Personality Disorders Treatment

Types of Personality Disorders (Clusters A, B, and C)

Clinicians organize the types of personality disorders into three main groupings—Cluster A (odd or eccentric), Cluster B (dramatic, emotional, or erratic), and Cluster C (anxious or fearful)—to guide diagnosis and treatment planning. This personality disorders cluster system helps mental health professionals identify patterns and select appropriate therapeutic approaches.

It’s worth noting that individuals may show personality traits from multiple clusters, and behaviors can overlap. A full diagnosis of any specific personality disorder requires evaluation by a qualified mental health professional using standardized criteria. While this article focuses on treatment, understanding the clusters helps explain why different therapies may be recommended for different presentations—for example, why dialectical behaviour therapy is often first-line for Cluster B conditions like borderline personality disorder.

Cluster A Personality Disorders (Odd or Eccentric)

Cluster A conditions feature unusual thinking and behavior, social detachment, and deep mistrust of others. These patterns often lead to significant isolation and difficulty forming social relationships.

The Cluster A disorders include:

• Paranoid personality disorder: Characterized by pervasive distrust and suspicion of others’ motives, even when no evidence supports these beliefs. Individuals may interpret neutral comments as verbal abuse or threats.

• Schizoid personality disorder: Marked by emotional detachment, a strong preference for solitary activities, and a limited range of emotional expression. These individuals often seem indifferent to praise or criticism.

• Schizotypal personality disorder: Features odd beliefs, distorted perceptions, social anxiety, and eccentric behavior. People may experience magical thinking or unusual sensory experiences.

Individuals with Cluster A conditions may be less likely to seek treatment voluntarily because they often don’t see their patterns as problematic. They frequently present when symptoms become severe or when co-occurring problems such as substance abuse emerge.

Structured, supportive environments like upscale residential programs can help these individuals feel safer engaging in therapy, providing consistent routines and reduced external stressors that make therapeutic work possible.

Cluster B Personality Disorders (Dramatic, Emotional, or Erratic)

Cluster B includes disorders marked by intense, unstable emotions, impulsive behaviour, chaotic relationships, and higher risk for self harm or substance misuse. These are among the most frequently diagnosed personality disorders in clinical settings.

The Cluster B disorders include:

• Borderline personality disorder (BPD): Characterized by unstable moods, intense fear of abandonment, patterns of self harm, and rapidly shifting relationships. People may experience a distorted self image and chronic feelings of emptiness.

• Antisocial personality disorder: Features disregard for others’ rights, deceitfulness, impulsivity, and sometimes criminal behavior. Signs often appear by age 11-15, though the formal diagnosis requires the person to be 18 or older.

• Histrionic personality disorder: Involves attention-seeking behavior, dramatic emotional expression, and an overwhelming desire for approval. Individuals may feel uncomfortable when not the center of attention.

• Narcissistic personality disorder: Marked by grandiosity, a deep need for admiration, and lack empathy for others. Behind the confident exterior often lies fragile self esteem.

Research shows that borderline and antisocial personality disorders are among the most commonly diagnosed in the United States. BPD affects approximately 1.6-5.9% of the population over a lifetime, with specialized therapies achieving effect sizes of 0.50-0.65 compared to standard treatment.

Dialectical behavior therapy DBT and other intensive, skills-based approaches are especially effective for BPD when delivered consistently in safe, structured, often residential environments. At Legacy Healing Center, we frequently treat Cluster B conditions alongside alcohol, opioid, and stimulant addictions in our luxury, trauma-informed programs—addressing both the personality disorder symptoms and substance use in an integrated approach.

Cluster C Personality Disorders (Anxious or Fearful)

Cluster C is characterized by high anxiety, fearfulness, avoidance, and dependency that significantly limit daily functioning and quality of life.

The Cluster C disorders include:

• Avoidant personality disorder: Features extreme social inhibition, feelings of inadequacy, and hypersensitivity to criticism or rejection. Individuals desperately want connection but fear it too much to pursue it.

• Dependent personality disorder: Involves an excessive need to be taken care of, difficulty making decisions without reassurance, and intense fear of separation. This goes beyond normal desires for support.

