Can personality disorders be changed?

For a long time character pathology, or personality disorder as it is known today, was associated with therapeutic nihilism. The general idea was that people with character pathology have a qualitatively different character make-up than healthy people. Their character was considered to be unchangeable which explained the lack of therapeutic success. Recent insights have radically changed this view. Specialised treatments have high success rates and seem to lead to dramatic changes in maladaptive personality features. An important issue, however, is the extent of the changes that are brought about. Is the change only superficial, or does psychological treatment cause deeper changes, so that a person who used to have a personality disorder really undergoes a change in character? there is now some evidence that psychotherapy can lead to fundamental changes, which again suggests that pessimism is ill founded. On the other hand, we argue that traces of the former character set-up cannot be completely removed so that some vulnerability remains and people may return to old maladaptive patterns. In this respect there is no fundamental difference between treatment of axis-1 disorders such as anxiety or depression, and personality disorders. (netherlands journal of psychology, 62, 9-18.).