Treating Clients with Personality Disorders - Why are clients with personality disorders often more difficult to treat than clients who just have an acute disorder, such as depression or anxiety? Well, one reason is the following-- personality disorder clients have usually experienced very significant problems in relationships and/or school or work ever since childhood or early adulthood. They have highly distorted, very entrenched negative beliefs about themselves, other people, and the world. They bring these beliefs to every situation or context, including therapy. So negative beliefs, such as I'm vulnerable or other people will hurt me, become easily activated in session even when the therapist has done everything right. Once their beliefs are activated, they often experience a high degree of negative emotion. They may then behave in a highly dysfunctional way, using unhelpful coping strategies. These clients tend to be inflexible using these strategies across situations, even when the use of the behavior is clearly disadvantageous.