Personality Disorders: Crash Course Psychology #34

Personality Disorders: Crash Course Psychology #34

I can be smooth and charming and slick. I
can make a very confident impression and it’s hard to leave me at a loss for words. Sometimes I find myself fantasizing about
unlimited success and power, and beauty. I have repeatedly used deceit to cheat, con,
or defraud others for my personal gain. To be honest, I don’t have much concern for the
feelings of other people, or their suffering. Doesn’t sound like the Hank you know, does
it? These are all statements from the Self-Assessment
measure for Personality Disorders, that lets patients describe themselves, ranking each statement
in terms of how accurate they think it is. To be honest, you can’t rely too much on this
kind of self-reporting to assess what we are talking about today because while some people
who are over-confident or obsessed with power or downright deceitful might tell you that
they are, there is a certain subset that won’t. Many of the disorders that we have talked
about so far are considered, “ego-dystonic” meaning that people who have them are aware
that they have a problem and tend to be distressed by their symptoms. Like a person with Bipolar Disorder or OCD
generally knows that they have a psychological condition and they don’t like what it does
to them. But some disorders are trickier then that.
They are “ego-syntonic,” the person experiencing them doesn’t necessarily think that they have
a problem and sometimes, they think the problem is with everyone else. Personality disorders fall into this category.
These are psychological disorders marked by inflexible, disruptive, and enduring behavior
patterns that impair social and other functioning — whether the sufferer recognizes that or not. Unlike many other conditions that we’ve talked
about, personality disorders are often considered to be chronic and enduring syndromes that
create noticeable problems in life. And as you can tell from these self assessment
statements, they can range from relatively harmless displays of narcissism, to a true
and troubling lack of empathy for other people. Not only can personality disorders be difficult
to diagnose and understand, they can also be downright scary. Most of the extreme and
severe disorders go by names that you probably recognize: psychopathy and sociopathy. I’m talking,
like, serial killers here, mob bosses, Vlad the Impaler. Cultures have been studying human personality
characteristics for thousands of years, but the concept of personality disorders is a
much newer idea. Much of our modern classifications of these
disorders are based on the work of German psychiatrist, Kurt Schneider, who was one
of the earliest researchers into what was then known as psychopathy and published a
treatise on the study in 1923. Today, the DSM 5 contains ten distinct personality
disorder diagnoses, grouped into three clusters. The first cluster, cluster A, includes what
are often labeled simply as “odd” or “eccentric” personality characteristics. For example,
someone with paranoid personality disorder may feel a pervasive distrust of others and
be constantly guarded and suspicious while a person with a schizoid personality disorder
would seem overly aloof and indifferent, showing no interest in relationships and few emotional
responses. Cluster B encompasses dramatic emotional or
impulsive personality characteristics. For example, a narcissistic personality can display
a selfish grandiose sense of self-importance and entitlement. Meanwhile, a histrionic personality
might seem like they’re acting a part to get attention, even putting themselves at risk
with dramatic, dangerous, and even suicidal gestures. The behavior of Cluster B can be
truly self-destructive and frightening, and these disorders are often associated with
frequent hospitalization. Finally, Cluster C encompasses anxious, fearful,
or avoidant personality traits. For example, those with avoidant and dependent personality
disorders often avoid meeting new people or taking risks and show a lack of confidence,
an excessive need to be taken care of, and a tremendous fear of being abandoned. Now,
in the past, and, to a great extent, today, some of these categories have been controversial.
Many researchers argue that some of these conditions overlap with each other so much
that it can be impossible to tease them apart. Narcissistic personality disorder, for example,
has many traits that resemble histrionic personality disorder. And because of this gray area, the
most commonly diagnosed personality disorder is actually personality disorder not otherwise
specified or PDNOS. The prevalence of this diagnosis suggests that while clinicians can
identify a personality disorder in a patient, figuring out the details of the condition
can be messy and difficult. One proposed alternative for diagnosing these
disorders is the Dimensional Model, which, in essence, gets rid of discrete disorders
and replaces them with a range of personality traits or symptoms, rating each person on
each dimension. So the Dimensional Model would assess a patient not with the aim of diagnosing
one disorder or another, but instead, simply finding out that they rank high on say, narcissism
and avoidance. It’s a work in progress, so with another generation, the clinical definition of
“personality disorder” may evolve pretty radically. One of the best-studied personality disorders
right now is Borderline Personality Disorder, or BPD. Borderline makes it sounds like patients
are like, pretty close to being healthy, but not quite, but that is not at all the case.
BPD sufferers have often learned to use dysfunctional, unhealthy ways to get their basic psychological
needs met, like love and validation, by using things like outbursts of rage, or on the other
end of the spectrum, self-injury behaviors like cutting or worse. People with BPD were
once commonly maligned by clinicians as ‘difficult’ or ‘attention-seeking’, but we now understand
BPD as a complicated set of learned behaviors and emotional responses to traumatic or neglectful
environments, particularly in childhood. In a sense, people with this disorder learn that
rage or self-harm helped them cope with traumatic situations, but as a result, they also end
up using them in non-traumatic situations. Although challenging for patients and clinicians
alike, the good news is that some psychotherapies have helped even the most severely suffering,