• Obsessive compulsive personality disorder (OCPD): Characterized by preoccupation with orderliness, perfectionism, and control at the expense of flexibility and efficiency. Importantly, this differs from obsessive compulsive disorder (OCD)—OCPD is a personality style rather than a specific pattern of intrusive thoughts and rituals.

People diagnosed with Cluster C conditions may be more willing to seek treatment because their anxiety and distress are clearly felt. However, they often struggle with change and decision-making in treatment, sometimes becoming overly dependent on their therapist or treatment team.

Consistent psychotherapy, combined with psychiatric medicines for anxiety or depression when needed, can significantly reduce symptoms and improve quality of life for those with Cluster C presentations.

Causes and Risk Factors for Personality Disorders

No single cause explains why some people develop personality disorders while others don’t. Instead, these conditions emerge from a complex interaction of genetics, brain development, temperament, and life events.

Key risk factors include:

At Legacy Healing Center, we commonly address these root causes through trauma-informed care, helping clients understand how their early experiences shaped their current patterns—and how healing is possible.

How Are Personality Disorders Diagnosed?

Only licensed mental health professionals—psychiatrists, psychologists, psychiatric nurse practitioners, or licensed therapists—can formally diagnose personality disorders using DSM-5 criteria from the Statistical Manual. Self-diagnosis based on online quizzes or articles isn’t reliable and can lead to misunderstanding or inappropriate self-treatment.

The diagnostic process typically includes:

• Comprehensive clinical interview covering symptoms, relationships, work history, and life patterns

• Review of medical and psychiatric history, including substance use and prior hospitalizations

• Structured assessments or questionnaires when appropriate

• Evaluation over time, since personality patterns must be persistent and pervasive

Personality disorders are typically diagnosed in adults (age 18+) because personality is still developing in adolescence. Antisocial personality disorder is an exception—early signs often appear in the teen years as conduct disorder, though the formal personality disorder diagnosis comes later.

Ruling out other mental health conditions is crucial. Bipolar disorder, psychotic disorders, PTSD, and even medical issues can mimic personality disorder symptoms. Getting the diagnosis right matters because it guides the treatment plan.

At Legacy Healing Center, clinicians screen carefully for co-occurring substance use disorders, PTSD, and mood disorders to create truly integrated, dual-diagnosis care plans. This comprehensive approach ensures nothing gets missed.

If you suspect you or a loved one may have a personality disorder, we encourage you to contact a professional for evaluation rather than relying on self-diagnosis. Call us at 888-534-2295 to speak with an admissions specialist who can guide you toward the right assessment resources.

Core Treatments for Personality Disorders

Talk therapy (psychotherapy) is the primary, most evidence-based treatment for most personality disorders. Unlike medications that target specific symptoms, therapy focuses on the underlying patterns of thinking, feeling, and relating that define these conditions. Research consistently shows that specialized psychotherapies can treat personality disorders effectively, with many people experiencing significant improvement.

Treatment is often long-term and works best when delivered consistently and collaboratively. Many individuals start in a high-structure environment like a luxury residential rehab—where they can focus entirely on healing—before stepping down to outpatient care for ongoing support.

Finding the right therapeutic approach sometimes requires trying more than one method or combining approaches over time. What works for one person may not be ideal for another, which is why personalized treatment planning matters so much.

Psychotherapy Approaches (DBT, MBT, CBT-Based, and More)

Evidence-based psychotherapies help people understand their disruptive patterns, manage emotions more effectively, and build healthier relationships and coping skills. Here’s what the research supports:

Dialectical Behavior Therapy (DBT)

Dialectical behavior therapy originated in the late 1980s specifically for borderline personality disorder and is now widely used for self harm, suicidality, and emotional dysregulation across mental disorders. It’s one of the most extensively researched treatments available.

DBT focuses on four core skill modules:

• Mindfulness: Present-moment awareness and acceptance

• Distress tolerance: Surviving crises without making things worse

• Emotion regulation: Understanding and reducing impulsive behaviour driven by intense feelings

• Interpersonal effectiveness: Communicating needs while maintaining relationships and self identity

Treatment typically includes individual therapy sessions, group therapy for skills training, phone coaching between sessions, and therapist consultation teams. DBT has a strong research base showing reduced suicidality, decreased self harm, fewer hospitalizations, and improved overall functioning.

