Psychology Support for Personality Disorders

By David Hennessy, Clinical Psychologist, Varsity Lakes, Gold Coast, QLD.

Personality disorders are often misunderstood. In everyday language, the word “personality” can sound fixed, judgemental, or blaming. In psychology, personality disorders are better understood as long-standing patterns in emotion, relationships, identity, coping, self-protection, and behaviour that may have developed for understandable reasons, but are now causing distress or limiting a person’s life [1–3].

Psychology support for personality disorders aims to help people understand these patterns with care and honesty. The goal is not to label a person as the problem. The goal is to understand what keeps happening, why it may make sense, what it costs, and what new skills or choices may help.

Furthermore, personality disorder patterns are often influenced by a person’s life experiences, coping strategies, relationships, temperament, and environment. For this reason, effective therapy usually focuses on understanding the individual rather than making assumptions based solely on a diagnosis. 

Importantly, personality disorders exist on a spectrum. Some people experience only a few traits that occasionally create difficulties, while others experience more persistent patterns that affect relationships, work, emotional wellbeing, and day-to-day functioning.

This service page is designed as a broad overview of psychology support for personality disorder traits.

What Are Personality Disorders?

Personality disorders involve enduring patterns in the way a person relates to themselves, other people, emotions, decisions, boundaries, conflict, closeness, safety, and stress [1]. These patterns often show up across different parts of life, such as relationships, family, study, work, parenting, friendships, health care, or crisis situations.

Some people have a formal diagnosis. Others may have traits or patterns without meeting full diagnostic criteria. Either way, support can begin with the difficulties the person is actually experiencing.

Common therapy themes may include:

• Strong emotions that feel hard to manage
• Fear of rejection, abandonment, conflict, criticism, or disapproval
• Relationship patterns that repeat despite good intentions
• Impulsive behaviour during distress
• Self-criticism, shame, guilt, emptiness, or confusion about identity
• Difficulty making decisions independently
• Over-reliance on reassurance or approval
• Avoidance of difficult conversations
• Difficulty trusting oneself or others

How Psychology Support May Help

Evidence-based psychological support for personality disorder traits is usually practical, structured, relational, and collaborative [2–4]. Therapy may include developing insight, but it also needs to support behaviour change in daily life.

Depending on the person’s needs, therapy may focus on:

• Understanding emotional triggers and relationship patterns
• Building emotion regulation and distress tolerance skills
• Reducing impulsive or crisis-driven behaviour
• Improving communication, boundaries, and assertiveness
• Developing a more stable sense of self
• Strengthening values-based decision-making
• Reducing shame and self-criticism
• Building independence gradually and safely
• Creating practical plans for high-risk situations

For some people, Dialectical Behaviour Therapy-informed skills may be useful, particularly where emotional intensity, impulsivity, or interpersonal conflict are prominent [5,6]. Other approaches may include Cognitive Behavioural Therapy, Acceptance and Commitment Therapy, mindfulness-based strategies, schema-informed work, supportive psychotherapy, and structured relational approaches. You may also find the articles What Is Acceptance and Commitment Therapy?, What Is Cognitive Behavioural Therapy?, and What Is Mindfulness-Based Therapy? helpful.

A Practical and Respectful Approach

Many people with personality disorder traits have spent years being misunderstood, criticised, dismissed, or treated as “difficult”. A more useful starting point is curiosity. What has this person had to adapt to? What are they trying to protect? What happens when they feel unsafe, ashamed, criticised, abandoned, trapped, or alone?

As a clinical psychologist, I aim to provide support that is respectful, clear, and practical. My background as a tradesman also shapes the way I think about therapy. A pattern may make sense once we understand how it was built, but if it is no longer working, we need practical tools, repeated practice, and a plan that can hold up under real-world pressure.

Therapy does not promise a completely different life. Change is usually gradual. However, many people can learn to pause sooner, repair more effectively, communicate more clearly, tolerate distress more safely, and make choices that better fit the person they are trying to become.

Learn More About Personality Disorders

If you would like to explore specific personality disorders in more detail, the following articles may be helpful:

• Understanding Borderline Personality Disorder
• What Does Borderline Personality Disorder Feel Like?
• Understanding Dependent Personality Disorder
• What Does Dependent Personality Disorder Feel Like?
• DBT Wise Mind Exercise

Psychology Support in Varsity Lakes and by Telehealth

Hennessy Clinical Psychology provides psychology support for adolescents and adults experiencing personality disorder traits and related difficulties in emotion regulation, relationships, identity, self-confidence, coping, and behaviour.

