Difficult People Are Everywhere (Part 1)

People with personality disorders are in our homes, our workplaces—and yes, in our politics.

The word personality comes from the Greek persona, meaning mask. When we first meet someone, we see their public face—the version they show the world. Over time, as we get closer, we begin to sense who they really are beneath that surface. That deeper, consistent pattern is what psychologists call personality. Everyone has one.

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Personality Is Not a Problem

Your personality is shaped by both genetics and upbringing—roughly half genetic/nature, half nurture/your upbringing. It forms early in life and tends to stay fairly stable over time.

Personality styles:

• Begin early
• Persist over time
• Show up across many situations
• Create the incredible diversity of human beings

Much of the time, personality styles are strengths, not flaws.

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What a Personality Disorder Is Not

A personality disorder is not:

• Bad behavior
• A moral failure
• Laziness or lack of motivation
• Someone being “difficult on purpose”

These labels create stigma—and they prevent understanding.

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So, What Is a Personality Disorder?

A personality disorder is a rigid, deeply ingrained way of thinking, feeling, and relating that once helped a person cope with life—but now repeatedly causes problems.

People with personality disorders struggle with:

• Distorted ways of seeing themselves and others
• Ongoing relationship conflicts
• Trouble managing emotions or impulses
• Significant problems at work, at home, or socially

These patterns aren’t occasional. They are enduring and show up again and again, even when they cause suffering.

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How Common Are Personality Disorders?

Much more common than most people realize.

• About 1 in 10 people in the general population has a personality disorder
• Taken together, all personality disorders are the most common group of mental health diagnoses

Which means people with personality disorders are everywhere:

• In families
• In workplaces
• In leadership roles
• And yes, in politics

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Why They Feel So “Difficult”

In healthcare settings, personality disorders show up even more often:

• In emergency rooms 10%
• In psychiatric hospitals and outpatient settings 30%
• In substance-use and forensic treatment programs 50%
• In primary care offices, where they account for many “frequent flyers” 15%

In fact: Up to half of conflicted doctor–patient relationships are driven not by illness, but by personality traits—on the part of the Physician or Patient. Personality types help explain why certain interactions feel exhausting, emotional, or impossible to resolve.

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From Labels to Understanding

Psychiatric labels can sound harsh. But behind them are familiar human traits taken to extremes:

Personality Style—>When It Becomes a Disorder

Personality style—>Personality Disorder

Vigilant—>Paranoid

Different Drummer–> Schizoid

Self-confident–>Narcissistic

Mercurial–>Borderline

Adventurous—>Antisocial

Dramatic—>Histrionic

Orderly–> Obsessive-Compulsive

Sensitive—>Avoidant

Devoted —>Dependent

Seen this way, personality disorders aren’t mysterious or monstrous. They are human patterns that have lost flexibility.

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Why This Matters

When we don’t understand personality:

• We blame
• We argue
• We disengage

When we do understand this

• People become predictable rather than baffling
• Boundaries become clearer
• Compassion becomes possible—without being naïve
• Psychotherapeutic treatment becomes possible

Understanding personality doesn’t mean excusing harmful behavior.

It means responding more wisely.

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What’s Next

In upcoming posts, we’ll explore

• Description of different personality styles and disorders
• Tips on how to manage people with different personality style and disorders
• Effective treatments which are widely available

Because once you understand personality, “difficult people” start to make sense.

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About the Author

Robert E. Feinstein, MD is a psychiatrist, psychoanalyst, educator, and lifelong student of what makes therapy work. He divides his time between clinical practice in Stamford, CT, teaching at the Northwell/ Zucker/Hofstra School of Medicine, and creating innovative ways to train therapists and strengthen mental health systems. He writes to bring clinical wisdom, human understanding, and practical teaching tools to the next generation of patient and therapists.