Distorted Thinking Patterns
People with personality disorders tend to exhibit distortions in the way they interpret and think about the world, and in the way they think about themselves. Not surprisingly, people with personality disorders think about things quite differently than people with healthy personalities. They may have thinking patterns that are very extreme and somewhat distorted. These dysfunctional patterns are particularly problematic when a person with a personality disorder attempts to understand their interactions with others. Examples of these problematic interpretations of the self-in-the-world include: 1) extreme black-or-white thinking patterns, 2) patterns of idealizing then devaluing other people or themselves, 3) patterns of distrustful, suspicious thoughts 4) patterns that frequently include unusual or odd beliefs that are contrary to cultural standards, or 5) patterns of thoughts that include perceptual distortions and bodily illusions. Let's look at these five thought patterns a little more closely:
Black-or-white thinking can also be referred to as all-or-nothing thinking. Thoughts become polarized as either-or; "always this" or "never that." Some examples of this type of thinking might be: "I never get anything right!" or, "If I am not brilliant, then I must stupid" or, "A woman can't have a career and be a stay-home mom" or, "If he does not love me, then he must hate me" or, "If I can't do this perfectly, then I won't do it at all!" You can see these kinds of thoughts leave no room for shades of gray and do not allow for compromise, or a consideration of multiple alternatives or possibilities. For instance the conclusion, "If I am right, you must be wrong" might be more correctly stated, "We might both be right, or both be wrong."
Another related pattern of extreme thinking is the tendency to vacillate between over-idealizing, then completely devaluing, other people or oneself. Most healthy people recognize that we each have some good, and some bad qualities; i.e., we behave well sometimes, but not certainly not all the time. However with a vacillating pattern of extreme thinking, people are seen as either all good, or all bad, but not both. This distorted thinking pattern can be played out when a client begins to work with a new therapist. Initially, the therapist is seen as the perfect human being who has all the answers to their problems, who knows everything, never makes any mistakes, and who will never disappoint or frustrate the client. However, as soon as there is the slightest indication that the therapist has ordinary human limitations such as becoming sick and missing a therapy appointment; or who doesn't immediately have a solution to their client's problems; or who says or does something frustrating to client; then the all-good therapist suddenly becomes a completely horrible, incompetent, and ignorant person in their client's eyes. This pattern can also be played out in friendships, romantic relationships, or family relationships and can cause a great deal of disillusionment, grief, and conflict for everyone involved.
A third pattern of distorted thinking is a heightened level of suspiciousness, being distrustful of others, and believing that most other people are dishonest and potentially harmful. With this pattern of thinking, other people's actions and motivations are nearly always questioned and considered to be suspect. A person with this pattern of thinking will interpret even the kindest gestures in a negative way. For example, a simple gift might be interpreted as a disguised attempt to manipulate them. It is very easy to imagine that suspiciousness and distrust can cause tremendous distress, and certainly interferes with the formation healthy and enjoyable relationships with others.
Some people with personality disorders have some very odd beliefs including superstitions, unusual religious beliefs, and worldviews that are extremely out of tune with a person's culture, religion, and environment. This is not to say that everyone who has religious beliefs or superstitions has a personality disorder. It is very important to emphasize that the beliefs have to be extreme and markedly different from the person's cultural norms and their environmental context. By way of example, let's consider a Christian man who grew up in the United States. Assume he is still living in the USA and he thinks that carrying around a slice of cheddar cheese in his pocket all day will help him get to heaven after death. Many people in the Judeo-Christian culture of the USA believe in heaven and some sort of afterlife; but the belief that cheese has something to do with heaven and an after-life is certainly uncommon. People from this culture would consider the notion that cheese gets you into heaven, an unusual and odd belief.
Another type of distorted thinking is perceptual distortion. Perceptual distortions are particularly common in people with Schizotypal Personality Disorder. Examples of perceptual distortions are things such as seeing another person's face morph right before your eyes, but then as you look closer, you realize the face is actually still the same. Another example would be feeling as though someone is calling your name, but when you turn around, no one is there. These perceptual distortions are typically fleeting and the person who experiences them is usually able to distinguish these experiences from reality. In other words, they realize these distortions do not represent a factual event. This is quite different from visual or auditory hallucinations which are indistinguishable from reality by the person who experiences them.