Reflections on “Quiet” Personality Disorder

Most people lead lives of quiet desperation.

– Henry David Thoreau –

As strange as this might sound, I’ve always loved this quote. Since I was a teenager this quote has explained a feeling I have about many of the people I meet every day. Most are friendly and appropriate but underneath something is just not OK. Underneath, they are desperate. And, the strangest thing about being with them is that they don’t seem to be aware of their desperation. It’s as if they know how to get me to believe they are OK but they also know how to convince themselves they are OK.

Until something goes wrong.

Maybe they lose their job, or get a divorce, or have a friend die, or get depressed without knowing why.  But, something happens.

Then, they show up for therapy. And the wound, the gash, the problem has opened a doorway into their desperation. Usually, they want to shut the door right away. They want to go back to work or family or whatever, and they want to do it right now. But, I can feel it…that hidden desperation deep inside them. And I want to go into that desperation. I want to get close to it. I want to know it. I want to heal it. I want to give them a chance at a life that is fully lived not dulled by quiet desperation.

In the world of personality disorder treatment some conditions get a lot of attention and some get very little. Borderline personality gets a lot of attention. It is big and dramatic. It draws attention through cutting or promiscuity or drug abuse or rage or hysterical breakups. And, borderline personality deserves a lot of attention. But so do the quiet personality disorders.

Masochistic personality, schizoid personality, paranoid personality, obsessive-compulsive personality all deserve lots of attention.

These are conditions that are too often neglected or rejected by therapy. People with these conditions are told that they seem to be OK, that they have a job, and a family; they are stable. They are often told they do not need therapy. Or, they need a short-term therapy to give them some tools to manage their stress. This is not true. They are as deeply wounded as borderline personality patients. They are just quiet. They need a therapy that reaches deep inside and relieves them of quiet desperation. Let’s all do our best to see these people give them the life they deserve.

To learn more about treating all types of personality disorder, get in touch with us. At Nysa Therapy, we provide consultation and training for mental health professionals, so that we can get to the heart of it with patients struggling with personality disorder.