Personal development
Personal development or ‘constructive personality change’ is an objective of longer term counselling/psychotherapy. It is mandatory for those seeking to work as a therapist, helpful for those pursuing a ‘serious’ high profile career (e.g. work in media, organisational leader, senior professional etc.), a way of coping with prolonged adverse circumstances (e.g. abuse and or neglect experienced as a child, serious addictions, etc.) and for anyone who wants ‘more’ out of life. Dr Tony Weston regularly works with clients on personal development issues, including therapists/therapists-in-training, clients overcoming adverse circumstances and organisational leaders from a variety of governmental and non-governmental sectors, including owner/leaders.
Many authors have contributed to concepts of personal development, including Rogers (1959), Hillman (1979), Kohlberg (1984), Maslow (1987), Washburn (1988), Samuels (1989), Wilbur (1990) and Rowan (1993, 1995).
Rogers wrote extensively about the goals of longer-term psychotherapy and developed the concept of ‘the fully functioning person’. Within his description of the ‘fully functioning person’ Rogers (1959) included concepts of psychological adjustment, acceptance of others, existential living, self-liking, openness to experience and an internalised locus of evaluation (as opposed to an externalised locus of evaluation). This website includes sections on a range of mechanisms that might give rise to particular personality problems and these include:
Attachment Styles, the extent to which a person feels the need to avoid emotional expression and/or feels at risk of losing/missing important others
Rejection Sensitivity, acting in ways in order to defend one-self from being rejected by others (sometimes the strategies to prevent rejection can become self-fulfilling)
Feeling and thoughts that may cause difficulties
Being Oneself daring to be who you really are
Working with the presenting problem(s) and underlying mechanisms can give rise to lasting change.
One way of measuring ‘constructive personality change’ is to consider changes in so-called ‘personality disorders’, an ‘enduring pattern of inner experience and behaviour that deviates markedly from the expectations of the individual’s culture’ (APA 2000) that can be manifest in cognition (perceptions and interpretations of self, others and events), affectivity (emotional responses), interpersonal functioning and impulse control. A preferable phrase is ‘personality process’ to indicate an habitual way of processing information resulting in actions and behaviours that may cause difficulties. Therapy to understand the nature and origin of these ‘habits’ and how they can be changed tends to span a number of sessions spread out over a period of several months.
There are a number of ‘personality disorders’ and some of these are described below briefly, together with some outcome data from this service. The Personality Beliefs Questionnaire (PBQ, Beck & Beck 1991) measures the extent to which people endorse beliefs associated with personality disorders (Beck et al 2007) and has been empirically validated (Beck et al 2001, Butler et al 2002). In a collaboration with Aaron Beck, before his death, I’ve adapted the PBQ adapted for use by UK English-speaking clients by me at this service.
The Avoidant personality is characterised by ‘a pervasive pattern of social inhibition, feelings of inadequacy and hypersensitivity to negative evaluation’ (APA 2000). In my clinical experience often this is an adaptive response in childhood to experiences of being mistreated by adults, such as being ignored, lack of recognition, affirmation & validation and on the contrary being criticised, blamed and abused; resulting in fearfulness and wariness around others. This avoidant process is adaptive in childhood as an attempt to avoid further attachment injuries, however in adulthood this becomes maladaptive, as a fear-based inability to create close relationships & friendships with other adults. The following graph shows outcomes for 103 clients to April 2024 seen by Dr Tony Weston. The average number of sessions was 20 sessions. Average client age was around forty years (range 15-60 years), around three-quarters were female, one quarter were single and two-thirds were parents.
On average clients improved from clinical to non-clinical scores for avoidant process and at better than 99.9% confidence these are ‘large’ improvements in avoidant process (ES = 2.16).
The Dependent personality is characterised by ‘a pervasive and excessive need to be taken care of that leads to submissive and clinging behaviour and fears of separation’ (APA 2000). In my clinical experience this arises in childhood as an adaptive attempt to turn a disinterested and neglectful caregiver into an engaged and caring parent figure. This becomes maladaptive in adulthood when similar strategies of submissiveness and clinging are used as attempts to manage fears of rejection and lack of secure attachment from childhood in adulthood, these behaviours are typically disliked by peers and unfortunately, creates the feared scenario. The following graph shows outcomes for 38 clients seen by Dr Tony Weston to April 2024 (average 21 sessions):
On average clients improved from clinical to non-clinical scores for Dependent process and at better than 99.9% confidence these are ‘large’ improvements in dependent process (ES = 2.77).
