The Psychopath Checklist

To have personality disorder diagnosed, a person needs to demonstrate at least three or four characteristics.

 

NARCISSISTIC PERSONALITY DISORDER

To have personality disorder diagnosed, someone needs to demonstrate at least three or four characteristics.

These are the characteristics that identify them. They:

  • Believe there are special reasons they are different, better or more deserving than others,
  • Have fragile self-esteem, needing others to recognise their worth and needs,
  • Feel upset if others ignore them or don’t give them what they feel they deserve,
  • Resent others successes,
  • Put their own needs above the needs of others, and demand that others do the same,
  • Take advantage of others.

Narcissists can be very difficult to be around, not least because they often don’t realise they have a problem. They have a strong sense of superiority and often come across as arrogant. They need constant admiration to feel fulfilled and despite their apparent arrogance, they often have very fragile egos.

To feel better about themselves they will belittle or criticise those around them. If challenged on this, they may be dismissive or suggest the other person is being weak. In the extreme, they can be controlling, blaming and self-absorbed. It’s not just cockiness or joking – they typically believe they are more important and more worthy, and their needs should take priority, regardless of their actual status.

About 1% of the population suffer from narcissistic personality disorder.

 

OBSESSIVE COMPULSIVE PERSONALITY DISORDER

People with obsessive-compulsive personality disorder are often highly valued by their bosses – they are reliable and their standard of work is high. But they can be virtually impossible to work with. They are also difficult to live with.

These are the characteristics that identify them. They:

  • Need to keep everything in order and under control.
  • Obsessively check their work, worrying it’s not good enough,
  • Set unfeasibly high standards for themselves and others,
  • Behave judgmentally towards other people,
  • Think their way is the best way of making things happen,
  • Struggle to adapt to change,
  • Worry that they, or others, might make mistakes,
  • Expect catastrophes if things aren’t perfect,
  • Find criticism very difficult to handle,
  • Find it difficult to spend money on themselves or others,
  • Have a tendency to hang on to items of no obvious value.

Obsessive compulsives are extreme perfectionists, and they get very upset if things aren’t done in exactly the right way, often insisting that things are done again. They are rarely late and usually arrive excessively early.

They are often workaholics and sacrifice relationships. They struggle to relax even at home, with rigid, inflexible routines. They can be preoccupied with cleanliness and symmetry and can be difficult to live with. They dislike unpredictable things or any sense of loss of control.

About 5% of the population is affected by obsessive compulsive personality disorder, and it is more common in men.

 

AVOIDANT PERSONALITY DISORDER

Nervous and anxious people can often be misdiagnosed with an anxiety disorder when their anxiety is really part of a personality disorder.

The group of personality disorders characterised by anxiety and fearfulness can be very debilitating and isolating. Avoidant personality disorder is strongly associated with neglect or rejection in childhood – those affected sometimes describe being disliked by one parent.

These are the characteristics that identify them. They:

  • Avoid work or social activities involving others,
  • Expect disapproval and are very sensitive to criticism,
  • Worry constantly about being ‘found out’ and rejected,
  • Feel insecure or inferior,
  • Worry about being ridiculed or shamed by others,
  • Avoid relationships, friendships and intimacy because they fear rejection,
  • Feel lonely and isolated,
  • Avoid trying new activities in case they embarrass themselves,
  • Feel a desperate need to be liked and accepted.

People with avoidant personality disorder are often burdened with feelings of inferiority and their principal coping strategy is avoidance. They also struggle in social situations, but they will still feel lonely and long for company. They are very self-critical and have an almost pathological fear of being rejected, embarrassed or humiliated in social settings. As a result, they often choose jobs where they can work alone.

 

DEPENDENT PERSONALITY DISORDER

People affected by dependent personality disorder are very reliant on others and struggle to attain independence. They have a need to be taken care of and for others to make decisions for them. They are sometimes described as needy or clingy.

They often have a strong sense of self-doubt and will often refer to themselves as stupid or inept and belittle their own abilities. They also tend to seek relationships with dominant or overprotective partners and avoid positions of responsibility. Their social life tends to be limited to this person or a small group of people on whom they are dependent.

This personality disorder is associated with separation and chronic physical illness when growing up.

These are the characteristics that identify them. They:

  • Feel needy, weak and unable to make decisions or function properly without help or support,
  • Allow others to assume responsibility for many areas of their lives,
  • Are afraid of being left to fend for themselves,
  • Have low self-confidence,
  • Feel easily abandoned or deserted,
  • Feel hopeless and incompetent, and see others as being much more capable than themselves,
  • Appear to others to be submissive and passive.

