Conversations We All Should Have

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Mayo Clinic

Personality Disorders

Symptoms and causes


A personality disorder is a type of mental disorder in which you have a rigid and unhealthy pattern of thinking, functioning and behaving. A person with a personality disorder has trouble perceiving and relating to situations and people. This causes significant problems and limitations in relationships, social activities, work and school.

In some cases, you may not realize that you have a personality disorder because your way of thinking and behaving seems natural to you. And you may blame others for the challenges you face.

Personality disorders usually begin in the teenage years or early adulthood. There are many types of personality disorders. Some types may become less obvious throughout middle age.


Types of personality disorders are grouped into three clusters, based on similar characteristics and symptoms. Many people with one personality disorder also have signs and symptoms of at least one additional personality disorder. It's not necessary to exhibit all the signs and symptoms listed for a disorder to be diagnosed.

Cluster A personality disorders

Cluster A personality disorders are characterized by odd, eccentric thinking or behavior. They include paranoid personality disorder, schizoid personality disorder and schizotypal personality disorder.

Paranoid personality disorder

  • Pervasive distrust and suspicion of others and their motives

  • Unjustified belief that others are trying to harm or deceive you

  • Unjustified suspicion of the loyalty or trustworthiness of others

  • Hesitancy to confide in others due to unreasonable fear that others will use the information against you

  • Perception of innocent remarks or nonthreatening situations as personal insults or attacks

  • Angry or hostile reaction to perceived slights or insults

  • Tendency to hold grudges

  • Unjustified, recurrent suspicion that spouse or sexual partner is unfaithful


Schizoid personality disorder

  • Lack of interest in social or personal relationships, preferring to be alone

  • Limited range of emotional expression

  • Inability to take pleasure in most activities

  • Inability to pick up normal social cues

  • Appearance of being cold or indifferent to others

  • Little or no interest in having sex with another person


Schizotypal personality disorder

  • Peculiar dress, thinking, beliefs, speech or behavior

  • Odd perceptual experiences, such as hearing a voice whisper your name

  • Flat emotions or inappropriate emotional responses

  • Social anxiety and a lack of or discomfort with close relationships

  • Indifferent, inappropriate or suspicious response to others

  • "Magical thinking" — believing you can influence people and events with your thoughts

  • Belief that certain casual incidents or events have hidden messages meant only for you


Cluster B personality disorders

Cluster B personality disorders are characterized by dramatic, overly emotional or unpredictable thinking or behavior. They include antisocial personality disorder, borderline personality disorder, histrionic personality disorder and narcissistic personality disorder.


Antisocial personality disorder

  • Disregard for others' needs or feelings

  • Persistent lying, stealing, using aliases, conning others

  • Recurring problems with the law

  • Repeated violation of the rights of others

  • Aggressive, often violent behavior

  • Disregard for the safety of self or others

  • Impulsive behavior

  • Consistently irresponsible

  • Lack of remorse for behavior


Borderline personality disorder

  • Impulsive and risky behavior, such as having unsafe sex, gambling or binge eating

  • Unstable or fragile self-image

  • Unstable and intense relationships

  • Up and down moods, often as a reaction to interpersonal stress

  • Suicidal behavior or threats of self-injury

  • Intense fear of being alone or abandoned

  • Ongoing feelings of emptiness

  • Frequent, intense displays of anger

  • Stress-related paranoia that comes and goes

Histrionic personality disorder

  • Constantly seeking attention

  • Excessively emotional, dramatic or sexually provocative to gain attention

  • Speaks dramatically with strong opinions, but few facts or details to back them up

  • Easily influenced by others

  • Shallow, rapidly changing emotions

  • Excessive concern with physical appearance

  • Thinks relationships with others are closer than they really are


Narcissistic personality disorder

  • Belief that you're special and more important than others

  • Fantasies about power, success and attractiveness

  • Failure to recognize others' needs and feelings

  • Exaggeration of achievements or talents

  • Expectation of constant praise and admiration

  • Arrogance

  • Unreasonable expectations of favors and advantages, often taking advantage of others

  • Envy of others or belief that others envy you


Cluster C personality disorders

Cluster C personality disorders are characterized by anxious, fearful thinking or behavior. They include avoidant personality disorder, dependent personality disorder and obsessive-compulsive personality disorder.

