Understanding Personality Disorders: Treatment, Hope, and Healing

July 21st, 2025

By P. Casey Arrillaga, LCSW, LCDC

Personality disorders are often stigmatized and
misunderstood, not only among everyday people but even within the professional
community. When most people hear the term personality disorder, they
picture someone difficult, dramatic, or even dangerous. These stereotypes,
unfortunately, have done real harm.

In this post, we will explore the truth about these
disorders and how they can be helped, including in residential treatment. This
post will be the first in a series over time, in which we will explore some
personality disorders in depth, such as Borderline Personality Disorder and
Narcissistic Personality Disorder. This blog series is here to offer education,
compassion, and—most importantly—hope.

Breaking the Stigma Around Personality Disorders

For people living with a personality disorder, daily life
can feel confusing, overwhelming, or lonely. And for their loved ones, it can
be hard to know how to help. Sometimes family members feel a similar mix of
difficult emotions. It can be tempting for everyone involved to blame and shame
the person with the disorder. This only makes this worse, because shame
is often at the root of personality disorders [1] [2].

In reality, personality disorders are not character
flaws—they’re deeply rooted patterns of thinking, feeling, and relating to
others that often develop in response to early life experiences, trauma, and
unmet emotional needs. As we’ve talked about in earlier posts about trauma
(here’s another
post on this), it doesn’t matter if others think the person in question has
had a traumatic life. What is important is that the person who developed the
disorder experienced what was happening around them as unsafe. Based on this,
they started to change their personality and how they view the world in a
misguided attempt to feel safer.

Personality disorders thus affect how people relate to
themselves, others, and the world around them. This can show up as intense mood
swings, fear of abandonment, perfectionism, chronic emptiness, impulsive
behavior, or difficulty trusting others. These patterns are usually long-standing
and feel like “just how I am.” But under the surface, there’s often a world of
pain, sensitivity, and a deep desire for connection. Many people with
personality disorders also struggle with depression
[3], anxiety
[4], substance use
[5], or trauma-related
symptoms [6], making it harder to find the support they deserve. They may
go to residential treatment for substance use but never get to the underlying sources
of pain. This can lead to feelings of hopelessness for that person and
frustration for those who love them. It doesn’t have to be that way.

Effective Treatment for Personality Disorders

One of the most damaging myths about personality disorders
is that they are untreatable. In truth, many people with personality disorders
make significant improvements in their quality of life and relationships with
the right kind of help. Evidence-based therapies—like Dialectical Behavior
Therapy (DBT), Schema Therapy, and Mentalization-Based Therapy—have been shown
to reduce
distress, improve functioning, and support long-term healing [7]. Treatment
may take time, but change is absolutely possible. Recovery doesn’t mean
becoming a different person—it means becoming more fully yourself, with greater
emotional balance, self-understanding, and freedom from harmful patterns.

For family members and friends, it’s also important to know
that support is available. Learning about personality disorders can shift the
way you see your loved one—not as manipulative, difficult, or broken, but as
someone coping with deep emotional pain. Education, therapy, and support groups
can help you set healthy boundaries, offer support without enabling, and take
care of yourself in the process.

How Windmill Wellness Ranch Treats Personality Disorders

At Windmill, we see our clients at human beings, not
pathologies. Where some professionals may shy away from doing the more
difficult work, we embrace it. This means that we work with clients who
experience the pain of personality disorders and help them find their true
selves underneath. This includes creating hope, using evidence-based practices,
and helping them find better relationships with both themselves and those who
love them. Since people with personality disorders often struggle with
substance use as well, our residential setting provides safety and support to
untangle and address both issues.

We are also proud of the support we offer families. Our
weekly family workshops and SMART
Recovery Family & Friends meetings create a forum for our clients and
their families to learn and practice new tools and ways of understanding each
other. These resources are available indefinitely, because our alumni and
families are welcome to keep coming to these meetings for as long as they like
after treatment has concluded.

Finding Hope at Personality Disorders Treatment Centers

Whether you’re just beginning to explore this topic or
you’ve been living with these challenges for years, we invite you to stay
curious, compassionate, and open to the possibility of change. Personality
disorders are not a life sentence. With support, recovery is not only
possible—it’s happening every day. If you or someone you love is struggling,
don’t hesitate to reach out and get help. Our admissions team can walk you
through what to expect and answer any questions. Call 830-251-5606 or contact us online.

References:

[1] Jørgensen, C. R., & Bøye, R. (2024). “I am ashamed
that I exist. I feel like apologizing for existing”: The phenomenology of shame
in patients with borderline personality disorder: A qualitative study. Personality
Disorders: Theory, Research, and Treatment, 15(3), 181.

[2] Fjermestad-Noll, J., Ronningstam, E., Bach, B. S.,
Rosenbaum, B., & Simonsen, E. (2020). Perfectionism, shame, and aggression
in depressive patients with narcissistic personality disorder. Journal
of personality disorders, 34(Supplement), 25-41.

[3] Köhne, A. C., & Isvoranu, A. M. (2021). A network
perspective on the comorbidity of personality disorders and mental disorders:
an illustration of depression and borderline personality disorder. Frontiers
in Psychology, 12, 680805.

[4] Shah, A. Q., Prasad, D., Caropreso, L., Frey, B. N.,
& de Azevedo Cardoso, T. (2023). The comorbidity between Borderline
Personality Disorder (BPD) and Generalized Anxiety Disorder (GAD): A systematic
review and meta-analysis. Journal of psychiatric research, 164,
304-314.

[5] Stetsiv, K., McNamara, I. A., Nance, M., &
Carpenter, R. W. (2023). The co-occurrence of personality disorders and
substance use disorders. Current psychiatry reports, 25(11),
545-554.

[6] Bozzatello, P., Rocca, P., Baldassarri, L., Bosia, M.,
& Bellino, S. (2021). The role of trauma in early onset borderline
personality disorder: a biopsychosocial perspective. Frontiers in
psychiatry, 12, 721361.

[7] Hernandez-Bustamante, M., Cjuno, J., Hernández, R. M.,
& Ponce-Meza, J. C. (2024). Efficacy of dialectical behavior therapy in the
treatment of borderline personality disorder: a systematic review of randomized
controlled trials. Iranian Journal of Psychiatry, 19(1),
119.

About The Author

P. Casey Arrillaga is the Team Leader for Education at
Windmill Wellness Ranch, and he is the author of books including “Realistic
Hope: The Family Survival Guide for Facing Alcoholism and Other Addictions”.