Personality Disorders Explained: Compass Therapy

On the eve of the publication of DSM-V, the world's major tool for understanding mental illness and personality disorders, psychiatrists are pulling their hair out, trying to find a central working model that makes sense of people's inner worlds.

The main problem psychiatrists and personality theorists find with the concept of personality disorders -- longstanding patterns of cognition, emotion, and perception -- is that so many of the present personality disorder categories overlap one other when observed in real life.

Called co-morbidity (a terrible word since it sounds like death warmed over!), it simply means that very few people are pure prototypes of the narcissistic, compulsive, antisocial, paranoid, dependent, histrionic, schizoid, or avoidant personality disorders. This rests on the assumption that human behavior and its attendant psychopathology should be neat and tidy, like the data found in most other hard sciences: chemistry, physics, and mathematics.

But humans are not purely objective creatures with totally predictable instincts. We are deeply subjective individuals with personal life histories and points of view. I say that it is time psychiatry wakes up to this fact of life, and accepts the simple truth that individuals seen in therapy can demonstrate elements of narcissistic entitlement, antisocial rule-breaking, and histrionic melodrama coexisting within their personality and relationships.

Compass Therapy makes a contribution here by asserting that all human beings possess personality rigidities that are behaviorally significant in varying circumstances. These rigidities increase under stress and decrease with personality integration, which needs to be a primary goal of all therapy.

What has blocked this perception from developing in psychiatry is the ongoing war between psychoanalytically oriented professionals who believe there exists an unconscious motivation for every inner conflict, the behavioral professionals who believe that medication and behavioral conditioning can remove symptoms without a client's subjective involvement in the process, and humanistic professionals who believe that giving a client an empathetic ear for airing their inner distress will eventually lead them into making more adaptive and self directing life choices.

Compass Therapy draws upon all of these perspectives in order to develop an overview that pertains to every single client: we need to see with X-ray vision into the objective structure of personality to grasp why people subjectively choose the way they do, especially when their choice patterns bring them anxiety, depression, hostility, withdrawal, alienation, and other symptoms that make life intolerable.

With a cursory glance at the diagram above you can recognize when your client is stuck favoring one of the universal compass points of personality to the exclusion of others, or if your client rigidly uses different compass points in different situations. This solves the co-morbidity problem because it is common for people to swing around the Self Compass in non-adaptive ways, precisely because they've never learned through cognitive and emotional maturity how to use a whole Self Compass to flexibly adapt to life situations.

The Compass Model introduces new learning on how mental health functions, exactly how it breaks down, and how to expand a client's personality into healthy compass points that foster health in personality and relationships. Understanding this system give a counselor invaluable information immediately, since it illuminates the client's personality structure in every moment of counseling.

Without this model you are left floundering, trying to figure out the complex causes of historical or developmental traumas, and then how how to promote healing and change. The Self Compass Model organizes an immense foundation of clinical and empirical data, yielding a simple and effective perception of the client's health or dysfunction. A second substantial advantage is that a therapist can share compass concepts directly with clients, since these concepts are understood even by school age children.

I encourage you to get an early start on grasping the new DSM-V by first mastering the principles of Compass Therapy. To help you along, here are five Compass Therapy books for you to consider adding to your core clinical and/or pastoral counseling library.

COMPASS THERAPY

THE SELF COMPASS

CHRISTIAN PERSONALITY THEORY

PASTORAL COUNSELING AND COACHING 

CHRISTIAN COUNSELING THAT REALLY WORKS

Compass Therapy on Personality Disorders

The term "personality disorder" -- described in DSM-IV and DSM-V (Diagnostic and Statistical Manual of Mental Disorders) -- captures the chronic and rigid inflexibility of a personality pattern. Unfortunately, this term can also have a side effect of diminishing a person's self-esteem and creating futility about the future. Even therapists can feel pessimistic about treating personality disorders.

Compass Therapy changes this by using the term "personality patterns," thus emphasizing that rigid patterns are merely growth deficiencies that can be replaced with healthy personality growth. People are familiar with the concept of laying aside old patterns, such as eating too much or driving too fast. They quickly grasp that growth stretches into unused compass points makes their behavior more resourceful and their life happier.

Therapists can remember nine major personality patterns by their location around the Self Compass. Each pattern is stuck on one or two compass points to the neglect of the others. Compass Therapy guides the expansion of personality into rhythmic use of all four complimentary points.

Personality Patterns Self Compass

*The dependent and histrionic patterns are located on the Love compass point, where the dependent trend intensifies into chronic pleasing and placating (dependent) or the melodramatic craving for attention (histrionic). Both patterns share intense needs for approval and affection, as well as a fixated focus on others that blocks access to the spiritual core.

*The paranoid and antisocial patterns are stuck on the Assertion compass point, where the aggressive trend develops into edgy suspicion (paranoid) or impenitent exploitation (antisocial). These two patterns frequently co-vary as personality mixtures, and share an undercurrent of hostility. They consider others as adversaries over whom they must triumph.

* The avoidant and schizoid patterns are located on the Weakness compass point, where the withdrawn trend intensifies into fearful loneliness (avoidant) or isolated detachment (schizoid). Both patterns create flat affect, a lack of motivation in personal development, and massive deficiencies in interpersonal skills.

* The narcissistic and compulsive patterns are lodged on the Strength compass point, where striving for superiority pushes the controlling trend into either the grandiose entitlement of the narcissist or the judgmental perfectionism of the compulsive. These two patterns share a common preoccupation with issues of adequacy, power, and prestige. Both patterns are quite comfortable taking control and dictating. Both patterns share the demand for perfection, the narcissist seeking the glory of ambition and the compulsive enforcing the status quo.

*The borderline pattern blends elements of the top and bottom halves of the Self Compass, flip-flopping in rapid swings from one extreme to its opposite. A built-in ambiguity within the pattern makes unpredictable whether the person will come across as a “top dog” (Strength and Assertion compass points) or an “underdog” (Love and Weakness compass points). This oscillating fluctuation forms the “rigid fluidity” of the borderline pattern.

I've taught students at several universities how to understand and treat these personality disorders. When I first used the material found in the Diagostic and Statistical Manual of Mental Disorders, my students remained puzzled, because they could never remember what distinguished one disorder from another, let alone how to construct an effective treatment plan based on each pattern's unique needs.

However, when I started using the Compass Therapy model, based on the user-friendly model of the Self Compass, students and veteran therapists alike said they could finally locate each disorder relative to the others, and understand the rationale regarding the facilitation of therapeutic growth toward a healthy and balanced personalty.

Here's what Lallene Rector, Professor of Psychology of Religion and Pastoral Psychotherapy, Garrett-Evangelical Seminary, Northwestern University, writes about the Compass Therapy perspective on Personality Disorders: 

"One of the real gems in the Montgomerys’ work is a systematic analysis of 'personality patterns' following DSM descriptions of the personality disorders. Attention is paid to the pattern’s interior, its origins, cognitive self-talk, emotional dynamics, and impact on others, as well as its way of relating to God."

To connect the diagnosis of a personality pattern
with a successful compass treatment, read

 COMPASS THERAPY