This document discusses personality disorders and their potential role in abusive relationships. It outlines the main personality disorder clusters and describes several specific disorders - paranoid, schizoid, schizotypal, antisocial, histrionic, narcissistic, borderline, avoidant, dependent, and obsessive-compulsive personality disorders. For each disorder, it provides an overview of traits and symptoms. It also explores potential root causes and risk factors, such as family environment, childhood experiences, and parenting styles.

1. Inside the MIND of an Abuser
Part of Psychological Ttreatment for Abused Women
and Children
For
UP WOMEN LAWYERS CIRCLE (WILOCI)
May 2016
MILEN SANTIAGO RAMOS MA. MSc PhD
Clinical Psychology – Neuroscience – Criminology

4. DOMESTIC VIOLENCE
INTIMATE PARTNER
VIOLENCE
INTIMATE PARTNER
RELATIONAL DISTRESS
BATTERED WIFE SYNDROME/
DOMESTIC STOCKHOLM
SYNDROME
Rape trauma syndome
False memory syndrome
PSYCHOPATHOLOGY
PERSONALITY
DISORDERSFACTORS OTHER THAN PSYCHOPATHOLOGY
(Philippines)
(i.e. advent of OFW –
children are left on their own
our women in their place of work are prone to many forms of abuses
advent of technology leads to cyber or digital forms of abuse to replace
parental physical presence
MILEN SANTIAGO RAMOS MA. MSc PhD
Clinical Psychology – Neuroscience – Criminology

6. The Role of Personality Disorder in
Abusive Relationship

7. What are the main types of personality disorder?
three clusters of personality disorders:
odd or eccentric disorders;
dramatic, emotional or erratic disorders;
and anxious or fearful disorder

8. PERSONALITY DISORDERS
Suspicious
Emotional and
impulsive
Anxious
paranoid borderline avoidant
schizoid histrionic dependent
schizotypal narcissistic
obsessive
compulsive
antisocial

9. Paranoid personality disorder is a pervasive distrust and suspiciousness
of others, such that their motives are interpreted as malevolent.
suspicious
feel that other people are being nasty to you (even when evidence shows
this isn’t true)
feel easily rejected
tend to hold grudges
Schizoid personality disorder is a pervasive pattern of detachment from
social relationships and a restricted range of expression of emotions in
interpersonal settings.
emotionally 'cold'
don't like contact with other people, prefer own company
have a rich fantasy world

10. Schizotypal personality disorder is a pervasive pattern of social and
interpersonal deficits marked by acute discomfort with reduced capacity for close
relationships. It is also characterised by distortions of thinking and perception and
eccentric behaviour.
eccentric behaviour
odd ideas
difficulties with thinking
lack of emotion, or inappropriate emotional reactions
see or hear strange things
sometimes related to schizophrenia, the mental illness
Antisocial personality disorder is a pervasive pattern of disregard for and
violation of the rights of others.
don't care much about the feelings of others
easily get frustrated
tend to be aggressive
commit crimes
find it difficult to make close relationships
impulsive - do things on the spur of the moment without thinking about them
don’t feel guilty about things you've done
don’t learn from unpleasant experiences

11. Histrionic personality disorder is a pervasive pattern of excessive emotion and
attention seeking.
over-dramatise events
self-centered
have strong emotions which change quickly and don't last long
can be suggestible
worry a lot about your appearance
crave new things and excitement
can be seductive
Narcissistic personality disorder is a pervasive pattern of grandiosity (in fantasy or
actual behaviour), need for admiration, and lack of empathy.
have a strong sense of your own self-importance
dream of unlimited success, power and intellectual brilliance
crave attention from other people, but show few warm feelings in return
take advantage of other people
ask for favours that you do not then return

12. Borderline personality disorder is a pervasive pattern of instability of interpersonal
relationships, self-image, moods, and control over impulses.
Understanding borderline personality disorder is particularly important because it can be
misdiagnosed as another mental illness, particularly a mood disorder.
People with borderline personality disorder are likely to have:
Wide mood swings.
Inappropriate anger or difficulty controlling anger.
Chronic feelings of emptiness.
Recurrent suicidal behaviour, gestures or threats, or self-harming behaviour.
Impulsive and self-destructive behaviour.
A pattern of unstable relationships.
Persistent unstable self-image or sense of self.
Fear of abandonment.
Periods of paranoia and loss of contact with reality
impulsive - do things on the spur of the moment
find it hard to control your emotions
feel bad about yourself
often self-harm, e.g. cutting yourself or making suicide attempts
feel 'empty’
make relationships quickly, but easily lose them
can feel paranoid or depressed
when stressed, may hear noises or voices

