Residential Treatment of Personality Disorders at CooperRiis

Q: What are the three clusters of personality Disorders?

Cluster A Personality Disorders: The three personality disorders in this cluster are characterized by distorted thinking, social awkwardness, and social withdrawal. Paranoid PD Schizoid PD Schizotypal PD Cluster B Personality Disorders: The four personality disorders in this cluster are characterized by difficulties with impulse control and emotional regulation. Antisocial PD Borderline PD Histrionic PD Narcissistic PD Cluster C Personality Disorders: The three personality disorders in this cluster are characterized by high levels of fear and anxiety. People in this cluster need lots of reassurance from others. Avoidant PD Dependent PD Obsessive Compulsive PD

If you or a loved one has been diagnosed with borderline personality disorder, avoidant personality disorder, or a related condition, we want you to know:

There is hope.

Our whole-person, sustainable approach to recovery has helped adults aged 18+ with personality disorders heal from trauma, learn how to cope with distress, build healthy relationships with others, and develop well-adapted senses of self.

We can help you or your loved one too.

Recovery is Possible

We treat adults aged 18+ with personality disorders.

Our Approach to Healing Personality Disorders

Authored by Eric Levine, Ed.D. and Reviewed by Amy Zimmerman, DO Psychiatrist

A Focus on Wellness & Possibility

For individuals with personality disorders, emotions can feel unbearable, secure relationships can be out of reach, and the world can seem like a hostile, unforgiving place. We understand how harrowing these experiences are, so we meet these individuals at both The Farm (our long-term residential treatment center) and CooperRiis at Asheville (our short-term residential treatment center) with warmth and compassion.

At the same time, we firmly believe that individuals with personality disorders are capable of healing from trauma and living full, gratifying lives. For this reason, we shift residents’ focus away from their pasts and towards the uplifting possibilities we know their futures can hold.

What are personality disorders?

Personality encompasses the thought patterns, behavioral norms, and traits that make a person unique. It is influenced by experiences, environments, and inherited traits; it influences both the way people see themselves and the way they interact with others. Personality disorders occur when people are prevented — usually as a result of childhood trauma — from developing stable senses of self and constructive views of others. These conditions are characterized by persistent, maladaptive patterns of thinking, feeling, and behaving that inhibit normal, healthy functioning in life. They often manifest in at least two of the following ways:

Having a distorted view of oneself or others
Expressing emotions in unhealthy ways
Impaired interpersonal functioning/ difficulty building relationships
Impulsivity or reactivity

Normal traits that have become extreme often characterize personality disorders. For example, being conscientious is generally considered a good thing. So is self confidence. But an unyielding devotion to work at the expense of all other aspects of life can seriously impact someone’s health. Likewise, overblown displays of self-assuredness can lead to damaging consequences, especially because it is often the result of profound insecurity. With holistic, individualized treatment, it is possible for people with personality disorders to replace maladaptive thoughts and behaviors with adaptive ones over time.

What are the three clusters of personality Disorders?

Cluster A Personality Disorders:
The three personality disorders in this cluster are characterized by distorted thinking, social awkwardness, and social withdrawal.

Paranoid PD
Schizoid PD
Schizotypal PD

Cluster B Personality Disorders:
The four personality disorders in this cluster are characterized by difficulties with impulse control and emotional regulation.

Antisocial PD
Borderline PD
Histrionic PD
Narcissistic PD

Cluster C Personality Disorders:
The three personality disorders in this cluster are characterized by high levels of fear and anxiety. People in this cluster need lots of reassurance from others.

Avoidant PD
Dependent PD
Obsessive
Compulsive PD

What are the signs and symptoms of personality disorders?

The symptoms of personality disorders vary dramatically according to type and severity.

Paranoid Personality Disorder is characterized by:

Generalized mistrust and suspicion of others
An extreme reluctance to confide in others
Paranoia
The consistent misinterpretation of others’ behavior as malicious
A preoccupation with finding ‘clues’ to validate fears

Schizoid Personality Disorder is characterized by:

Indifference to social relationships and relationship avoidance
Indifference to praise
The expression of a limited range of emotions or the appearance of being emotionally cold and detached
A lack of close friends and no desire for close relationships

Schizotypal Personality Disorder is characterized by:

Disturbing thoughts and behavior
Unusual or odd beliefs (aliens, UFOs, etc.) and fears
Odd behavior and/or speech
Difficulty making/keeping friendships
Suspiciousness and/or paranoia

Antisocial Personality Disorder is characterized by:

Antisocial behavior
Disregard for others’ emotions
Externalization and minimization of responsibility
Deceitfulness
Impulsive and risky behavior
Hostility and aggression
Lack of restraint
General discontent

Borderline Personality Disorder is characterized by:

Heightened reactivity and sensitivity
Emotional dysregulation and volatility
A tendency towards crisis
Self-destructive behavior
Difficulty managing slights
Feelings of worthlessness and insecurity
Impulsivity
Impaired social relationships; a pattern of unstable, intense relationships
Mood swings
Intense fear of abandonment

Histrionic Personality Disorder is characterized by:

Excessive attention-seeking
Intense and dramatic displays of emotion
The belief that relationships are closer than they are
A high susceptibility to the influence of others
Rapidly changing emotions
Profound insecurity

Narcissistic Personality Disorder is characterized by:

A preoccupation with one’s own interests and a disregard for others’ feelings
The inability to empathize
An excessive need for the praise and admiration of others
The inability to handle any criticism
A pervasive sense of entitlement
Profound insecurity

Avoidant Personality Disorder is characterized by:

Extreme shyness
Self-isolation
Excessive fear of ridicule, criticism, and rejection
A preoccupation with looking foolish
A low threshold for criticism
Low self-esteem

Dependent Personality Disorder is characterized by:

Profound insecurity
Emotional dependence on others
Excessive people-pleasing behaviors
Difficulty being alone
Needy and clingy behavior
Intense fear of separation and/or abandonment
Inability to make decisions without help from others
Utter devastation in response to the end of relationships
Oversensitivity to criticism
Inability to start projects or tasks
The tolerance of mistreatment or abuse in order to stay in a relationship

Obsessive-Compulsive Personality Disorder is characterized by:

An excessive concern with orderliness and excessive attention to detail
Perfectionism
The need to be in control
An excessive devotion to work
Difficulty relaxing or enjoying leisure time
Overly meticulous planning

Although many of these symptoms may be displayed occasionally by healthy, well-adjusted individuals, the intensity and frequency with which they are displayed by those with personality disorders seriously impacts their lives and can harm others.

It is possible for people to be diagnosed with multiple personality disorders at once or a personality disorder and another mental health condition, such as depression. Because there is such a wide range of symptoms associated with personality disorders, it is important to seek professional psychiatric help if you suspect you or a loved one might be dealing with this kind of condition. If you’d like to learn more about getting that help at CooperRiis, call us today.

Can personality disorders go away?

With time, consistency, and the right combination of interventions, recovery from these types of conditions is possible. Therapy is an important dimension of personality disorder treatment, with modalities such as dialectical behavior therapy (DBT), which we offer at our residential treatment centers, showing a high level of efficacy for a wide range of individuals.

Is CooperRiis right for me or my loved one?

Unlike some inpatient psychiatric facilities, CooperRiis is an open, voluntary residential treatment center that operates without locked doors. The individuals with personality disorders who respond best to our residential treatment programs are those who are willing to be a part of our healing community and who are committed to their recovery journeys.

Every individual has unique needs, and the best way to determine if CooperRiis is a good fit is to give us a call. One of our friendly admissions team members can help you determine if our holistic, community-oriented approach is right for you or your loved one.

Dream Statements

We begin every resident’s recovery by helping them craft a Dream Statement. Dream Statements express life aspirations. They guide residents’ development of core goals (attainable in 3 months) and achievable goals (attainable in 1-2 weeks), enabling them to map clear paths towards the lives they envision for themselves.

Living Mindfully

Many of the unhealthy beliefs and behaviors associated with personality disorders are defense mechanisms developed in response to trauma. Through integrated recovery plans that include Trauma Resource Model (TRM)-informed treatments, we help residents gain an awareness of the triggers and impacts associated with their defense mechanisms. Then, we teach them mindfulness practices that help them relate to the world around them in new, adaptive ways. With an improved understanding of themselves and the world they occupy, residents can start taking steps toward their life goals.

Cultivating Self-Efficacy

Individuals with personality disorders often suffer from persistent feelings of hopelessness and helplessness. Our programs support residents in building their self-efficacy by retraining their physiological and psychological reactions to distress. We teach them coping strategies they can use to regulate their emotions, empowering them to address challenges using their problem solving skills. The more challenges they successfully overcome, the more agency residents feel they have in their lives.

Building Strong Relationships

CooperRiis’ supportive, accepting community is an important facet of recovery for individuals with personality disorders. Through psychotherapy sessions, work crews, interest groups, and shared meals, residents interact with a variety of community members throughout their recovery journeys. Since our staff-to-resident ratio is better than 1:1, the bulk of these interactions occurs in the presence of experts who can give residents the real time feedback and encouragement they need to successfully overcome fears, navigate conflict, and engage in the process of building strong relationships.

Learning to Trust

Difficulty trusting others is one of the biggest reasons that people with personality disorders struggle to form and maintain secure, healthy relationships. Our highly trained staff members help residents overcome this impediment by being reliable, consistent sources of support. They communicate with residents transparently, offer validation compassionately, and hold boundaries dependably. When residents realize they won't be abandoned, rejected, or betrayed at CooperRiis, they feel safe to start placing trust in the people around them.

Flexibility and Adaptability

Through psychotherapy, interactions with others in staff-facilitated settings, and mindfulness practices, our programs help residents let go of the need to control their environments, enabling them to share spaces, collaborate, and be in relationship with others productively. Through the work they do with CooperRiis team members, residents learn how to recognize and appreciate the complex, dynamic nature of the individuals around them.