Appointments are available in person from Varsity Lakes on the Gold Coast and by telehealth across Australia. Therapy is tailored to the individual and may draw upon Cognitive Behavioural Therapy (CBT), Acceptance and Commitment Therapy (ACT), Dialectical Behaviour Therapy (DBT)-informed skills, mindfulness-based approaches, supportive psychotherapy, and other evidence-based interventions depending on the person’s needs and goals.

The focus of therapy is not on labels. Rather, the focus is on understanding patterns, building practical skills, strengthening resilience, improving relationships, and supporting meaningful long-term change.

If you would like to arrange an appointment, please visit the Contact Page for current booking information.

Frequently Asked Questions

Do I Need a Personality Disorder Diagnosis Before Seeking Psychology Support?

No. Many people seek support because they notice repeated patterns in emotions, relationships, coping, self-criticism, avoidance, dependency, anger, shame, or impulsive behaviour. A diagnosis may help some people, but therapy can also begin with the patterns that are causing distress or affecting functioning.

Can Psychology Help With Personality Disorder Traits?

Psychology can help many people understand long-standing patterns and practise more workable responses. Support may include emotion regulation skills, relationship skills, distress tolerance, assertiveness, behavioural planning, self-understanding, and relapse prevention. Progress varies, and therapy usually works best when it is collaborative, consistent, and realistic.

Is DBT the Only Therapy for Personality Disorders?

No. DBT has strong evidence for Borderline Personality Disorder, particularly where emotional dysregulation, self-harm risk, and impulsive behaviour are prominent [5,6]. However, other structured therapies may also be useful depending on the person’s needs, diagnosis, goals, risks, strengths, and therapy fit [3,4,7].

Does Hennessy Clinical Psychology Work With Adolescents and Adults?

Yes. Hennessy Clinical Psychology provides psychology support for adolescents and adults, with appointments available in Varsity Lakes on the Gold Coast and by telehealth across Australia.

References

1. American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). American Psychiatric Association Publishing.
2. National Health and Medical Research Council. (2012). Clinical practice guideline for the management of borderline personality disorder. Commonwealth of Australia. https://www.bpdfoundation.org.au/images/mh25_borderline_personality_guideline.pdf
3. Project Air Strategy for Personality Disorders. (2023). Clinical practice recommendations for personality disorders. University of Wollongong. https://www.projectairstrategy.org
4. Storebø, O. J., Stoffers-Winterling, J. M., Völlm, B. A., Kongerslev, M. T., Mattivi, J. T., Jørgensen, M. S., Faltinsen, E., Todorovac, A., Sales, C. P., Callesen, H. E., Lieb, K., & Simonsen, E. (2020). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, 2020(5), CD012955. https://doi.org/10.1002/14651858.CD012955.pub2
5. Linehan, M. M., Armstrong, H. E., Suarez, A., Allmon, D., & Heard, H. L. (1991). Cognitive-behavioral treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry, 48(12), 1060–1064. https://doi.org/10.1001/archpsyc.1991.01810360024003
6. Stoffers-Winterling, J. M., Storebø, O. J., Kongerslev, M. T., Faltinsen, E., Todorovac, A., Sedoc Jørgensen, M., Sales, C. P., Callesen, H. E., Lieb, K., & Simonsen, E. (2022). Psychological therapies for people with borderline personality disorder. Cochrane Database of Systematic Reviews, (3), CD012955. https://doi.org/10.1002/14651858.CD012955.pub2
7. Bateman, A. W., & Fonagy, P. (2009). Randomized controlled trial of outpatient mentalization-based treatment versus structured clinical management for borderline personality disorder. American Journal of Psychiatry, 166(12), 1355–1364. https://doi.org/10.1176/appi.ajp.2009.09040539
8. Zanarini, M. C., Frankenburg, F. R., Reich, D. B., & Fitzmaurice, G. (2012). Attainment and stability of sustained symptomatic remission and recovery among patients with borderline personality disorder and Axis II comparison subjects: A 16-year prospective follow-up study. American Journal of Psychiatry, 169(5), 476–483. https://doi.org/10.1176/appi.ajp.2011.11101550