By Patrick Strudwick; Photography by Freepik

If there’s a question mark over your partner’s behaviour, then please take a moment to read this…

Are you dating someone who isn’t actually a nice guy after all? There were two dates in when Rebecca Mukhari* began to suspect something wasn’t right in her relationship. As she left the house and made her way to the car, she saw Mark sitting motionless, staring into space. He greeted her with scarcely a glance, then went back to staring. That’s when she saw exactly what was captivating him: his own reflection in the car window.

Over the next 18 months, the 37-year-old PA had to share her boyfriend with someone else: his ego. He’d preen for hours before nights out. Conversations were always about him. His obsession with designer clothes plunged him into debt. His need for the approval of the mirror, other men and, worst of all, other women, finally drove her away. This wasn’t just vanity, it was pathological narcissism.

READ MORE: 7 Signs You’re Dating A Narcissist

Behind the mask

Personality disorders (PDs), such as narcissism, are more prevalent than society would have us believe. Yes, American Psycho’s Patrick Bateman was a sociopathic narcissist, but you don’t have to gouge out someone’s eyes with your fingers to classify as one. Personality disorders run the gamut from the obvious and extreme – psychopathy, say – to far milder versions. Avoidant personality disorder (AvPD), for example, is characterised by extreme aloofness, often masquerading as “commitment issues”.

READ MORE: “I Cheated On My Husband – And This Is Why I Did It”

Or there’s dependent personality disorder (DPD), a complex pathological condition that manifests itself in an almost obsessional neediness. But, to you and your friends, he’s just clingy. And, although there’s little South African research available, psychiatric evidence suggests around one in 20 Brits suffers from mild forms of personality disorder – it’s thought clinically serious PDs affect about one in 50 people. That makes the likelihood of someone in your office or friendship group suffering from, or living with someone with a PD, highly possible.

Stressing the problem

Thirty-two-year-old Jenna Mathieson met Alex at a party. They had mutual friends, flirted all night and by 9am the next day were a couple. Alex was charming – an events planner with his sights on the top job at work “within four years”. “We met on a Saturday night and by the following Friday, he was talking kids and mortgages,” says Jenna. Here, she believed, was a man who was in it for the long haul. But six months in and his euphoric highs and romantic intensity were countered by acute aloofness and painful rejection – he’d invite Jenna to parties, then withdraw the offer minutes before they were due to go out and once he cancelled a holiday hours before they were due to fly.

“This was standard behaviour,” Jenna says. “And I made allowances for it. Looking back, I should have known how it would all end.” Three days after Alex sent a message saying he wanted Jenna to be his wife, he ended the relationship. She hasn’t heard from him since, although mutual friends say he is seeking help for his behaviour, which shows classic symptoms of avoidant personality disorder coupled with narcissism.

READ MORE: 5 Signs Your Relationship Is Actually Dysfunctional AF

“Personality disorders are an enduring way of behaving and thinking, which leads to significant harm or distress either to the individual or the people around them,” explains professor Dinesh Bhugra, co-author of Models of Psychopathology. “There are 10 types and all of them affect relationships differently, but they are generally formed by early childhood relationships: you develop unhealthy attachment patterns to those looking after you – because they were neglectful or abusive – and those patterns get replicated as an adult.” Philippa Perry, psychotherapist and author of How to Stay Sane, explains further:

“They’re a set of defence mechanisms that were built up, probably pre-verbally, as a way of surviving. But what protected you when you were younger could cause serious harm as you get older.” Both stress that such disorders are characterised by an endemic pattern of behaviour. Everyone has moments of vanity or self-serving attributes, but not everyone has the persistent, unerring narcissism of Mad Men’s Don Draper, or the ever-present emotional coldness and disregard for social norms, like Sherlock Holmes’ apparent schizoid detective, portrayed by Benedict Cumberbatch.