The Passive-Aggressive (negativistic) personality is characterised by ‘a pervasive pattern of negativistic and passive resistance to demands for adequate performance in social and occupational situations’ (APA 2000). In my clinical experience this arises from childhood experiences with angry and aggressive caregivers who refuse to listen, understand or accept legitimate attempts at self-assertion by the child, who has little option other than to develop what at that time were adaptive ways to resist coercive control and demands from adults. This becomes maladaptive in adulthood when the similar strategies of passive resistance are utilised, rather than more adaptive attempts to discuss, negotiate and develop mutually agreeable ways forward. These strategies could not be learned in childhood because of the failures of the adults around the child. Results for 45 clients to April 2024 seen by Dr Tony Weston are shown below (average 19 sessions):
On average clients improved from clinical to non-clinical scores for Passive-Aggressive process and at better than 99.9% confidence these are ‘large’ improvements in passive-aggressive process (ES = 2.21).
The Obsessive-Compulsive personality is characterised by ‘a preoccupation with orderliness, perfectionism and mental and interpersonal control, at the expense of flexibility, openness and efficiency’ (APA 2000). In my clinical experience this arises from childhood attempts to negotiate interpersonally dangerous and chaotic environments wherein it is adaptive for the child to attempt to create order and maintain self-control to stay out of trouble and try to build a safe environment. These fear-based habitual ways of being and behaving become maladaptive in adulthood when they are no longer required and consume time, energy and other resources at the expense of more adaptive ways of simply responding to cues from the environment. Following are outcomes for 69 clients seen by Dr Tony Weston to April 2024 for an average of 16 sessions:
On average clients improved from clinical to non-clinical scores for Obsessive-Compulsive process and at better than 99.9% confidence these are ‘large’ improvements in obsessive-compulsive process (ES = 1.78).
The Anti-Social personality is characterised by ‘a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adulthood and continues into adulthood. This pattern has also been referred to as psychopathy, sociopathy or dyssocial personality disorder’ (APA 2000). In my clinical experience this arises from adaptive responses in childhood to dangerous home and social environments when extreme measures were required to survive. These can become maladaptive in adulthood when such extreme measures may no longer be required for survival, or the choices to inhabit hostile environments may necessitate the perpetuation and further refinement of extreme survival measures. Following are outcomes for 36 clients seen at by Dr Tony Weston to April 2024 for an average of 19 sessions:
On average clients improved from clinical to non-clinical scores for Anti-Social process and at better than 99.9% confidence these are ‘large’ improvements in anti-social process (ES = 1.17)
The Narcissistic personality is characterised by ‘a pervasive pattern of grandiosity (in fantasy or behaviour), need for admiration, and lack of empathy [for other people]’ (APA 2000). In my clinical experience this is an adaptive strategy arising in childhood from a caregiver failure to recognise, validate and affirm the child. Lack of recognition, validation and affirmation feels so awful to the child that they desperately attempt to create ‘pseudo self esteem'(grandiosity, larger then life, admiration), irrespective of the feelings of others, such are their desperate attempts to survive. This can become maladaptive in adulthood when unempathic demands for admiration from others may be rejected, creating the feared scenario of feeling abandoned and alone. Following are outcomes for 20 clients seen by Dr Tony Weston to April 2024 for an average of 17 sessions:
On average clients improved from clinical to non-clinical scores for narcissistic process and at better than 99.9% confidence these are ‘large’ improvements in narcissistic process (ES = 1.70).
The Histrionic personality is characterised by ‘a pervasive and excessive emotionality and attention-seeking behaviour’ (APA 2000). In my clinical experience this adaptive strategy in childhood often arises from disinterested caregivers who only give a child attention when the child is ’emotional’; the child learns that in order to gain caregiver attention they have to behave in excessively emotional ways. This becomes maladaptive in adulthood when attention-seeking behaviour may result in rejection by peers or only work with particular people in particular settings. Outcomes for 26 clients seen by Dr Tony Weston to April 2024 are shown below after an average of 19 sessions:
On average clients improved from clinical to non-clinical scores for histrionic process and at better than 99.9% confidence these are ‘large’ improvements in histrionic process (ES = 1.85).
