How mad are you?

It's not just psychopaths who suffer from personality disorders - we all have character flaws. But the good news is that once you know what they are, you can turn them to your advantage. By Jane Feinmann

Tuesday 26 April 2005 00:00 BST

He's a man with everything going for him. He's bright, good-looking and supremely self-confident. Tipped for corporate stardom, at 38 he already has a high profile in the computer industry and a six-figure salary, as well as a beautiful wife and child, top-of-the-range car and fabulous house.

He's a man with everything going for him. He's bright, good-looking and supremely self-confident. Tipped for corporate stardom, at 38 he already has a high profile in the computer industry and a six-figure salary, as well as a beautiful wife and child, top-of-the-range car and fabulous house.

If Alex sounds too good to be true, that's because he is. As well as being excessively charming and competent, he's also arrogant, deceptive and devious. His dark side shows most clearly in the string of affairs and one-night stands in which he indulges that "seem to have little to do with the sex itself and more to do with his need for control, risk, attention and power".

That's the view of the psychologist who is currently helping Alex to understand the good, the bad and the ugly about his behaviour - and specifically to accept and learn to cope with the fact that he has a personality disorder. The diagnosis is chilling, associated in most people's minds with violent psychopaths and "worthless worms... who are existentially dead" (as one media psychologist put it recently) rather than with successful businessmen.

There are 10 major personality disorders, each of which causes problems as a result of what psychiatrists call maladaptive coping - unhealthy responses to emotional demands such as stress, including depression, alcohol and drug abuse, and an inability to maintain relationships. And because a personality disorder is the person's very self, it is widely seen as untreatable by psychiatrists.

But that was in the past. Today, research is showing that treatment in the form of cognitive behavioural therapy allows people with personality disorders to live normally. As a result, the Government's National Institute of Mental Health, in a report titled Personality Disorder: No Longer a Diagnosis of Exclusion, has ordered psychiatric services to treat the condition.

"By helping people to face up to their personalities, they can stop seeing themselves as automatically a bad person and build a life for themselves," says Homerton University Hospital psychiatrist Dr Trevor Turner. "It's about putting a positive spin on what seems like negative characteristics. A leopard may not be able to change his spots but he can get to understand how useful they are in a shady jungle."

More significantly for the 90 per cent of us unlikely to end up at a psychiatric appointment, there is a growing consensus that personality disorder is only a matter of degree. "There's increasing recognition that there is a spectrum of behaviour, with personality disorders at one end and 'normal' personality traits at the other," says Gill Graham, a chartered occupational psychologist and principal consultant at Cargyll Consultants, a company that works to increase the effectiveness of people in their working lives. "Behaviours from both ends of the spectrum are present in almost everyone - they just differ in intensity, appropriateness and the extent to which we can control them."

For Stephen Palmer, professor of psychology at City University in London, stress also plays a key factor. "Many people are slightly paranoid but the more pressure you're under at work, the more likely you are to suspect that other people have got it in for you."

Inevitably, as it becomes clear that finding the right fit between our natural abilities and a career that works best for the employer as well as the employee, there's growing corporate interest in personality traits. "Context is crucial," says Graham. After all, being at least a tiny bit histrionic and narcissistic is essential for today's celebrities, while an obsessive-compulsive personality will suit accountancy or engineering.

"Dependent people who are naturally anxious and inhibited can work well in a supportive team environment where there are no surprises, while they would flounder in an environment where they were challenged or had to make tough decisions," says Graham.

Even paranoia can be a bonus, says Turner - if it's being displayed by a GP whose local hospital really is planning to cut services: "It is a positive benefit for the community," he says.

Yet difficult personality traits can't always be pigeon-holed. And personality, just like personality disorder, is now seen as treatable - as long as the person concerned is willing to play ball. "There's such a barrier to seeing yourself as others see you," says Graham, "whether you're a mother being controlling in trying to care for her child or someone who is unreasonably anxious about public speaking, for instance."

Most people with a problem blame others, says Palmer. "It can be difficult to acknowledge that you are the problem and not 'the bastards' who make your life hell at work, home and in the pub," he says.

Palmer is chairman of the British Psychology Society's newly established Special Group in Coaching Psychology. Since its inauguration last December, this group has accumulated 1,750 members to cater for the "massive" demand for coaches with a clinical background. Employers are realising that coaching in the workplace is acceptable in a way that counselling isn't.

But changing a personality trait is painfully slow. "A personality driven by genetics and shaped by experience is not going to change fundamentally," says Graham. "But you can learn and unlearn skills so that your behaviour can change. If your personality is indecisive, you can't suddenly become decisive. But you can learn how to make decisions - even how to make them quickly."

High-fliers like Alex frequently have to acknowledge that what makes them a confident risk-taker can also potentially derail them. "There can be a very thin line between being exceptional and being dangerous, which means that high-potential employees are both a bonus and potentially a liability," says Graham.

So Alex is struggling to accept that he disregards others and ignores their needs (traits of an antisocial personality), and that he has inflated ideas of his own importance and craves attention (narcissistic disorder). He has had to come to terms with the fact that what he sees as confidence is frequently perceived as arrogance, and that having exciting sex may be OK, but, says Graham, he needs to be smarter about with whom and where.

"Personality traits are the bread and butter of occupational psychology," she concludes. "It is the combination and intensity and the extent to which they go unacknowledged that causes the problem."

Know your mind

* Paranoid

As a trait: cautious, observant.

As a disorder: suspicious.

Best: where caution and attention is rewarded.

Worst: in jobs that require spontaneity.

* Schizotypal

As a trait: independent, calm, a little bit cunning. As a disorder: manipulative, emotionally cold.

Best: in self-motivating, high-control jobs.

Worst: in jobs that require interpersonal skills.

* Borderline

(One of most common, especially in women).

As a trait: sensitive, volatile, spontaneous and imaginative.

As a disorder: prone to self-harm, changing moods.

Best: in creative, non-rigid environments.

Worst: in threatening situations; the army, police.

* Antisocial

(Most common in young, poorly educated men).

As a trait: adventurous, clever, ready to fight for his cause.

As a disorder: aggressive, lacking conscience.

Best: in exciting, fast-paced environments.

Worst: in jobs or relationships that require caring.

* Narcissistic

As a trait: self-confident.

As a disorder: arrogant, egotistical, greedy, uncaring.

Best: in competitive, entrepreneurial environments.

Worst: in jobs that require following orders.

* Histrionic

As a trait: stylish, fashionable.

As a disorder: demanding, self-centred, vain, superficial.

Best: in Ab Fab-style environments.

Worst: in business-like environments.

* Avoidant

As a trait: reliable, reclusive.

As a disorder: painfully self-conscious, suspicious.

Best: in structured environments where there is a minimum of new experience.

Worst: at public speaking, can be unpredictable.

* Dependent

As a trait: faithful to partner.

As a disorder: weak, insecure.

Best: in secure environments where they can become close to others.

Worst: in challenging environments, singles bars.

* Obsessive compulsive

As a trait: single-minded.

As a disorder: inflexible.

Best: in any ordered environment such as accountancy, admin, police.

Worst: in chaotic environments which lack rules.

Compiled with the help of occupational psychologist Gill Graham and Professor Kate Davidson

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