Integrated, Whole-Person Treatment

Individuals with personality disorders respond best to holistic, multimodal recovery programs. That’s why, rather than relying exclusively on medications or therapy, we combine a variety of evidence-based treatments to address all of the following seven domains of health for our residents:

The Seven Domains of Recovery

Treatment Plans That Meet Residents Where They Are

No matter where they are on their recovery journey, every CooperRiis resident receives personalized care from a multidisciplinary team made up of professionals with expertise in each of these seven domains. While this means every individual’s recovery plan is unique, the following types of treatments have been especially beneficial for our residents with personality disorders:

Growth-Oriented Environment

CooperRiis' peaceful campuses help those who are ready to recover in a voluntary, non-crisis setting acquire the skills they need to operate effectively in the outside world. We are careful to introduce opportunities for growth gradually, helping residents build confidence in themselves as they learn how to share spaces with others. Through work crews, individuals with personality disorders practice collaborating productively and experience the gratification of contributing meaningfully to their community.

Mindfulness Techniques

We teach residents breathwork and mindfulness techniques that they can use to become aware of their triggers, interrupt unhelpful patterns of thought, and de-escalate their emotions.¹ Whether they're experiencing anxiety or reeling from a perceived offense, residents can use these strategies to center their focus on the present, ground their awareness in their senses, and self soothe. This enables them to recruit their rational faculties and address challenges constructively.

Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is an evidence-based psychotherapeutic modality that was developed specifically to treat individuals with personality disorders. This approach teaches mindfulness techniques, builds distress tolerance, and supports the adoption of healthy coping strategies so residents can respond thoughtfully, rather than react impulsively, to the world around them. Through DBT, our accredited, experienced psychotherapists help residents regulate their emotions, recognize when their perspectives are out of touch with reality, and develop self-efficacy.

Exercise/Movement Practices

Research shows that regular exercise reduces stress, supports healthy emotional regulation, promotes confidence, and elevates people's overall moods. For these reasons, it's a key component of the recovery programs we develop for individuals with personality disorders. After helping residents select movement practices that suit their interests and preferences, we support them in establishing sustainable habits around those practices. We're careful to position exercise as an empowering, uplifting, and enjoyable activity.

Nutrition and Supplements

Nutrition can play a large role in mood regulation. Some food products, such as alcohol, sugar, and caffeine, can exacerbate emotional volatility if consumed in excess. That's why we collaborate with each of our residents to create balanced, personalized nutrition plans that provide them with all of the nourishment they need while mitigating their symptoms. For some individuals, we recommend the addition of supplements to enhance the benefits of a well rounded diet.

Medication

Like everything at CooperRiis, decisions about medication are collaborative: Our integrative psychiatrists work with residents to develop approaches to medication that align with their specific needs, goals, and preferences. We strive to prescribe the lowest dose that will support the highest quality of life for all our residents, and we maintain regular communications with them so necessary medication adjustments can be made in real time.

Community

Supportive, compassionate, and affirming, the community at CooperRiis helps residents with personality disorders learn how to build and maintain healthy relationships. Residents engage with their community through activities, group therapy, work crews, and other outlets. This variety of structured social opportunities helps them build the relational skills they need, including active listening skills, productive self advocacy skills, and effective conflict resolution skills, while helping them grow their support network.

Family Education

Familial support reduces the rate of re-hospitalization for those with mental illnesses, according to a recent study.² We not only keep family members updated on their loved one's progress with us, but we also provide them with an in-depth education on how they can become the support system individuals with personality disorders need in order to achieve their highest levels of health and wellness.

Our Recovery Model Works

Data collected over 10 years show that residential treatment for borderline personality disorder, avoidant personality disorder, and other types of personality disorders at CooperRiis works. Individuals who benefit from our holistic, community-oriented model of care make demonstrable progress in multiple domains of health.

After participating in our program, people with personality disorders:

Are able to regulate their emotions effectively.
Can respond to challenges with thoughtful confidence.
Are more connected to reality.
Have positive, more stable senses of self.
Are able to build and maintain healthy relationships with others.

An extensive body of research and clinical experience affirms these findings: Combining psychotherapy with a strong, supportive community, mindfulness practices, physical wellness programs, and an integrative approach to medication can dramatically improve the lives of individuals with personality disorders.

2019 Alumni Survey Results

1 %

are engaged in either competitive employment, volunteering, or going to school.

1 %

are living independently with roommates or on their own.

1 %

report they have had no psychiatric hospitalizations.

Research Citations

¹Enkema, M.C., McClain, L., Bird, E.R. et al. Associations Between Mindfulness and Mental Health Outcomes: a Systematic Review of Ecological Momentary Assessment Research. Mindfulness 11, 2455–2469 (2020). https://doi.org/10.1007/s12671-020-01442-2

²Tomita, A., Lukens, E. P., & Herman, D. B. (2014). Mediation analysis of critical time intervention for persons living with serious mental illnesses: Assessing the role of family relations in reducing psychiatric rehospitalization. Psychiatric Rehabilitation Journal, 37(1), 4–10. https://doi.org/10.1037/prj0000015

We can help.

What can I expect when I call?

Residential Treatment for Personality Disorders at CooperRiis