When patterns become entrenched.
In people with personality disorders, certain features of their personality and their relational and behavioural patterns are particularly pronounced and inflexible. These are deeply rooted, enduring patterns of experience, typically shaped in childhood, present since adolescence and manifest since adulthood, which manifest as rigid responses to a variety of personal and social circumstances. People with personality disorders deviate persistently in their perception, thinking, feeling and manner of relating from the majority of people (in a comparable population group). Their patterns are stable, and they impair social relationships and ultimately lead to suffering not only for those affected, but frequently also for those around them. The prevalence of personality disorders in the general population is only partly established. According to current data, we estimate a prevalence of approximately 9% in Germany, though this is considerably higher at 40–60% in the group of patients receiving psychiatric treatment.
It is often reactive depressive symptoms (arising from conflicts, after separations, etc.), comorbid conditions (e.g. addiction disorders, eating disorders) or deliberate self-harming behaviour (self-injury, suicide attempts) that lead people with personality disorders to seek outpatient or inpatient psychiatric-psychotherapeutic treatment. On the basis of the reported symptoms, the clinical history, information from relatives, observed and experienced relational patterns, and with the aid of specific diagnostic instruments (SCID II, PSSI, etc.), a personality style, a diagnosis of personality accentuation or a personality disorder can be identified. In contrast to the assumption that this must be hurtful or shameful for those affected, we often find that the diagnosis can also bring great relief, in that those affected encounter for the first time an understanding and acceptance of what has persistently burdened themselves and/or those close to them, but which had hitherto been impossible to put into words or to place in context.