Cluster B

What Does “Cluster B” Mean?

Personality disorders are atypical ways of thinking about oneself and relating to other people. They permeate most, if not all, facets of one’s life, and usually emerge during the teenage or young adult years. On the whole, these disorders are notoriously difficult to treat, and, as such, can engender impairment for the individual and pain for those within the afflicted person’s orbit. Personality disorders are grouped into three clusters; Cluster B disorders are marked by inappropriate emotionality and heightened drama.

The disorders in Cluster B are Antisocial Personality Disorder, Borderline Personality Disorder, Histrionic Personality Disorder and Narcissistic Personality Disorder.

These disorders are taxonomically grouped together by the DSM-V because a single, clear-cut diagnosis is very rare—patients often exhibit a number of overlapping symptoms. For example, someone with borderline tendencies (such as intense mood swings) may present with histrionic symptom overlap (for example, behaving erratically to garner attention). Similarly, someone who exhibits signs of both Narcissistic Personality Disorder and Antisocial Personality Disorder is sometimes referred to as a “malignant narcissist.”

Cluster A disorders describe odd and eccentric behavior and Cluster C includes those with anxious, fearful personalities and behavior. Cluster C is the most frequently discussed group in part because people with these disorders consistently draw attention to themselves and wreak havoc in relationships.  

Handling the Dramatic-Erratic Personality

No one chooses to have a personality disorder. But we can choose how we respond. It’s important first and foremost to cultivate compassion for the sufferer. Among our available options are distance (set boundaries), delay (deferring until the person calms down), and deny (say as little as possible; focus on external demands). To avoid adding fuel to the fire, it’s also important that we counteract our automatic defensive posture—listen and ask questions instead of engaging in a tug-of-war. Likewise, the CARS method may prove useful: this involves Connecting, Analyzing choices, Responding, and Setting limits. Regardless of how one responds when confronted with a Cluster B personality, it’s wise to avoid the urge to diagnose this person outside of a formal clinical setting. Rather, we can simply hold a “Private Working Theory” that informs how we engage with this person.


Personality Disorders

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