READ MORE: How To Tell If That Guy You’ve Been Seeing Might Be A Psychopath

Where to draw the line

But all PDs have one factor in common: stigma. Unlike more definable mental health problems, celebrities, for instance, don’t speak openly about PDs. Only the late Anna Nicole Smith’s borderline personality disorder (BPD) has been made public – and that was only because her psychiatrist revealed it. “Personality disorders are one of the most undiagnosed conditions,” says Bhugra. “There are several reasons for this: some mental-health professionals fear the label might exacerbate symptoms. Often people don’t seek help because they don’t realise there’s anything the matter. And there are also grey areas with diagnosis: when is something – say, jealousy – just a mild personality trait and when is it so damaging as to be symptomatic of a personality disorder?”

Bhugra points to tempestuous actor types. “The traits actors need – for example, the ability to fly into extreme emotional states instantly – comprise many of the elements present in histrionic personality disorder (HDP).” This disorder, with its excessive need for approval combined with dramatic, emotional, flirtatious behaviour, could be an asset for those in front of the camera, but might also explain the high divorce rates behind the scenes.

READ MORE: “I Had An Affair With A Married Colleague – This Is How It Happened”

But when, then, does being a bit obsessed with cleanliness become obsessive compulsive personality disorder (OCPD)? Or bursting into tears at the slightest thing become HPD? The answer lies in the extent of the damage inflicted. If the distress caused is so severe it makes sustaining friendships, a job or a relationship impossible, a professional diagnosis may be needed. “Dialectic behavioural therapy has been shown in US studies to be very effective,” says Bhugra, about the technique that uses cognitive behavioural therapy with mindfulness. But there are several approaches to managing a PD. “What helps is to become aware of your patterns of behaviour and develop an ‘observer’ part of yourself, so you can see your reactions at some distance,” says Perry. “This enables you to reflect before you react. I’ve seen clients really get to grips with their triggers and learn to act differently.”

Making it work

While holding a mirror up to a partner’s behaviour can prove futile, noting down some of their behaviour to build up a picture might strengthen their self-awareness. Much of the work has to come from the sufferer, as, for example, challenging someone who always thinks they’re right can make them defensive. “I got sick of Mark’s vanity, so I pointed out his imperfections,” says Rebecca. “But he’d get angry, or depressed or he’d go back to the gym.” This isn’t surprising, says Perry. “People might think the way to deal with a narcissist is to ‘take them down a peg or two,’ but, if anything, they need bringing up a peg or two as they actually have low self-esteem.”

Equally, with histrionic personality disorder, “it’s tempting to be swept along by the drama,” says Perry, but soothing them is more helpful. One tool for the sufferers themselves is to have a narrative ready for when distress arises. “It could be saying, ‘Yes, my mother abandoned me, but that doesn’t mean everyone will,’” says Perry. “Or, ‘Yes, they are late for dinner, but I won’t shout because that will make them disappear.’ Or, for a narcissist: ‘I’m good as I am. I don’t need to be better than others in order to be equal to them.’” To avoid relationships where one is the “carer” looking after the “sick one”, Perry advises a trade-off. “You might agree, for instance, that one of you looks after the other’s avoidant tendencies while the other keeps an eye on your obsessive tendencies.”

READ MORE: “I Watched Porn With My Partner For The First Time – This Is What Happened”

Certain PDs are tougher to deal with in a relationship. Avoidant personality disorder may work well for the sufferer – to avoid emotional intimacy, they may have an affair and be happy with that. By contrast, dependent personality disorder is more conducive to a relationship as long as both parties challenge extreme beliefs such as, “Without you I will die.” It also helps to be aware of difficulties before you even enter a relationship. “People with personality disorders have often had dysfunctional early relationships, so they tend to be drawn to the same type of dysfunction later on as it’s familiar,” says Perry. “Distant father? Women will look for the cold-bastard type. So what you think is your type is wholly destructive.”

Warning signs in a potential partner can also come from finding out about their history – although this will only give hints. If, for instance, he hasn’t had a relationship in a decade, it’s possible there is an avoidant side to his personality. Or if three women in a row dumped him for being overly jealous, it might be a sign of paranoid or narcissistic patterns. The message is clear: awareness, nurturing and help from inside and outside the relationship can transform not only your love life but could render any diagnosis redundant. “It’s entirely possible to manage and treat – go to your GP in the first instance,” says Bhugra. “The earlier the diagnosis and intervention, the greater your chance.”

*Names have been changed.

This is why so many couples break up and get back together again. Plus: This is how long most couples date before getting married.