Cluster B personalities are familiar to everyone, but they are notoriously difficult to define and understand. The characteristics that make up these personalities are somewhat disparate, and yet they appear together as a pattern again and again. You will rarely find Cluster B defined or described as a whole, because it is so difficult for people to get a conceptual grip on it. The APA's diagnostic manual, keeping it simple, describes Cluster B thus, "Individuals with these disorders often appear dramatic, emotional, or erratic." That's it. That's what the DSM has to say on the subject. The UK's NHA describes Cluster B thus, "Someone with a cluster B personality disorder struggles to relate to others. As a result, they show patterns of behaviour (sic) most would regard as dramatic, erratic and threatening or disturbing."
I'm sure I can't expect to do better than the APA or the NHA, but here's my best shot . . . (1) thinking is characterized by cognitive distortions in the form of strongly developed defense mechanisms in which the individual fails to recognize the negative impact to them from their own actions and behaviors (more on this next time), (2) excessive use of out and out dishonesty and subterfuge, (3) actions and interactions frequently tied to secondary gains (i.e., attention seeking behavior), (4) excessive emotional reactions, and (5) apparent lack of substantive empathy (but superficial empathy may be expressed). These personality disorders, besides having some common characteristics, are conceptually tied because there is a fair degree of co-morbidity. In other words, it is not uncommon to find someone, for example, who has a combination of narcissistic and anti-social traits. And this holds true for all four Cluster B disorders.
In this cluster, we have Anti-Social Personality Disorder. This is very broadly defined disorder that accurately describes just about anyone who has found themselves up against the criminal justice system more than once. It is more widely known by the older term of psychopathic personality. It's characteristics include lack of empathy, lack of stress reaction to violence, dishonesty, disregard for the safety of self and others (but, especially others), lack of remorse, impulsivity, consistent irresponsibility, etc. One point I would like to emphasize is that anti-social types often fail to plan or think ahead. This, of course, is tied to impulsive behaviors, lack of ability to get one's needs met through normative behaviors (e.g., holding a job and budgeting your money to pay rent), and lack of concern about consequences (because cognitively the individual is trapped in the moment, they seem blithely unaware that tomorrow is going to happen).
Then there is Borderline Personality Disorder. This is the most difficult to understand and relate to, but we see this pattern of behavior quite frequently in the mental health system. With this personality profile, you often see intense emotional reactions, misunderstandings, the individual frequently attributes negative motivations to others, self harm behaviors (e.g., cutting), suicidal gestures, suicide attempts, intense anger (but often masked), and highly unstable relationships. Being in any kind of relationship with such an individual can be very difficult due to the constant manipulation and polar emotional swings between clinging and anger.
And, lastly, we have Narcissistic Personality Disorder. It's been splashed all over the news, of late. Most people already have a sense of what narcissism is, but that concept is not necessarily the same as the personality disorder. Anyway, I'll save this one for a later, dedicated, blog post.
In our next installment we'll try to get a grip on those pesky Cluster B cognitive distortions that are so damn crazy making.