us can be difficult sometimes. We have “off” days and times in our lives when things are trickier, and this may on occasion lead us to be less than lovely to people in our lives, including people at work.

Keeping that caveat in mind though, some people do seem to be difficult more of the time than not.  Their behaviour appears particularly emotionally charged or disproportionate to the issue at hand, or they may create conflict between colleagues or within teams.  Where this behaviour is ongoing or deeply entrenched it may be that there are more deep-seated psychological issues in play.  One possibility is that the person has a personality disorder.

Personality refers to individual differences in characteristic patterns of thinking, feeling and behaving. Our personality is what makes us unique.

It is important to distinguish between personality disorders and personality traits.  Personality traits are attitudes and behaviours.  In a healthily functioning person, we adapt our behaviour to others and ideally respond in a way most likely to get the best from others and ourselves.  Learning how to respond in the most adaptive way is a developmental process, usually one that is well developed by adulthood.

Personality disorders are characterised by*:

1. Repeating patterns of feelings and behaviour that are

  • inflexible and pervasive
  • occur across all personal and social situations, and
  • lead to significant distress and/or impairment in social, occupational, or other important areas of functioning.

2. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.

Current psychological theory understands personality disorders as:

  • organised patterns of behaviour and thinking
  • coping patterns.

These patterns, although often maladaptive in context and sometimes distressing to the person, make perfect sense in the context of the person’s belief system.

Why do some people develop personality disorders?

Psychologists think that people hold a variety of ideas and beliefs about:

  • themselves
  • other people
  • the world and the future (life).

These ideas help us make sense of life experiences and ideally we choose the most adaptive one in a given situation.

But some people develop rigid and inflexible beliefs, most likely as a result of an interaction between biology and life experience.

Often rigid beliefs make perfect sense in light of negative childhood experiences, or the meanings a child might make of some benign experiences.  For example:

  • failing to meet parental/family/cultural standards
  • being on the receiving end of other people’s stress or distress
  • an absence of good things
  • being the “odd one out” at home or school
  • out-of-the-ordinary traumatic experiences.

We also know that chronic stress in childhood creates physiological (body) changes which means the person’s autonomic nervous system reacts excessively to relatively low levels of stress and takes longer than normal to return to “baseline” once the stress is removed.

Rigid and inflexible beliefs can lead to rigid and inflexible interpersonal and behavioural strategies.

So, the problem is that the person only has a limited repertoire of strategies to draw on and tends to apply the same one across all situations.

Recent neuroscience research also suggests that people with personality disorders may have impaired regulation of the neural circuits that modulate emotion. In particular, both a low threshold of excitability and less effective dampening down of the negative emotion circuit.  So the person is more likely to feel overwhelmed by emotions as well as having less effective tools for coping with them.

When the frontal lobe is damaged (for example, in a head injury), the person may also have difficulty managing how effectively they express their feelings. There are also individual differences in how the “pre-frontal” part of the brain manages to dampen down overwhelming emotions.

Why don’t people change?

Both the styles of thinking and the patterns of behaviour tend to be self-maintaining.  This process can be explained via faulty information processing systems (what I pay attention to) and flexibility of thinking (or not). If my thinking is rigid and I only pay attention to the information that “fits” there’s no change or adaptation to change.  An analogy of a shape sorter is useful for understanding this process: if my processing system looks only for green circles, I will miss all the other colour and shape options.  And if my system can only register green circles, I can’t make use of any others.

Another way of thinking about this is that the person may “know” what to do but won’t do it – likewise, they may “know” what not to do but still do it. They “know” people are sometimes late, but have learned over and over that people who don’t care about them are late or never show up, so find it hard to imagine other reasons for such behaviour. They “know” they shouldn’t shout at a colleague, but the only way they have seen strong views being expressed is by shouting and they haven’t learned interpersonal skills about being more quietly persuasive.

What can be done?

While personality disorders can be difficult to manage in a workplace environment, it is certainly possible for this to be done effectively. For the person with the disorder, a combination of skilled psychology therapy with a clinical psychologist and sometimes medication can enable some shifts in attitudes and behaviours. Psychological treatment is designed to help people learn new emotional and interpersonal skills.

We can also provide support and guidance for the person’s manager(s) and teams for the most effective scaffolding and strategies. Ideally, we will work with both the person and their manager, or if this is not possible working with the people around them can be effective.

* DSM-5 (American Psychiatric Association, 2011)