repeatedly hospitalized BPD patients. But probably the most famous well-established,
and frankly, troubling personality disorder is Antisocial Personality Disorder. Now, you’ve heard
of this before, but maybe by one of its now somewhat out of vogue synonyms, “psychopathy”
or “sociopathy.” People with Antisocial Personality Disorder, usually men, exhibit a lack of conscience
for wrongdoing, even towards friends and family members. Their destructive behavior surfaces
in childhood or adolescence, beginning with excessive lying, fighting, stealing, violence,
or manipulation. As adults, people with this disorder are thought to generally end up in
one of two situations: either they are unable to keep a job and engage in violent criminal
or similarly dysfunctional behavior; or they become clever, charming con-artists, or ruthless
executives who make their way to positions of power. Tony Soprano would have qualified
for a diagnosis, even if he wasn’t nearly as bad as, say, serial killer Ted Bundy or
Vlad the Impaler, the infamous 15th century Romanian prince who personally watched about
100,000 people get impaled or have the skin of their feet licked off by goats. Yeah. That happened. Despite this classic remorselessness, lack
of empathy, and sometimes criminal behavior, criminality is not always a component of antisocial
behavior. Certainly many people with criminal records don’t fit that psychopathic profile.
Most show remorse, love, and concern for friends and family. But still, although anti-social
personalities make up just about 1% of the general population, they were estimated in one study
to constitute about 16% of the incarcerated population. So, how might someone end up with such a disturbing
disorder? Well, as you might expect, the causes are probably a tangled combination of biological and
psychological threads, both genetic and environmental. Although no one has found a single genetic
predictor of Antisocial Personality Disorder, twin and adoption studies do show that relatives
of those with psychopathic features do have a higher likelihood of engaging in psychopathic
behavior themselves. And early signs are sometimes detected as young as age three or four, often
as an impairment in fear conditioning, in other words, lower than normal response to
things that typically startle or frighten children like loud and unpleasant noises.
Most kids only need to get burned by a hot dish once to know to stay away, but kids who
end up displaying Antisocial Personalities as adults don’t necessarily connect or care about
the learned consequences when they’re little. From there, like we’ve seen in other disorders,
genetic and biological influences can intersect with an abusive or neglectful environment
to help wire the personality in a peculiar and damaged way. While the vast majority of
traumatized people don’t grow up to be killers or con-artists, genes do seem to predispose some
people to be more sensitive to abuse or trauma. Meanwhile, studies exploring the neural basis
of Antisocial Disorder have revealed that when shown evocative photographs, like a child
being hit or a woman with a knife at her throat, those with psychopathic personality features
showed little change in heart rate and perspiration, as compared to control groups. And the classic antisocial lack of impulse
control and other symptoms have also been linked to deficits in certain brain structures.
One study compared PET scans from 41 people convicted of murder to those of non-criminals
and found that the convicted killers had greatly reduced activity in the frontal lobe, an area
associated with impulse control and keeping aggressive behavior in check. In fact, violent
repeat offenders had as much as 11% less frontal lobe tissue than the average brain. Their
brains also responded less to facial displays of stress or anguish, something that’s also
observed in childhood, so it’s possible that some antisocial personalities lack empathy
because they simply don’t or can’t register others’ feelings. Research has also suggested
an overly reactive dopamine reward system, suggesting that the drive to act on an impulse
to gain stimulation or short-term rewards regardless of the consequences may be more
intense than the average person’s. As we mentioned before, because personality
disorders are pretty much egosyntonic by definition, people don’t often acknowledge that they have
a problem or a need for treatment – and in the case of Antisocial Personality Disorder,
even if they did, there aren’t many specific treatments available, at least not for adults. But there are some promising interventions
for kids and adolescents whose minds and brains are more plastic and adaptable. In this way,
the best way to treat Antisocial Personality Disorder may be in trying to prevent it. According
to American psychiatrist Donald W. Black, among others, many kids diagnosed with Conduct
Disorder, the diagnostic precursor to Antisocial Disorder, are at high-risk for developing
Antisocial Personalities as adults. But by identifying warning signs early on and by
working with these kids and families to correct their behavior and remove negative influences,
some of that impulse fearlessness could be channeled into healthier directions, like
to reward promoting athleticism, or a spirit of adventure. It’s important to remember that
Antisocial Personality Disorder is only one type of personality disorder. This is a diverse
family of psychological conditions determined by many different factors and we’re still
in the early stages of diagnosing and understanding the mechanisms behind them. Today, you learned about personality disorders
and the difference between ego-dystonic and ego-syntonic disorders. We looked at the three
clusters of personality disorder, according to the DSM V, and how personality disorder
symptoms often overlap. We also took a look at Borderline and Antisocial Personality Disorders,
including their potential bio-psycho-social roots. Thank you for watching, especially to all
of our Subbable subscribers, without whom we could not make Crash Course. To find out
how you can become a supporter, just go to This episode was written by Kathleen Yale,
edited by Blake de Pastino, and our consultant is Dr. Ranjit Bhagwat. Our director and editor
is Nicholas Jenkins, the script supervisor and sound designer is Michael Aranda, and
the graphics team is Thought Cafe.