Mentalization-Based Therapy (MBT)

Mentalisation based therapy was developed in the 1990s for BPD and helps individuals understand their own and others’ mental states—sometimes described as “thinking about thinking.” The therapy focuses on improving insight into feelings, intentions, and beliefs.

MBT reduces impulsive reactions and relationship conflicts by helping people pause before acting on distorted perceptions of what others think or feel. It’s often long-term, offered in both individual and group formats, and well-suited to structured clinical environments where consistent therapeutic relationships can develop.

Cognitive and Integrative Approaches

Cognitive therapy and cognitive behavioral therapy (CBT) focus on identifying negative thought patterns and unhelpful behaviors, understanding where they began, and practicing alternatives. These approaches help with low self esteem, distorted thinking, and socially undesirable behavior patterns.

Cognitive Analytic Therapy (CAT) combines cognitive and psychodynamic elements, mapping out recurring relationship patterns and developing healthier alternatives.

Structured Clinical Management (SCM) blends case management, skills training, and supportive therapy with clear goals and boundaries. It’s particularly useful for BPD and complex presentations.

Psychodynamic psychotherapy explores unconscious conflicts and early relationship patterns that shape current difficulties. While typically longer-term, it can lead to deep, lasting change for many individuals.

At a high-end center like Legacy Healing, these therapies are customized and potentially combined with trauma-focused modalities such as EMDR or somatic therapies, depending on the individual’s history and needs.

Medications in Personality Disorder Treatment

There are currently no medications approved by the U.S. Food and Drug Administration (FDA) specifically for treating personality disorders themselves. However, psychiatric medicines play an important supporting role in comprehensive treatment.

Psychiatrists often prescribe medications to target specific symptoms that frequently co-occur:

Medications are usually an adjunct to psychotherapy, not a standalone cure. They should be reviewed regularly to monitor benefits, side effects, and interactions—especially important for individuals also taking medications for substance use disorders.

At Legacy Healing Center, our medical teams perform thorough medication evaluations, coordinate with detox and addiction treatment, and educate clients about their prescriptions in clear, understandable language. We believe you deserve to understand what you’re taking and why.

Important: Always consult with your prescriber before changing or discontinuing any psychiatric medication. Sudden changes can cause withdrawal effects or symptom flares.

Creative and Holistic Therapies

Many people with personality disorders benefit from adjunctive therapies that help them express emotions, reduce stress, and connect mind and body. These approaches enhance—but don’t replace—core psychotherapy.

Art therapy offers a way to explore feelings nonverbally, process trauma, and improve emotional regulation. When words feel overwhelming or blocked, creative expression can open new pathways to healing.

Other holistic support services often offered in luxury rehab settings include:

• Mindfulness and meditation: Increases emotional awareness, reduces reactivity, and builds the capacity to tolerate distressing feelings

• Yoga and breathwork: Calms the nervous system, builds body awareness, and helps with grounding when unstable emotions arise

• Music therapy and experiential groups: Processes relationship and identity themes through action-based methods

These therapies are a hallmark of high-end, whole-person programs like those at Legacy Healing Center. They promote self-soothing skills, enhance engagement in treatment, and address mental health from multiple angles.

Inpatient, Residential, and Outpatient Treatment Options

Understanding your options helps you choose the right level of care for your situation. Treatment settings range from intensive 24/7 support to flexible outpatient arrangements.

Levels of care at a glance:

When inpatient hospitalization may be needed:

• Imminent risk of self harm or suicide attempts

• Severe impulsive or aggressive behavior placing self or others at risk

• Acute psychosis or severe intoxication/withdrawal requiring medical stabilization

Residential personality disorder and dual-diagnosis treatment at Legacy Healing Center includes:

• 24/7 support and monitoring from trained clinical staff

• Daily individual therapy and group therapy sessions

• DBT or similar skills-based programs delivered consistently

• Comprehensive medication management

• Safe, upscale environment with private or semi-private rooms

• Chef-prepared meals and amenities that reduce external stress

Outpatient and step-down options provide continued support services as you transition back to daily life, with decreasing unhealthy patterns while building self confidence and stable relationships.

