The Alternative Model for Personality Disorders: Why a New, Compassionate Approach Matters
If you’ve ever been told you might have a personality disorder (or wondered if a family member, partner, or friend might) you probably know how heavy that can feel. For many people, those words carry shame, fear, or confusion — as if something deep inside is “wrong” or unchangeable. This is certainly the lens taken by most media; how often are we shown villains with borderline or paranoid personality disorders? But the truth is, our understanding of personality has come a long way.
Over the past ten years, the mental health world has moved towards a newer, more accurate approach that allows for greater nuance and compassion. The Alternative Model for Personality Disorders (AMPD) is a more trauma-informed approach that looks not at “what’s wrong with you,” but rather focuses on the parts of our personalities that cause us problems when trying to understand ourselves and relate to others.
Why a New Model Was Needed
The traditional model groups people into fixed categories — borderline, narcissistic, avoidant, and so on. But human beings don’t fit neatly into boxes. Our personalities are shaped by both our biology and our experiences — especially our early relationships and the ways we learned to cope with pain or threat. In fact, with the traditional model, most people who are diagnosed with one personality disorder meet criteria for at least one other. This tells us that our current diagnostic system is flawed.
The Alternative Model (introduced in the DSM-5) takes a more flexible, dimensional approach (like other disorders that use a spectrum). It helps us understand how patterns in self-identity, emotion, and relationships develop — often as understandable responses to early stress, trauma, or disconnection.
Instead of labeling people, this model focuses on functioning and growth — helping us make sense of the why behind the patterns and understand the impact on someone’s life. This allows for a diagnosis that truly captures each person’s unique experience and unique challenges.
The Heart of the Alternative Model
At its core, the AMPD looks at how we understand and experience ourselves, and how we connect with others. It focuses on two main areas, called personality functioning:
Self – Our sense of identity and direction in life. When we struggle with this aspect of personality functioning, we might be overly rigid or overly lenient with autonomy or boundaries. It might be hard to know who we are, or what we want from life.
Interpersonal – Our capacity for empathy and intimacy. Difficulties with this domain of functioning might look like problems building and sustaining meaningful relationships with others or struggling to understand other people’s experiences. It might feel like other people are impossible to understand or dangerous to let too close.
From a trauma-informed perspective, these are not “flaws” — they’re survival strategies that once kept you safe but now get in your way. Therapy can be a space to gently rebuild a sense of safety in self and in relationship.
Understanding the Patterns, Not the Labels
The second part of the model looks at the traits that shape our patterns of thinking, feeling, and relating. Some examples:
Negative Affectivity – Tendency toward frequent and intense negative emotions
Detachment – Withdrawing from or shutting down during social interactions
Antagonism – Experiences by others as hostile, calculated, and distrusting
Disinhibition – Preference for immediate rewards over long-term planning
Psychoticism – Having unusual perceptions or beliefs
It is important to remember that each of these traits exist on a continuum. We likely all have moments where these traits emerge. To consider a diagnosis, a consistent pattern that causes significant difficulties or distress needs to exist.
In therapy, these traits don’t have to be seen as “symptoms” to get rid of — they’re often clues to what you’ve endured and how your nervous system has learned to protect you. With compassion and curiosity, we can understand the story each pattern tells, and work to rewrite a new one that works better in the present.
Healing Through Relationship
A trauma-informed, relational approach to personality focuses on repairing disconnection — both internally (with yourself) and externally (with others).
Healing happens in safe, attuned relationships where you can:
Be seen without judgment
Explore the patterns that once helped you survive
Practice new ways of relating that feel safe and empowering
Rebuild a steady sense of who you are and what you need
Therapy becomes less about fixing and more about remembering your wholeness.
The Bottom Line
The Alternative Model for Personality Disorders helps us shift from “what’s permanently wrong with me?” to “what happened to me — and how did I learn to adapt?”
It offers a less stigmatizing, more trauma-informed lens that honors your resilience and complexity. You are not defined by a diagnosis — you’re a whole person with a story that makes sense. And with the right support, new patterns of safety, connection, and identity can emerge.
Your personality isn’t broken — it’s often the story of how you learned to survive. And stories can change.
Trauma Therapy
If this perspective resonates with you or if you’re ready to explore your story with support, our skilled therapists at Authentic Connections Therapy and Wellness are here to help. We specialize in trauma-informed, relational care that honors your experiences, your resilience, and your capacity for growth. You don’t have to navigate these patterns alone. Reach out today to connect with a therapist who can walk alongside you as you build new patterns of safety, identity, and connection.
