Beyond management to cure: Enhancing the positive dimensions of personality

Introduction Individuals with severe personality disorders have little or no awareness of the satisfactions of life that are derived from an outlook of unity and connectedness with other people and nature. Their lack of awareness of the meaningful connections among all things is rooted in an outlook of separateness and fear, which leads to their self-defeating and often self-destructive thoughts, feelings, and actions. In this chapter on the future of work with patients with severe personality disorders, I will describe empirical findings about the path to well-being by which human character and self-awareness develops. I will also describe tools that are needed for the facilitation of growth in character, self-awareness, and well-being at each step along the path to happiness. This model of character development is supported empirically by both longitudinal studies of character development and findings from several randomized controlled trials about what is effective in psychotherapy. These empirical findings set the stage for acknowledgement of the many obstacles that can emerge in the treatment of patients with severe personality disorders, so that they can be understood within a general theoretical framework. In this way, the stage for future progress can be well grounded in the scientific tradition of hypothetical-deductive research and guided by the wisdom of experienced clinicians, such as those who have contributed to this book. Mental health professionals and their patients are increasingly aware of the basic need of all human beings for meaning that is greater than one’s self.