Legacy Healing Center offers a full continuum of care across California, Florida, Ohio, and New Jersey. Our admissions specialists can help determine the right level based on symptoms, safety concerns, and substance-use severity.

Personality Disorders and Substance Use: Why Dual-Diagnosis Care Matters

Many people with personality disorders also live with alcohol or drug misuse. Research shows that 50-70% of individuals with personality disorders have co-occurring substance use disorders—a staggering overlap that demands integrated treatment.

Why does this happen? People often use substances to cope with intense emotions, numb the pain of childhood trauma, or escape from relationship stress. Unfortunately, substance use typically makes personality disorder symptoms worse:

• Increased impulsivity and mood swings: Alcohol and drugs lower inhibitions and destabilize mood

• Higher risk of self harm, overdose, and legal/financial problems: Impaired judgment leads to dangerous decisions

• Interference with therapy engagement: Showing up intoxicated or withdrawing undermines progress

• Reduced medication effectiveness: Substances interact with psychiatric medications

Dual diagnosis—having both a personality disorder and a substance use disorder—requires integrated treatment that addresses both conditions simultaneously. Treating one while ignoring the other rarely works long-term.

Legacy Healing Center provides:

• Medical detox with 24/7 nursing and physician oversight when needed

• Evidence-based addiction treatment including individual therapy, group therapy, and relapse-prevention planning

• Concurrent personality disorder therapies like DBT or trauma-focused care

• A cohesive, luxury setting where both conditions receive equal attention

If you recognize patterns of self-medication with alcohol, opioids, stimulants, or prescription drugs, please reach out for specialized dual-diagnosis help. Trying to manage both conditions alone often leads to a cycle of crisis and temporary improvement. Professional support services can break that cycle.

What Happens If a Personality Disorder Is Left Untreated?

Untreated personality disorders don’t simply “go away” on their own. Without intervention, symptoms often escalate over time, creating a cascade of problems that affect every area of life.

Potential consequences of untreated personality disorders:

• Relationship instability: Chronic conflict, repeated breakups, divorce, and family members becoming estranged

• Work and school difficulties: Frequent job changes, unemployment, academic struggles, or inability to advance despite talent

• Self harm and suicidal thoughts: Research shows a 10% suicide rate in untreated borderline personality disorder, with 70% reporting a history of self harm

• Escalating substance abuse: Using more drugs or alcohol to cope as symptoms worsen

• Legal problems: Theft, DUIs, assaults, or other consequences of impulsive behaviors—particularly in cases of antisocial personality disorder

• Physical health decline: Poor self-care, chronic stress, and risky behaviors take a toll on the body

But here’s the hopeful reality: Research since the early 2000s consistently shows that many people with personality disorders—especially BPD—improve significantly with consistent treatment. Studies indicate 50-80% of people with borderline personality disorder experience meaningful remission over 5-10 years of care.

Don’t wait for a crisis to seek treatment. Early intervention shortens suffering and improves long-term outcomes. The patterns that feel permanent today can shift with the right support system and professional guidance.

How to Access Treatment and Advocate for Your Care

Access to personality disorder treatment varies by location and insurance coverage, but multiple pathways exist to get help. Whether you start with your primary care doctor, a community mental health center, or a specialized luxury rehab, taking that first step matters most.

Steps to initiate care:

1. Talk with your primary care doctor or mental health specialist about your symptoms and ask for a referral to someone experienced with personality disorders

2. Contact accredited treatment centers directly to discuss options, insurance coverage, and levels of care

3. In emergencies (active self harm, suicide risk, immediate danger), go to the nearest emergency room or call 988 (Suicide and Crisis Lifeline)

Advocating for yourself in treatment:

• Ask questions about your diagnosis, treatment options, and the evidence behind recommended therapies

• Request a written care plan that includes goals, types of therapy, medications, and crisis protocols

• Speak up if something isn’t working—good clinicians welcome feedback

The best treatment happens within a collaborative relationship where your preferences and values are respected. This includes decisions about medication choices, therapy styles, and how family members are involved in your care.

Ready to explore your options? Verify your insurance coverage online or call 888-534-2295 for a confidential consultation about luxury, individualized care for co-occurring personality and substance use disorders. Our admissions team is available 24/7 and can answer your questions about what treatment might look like for your unique situation.