13. Avoidant personality disorder is a pervasive pattern of social inhibition, feelings of
inadequacy, and hypersensitivity to negative evaluation.
(aka Anxious/Avoidant)
very anxious and tense
worry a lot
feel insecure and inferior
have to be liked and accepted
extremely sensitive to criticis
'Anxious and Fearful
sensitive to criticism
can have obsessional thoughts and images (although these are not as bad as those in
obsessive-compulsive disorder)
Dependent personality disorder is a pervasive and excessive need to be taken
care of, which leads to submissive and clinging behaviour and fears of separation.
passive
rely on others to make decisions for you
do what other people want you to do
find it hard to cope with daily chores
feel hopeless and incompetent

14. Obsessive-compulsive personality disorder is a pervasive pattern of
preoccupation with orderliness, perfectionism, and mental and interpersonal
control, at the expense of flexibility, openness, and efficiency
(aka Anankastic)
worry and doubt a lot
perfectionist - always check things
rigid in what you do, stick to routines
cautious, preoccupied with detail
worry about doing the wrong thing
find it hard to adapt to new situations
often have high moral standards
judgemental

15. ROOT CAUSE paranoid PD
The cause of paranoid personality disorder is still
unknown. However it appears to be found more common
in families with other disorders such
as schizophrenia, suggesting a genetic connection.
Other research suggests negative childhood experiences,
such as a threatening atmosphere, can also prompt the
disorder. Condescending parental influences that create
child insecurities may also contribute to the development
of paranoid personality disorder.

16. ROOT CAUSE schizoid PD
The schizoid personality disorder has its roots in the family of the affected
person. These families are typically emotionally reserved, have a high
degree of formality, and have a communication style that is aloof and
impersonal. Parents usually express inadequate amounts of affection to the
child and provide insufficient amounts of emotional stimulus. This lack of
stimulus during the first year of life is thought to be largely responsible for
the person's disinterest in forming close, meaningful relationships later in
life.
People with schizoid personality disorder have learned to imitate the style
of interpersonal relationships modeled in their families. In this environment,
affected people fail to learn basic communication skills that would enable
them to develop relationships and interact effectively with others. Their
communication is often vague and fragmented, which others find confusing.
Many individuals with schizoid personality disorder feel misunderstood by
others.

17. ROOT CAUSE schizotypal PD
There is now evidence to suggest that parenting styles, early separation,
trauma/maltreatment history (especially early childhood neglect) can lead to the
development of schizotypal traits. Over time, children learn to interpret social cues
and respond appropriately but for unknown reasons this process does not work
well for people with this disorder.
Neglect or abuse, trauma, or family dysfunction
during childhood can increase the risk of developing schizotypal personality
disorder.
Schizotypal personality disorders are characterized by a common
attentional impairment in various degrees.[9]
A study suggested that attention
deficits could serve as a marker of biological susceptibility to schizotypal
personality disorder.[
The reason is that an individual who has difficulties taking in
information may find it difficult in complicated social situations where interpersonal
cues and attentive communications are essential for quality interaction. This might
eventually cause the individual to withdraw from most social interactions, thus
leading to asociality

18. ROOT CAUSE antisocial PD
Social and home environment also contributes to the development of antisocial
behavior. Parents of troubled children frequently show a high level of antisocial
behavior themselves. In one large study, the parents of delinquent boys were
more often alcoholic or criminal, and their homes were frequently disrupted by
divorce, separation or the absence of a parent.
In the case of foster care and adoption, depriving a young child of a significant
emotional bond could damage his ability to form intimate and trusting
relationships, which may explain why some adopted children are prone to
develop ASP. As young children, they may be more likely to move from one
caregiver to another before a final adoption, thereby failing to develop
appropriate or sustaining emotional attachments to adult figures.
Erratic or inappropriate discipline and inadequate supervision have been linked
to antisocial behavior in children. Involved parents tend to monitor their child’s
behavior, setting rules and seeing that they are obeyed, checking on the child’s
whereabouts, and steering them