The Schizoid personality is characterised by ‘a pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings’ (APA 2000). In my clinical experience this strategy is adaptive in childhood when the caregivers are hostile and threatening; keeping distant and emotionally shut down is self-protective for the child. This can become maladaptive in adulthood when the person is perceived as distant, emotionless and difficult to reach; so others keep away and this creates the feared scenario of isolation from a world perceived as hostile. Outcomes for 35 clients seen by Dr Tony Weston to April 2024 are shown below after an average of 17 sessions:
On average clients improved from clinical to non-clinical scores for schizoid process and at better than 99.9% confidence these are ‘large’ improvements in schizoid process (ES = 1.62).
The Paranoid personality is characterised by ‘a pattern of pervasive distrust and suspiciousness of others such that their motives are interpreted as malevolent’ (APA 2000). In my clinical experience this adaptive strategy in childhood arises from threatening and untrustworthy caregivers and then it is helpful to keep away from ill-intentioned caregivers. This can become maladaptive in adulthood when all others are perceived as hostile and untrustworthy and kept away from; others don’t like to be perceived in this way and so keep their distance too, creating the feared scenario. Outcomes for 58 clients seen by Dr Tony Weston to April 2024 are shown after an average of 17 sessions:
On average clients improved from clinical to non-clinical scores for paranoid process and at better than 99.9% confidence these are ‘large’ improvements in paranoid process (ES = 1.67).
The Borderline personality is characterised by ‘a pervasive pattern of instability of interpersonal relationships, self image and affects, and marked impulsivity’ (APA 2000). In my clinical experience this is a complicated series of adaptive strategies from childhood as a response to abuse (physical, emotional, psychological & sexual) and neglect (physical, emotional & psychological) wherein the child is desperately trying to survive. Such desperate strategies are continued into adulthood when they become maladaptive and create further interpersonal difficulties as an adult. Outcomes for 44 clients seen by Dr Tony Weston to April 2024 are shown below after an average of 26 sessions:
On average clients improved from clinical to non-clinical scores for borderline process and at better than 99.9% confidence these are ‘large’ improvements in borderline process (ES = 2.43).
These kinds of personality processes usually begin by early adulthood and are often what seem like ‘adaptive’ ways of coping with adverse situations that continue into adulthood, when the coping mechanisms are no longer appropriate for the situation and can create problems for the person and others around them. These effects can be particularly pernicious when a person finds themselves ‘stuck’ in situations where they are rewarded for continuing to act out these out-dated coping mechanisms e.g. the histrionic actor, the obsessive-compulsive manager, the dependent partner, etc. Changing the way one habitually behaves (constructive personality change), can be challenging, time consuming and ultimately rewarding, to ‘master oneself’.
References:
American Psychiatric Association (2000) ‘Diagnostic and Statistical Manual of Mental Disorders – Fourth Edition, Text Revision’. Washington DC: Author.
Beck, A T and Beck, J S (1991) ‘The Personality Belief Questionnaire’ Bala Cynwyd PA: Beck Institute for for Cognitive Therapy and Research.
Beck, A T, Butler, A C, Brown, G K, Dahlsgaard, K K, Newman, C F and Beck, J S (2001) ‘Dysfunctional beliefs discriminate personality disorders’. Behaviour Research and Therapy 39 (10) 1213-1225.
Beck A T, Freeman A, Davis, D D and Associates (2007) ‘Cognitive therapy of personality disorders – Second Edition’. New York: Guilford Press.
Butler, A C, Brown, G K, Beck, A T and Grisham, J R (2002) ‘Assessment of dysfunctional beliefs in borderline personality disorder’. Behaviour Research and Therapy 40 (1) 1231-1240.
Hillman, J (1979) ‘The dream and the underworld’. Harper Row: New York.
Kohlberg, L (1984) ‘The psychology of moral development’ Harper Row: San Francisco.
Maslow, A H (1987) ‘Personality and motivation – Third Edition’ Harper Row: New York.
Rogers, C R (1959) ‘A theory of therapy, personality and interpersonal relationships as developed in the client-centred framework’. In Koch, S (Ed). Psychology: A study of science, volume 3, Formulations of the person and the social context. New York: McGraw-Hill 184-256.
Rowan, J (1993) ‘The transpersonal in psychotherapy and counselling’. Routledge: London.
Rowan, J (1995) ‘What is counselling about’ Counselling 12-13.
Samuels, A (1989) ‘The plural psyche’ Routledge: London.
Washburn, M (1988) ‘The ego and the dynamic ground’ SUNY Press: Albany.
Wilber, K (1990) ‘Two patterns of transcendence: A reply to Washburn’. Journal of Humanistic Psychology 30 (3) 113-136.