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  1. i learned more in this video that is 11 minutes long, than in my Sociology class which ive been in for like 5 months

  2. I think it's safe to say that a boy in my class is a sociopath or psychopath, or has something including that or the same symptoms.

  3. Hilarious the names of everything have been changed the definitions rewritten and the invoices keep flowing. If you can afford to waste the time and money lying on a couch spouting nonsense to a grifter you could instead buy yourself a dremel and some jewelry tools and little hammers and make little engraved metal boxes. Every time you have bad thoughts, write them down , pop them into a box and mail it to Hank.

  4. I had a friend with multi personality disorder and it was pretty hard for me to comprehend what was going on when ever he would switch. It got so bad to the point where we would fight. I know what I did was wrong and he has forgiven for my nativeness and ignorance to his condition, but now he is the closest friends i have and I love him unconditionally. It can get hard time to time but from all his personalities they are all very sweet, but each serve a different use for his life. Most of the people who have this usually faced some for of trama growing.
    So I try my best to provide my friend the comfort and love he couldn't get when he was growing up.

  5. Sometimes I get really curious if I'm teetering between being healthy and being borderline because certain weeks I'll have outburts that cause me to gain obsessions with friends and become easily angered, and whenever someone talks about bpd and begins listing symptoms and how bpd might form I just think oh no…

    I need a therapist but they are scary and expensive haha,,

  6. Whoever edits these videos has a RUNON SENTENCE DISORDER! seriously. It does a dis service to the viewer and makes your vid unwatchable. I really really hate it.

  7. I dated a girl who had narcissistic and histrionic personality disorders.

    It was exhausting. Oh, and before people think I'm throwing stones, I have Aspergers and sociopathy.

    We were quite the pair.

  8. I dated a girl who had narcissistic and histrionic personality disorders.

    It was exhausting. Oh, and before people think I'm throwing stones, I have Aspergers and sociopathy.

    We were quite the pair.

  9. I used to have a very good relationship with my mother. My biological father was never there. And I gained a step dad that was a criminal in and out of prison. But other than that he was a great stepdad for the most part. Thru the years me and my mom's relationship has almost diminished over the years of me becoming a young adult. But I eally think it's me. It's like I cannot connect emotionally not my mom hardly anymore. And I hate it. But I'm also like most on how to regain feelings, emotions, a connection towards my mom. And I cannot take my mom for granted because having a parent is a privilege. I'm not sure what to do. How to do it. Ugh! Nvm y'all😔
    And it's so sad too, I have a caseworker/doctor to talk to and they don't care at all… pisses me off

  10. i was diagnosed with borderline personality disorder and i was hospitalized 4 times. they just recently figured out this is what i had. borderline personality disorder is difficult to live with but i try my best!

  11. I thought the information was valid. However, I felt it did absolutely nothing to counter the misconception that mental illness=criminality. I also thought he spoke in black and white terms. I would wager that not ALL experiencing these mental illness have NO empathy, but MAY have problems with empathy. The true victims of these mental illnesses are in fact, the people who have to bear them. I dated, for a time, a man with Avoidant Personality Disorder. He had compassion, except maybe as it applied to himself, he loathed and feared himself. But he is also someone who is a productive member of our society; although an unhappy one. I would ask the Crash Course team to please try better at not depicting the people who suffer from these as "others". They are all around us, they are struggling and we should endeavor to understand and help them.

