James is a 40-year-old male who has been referred for therapy by his boss. This became necessary after repeated complaints from his colleagues who find it difficult to work with him. James complains to the counsellor that the people around him are stupid and incompetent and admits that his “intellectual superiority” makes it difficult for others to interact with him. James is convinced that people envy him and are out to get him. James admits that he may be abrasive and contemptuous of others at times but that’s only because he hates inadequacy and mediocrity and he is just showing them “tough love.” He constantly brags about his achievements and compares himself to affluent and powerful persons such as Michael Lee Chin, Butch Stewart, and aliens with advanced powers. James rarely takes responsibility for his actions and talks constantly of having been deprived in earlier years. In fact, James blames the world and factors outside of himself for his failures. Furthermore, he admits that when he is criticized he becomes outraged and will lash out at the person(s) making the criticism. James is married but now has an inactive sex life. He believes that sex is for “common” people as it is mundane and beneath him and what he represents himself to be. He speaks of women who express their unending love for him and of having had one or two who stalked him for a while. James has three children but his relationship with his family is strained. He expresses being upset with his wife for how his children have turned out. “They are all just so mediocre,” he says almost scornfully.
What is a personality disorder?
The Diagnostic and Statistical Manual of Mental Disorders, 4th edition, 1994, commonly referred to as DSM-IV, defines a personality disorder as “a pattern of deviant or abnormal behaviour that the person doesn't change even though it causes emotional upsets and trouble with other people at work and in personal relationships. It is not...