Avoidant personality disorder

  • Too sensitive to criticism or rejection

  • Feeling inadequate, inferior or unattractive

  • Avoidance of work activities that require interpersonal contact

  • Socially inhibited, timid and isolated, avoiding new activities or meeting strangers

  • Extreme shyness in social situations and personal relationships

  • Fear of disapproval, embarrassment or ridicule

Dependent personality disorder

  • Excessive dependence on others and feeling the need to be taken care of

  • Submissive or clingy behavior toward others

  • Fear of having to provide self-care or fend for yourself if left alone

  • Lack of self-confidence, requiring excessive advice and reassurance from others to make even small decisions

  • Difficulty starting or doing projects on your own due to lack of self-confidence

  • Difficulty disagreeing with others, fearing disapproval

  • Tolerance of poor or abusive treatment, even when other options are available

  • Urgent need to start a new relationship when a close one has ended


Obsessive-compulsive personality disorder

  • Preoccupation with details, orderliness and rules

  • Extreme perfectionism, resulting in dysfunction and distress when perfection is not achieved, such as feeling unable to finish a project because you don't meet your own strict standards

  • Desire to be in control of people, tasks and situations, and inability to delegate tasks

  • Neglect of friends and enjoyable activities because of excessive commitment to work or a project

  • Inability to discard broken or worthless objects

  • Rigid and stubborn

  • Inflexible about morality, ethics or values

  • Tight, miserly control over budgeting and spending money


Obsessive-compulsive personality disorder is not the same as obsessive-compulsive disorder, a type of anxiety disorder.



Personality is the combination of thoughts, emotions and behaviors that makes you unique. It's the way you view, understand and relate to the outside world, as well as how you see yourself. Personality forms during childhood, shaped through an interaction of:

  • Your genes. Certain personality traits may be passed on to you by your parents through inherited genes. These traits are sometimes called your temperament.

  • Your environment. This involves the surroundings you grew up in, events that occurred, and relationships with family members and others.


Personality disorders are thought to be caused by a combination of these genetic and environmental influences. Your genes may make you vulnerable to developing a personality disorder, and a life situation may trigger the actual development.


Risk factors

Although the precise cause of personality disorders is not known, certain factors seem to increase the risk of developing or triggering personality disorders, including:

  • Family history of personality disorders or other mental illness

  • Abusive, unstable or chaotic family life during childhood

  • Being diagnosed with childhood conduct disorder

  • Variations in brain chemistry and structure


Book Suggestions

Grit: The Power of Passion and Perseverance

Angela Duckworth


Authentic Happiness

Book by Martin Seligman



Mihaly Csikszentmihalyi


Feeling Good: The New Mood Therapy

David D. Burns


Thinking, Fast and Slow

Daniel Kahneman


The Power of Habit

Charles Duhigg


Blink: The Power of Thinking Without Thinking

Malcolm Gladwell


Drive: The Surprising Truth About What Motivates Us

Daniel H. Pink


David and Goliath

Malcolm Gladwell


Willpower: Rediscovering the Greatest Human Strength

John Tierney and Roy Baumeister


Reasons to Stay Alive

Matt Haig

Digital Minimalism: Choosing a Focused Life in a Noisy World"

Cal Newport


Range: Why Generalists Triumph in a Specialized World

David Epstein


How Happiness Happens: Finding Lasting Joy in a World of Comparison, Disappointment and Unmet Expectations

Max Lucado




  • We know specific key factors early in life permit success later in life.

  • We know these key factors are predicated on the development of specific skills at a specific range of ages

  • We know these skills are learned through proper practice.

  • We know we should teach these skills to families and youth now.



1/ We know specific key factors early in life preclude success later in life. These key factors are

  • The ability to make choices dependent on intrinsic factors and interests, not reactions to external stimulus; they have their own mind; can exhibit critical thinking.

