Personality disorders

Definition

According to the DSM, a personality disorder is a persistent pattern of inner experiences and behaviors that deviates from cultural expectations. The pattern is:

• pervasive (present in many situations)
• rigid (difficult to adapt)
• early onset (adolescence or early adulthood)
• and causes significant distress or impairment in functioning.

Reframing from the perspective of contextual thinking

Within this project, we view personality disorders from the idea that context blindness and limitations in complex thinking are at the root. Much behavior that is seen as “strange” or “deviant” can be understood as a way of surviving in a society that strongly relies on context sensitivity.

A core problem here is the lack of basic trust. Without the ability to properly integrate intentions, timelines, and patterns, trust becomes fragile. This explains why in various personality disorders (e.g., borderline, paranoid) trust quickly turns into suspicion or emotional crisis.

Cluster A — odd and eccentric

• Paranoid — sterk eerstegraads en wantrouwend interpreteren; complexe structuren worden vereenvoudigd tot “opzet” of “samenzwering”.

Casus

Sciensano, an independent institution of the Belgian government, issued the guidelines regarding testing and quarantine. But some saw Sciensano as a 'power structure' of the Belgian labs. It was said that Sciensano and the Belgian labs are one entity, because Sciensano performs quality control of the labs. Sciensano indeed performs quality control, but also as an 'independent institution' of the government, not of the labs themselves. But that is already a lot more complex, and to understand that you need 'patience', which is difficult for someone who mainly relies on 'first-degree' thinking.

• Schizoid — withdrawal from social interactions as a comprehensible reaction to an overwhelming world that is difficult to contextualize.
• Schizotypal — eccentric behavior, magical thinking, ideas of reference. With limited context integration, random patterns are seen as meaningful; that lies on a continuum towards psychosis.

Cluster B — emotional and unpredictable

• Antisocial — egocentric/transactional thinking can lead to rule-breaking when the consequences for others are not considered. This is often clumsy coping, not always intentional “badness”.
• Borderline — a very strong emotional response with limited cognitive empathy to frame those emotions; difficulty showing the "appropriate" emotion depending on the context.
• Theatrical (histrionic) — emphasis on expression without sufficient attunement to the situation and audience; emotions seem "overdone" because context integration falters.
• Narcissistic — fragile self-esteem is protected via fantasies of grandeur or superiority. Limited cognitive empathy and a narrow context focus cause others' signals to be missed; that seems cold or condescending, but is often a rigid coping mechanism to reduce unpredictability. See also pseudo-narcissism as a misinterpretation with a mismatch of thinking styles.

Cluster C — anxious and insecure

• Avoidant — avoidance as a strategy when context feels too complex or socially unpredictable.
• Dependent — aligning with someone who brings "order" to complexity; can turn out to be supportive or toxic depending on the partner (e.g., with a narcissistic partner).
• Obsessive-compulsive personality disorder — rigidity, perfectionism, and control to make complexity predictable. Related to very strong first-degree thinking.

Summary

From a contextual thinking perspective, the focus shifts from “deviance” to strategy: many PD-traits are attempts to find a foothold with limited context integration. That explains withdrawal (schizoid), pattern-seeking (schizotypal), emotional dysregulation (borderline), transactional/egocentric reactions (antisocial, narcissistic), avoidance (avoidant), dependent organizing (dependent), and rigid controlling. The continuum touches upon very strong first-degree thinking: from rigidity via compulsion to psychotic experiences.