19. Erratic or inappropriate discipline and inadequate supervision have been linked
to antisocial behavior in children. Involved parents tend to monitor their child’s
behavior, setting rules and seeing that they are obeyed, checking on the child’s
whereabouts, and steering them away from troubled playmates. Good
supervision is less likely in broken homes because parents may not be available,
and antisocial parents often lack the motivation to keep an eye on their children.
The importance of parental supervision is also underscored when antisocials
grow up in large families where each child gets proportionately less attention
A child who grows up in a disturbed home may enter the adult world emotionally
injured. Without having developed strong bonds, he is self-absorbed and
indifferent to others. The lack of consistent discipline results in little regard for
rules and delayed gratification. He lacks appropriate role models and learns to
use aggression to solve disputes. He fails to develop empathy and concern for
those around him.

20. Antisocial children tend to choose similar children as playmates. This association
pattern usually develops during the elementary school years, when peer group
acceptance and the need to belong first become important. Aggressive
children are the most likely to be rejected by their peers, and this rejection drives
social outcasts to form bonds with one another. These relationships can
encourage and reward aggression and other antisocial behavior. These
associations may later lead to gang membership.
Child abuse also has been linked with antisocial behavior. People with ASP are
more likely than others to have been abused as children. This is not surprising
since many of them grow up with neglectful and sometimes violent antisocial
parents. In many cases, abuse becomes a learned behavior that formerly abused
adults perpetuate with their own children.
It has been argued that early abuse (such as vigorously shaking a child) is
particularly harmful, because it can result in brain injury. Traumatic events can
disrupt normal development of the central nervous system, a process that
continues through the adolescent years. By triggering a release of hormones and
other brain chemicals, stressful events could alter the pattern of normal
development.

21. ROOT CAUSE histrionic PD
Little research has been done to find evidence as to what
causes histrionic personality disorder and where it stems from.
There are a few theories, however, that relate to the lineage of
its diagnosis. Traits such as extravagance, vanity, and
seductiveness of hysteria have similar qualities to women
diagnosed with HPDAn example of over-zealousness could be
compared to the famous grande hystérie, a well-known
demonstration of hypnotism by Jean-Martin Charcot by using
his best-known subject, Blanche Wittmann. Wittmann was
known for her attractiveness and ability to make herself the
center of attention from her hysteria and lavish performance

22. Psychoanalytic theories incriminate authoritarian or distant
attitudes by one (mainly the mother) or both parents, along
with conditional love based on expectations the child can
never fully meet Using psychoanalysis Freud believed the
lustfulness was a projection of the patient's lack of ability to
love unconditionally and develop cognitively to maturity, and
that such patients were overall emotionally shallow He
believed the reason of not being able to love could have
been from a traumatic death experience from a close
relative during childhood or divorce between parents, which
gave the wrong impression of committed relationships.
Exposure to one or multiple traumatic occurrences of a close
friend or family member leaving (abandonment or fate of
mortality) would make the person unable to form true and
affectionate attachments towards people

23. ROOT CAUSE narcissistic PD
Narcissistic traits are quite common in adolescence but this does not necessarily
mean that the child will go on to become a narcissist. Research has found the
diagnosis of narcissism to be significantly more common among men.2
Faulty or
inadequate parenting, for example a lack of limit setting, is believed to be a major
cause, and both permissive and authoritarian styles of parenting have been found
to promote narcissistic symptoms. The following parenting behaviors may result in
a child becoming a narcissist in adulthood:
Permissive parents who give excessive praise to the child, thus fostering an
unrealistic view of themselves
Overindulgence and spoiling by parents
Failing to impose adequate discipline
Idealization of the child
A child who is spoiled or idealized will grow into an adult who expects this pattern
to continue. Idealization may require the child to suppress their own self-
expression to meet the desires of the parent and to gain their love and
approval.7
To develop a realistic image of the self the child must be provided with
realistic information of discipline and reasonable limits must be set by the parents
as to what the child can and cannot do. Narcissists generally feel unprepared for
adulthood, having been fostered with an unrealistic view of life.