  12. Where’d they find this guy at an auction? Let’s start the bidding at 1000 and hehysywhausywhususuwhjwush we got 950 ebebsggsgsgshshhwhshss 900! Eueydyushwjajahgsgshshhababa

  13. everything is technically environmental because our genes are a product of historical environments that our ancestors lived in.

  14. 5:06 onwards honestly made me cry a little bit. ive heard and understood this before, but just the way you put it honestly turned on a lightbulb and made so much more sense than it ever has and it’s now so much clearer – and easier to process – why i am the way i am

  15. Cool video!

    Hey, does anyone know of any YT channel, website or so where it is explained how to talk with people with mental illness? The theory of the diseases is good and important to know, but I’d like examples on how to have conversations with people. I know that it will always have to be done individually because every person is different, but there are some basics for every disease, or?

  16. Self judging from his statements, I may be a BPD since I suffer from bursts of rage due to my childhood from bad parenting. I’ve been hospitalized several times too.
    I need to get help.

  17. People who behave like some of these do exist. I have met them. I knew a man for four years. Very charming, very manipulative. He could cause the suffering of another person, be aware of it and walk away. He could pretend to be sympathetic, keep doing it again and again, repeatedly. All the while he could pretend to be helping you but he could be actually the source of all your pain. No remorse or conscience.

    They do exist.

  18. This branch of psychology is so beautiful because it helps us take judgment out of the conversation about people who behave poorly.

    The extension of mental health studies seems to have the power to liberate us from the lack of understanding we all, des temps en temps, have for criminals or anti-social “rude” folks in our life.

    At the peak of this feild we might just get to a place where we look at people who behave badly with compassion and see them all as people needing treatment rather than treating them like unknowable beings with incomprehensible evil in their hearts.

    We might even take it further and look at the wide array of cognitive and behavioral abnormalities as “conditions” that make up our mental state & personality, which can be addressed in a way that compliments our more eccentric traits instead of eliminating them.

    Because idk about y’all, but I’m damn tired of being angry all the time. It feels damn liberating, even kinda euphoric to look at even the worst actors in our society and think we can help them get better.

    My mom puts it best when she talks about helping her 1st grade students act better in class, “Less punishment, more chats, more hugs.”

  19. I came here to learn about Personality Disorders and I’m utterly mortified that this is the tone and approach to them. Knowing that many people have developed these disorders because of a traumatic childhood or traumatic events, why does the host introduce these people in this way? No wonder people cannot come forward and ask for help with their conditions. This person appears to be highly intelligent and engaging but, it seems to me that, it’s at the expense of people suffering with mental illness.

  20. I have been diagnosed with Borderline Personality Disorder, and even got 100% on the BPD section of the test! Oh Lord, that’s depressing.

    Like if you also have BPD. 😂😭

  21. Its brave New World to Happy your manic to sad depressed to energetic easily bored ADHD and on. To be healthy you need to be a Grey mouse and have the feelings of a British royalty who Seem drugged on Anti depressens

  22. “Acting a part”, attention-seeking, dramatic and dangerous risk-takers. Self destructive and frightening **SHOWS MILEY CYRUS*** at 3:08

  23. this suggests that BPD people can't be abused by neurotypical people; they can, and frequently are – sometimes we are right

  24. Vlad kinda HAD to be a psychopath. His contemporary neighbors were looking into taking over his kingdom and his people. Vlad´s subjects expected him to enforce intimidation to keep the borders safe.

  25. Tony Soprano killed Ralphie because he was a psychopath, after raphie burned down the stable, killing the horse….tony has compassion and empathy, he was just raised with twisted morals. He learned at a very young age that cops are the enemy and that his “standard business practices” (that typically involve violence) are done within their communities set parameters. Tony gets nervous and angry when his employees operate outside their unconventional ethics. He feels sad for those who lost their lives “unjustly” (the stripper ralphie killed). He isn’t just looking out for himself, but his family and friends as well. Plus he loves duckies!!

    Ralphie would be a much better example of a true psychopath. Tony seems more conditioned to be the way he is. Ralphie is just a monster though.

    Damnit, I could have been learning science instead of writing this….