 

PARANOID PERSONALITY DISORDER

Odd, eccentric, loner… These are words typically used to describe those with paranoid personality disorder. These people are the hardest to treat because they are suspicious and wary of everyone – the main reason they don’t seek help. They are often very suspicious of others, involve themselves in legal disputes and write lots of letters of complaint. This is more than just the cliché of thinking everyone is out to get them. Instead, it is often left to family to seek help for them.

They can be very hard to work with because they are prone to assume that the usual mistakes everyone makes are deliberately directed against them. They fall out with lots of people and can get over-angry if, for example, someone occupies their car parking space or unintentionally cuts them up while driving. They often have frequent suspicions about their partner’s fidelity.

These are the characteristics that identify them. They:

  • Find it hard to confide in people, even friends, and very difficult to trust others,
  • Often suspect that others will use or take advantage of them,
  • Watch others closely, looking for signs of betrayal or hostility,
  • Bear grudges,
  • Read threats and danger that others don’t see into everyday situations,
  • Get angry about things that others say or do, and dwell on them,
  • Look for opportunities to get even.

This personality disorder occurs in approximately 3% of the population.

 

SCHIZOID PERSONALITY DISORDER

People with schizoid personality disorder often come across as aloof or disninterested in others. They don’t pay much attention to social norms, so their behaviour may seem strange. They are not really interested in forming relationships and are often loners.

These are the characteristics that identify them. They:

  • Can appear emotionally cold,
  • Do not like mixing with others and prefer their own company,
  • Have a very detailed fantasy life they often retreat into, spending a lot of time daydreaming,
  • Have no real interest in sex – intimacy is an encroachment into their personal space,
  • Do not get angry or hostile, even when provoked,
  • Find it hard to express feelings.

 

SCHIZOTYPAL PERSONALITY DISORDER

People with schizotypal personality disorder are the kind of odd, eccentric types you might come across anywhere. Although they may seem alarming at first, they are actually harmless – it’s just who they are.

These are the characteristics that identify them. They:

  • Find forming close relationships very difficult,
  • Behave in an eccentric way,
  • Believe they have special powers, such as a sixth sense or ESP, or are psychic,
  • Get anxious and paranoid in social situations,
  • Sometimes hear voices or talk to themselves,
  • Use odd or unusual words or phrases,
  • Struggle to experience normal emotions.

This personality disorder occurs in approximately 3% of the population and is more common in men.

 

Treatments that can help personality disorders:

There is no quick cure for a personality disorder, but treatment – and this is going to be lengthy – can make life easier. Some people improve so much they can rid themselves of the disorder altogether. However, it is important to get a formal diagnosis by a psychiatrist or psychologist. Most mental health trusts have specialist teams who assess, diagnose and treat them.

Rather than drugs (personality disorders can not be cured with medication) psychotherapy is the answer but it must be tailored to the condition and of course the individual. Antidepressants can help with mood or emotional difficulties and feelings of impulsiveness or anxiety. Low doses of antipsychotic drugs are also sometimes prescribed to reduce agitation, but in the long run, the talking therapies are the better – and best – option.

Some individuals may need treatment over several years. Where the main symptoms indicate difficulty in managing emotions, Dialectical Behavioural Therapy, which utilises elements of Cognitive Behaviour Therapy (CBT) can help people to identify and change unhelpful thoughts and behaviours.

It is possible to treat some people in group therapy, but most therapy is better conducted individually. Some psychiatric hospitals offer therapeutic communities, where people with personality disorders choose to live for a period of time. This gives them the space and opportunity for introspection, self-analysis and control.

Many people don’t need regular treatment – just advice and support at times when they’re struggling. In general, admission to a psychiatric hospital is something that should be avoided if possible because research has found that mostly, it is of little benefit to those with personality disorders and can often be counterproductive, as it stops them developing coping strategies. Most hospitals offer outside support to patients in the community.

If your partner, colleague or friend has a personality disorder, it’s important that you look after yourself first. This might sound harsh, but it is vitally important to set clear rules and expectations around their behaviour and distance yourself – even be prepared to walk away – whenever the boundary is overstepped, but it is also important to stress that it’s a temporary measure and doesn’t mean you don’t love or care about them.

 

Copyright Andrew Newton 1999. All rights reserved.