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Can People with Personality Disorders Change?

Relationships, Trauma, Therapist Guide
4 min read

Can People with Personality Disorders Change?

I’m often asked by partners and family members if a loved one with a Personality Disorder can change.  The short answer is that they have the ability to change, but it takes work and that needs to come from them.  They have to be aware or recognize that something needs to change to improve their relationships and aspects of themselves.  

Personality Disorders are characterized by rigid, inflexible patterns of thinking and behaviors that impair a person’s functioning.  A person may have trouble with perception (their inner experience) and relating to others/situations that result in distress.  This often causes problems with relationships, social activities, work, and school.  They may have a distorted sense of themselves or how others see them.  This can lead to feeling victimized, isolated, and disconnected. 

Additional Features include:

  • Feeling overwhelmed by negative emotions such as stress, anxiety, worthlessness, or anger.
  • Emotional Volatility; low distress tolerance.
  • “Black & White” thinking.
  • Erratic or impulsive behavior.
  • May be prone to depression and/or substance use.

The two most common Personality Disorders I see are Borderline Personality Disorder (BPD) and Narcissistic Personality Disorder (NPD).  These disorders are often rooted in childhood trauma or damaging experiences with their caregivers, where needs for love, security, and attention were not met or neglected. As a result, they may not develop a strong sense of themselves and their own identity, which affects personality. 

Through therapy, treatments, and support groups I have seen those with BPD make vast improvements in areas such as emotional regulation, distress tolerance, anger, and relationships.  This typically comes through increased awareness and understanding of past traumas, events, and damaging relationships or experiences that have influenced their thoughts, feelings, and behaviors over time.  Clients with NPD traits have made efforts to see others’ perspective, be more reflective, connect to their own feelings and try to respond differently in relationships.

However, with most disorders, there is varying severity of these traits and symptoms where partners and family members may lack awareness or are in denial that something needs to change; they don’t see their behaviors as a problem.  They see others as the problem and continue to feel victimized.  In these situations, you must find ways to best take care of yourself.  

How to Take Care of Yourself in the Relationship

This looks like:

  • Having firm, healthy boundaries in the relationship- this can be setting boundaries on time spent with your family member, your expectations and hopes of the relationship.

  • Advocating for yourself and communicating your needs- This may include what you will or will not tolerate in the relationship and how you plan to take care of yourself emotionally.

  • Seeking outside support from friends, other family members, or therapy. If you feel consumed, defeated, and activated by these relationships it is helpful to get a healthy perspective, so you do not negatively internalize feelings about yourself based on their behaviors, actions, and words.
  • Educate yourself so you can feel more affirmed and rooted in your own feelings and decisions. These book recommendations can help you learn more about navigating these relationships and heal from your own experiences:

    • The Narcissist in Your Life: Julie L. Hall
    • The Narcissist’s Playbook: Dana Morningstar
    • What Happened to You?: Bruce D. Perry & Oprah Winfrey
    • Stop Walking on Eggshells: Paul T. Mason & Randi Kreger
    • I Hate You-Don’t Leave Me: Jerold J. Kreisman & Hal Straus

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About the author: Rodman Walsh is a California based Therapist whose specialities cover relationship issues, personality disorders, general anxiety, and more. Click here to read more content from Rodman and schedule a free introductory call.