Therapy for Personality Disorders

 Clinically Review By: Corey Pitts, MA, LCMHCS, LPC, LCAS, CCS

What are the types of personality disorders?

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), personality disorders are grouped into three clusters, each defined by distinct personality traits and patterns of behavior.

Cluster A personality disorders

Cluster A disorders involve odd or eccentric patterns of thinking and behavior:

• Paranoid personality disorder: Persistent distrust and suspicion of others, often interpreting their motives as harmful even without evidence

• Schizoid personality disorder: Limited emotional expression and a preference for solitary activities, with little interest in close relationships

• Schizotypal personality disorder: Unusual beliefs and ways of thinking that can make social relationships feel difficult or uncomfortable

Cluster B personality disorders

Cluster B disorders involve dramatic, emotional, or unpredictable patterns of behavior:

• Antisocial personality disorder: A persistent pattern of disregarding others' rights, often accompanied by impulsivity and a lack of remorse

• Borderline personality disorder: Intense emotional swings, unstable relationships, and difficulty maintaining a stable sense of self

• Histrionic personality disorder: Excessive emotional and attention-seeking behavior that can strain relationships

• Narcissistic personality disorder: An inflated sense of self-importance and a limited capacity for empathy toward others

Cluster C personality disorders

Cluster C disorders involve anxious or fearful patterns of thinking and behavior:

• Avoidant personality disorder: Extreme sensitivity to criticism or rejection, leading to social withdrawal

• Dependent personality disorder: An excessive need to be taken care of, making independent decisions feel difficult

• Obsessive-compulsive personality disorder: A preoccupation with orderliness and control that can interfere with flexibility and relationships

 How are personality disorders treated?

Personality disorders are most commonly treated through therapy, medication, or a combination of both. Mental health professionals tailor treatment to the individual based on the specific disorder, its severity, and the person's goals.

Common therapy approaches

Different therapy approaches target different aspects of personality disorders. Therapy with a licensed mental health professional, including therapy for personality disorders like dependent personality disorder (DPD), can support individual mental health goals, reduce symptoms, and foster self-reliance.

A mental health professional will help determine which option or combination of options is best. These may include:

• Cognitive therapy/CBT: Helps people recognize and change distorted thought patterns linked to their personality disorder

• Dialectical Behavior Therapy (DBT): Blends cognitive techniques with mindfulness and emotional regulation and is most commonly used for borderline personality disorder (BPD)

• Schema therapy: Addresses deeply rooted beliefs and patterns that often develop early in life

• Psychodynamic therapy: Explores how past experiences shape current thoughts, feelings, and behavior

Mental health professionals may also prescribe medication to manage specific symptoms like anxiety or mood instability, but it's not a standalone treatment for personality disorders. 

What to expect from treatment

Treating personality disorders typically takes longer than addressing other mental health concerns. These are deeply ingrained patterns, and changing them takes time and consistency. 

Progress may look like improved self-awareness, healthier relationships, and better day-to-day functioning. However, outcomes vary depending on the disorder, its severity, and individual engagement in treatment.

Can online therapy help with personality disorders?

For many people living with a personality disorder, taking that first step can feel overwhelming. Online therapy may offer a more accessible path, especially for those who find in-person care difficult. Connecting to a therapist from a familiar environment can make the process feel less intimidating.

Online therapy may be an effective way to manage personality disorders, including antisocial personality disorder (ASPD). Those exploring therapy for personality disorders more broadly may find it helpful to learn about the range of available treatment approaches.

Through BetterHelp, individuals can work with licensed mental health professionals experienced in treating personality disorders. Those who find face-to-face interaction difficult may feel more at ease via text, audio, or video on their own terms. 

What the research suggests

A 2017 study found internet-based CBT to be effective for people seeking mental health support. Online therapy has also been studied for treating conditions that frequently occur alongside personality disorders, including anxiety and depression. It may be as effective as in-person therapy.

How to get started with BetterHelp

Getting started with BetterHelp takes three steps:

1. Complete a short questionnaire: A few questions about symptoms and preferences are used to match individuals with a licensed therapist experienced in personality disorders.

2. Get matched within 24 to 48 hours: No long waitlists or searching through directories.

3. Choose how to connect: Video, phone, live chat, or messaging, all on a schedule that works for each individual.

How can someone find the right support?

Finding the right support starts with understanding what’s being dealt with. A person living with a personality disorder may benefit from speaking with a mental health professional who specializes in that specific condition. Therapy with a licensed mental health professional, including therapy for personality disorders like paranoid personality disorder (PPD), can support mental health goals and foster healthier coping skills. 

A therapist will typically start with a psychological evaluation to help find out which disorder may be present and what treatment approaches are most likely to help. A formal diagnosis isn’t always required, though. BetterHelp can match a person with a licensed therapist experienced in personality disorder treatment so individuals can focus on making progress instead of trying to find care.

Personality disorders are treatable. The right support can change the way individuals think, relate to others, and move through the world. Those ready to seek support and build the skills needed to navigate a personality disorder can get matched with a BetterHelp therapist.

 Frequently asked questions

 Can therapy help with personality disorders? 

Therapy for personality disorders may help people manage symptoms, build healthier coping skills, and improve relationships. Results can vary depending on the type of disorder, its severity, and the consistency of engagement in treatment.

What type of therapy is most commonly used to treat personality disorders? 

CBT and DBT are among the most common approaches mental health professionals may use.

Can personality disorders be treated online? 

Online therapy platforms like BetterHelp may offer effective support through video, phone, live chat, or messaging. Research supports internet-based CBT as an effective option for managing related mental health concerns.

 Do I need a diagnosis before starting therapy for a personality disorder? 

No. A person can begin working with a therapist before receiving a formal diagnosis. A licensed mental health professional can help assess symptoms and recommend next steps based on what the person is experiencing.