24. ROOT CAUSE borderline PD
Childhood events as well as social and cultural surroundings play large roles in
personality development and may also serve to facilitate the development of a
personality disorder. Unstable family relationships, childhood neglect or
abandonment, and exposure to intense and chronic stress and fear as a child seem
to play a role in people developing BPD down the road. Early relationships help to
form the person you become and what you believe to be normal. Since those
suffering from BPD typically are prone to impulsivity, intense emotions, and a fear
of abandonment, unresolved issues can exacerbate these symptoms.
Childhood trauma such as sexual, emotional, or physical abuse also may lead to
the onset of borderline personality disorder. Unstable relationships are a main
symptom of BPD, and children with traumatic backgrounds or unhealthy family
relationships may be more prone to developing BPD later in life. They may have
little to no indication that their relationships are not normal.
Advances in Psychiatric Treatment published the results of a study indicating that
of those diagnosed with BPD, 87 percent reported childhood trauma of some kind.
Similarly, a child whose caregiver has a mental health disorder or substance abuse
problem, and who models risky behavior and poor lifestyle choices, may grow up
with a distorted image of self and the world around them.

25. ROOT CAUSE avoidant PD
The cause of avoidant personality disorder is not clearly defined, and may be
influenced by a combination of social, genetic, and biological factors. Avoidant
personality traits typically appear in childhood, with signs of excessive shyness and
fear when the child confronts new people and situations. These characteristics are also
developmentally appropriate emotions for children, however, and do not necessarily
mean that a pattern of avoidant personality disorder will continue into adulthood. When
shyness, unfounded fear of rejection, hypersensitivity to criticism, and a pattern of
social avoidance persist and intensify through adolescence and young adulthood,
a diagnosis of avoidant personality disorder is often indicated.
Many persons diagnosed with avoidant personality disorder have had painful early
experiences of chronic parental criticism and rejection. The need to bond with the
rejecting parents makes the avoidant person hungry for relationships but their longing
gradually develops into a defensive shell of self-protection against repeated parental
criticisms. Ridicule or rejection by peers further reinforces the young person's pattern of
social withdrawal and contributes to their fear of social contact.

26. ROOT CAUSE dependent PD
Overprotective, authoritarian parenting; sex role socialization. (Bornstein, pp. 38-
53)What is the link between parental overprotectiveness and authoritarianism and
the development of dependent personality traits in children? Parental
overprotectiveness and authoritarianism serve simultaneously to (1) reinforce
dependent behaviors in children of both sexes and (2) prevent the child from
developing independent, autonomous behaviors (since the parents do not permit
the child to engage in the kinds of trial-and-error learning that are involved in
developing a sense of independence and mastery during childhood). Thus, when
parental overprotectiveness or parental authoritarianism is characteristic of the
family unit, this will tend to produce high levels of dependency in children (since
both parenting styles foster and encourage dependent behavior).
When both parental overprotectiveness and parental authoritarianism are present
within the family unit, dependency in children is particularly likely to result.
(Bornstein, pg. 41)

27. Basic Belief:
I am helpless. [Strategy]: Attachment (Beck, Freeman & associates, pg. 26).
Representation of self as powerless and ineffectual; belief that others are powerful and in
control (Bornstein, pg. 162).
The "idealized self is made up of beliefs about how we should feel, think, or act" (Tamney,
pg. 32).
Typical beliefs for Dependent Personality Disorder:
I am needy and weak.
I need somebody around available at all times to help me carry out what I need to do or in
case something bad happens.
My helper can be nurturant, supportive, and confident if he or she wants to be.
I am helpless when I am left on my own.
I am basically alone unless I can attach myself to a stronger person.
The worst possible thing would be to be abandoned.
I must do nothing to offend my supporter or helper.
I must be subservient in order to maintain his or her good will.
I need others to help me make decisions or tell me what to do.
I must maintain access to him or her at all times.
I should cultivate as intimate a relationship as possible.
I can't make decisions on my own.
I can't cope as other people can.
I need others to help me make decisions or tell me what to do.

28. ROOT CAUSE obsessive compulsive PD
There is no single, specific “cause” identified
Several theories suggest that people with OCPD may have been raised by parents
who were unavailable and either overly controlling or overly protective. Also, as
children they may have been harshly punished. The OCPD traits may have
developed as a sort of coping mechanism to avoid punishment, in an effort to be
“perfect” and obedient.
Genetics may play a role, but this has not been well-studied. •
Cultural factors may play a role. Societies or religions that are very authoritarian
and bound by strict rules may impact early childhood development that affects
personality expression. A word of caution: not all rule-bound societies are
dysfunctional and OCPD traits may in fact be rewarded within that specific cultural
or religious context.

