Personality Disorders

Personality Disorders Therapy in New York

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What causes personality disorders?

Personality disorders can develop when a child is subject to emotional, physical, or sexual abuse, or if there isn’t adequate support for age-appropriate developmental needs. Some of these critical developmental needs include needs for:

physical care
attachment and bonding
a sense of security
exploration and play
appropriate discipline/boundary setting
coping skills
developing self-esteem
decision-making skills
critical thinking
growing independence
autonomy
identity formation

If you were subject to abuse or if there were inadequate support for critical developmental needs, you likely developed coping strategies to protect yourself from injury and meet your needs in the best way possible. Over time, however, these coping strategies became structured into your personality as rigid defense patterns that interfere with true growth and continue to influence the way you relate to the world, reach out for what you need, and interact with others.

Two examples of personality disorders we hear a lot about these days are narcissistic and borderline personality disorders. Each can originate during stages of a child’s life where specific needs that are required from caregivers to promote healthy emotional development are missing, and/or when the child is subject to emotional, physical, or sexual abuse.

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What is narcissistic personality disorder?

When you began, as a child, to explore the world and learn new skills, you needed to return to your caregiver for reassurance when you got scared or when you didn’t succeed. You may have been admired and praised only when performing to your caregivers’ standards but were not met with love and support when you struggled. Or you may have received love and admiration when you did what made your caregiver happy, but not when you pursued your own desires or interests. As a result of these patterns, you may have grown up with the constant need to perform and gain approval from others to maintain your self-esteem and defend against deep feelings of shame and vulnerability. Or you may feel that you can be loved only for what you do or how you appear, but not for your true self. You might even have lost touch with what your true self is, leaving you with a feeling of inner emptiness or deadness. These are underlying wounds in narcissistic personality disorder.

Here are some symptoms of narcissistic personality disorder:

Grandiosity: A sense of self-importance and superiority over others, often exaggerated. You may feel you are unique, exceptional, or entitled to special treatment and admiration.
Fantasies of Success, Power, or Beauty: Frequent daydreams or fantasies of unlimited success, power, brilliance, beauty, or ideal love.
Need for Excessive Admiration: An insatiable need for admiration and validation from others. You may seek constant attention, flattery, and praise to maintain your self-esteem.
Sense of Entitlement: Belief that you are entitled to special privileges or treatment, expecting others to cater to your needs and desires without question.
Manipulative and Exploitative Behavior: A willingness to exploit others for personal gain, often without guilt or remorse. This can include taking advantage of others financially, emotionally, or socially.
Lack of Empathy: Difficulty recognizing or understanding the feelings and needs of others. You may be indifferent or dismissive of other people’s emotions or suffering.
Envy and Belief that Others Are Envious: A tendency to envy others or believe that others are envious of them. This can contribute to a competitive and resentful attitude.
Arrogant and Haughty Behavior: Displaying haughty, snobbish, or condescending attitudes and behaviors. You may belittle or demean others to maintain your sense of superiority.
Fragile Self-Esteem: You may have a fragile self-esteem that is easily threatened by criticism, rejection, or failure.
Difficulty Maintaining Relationships: Problems in maintaining healthy and lasting relationships due to interpersonal difficulties, lack of empathy, and manipulative tendencies. You may have a history of unstable relationships.
Idealization and Devaluation: You may idealize others initially, but when others do not meet your unrealistic expectations, you may quickly devalue them.

It takes a lot of courage to seek help when one has features of narcissistic personality disorder, as seeking help requires some acknowledgement of need and vulnerability, which can feel quite threatening to those with NPD.

Psychodynamic Approaches to Treating Narcissistic Personality Disorder

Here are some key aspects of psychodynamic psychotherapy for narcissistic personality disorder:

Developing Self-Awareness, helping you become more aware of your thoughts, emotions, and behaviors, including the narcissistic traits that have been causing difficulties in your life. Developing self-awareness is a crucial first step in treatment.
Exploring Early Life Experiences,, particularly those related to attachment, caregiving, and family dynamics. Understanding how childhood experiences contributed to the development of narcissistic traits can lead to insights and healing.
Identifying Defense Mechanisms, such as denial, projection, and idealization, which you may have developed to protect yourself from painful emotions and maintain your self-esteem. We will help you to recognize and understand these defense mechanisms and explore healthier coping strategies.
Addressing Core Wounds related to self-esteem and self-worth. This can involve processing past experiences of rejection, neglect, or trauma that may have contributed to the development of narcissistic defenses.
Increasing the Capacity for Empathy by helping you become better aware of your own emotional reactions, as well as to understand the emotions and perspectives of others. This will improve your ability to form and maintain healthier relationships.
Exploring Vulnerability: You may have difficulty acknowledging vulnerability and emotional pain. Therapy provides a safe space for you to explore and express these feelings, which can be an essential part of the healing process.
Developing Healthier and More Realistic Self-Regard: This includes recognizing your strengths and limitations without resorting to extremes of grandiosity or self-deprecation.
Improving Interpersonal Relationships by developing better communication skills, empathy, and emotional regulation.

Long-Term Commitment: Treatment for NPD is typically a longer-term process compared to some other mental health issues. It requires a commitment to ongoing therapy to address deep-seated personality traits and patterns.

about me

Marina Rozenberg, MD.