  26. Apperantly i have schizoid personality disorder.
    I always felt like i was different from everyone i knew, but it is the only way i know i can feel, so i couldn't understand what normal means exacly….
    Im in therapy

  27. TBH you have no idea what you're talking about. People with personality disorders know they have them and generally don't like the social isolation or psychological distress those symptoms bring them.

    Empathy is NOT sympathy or compassion. All the absence of empathy entails is a disconnect between your emotions and someone else's. You don't necessarily understand why or what other people feel! But that has no relation in your compassion or morals. Most statistics relating to aspd are nonsence because so few people can keep their preconceptions in control… It even agree on what the diagnosis is.

    Anyway criminality has no relation to the disorder. All violent criminals will learn to reduce empathy and such as part of their experience. Also most aspd patients don't have conduct disorder because most of them don't get caught or simply aren't diagnosed or even don't engage in illegal activities instead displaying their lack of ability to learn from consequences and lack of impulse control elsewhere.

    The disorder is likely the least understood because there's so much psuedo science relating to it. If anything the real disorder is only tertiary to the mythos of the psuchopath, and it's pure coincidence that such a disorder exists at all, considering there was no real psychology involved with the proposed idea of a sociopath originally.

    In truth neurotypicals are desperate to separate themselves categorically from violent criminals so they made up a disorder, and their made up disorder has little relationship with the real deal.

    Some real info on aspd: they don't learn from consequences because they were raised in an environment where consequences were inconsistent and unavoidable. Their parents moods would change and with it so would the rules. One day something is encouraged, the next its punished without warning. As for impulse control, the chaos and instability they're raised in creates an environment where they can't predict the future or plan ahead. Anything they save for is liable to be taken away, and they're generally kept miserable at all times. This makes them want to focus entirely on the now, without planning ahead, because that isn't an option in their home life. Then these thoughts and behaviors become rooted deeply j to their psychy and are almost impossible to unlearn.

    And above all else, the empathy. I cannot stress enough how unnecessary this is. We can't empathize because the people who raised us fakes emotions in order to manipulate and control us. There was no rhyme or reason to their feelings, so there was no way to understand. Then we were often punished for our own emotions, and exposed to extremely distressing situations and material often enough to desensitize us. Nonetheless, anyone with aspd can understand how you feel if you use your words. We're not masters of manipulation, we just have to learn the social ques and such consciously because it's not intuitive to us. We don't hide our disorder in order to manipulate people, we do it to avoid your prejudice towards us, because we're instantly dehumanized and assumed an enemy once it's known.

  28. to the people who like to self diagnose and get mad when they’re told that they don’t have the particular problem: why would you want a mental disorder so badly?

  29. Ego-syntonic features of personality disorders go away when a person has that "aha moment". When we realize that maybe it's not them, it's us.

    I do not like that the video only discusses further into antisocial personality disorder (ASPD), brushes over borderline (BPD) and ignores the rest. As if ASPD is at the forefront of PDs and is the best example to represent all these disorders.

    It did not do a good job recognizing the pain people go through, both the mentally ill person as well as those around them, regarless of the personality disorder. Also, it does not help destigmatize conditions like BPD (which, incidentally, has an excellent prognosis if treated, with over 80 % in remission after 2 years of treatment) which is basically someone who can't handle their feelings, or talk about the spectrum of ASPD, who are capable of loving someone and want to learn how not to hurt them (it takes a non-sadistic person, let's be clear about that, but they exist). They aren't all serial killers or CEOs…

  30. anti social personality disorder is so misrepresented, people say they're anti social because they "don't like socializing uwu" which does not make you anti social. nobody wants to be an ACTUAL anti social, so don't identify as such.

  31. Why do we need empathy?
    It doesn't change how successful we are in our careers?
    Im 14, dont have a job, my perspective.

  32. Anyone else who sometimes really wants to die (for real) but then wants to survive so people will finally give them attention?

  33. What do you do when you're in a serious relationship with a literal narcissist with no empathy. I'm about to marry one end of this year and I'm having second thoughts. They keep hurting and emotionally abusing you and are unable to take responsibility for their actions and they truly believe they're never in the wrong and so they believe they don't need to change. Do you abandon someone with this condition? It isn't their fault they have this disorder but at the same time they don't feel bad about hurting you and blame you for their horrible actions. What do you do? Do you stay to your own detriment or leave them to their detriment? What do you do when you truly love someone and you believe they truly love you they just have this self obsessed, I can never do anything wrong and it's your fault that I hurt you, mentality.

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