  • Understanding ones identity through one’s values, beliefs and goals 

  • Adaptability and flexibility in different situations and circumstances to maintain productiveness and effectiveness.


2/ We know these key factors are predicated on the development of specific skills at specific range of ages

  • Self-regulation, the ability to recognize various feelings and behaviors and control and improve them, make choices in order to have a positive future.

  • Knowing one’s strengths and weaknesses, the ability to learn and improve, to relinquish ego barriers to learning.

  • The ability to understand and relate to the world and others and a set of values and principles to live by. Develop positive relationships.


3/ We know these skills are learned through proper practice.

  • Practice is the only way to learn yet when it comes to the most important and critical skills required for personal development, we have failed to establish and develop practice for their enhancement; especially for parent’s that have not been taught the basics from their own upbringing.

  • The program ConversationsWe All Should Have uses all the current research about success and well-being offering families and individuals to ability to increase their success potential. Most important is that there is methodology for discussion and practice.


4/ We know we should teach these skills to families and youth now.

  • The knowledge is out there but there are few real programs that offer the methodology for practice and development of these life skills in the home.

  • The Program ConversationsWe All Should Have discusses the Thinking, Emotions & Behaviors of Success & Well-being, for families and individuals. I developed the program to offer a simple concise method for integrating and developing personal skills in families in an effort to develop the basic skills in every individual.

  • A key function of the program is implementation through proper facilitation.



     The greatest single contributing factor influencing success and well-being is what transpires in the home. We need to focus much more on the primary contributor to success and well-being, families. Investing in parent-child relationships early may result in long-term positive results that build throughout an individuals' life. Research has proven repeatedly that parenting has a direct correlation with how children learn, behave and abide by the rules in society. The ability of young children to control their emotional and cognitive impulses (recognizing impulse, cause and effect consequence of continuing), is an extremely strong indicator of short-term and long-term success, academic and social.


     The initial setting for a child’s emotional life to develop relates directly to the attachment relationship with parents or caregivers. When the infant and child’s needs are met; when a child views the world as responsive and reliable they develop the belief that they are safe and that the world is trustworthy. The child caregiver relationship of this nature establishes the foundation for the development of emotional personal skills allowing the promotion of self-efficacy, self-regulation, prosocial behavior, and positive relationships with family and peers as well as diminished risk factors.  Why not teach these skills. Security attachment with mothers increases allows a secure attachment too teachers and relates to positive emotions and regulated anger.


     When a child is dealing with uncertainty, a lack of support, an unresponsive environment they will not be able to focus on developing the attributes and behaviors that allow learning, prosocial behavior and positive family and social relationships. Let’s stop the recycled not knowing. As parents do the program they ask children questions and maybe ask the same questions to themselves for the first time. Parents feel better about their ability to influence their children and do it more. By creating the habit of frequent conversations on important topics both parent and child benefit to positively influence each other’s lives. Poor and uneducated does not assume a lack of intelligence and rich and educated should not assume better family or parent. Simple additions can significantly and positively affect the future of success and well-being. How parents present themselves and how they allow their children to portray themselves is critical for the establishment of behaviors that are pro-social and enable success and well-being in the child’s future.



Emotional Competence

  • Emotional competence is a significant contributor and precursor to all aspects of success and well-being.

  • Emotional Competence is a function of a set of affect orientated behaviors, thinking and regulatory skills that develop over time.

  • The skills of emotional competence are most influenced by social experience and learning through the individuals relationship history and the values and beliefs of the environment in which a person lives.

  • Therefore emotional experience is gained through cognitive development and exposure to emotional discourse. Through this we learn how to feel and how to act upon that feeling.


 Several factors that discern emotional maturity

  • Awareness of one’s emotions. This attribute has greater levels of skill in recognizing multiple emotions simultaneously and the possibility that one may not be able at all times to recognize their emotion

  • Awareness of other people’s emotions

  • Being able to express one’s emotions

  • Empathy

  • The realization that inner emotions need not always be expressed outwardly.

  • Understanding the impact of one’s emotional expression on others and associated consequence

  • Coping strategies

  • Understanding mature relationships as well as asymmetry in sharing genuine emotions with young children

  • Emotional self-efficacy. Feeling the way one perceives they should feel according to their beliefs and values.