Clinical psychiatrist and therapist

I’ve been a practicing internal medicine physician since 2004. In the process of going through my own healing journey, I realized that I wanted to learn to use the tools that were most valuable to me in order to help others in their pursuit of more meaningful and genuine lives. To that end, I completed a 4-year postgraduate training program in Bioenergetic Analysis, and additional postgraduate programs in psychoanalytic psychotherapy. I am currently enrolled as a psychoanalytic candidate at the Object Relations Institute in NYC.

about me

What is borderline personality disorder?

Borderline personality disorder can develop when your early relationships with caregivers are inconsistent and chaotic, often characterized by verbal, physical or sexual abuse. This gets in the way of forming stable and secure attachments with your caregivers, interfering with the development of a stable sense of self, the capacity for emotional regulation, and the ability to navigate interpersonal relationships. As a result, you can struggle with severe mood swings, a chronic sense of emptiness, intense anger, and major fears of abandonment that can drive you to pursue desperate measures to escape the pain, including substance abuse, engaging in risky behaviors, and self-harm and suicidal behavior.

Here are some symptoms of borderline personality disorder:

Frantic Efforts to Avoid Real or Imagined Abandonment: You may struggle with intense fears of abandonment, whether real or perceived, and may go to great lengths to prevent abandonment, such as making frantic efforts to keep a person from leaving, even if the abandonment is not imminent.
Unstable and Intense Interpersonal Relationships: You may idolize someone one moment and then suddenly devalue or demonize them, leading to turbulent and unpredictable relationships.
A Weak or Unstable Sense of Self: You may struggle with your identity, frequently adopting the preferences, values, and opinions of others. You may have difficulty understanding your own goals, values, and roles in life.
Impulsivity: Impulsivity can manifest in various ways, such as reckless driving, substance abuse, binge eating, unsafe sex, and overspending. These impulsive behaviors are often attempts to alleviate emotional pain or numb intense emotions.
Recurrent Suicidal Behavior, Self-Harm, or Threats: You may be engaging in self-harming behaviors, such as cutting or burning yourself, or expressing suicidal thoughts and gestures. These actions are often driven by overwhelming emotional distress.
Affective Instability: You may experience intense and rapidly shifting emotional states, including intense anger, sadness, and anxiety that can change rapidly and be triggered by seemingly minor events.
Chronic Feelings of Emptiness: You may be experiencing chronic feelings of emptiness or boredom, which can lead to impulsivity in an attempt to fill the void.
Inappropriate and Intense Anger: You may have difficulty managing anger and expressing it inappropriately, with disproportionate intensity or duration, leading to conflicts and relationship difficulties.
Paranoia and Dissociation: You may have experienced transient episodes of paranoia, dissociation, or derealization during times of extreme stress, or feel disconnected from yourself or your surroundings.
Unstable Self-Image and Self-Worth: Self-esteem is often dependent on external factors, such as the approval and validation of others. You may experience rapid shifts in self-esteem, alternating between feelings of worthlessness and superiority.

Unraveling Borderline Personality Through Psychodynamic Therapy

Here are some key aspects of psychodynamic psychotherapy for borderline personality disorder:

Addressing Abandonment and Attachment Issues: BPD often involves intense fears of abandonment and difficulties with attachment. Together, we will explore these fears, helping you to understand their origins and develop more secure attachment patterns.
Working Through Trauma: Many individuals with BPD have a history of trauma, abuse, or neglect. Therapy can provide a space to process and work through these traumatic experiences.
Working on the Therapeutic Alliance: The feelings and dynamics that arise within the therapeutic relationship will help us to understand more about how you felt growing up with early caregivers and how you experience important relationships in present-day life. As abandonment fears and intense emotional reactions arise within the therapeutic relationship, we will have the opportunity to gain insight into the triggers and work through them together.
Identifying Maladaptive Coping Mechanisms and Relational Patterns, such as splitting (seeing people and situations as all good or all bad), idealization and devaluation, and self-destructive behaviors.
Promoting Emotional Regulation by developing a better understanding of your emotions, identify triggers, and learning healthier ways to regulate and express your feelings.
Promoting Insight into the origins of BPD symptoms and how these symptoms manifest in your daily life. This insight can lead to increased self-awareness and the ability to make more adaptive choices.
Challenging Idealization and Devaluation, which can lead to more stable and fulfilling relationships.
Developing a More Stable Sense of Self by exploring your sense of self, gaining clarity about your values and goals, and developing a more stable self-identity.
Long-Term Healing: Psychodynamic therapy is often a longer-term treatment approach, which can be beneficial for addressing deep-seated issues and providing ongoing support as you work toward recovery.

To get started with therapy for a personality disorder, please submit this form or call me to schedule a free 20-minute phone consultation.

conditions

I work with adults of all ages who are seeking help for the following conditions

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Conditions

Trauma

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Conditions

Personality Disorders

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Conditions

Loss or Grief

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Conditions

Chronic Pain or Illness

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What Are Personality Disorders?

Personality disorders are a group of mental health conditions characterized by enduring patterns of thought, feeling, and behavior that deviate significantly from the cultural expectations, are pervasive and inflexible, begin in adolescence or early adulthood, and lead to distress or impairment.

How Are Personality Disorders Diagnosed?

A diagnosis is typically made by a mental health professional, such as a psychologist or psychiatrist, after a thorough evaluation. This evaluation often includes a detailed interview, observation of the individual’s behavior, and sometimes, psychological testing.

Are Personality Disorders Common?

Personality disorders affect a significant portion of the population. It’s estimated that about 10-15% of adults have a personality disorder. However, many individuals with such disorders don’t seek treatment or are undiagnosed.