29. CHILD SEXUAL ABUSE

30. CHILD SEXUAL ABUSE
IN ORDER TO PROTECT CHILDREN
IT IS ESSENTIAL TO BE AWARE WHAT TYPE OF PERSON SEXUALLY
ABUSES CHILDREN.
IF WE CAN GET INTO THE MIND OF A PEDOPHILE WE MAY FIND OUT
WHAT MOTIVATES THEM AND WHAT TYOE OF CHILD IS AT RISK.
IT ALSO ENABLES US TO IDENTIFY HOW PEDOPHILES TARGET AND
GROOM THE CHILD AND WHAT STRATEGIES THEY USE TO STOP THE
CHILD FROM DISCLOSING.
ARMED WITH ACCURATE INFORMATION, IT BECOMES POSSIBLE TO
PROTECT CHILDREN FROM BEING ABUSED

31. Behavior you may see in a child or
adolescent
Has nightmares or other sleep problems without an explanation
Seems distracted or distant at odd times
Has a sudden change in eating habits
Refuses to eat
Loses or drastically increases appetite
Has trouble swallowing.
Sudden mood swings: rage, fear, insecurity or withdrawal
Leaves “clues” that seem likely to provoke a discussion about sexual issues
Writes, draws, plays or dreams of sexual or frightening images
Develops new or unusual fear of certain people or places
Refuses to talk about a secret shared with an adult or older child
Talks about a new older friend
Suddenly has money, toys or other gifts without reason
Thinks of self or body as repulsive, dirty or bad
Exhibits adult-like sexual behaviors, language and knowledge

32. Signs more typical of younger children
An older child behaving like a younger child (such
as bed-wetting or thumb sucking)
Has new words for private body parts
Resists removing clothes when appropriate times
(bath, bed, toileting, diapering)
Asks other children to behave sexually or play
sexual games
Mimics adult-like sexual behaviors with toys or
stuffed animal
Wetting and soiling accidents unrelated to toilet
training

33. Signs more typical in adolescents
Self-injury (cutting, burning)
Inadequate personal hygiene
Drug and alcohol abuse
Sexual promiscuity
Running away from home
Depression, anxiety
Suicide attempts
Fear of intimacy or closeness
Compulsive eating or dieting

34. Physical warning signs
Physical signs of sexual abuse are rare. If you see these signs,
bring your child to a doctor. Your doctor can help you understand
what may be happening and test for sexually transmitted diseases.
Pain, discoloration, bleeding or discharges in genitals, anus or
mouth
Persistent or recurring pain during urination and bowel movements
Wetting and soiling accidents unrelated to toilet training

35. Spiral Model of Child Sexual Abuse

36. Continous cycle

37. inhibited cycle

38. short circuit cycle

40. Teaching children to protect themselves
from sexual abuse
Efforts focused on empowering children to prevent sexual
abuse can be channelled into the following:
• preparing for everyday life;
• identifying and responding to potentially
dangerous situations;
• identifying, preventing and stopping sexual
abuse;
• seeking help

41. preparing for everyday life
Building up healthy self-esteem and encouraging children to respect
and have empathy for others are essential, and parents are
important
role models.
Healthy self-esteem can be developed in many ways and includes:
• Respect for individuality.
• Self-assertiveness and expressing needs and feelings
• Problem-solving and decision-making skills.
• Self-respect and respect from others
• Respect and empathy for others.
• Positive communication about sex.

42. identifying and responding to potentially
dangerous situations
To empower children to recognise and react effectively to potentially
dangerous situations, the key concept is that everyone has the right
to safety. Once children recognise this, the more readily they will
understand the need to respond. Having the right to be safe with
other people implies being responsible and caring for oneself, and
knowing how to react when threatened. The right to safety also
encompasses respect for other people’s right to safety and encourages
children to help others as well.
Children should also be taught to pay attention to their body’s early
warning signs of feeling threatened (butterflies in the stomach,
increased heartbeat, weak knees, etc.).

43. identifying, preventing and stopping
sexual abuse
• “Your body is your own”.
• Safe and unsafe touching.
• “No! Go! Tell!” strategy.
• A bad secret and a good secret.
• The offender is a known person.
• The offender is a stranger.
• Seeking help.
• Having open communication with children builds relationships
that are based on mutual confidence and increases the
likelihood of disclosure.
• Safety network.
• Helping others.

44. seeking help
A key reaction to potential
danger should be to seek help from a trusted adult.
Children must realise that they are not
“snitching” and that seeking help is their
right

45. SALAMAT PO