Age related emotional competence

  • Young children’s ability to express emotion is limited and require more support from their parents

  • Elementary school children are more able to express their emotions. They have some experience to refer to.

  • Youth become even more skilled at expressing their emotions and understand more complex emotions. There is a greater sense of identity, development of moral character and future goals.


Parenting style

  • There are different styles of parenting authoritarian, permissive and authoritative. Authoritarian is proven to allow the best outcomes. Within this style skills need to be enhanced to maximize the positive effect of being a family and a parent or caregiver.

  • Parents are the major influencer in a child’s life. Other factors such as financial status genes, culture and gender are of much less importance.

  • How a child thinks, feels and behaves will determine the degree of success and well-being they experience in their future. 

  • There is a direct correlation between the child’s behavior parenting style and  skill, school competence, violence, sexual behavior, drug and alcohol abuse, depression and anxiety.The optimal parent is:

  • Frequent Communication

  • Consistent

  • High degree of emotional support

  • Involved and responsive but don’t do what their children can do alone and allow for children to fail in order to learn for themselves.

  • Sets high expectations and respects child’s autonomy

  • Establish and enforce standards of behavior

  • Allows child to make mistakes and understands a child unhappiness is a part of self-regulation and allows motivation to improve

  • Rewards effort not the reaching of every goal, does not praise everything

  • Teach a growth mindset based in efforts success not fixed limitations

  • Praise and compliment sparingly allowing independent development of intrinsic values of challenge, courage, self-sufficiency and confidence

  • Support children autonomy and limit interference allowing better academic and emotional outcomes and development of positive intrinsic reward and value

  • Recognize their own emotions and stresses and their possible effect on children

  • Do not live through their children.

  • Live their own lives set a reach goals

  • Use reason, negotiation, and persuasion not force to gain cooperation

  • Enforce behavioral standards and stay in control

  • Democratic rather than dictatorial rule

  • Listen as much as talk

  • Children are given alternatives and choices with responsibility and consequences for those choices

  • Encourage academic success

Children of Authoritative parents are:

  • Better psychologically, socially and academically

  • Have a growth mindset, believing that effort succeeds there are no fixed boundaries or limitations

  • Develop successful peer relationships, Less influenced by negative peer pressure

  • Better at coping

  • Social responsible

  • Independent

  • Believe in themselves with High self-esteem, Positive self-concept, self-worth, self-respect

  • Conform to society, prosocial

  • Interested in their family

  • Respect authority

  • Accountable

  • Control their impulses emotionally and mentally

  • Confident

  • Responsible

  • Less likely to abuse drug or alcohol

  • Less likely to experience anxiety and depression

  • Less likely to behavior with violence

  • More successful

How parents raise their children may be more important than the parents' occupation, income, or educational level.

  • Content knowledge can ensue only when the child feels supported.

  • Teach parents to recognize their own anxiety and emotions

  • Kid’s do what their parents do or don’t do. Kids live up to their parents' expectations.

  • Teach parents about their own values to be better able to portray those values to their children.

  • Give parents and families the knowledge and skills to be optimal functioning families in order to develop socially, mentally, emotionally, intellectually and morally.

  • Offer sensitive caregiving (responding to a child’s signals promptly and appropriately) provides a secure base for children especially in the first three years of life and can predict better academic grades and healthier relationships into their thirties

  • The quality and content of time spent with kids is more important than the amount of time spent with kids.

  • Where kids think success comes from also predicts their attainment. Reward effort not the reaching of a goal.

  • Kids do what their parents do or don’t do not what they say. Parents need to seek knowledge, read, communicate, expect and set standards and then live them. Rich or poor the needs of a child are the same. 


Parents can portray images and behaviors of

  • Butts and boobs or beauty and brains

  • Muscle and mischief or manliness and courage

  • Greed and self-centeredness or prosperity and empathy

  • Ego and pleasure or will and love

  • Complacency and cowardice or challenge and growth

  • Fast and frivolous or steady and lasting

  • Focus on Style and appearance or substance and heart