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Why Cluster B Personality Is Misunderstood & Seldom Treated Correctly

Last Updated on February 9, 2024 by Diane Ridaeus

Alternative to Meds Editorial Team
Medically Reviewed by Dr Samuel Lee MD

There are not many successful, inpatient, mental health centers offering a holistic and integrative approach to mental health care for a person struggling with a complex diagnosis such as Cluster B personality disorder. By the time a doctor diagnoses an individual as having a Cluster B personality disorder, they have likely experienced a history of other diagnoses and psychiatric conditions.

The treatment approach at Alternative to Meds Center does not try to find the “right” diagnosis or label but rather investigates the potential underlying causes of their symptoms. By looking at factors such as neurochemistry, neurotoxicity, environmental contributors, diet, lifestyle factors, and family history, our treatment team is able to help a person begin to find new ways to treat their symptoms.

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What Is Cluster B Personality Disorder?

Cluster B personality disorder describes a number of disorders. Each has a fairly extensive list of characteristic behaviors or personality traits according to the latest consensus between the authors of the DSM and the authors of the International Disease model, the symptoms of which can be found below.1,2
cluster b personality disorder
One must bear in mind that the lines can be blurred when deciding if a characteristic is a “normal” personality trait or an “abnormal” psychiatric diagnosis. Often the perfect diagnosis is hard to achieve, considering the enormous overlap between the latter, and the liabilities of bias, assumptions, and individual differences in experience, cultural diversity, the typical lack of any sort of lab testing, and other variables in calculating a diagnosis.3

Cluster B specifies certain characteristics as opposed to Cluster A (schizotypal, paranoias, and similar symptoms) and Cluster C (referring to avoidance, dependence, and OCD-type symptoms).4

Of course, in a human being, such classification can be tricky to get right, since we are all so wonderfully unique. Nonetheless, to better understand the terminology commonly in use, the following summary and expanded descriptions are given below, based on the most current literature available.

Cluster B characteristics include the following:
  • Antisocial behavior
  • Histrionic personality disorder
  • Borderline personality disorder
  • Narcissistic personality disorder

1. Antisocial behavior
These characteristics include exploitive, criminal, and delinquent behavior and a lack of remorse for causing harm to others.5

2. Histrionic personality disorder
The word histrionic comes from the world of theater. Histrionic characteristics include the over-exaggeration of emotions, and actions calculated primarily to gain attention. It is the inflexible, unchanging nature of this trait that would tend to lead to a diagnosis. Behavior that is considered outside the boundaries of cultural norms, or as a result of substance abuse can often be misclassified as histrionic.6

3. Borderline personality disorder
Borderline personality disorders make up perhaps the widest umbrella term used in diagnosing mental illnesses and their symptoms, including impulsiveness, suicidality, sudden shifts in identity, dysfunctionality in managing interpersonal relationships, self-mutilation, feelings of emptiness, unreality, and intense episodes of anger or stress-related paranoia. Perhaps surprisingly, the most recent medical literature available states that psychotherapy is the treatment of choice for BPD, and that there is no evidence that psychoactive drug therapy improves these symptoms, despite the common practice of prescribing drugs for treatment.7
narcissistic personality disorder
4. Narcissistic Personality Disorder
Another word for narcissism is selfishness. Other synonyms may include entitlement, lack of empathy, exaggerated need for admiration, superiority, aggressiveness, envy, arrogance, and grandiosity.8

The term is derived from a character named Narcissus, from a Roman poem in the year 8 AD, describing a very handsome man who fell in love with his own reflection. It is thought that the reliance on others for the continued elevation of self-esteem results in a fragile vulnerability, despite outward appearances.9

More about Personality Disorders

Inpatient Treatment Planning for Cluster B Personality Disorder

An individual may experience a crisis moment, or a series of them in life, that may lead to considering inpatient treatment. Often, the traditional psychiatric approach provides diagnosis and medication as treatment. It may be prudent to consider a facility like Alternative to Meds Center, which doesn’t just treat the diagnosis, but looks to other potential triggers in an effort to provide authentic healing to the body, mind, and spirit.

Being in a therapeutic and compassionate treatment setting can provide the best opportunity for recovery, and by addressing root causes for symptoms, the team at Alternative to Meds Center truly provides a well-rounded approach to recovery from symptoms that may fall within a Cluster B personality disorder.

Major Life Issues Caused by Cluster B Personality Disorder

Sometimes, those with symptoms such as those described above will find themselves unable to function satisfactorily in life. Persistent behavioral problems and slip-ups can lead to legal problems, trouble keeping employment, and family dysfunction. Commonly, reliance on medication as treatment may add further complications. Fortunately, inpatient treatment can provide a welcome buffer during treatment and recovery.

Common Life Troubles Associated with Cluster B Personality Disorder

A person may find themselves trapped in a vicious cycle of addictive gambling behavior. For this individual, an inpatient treatment center can help the addictive cycle end by offering a supportive and trigger-free environment. Typically, a person with a gambling addiction would benefit from time away from gambling, games, or even electronics, in an effort to focus on their own healing, rather than continuing unhealthy behaviors.

Spending Sprees

In some cases, obsessive and compulsive behaviors including uncontrolled spending sprees or excessive online shopping are a side effect of certain medications. People with an addictive biochemistry will often find themselves engaged in such unhealthy behaviors. When compulsive spending becomes a major issue, inpatient care may be the best way to change direction in life. While enrolled in a safe & controlled inpatient environment, addictive biochemistry can be investigated & treated holistically with a program designed to correct it. CBT and other counseling may provide opportunities for personal enlightenment and heighten one’s ability to make better choices.  
road rage
Reckless Driving

Reckless driving and frequent episodes of road rage, aggression, and other symptoms can clearly signal that therapy would be productive. Toxicity may be a factor that can provide much relief when removed from the body.

Our approach at Alternative to Meds is practical, science-based, and compassionate.

Emotional Instability

Rapid changes in mood or frequent up and down emotional trends are associated with a diagnosis of the personality disorders included in Cluster B. Extreme cases may also experience problems like depression, anxiety, manic behavior, or even suicidal thoughts. Typically, while attending a healing center in a new environment, one is away from the everyday stressors or triggers. We frequently see cases where symptoms of emotional instability were triggered by an unhealthy environment, with problems such as neurotoxicity, heavy metals toxicity, dietary factors, nutritional deficiencies, and even genetics —  all acting as contributing factors. These are the areas we focus on in treatment. Where medication has been problematic, we also provide safe and gradual cessation under medical supervision.

Medication Withdrawal

As mentioned previously, evidence is lacking that medication works to relieve the symptoms classed as Cluster B disorders. We must be clear, it is NOT recommended to stop taking psychoactive medications without attentive medical assistance and guidance.

Quitting medications requires precision and careful oversight. Always seek the assistance of a professional who is familiar with the process and who is sympathetic to your health goals. Contact us at the Alternative to Meds Center for assistance and information about the programs we offer for medication cessation under medical care, as part of overall treatment for unwanted symptoms.

Holistic Treatment at Alternative to Meds Center

holistic psychiatry sedona drug rehabToday’s world is a complicated one. Too often, symptoms do not resolve with a diagnosis of this or that disorder, and certainly, the heavy reliance on drug treatment for relief has proven unsuccessful as noted in the most recent medical literature available to us today.

That is why Alternative to Meds Center focuses on discovering root causes for symptoms, and then specifically treats what is found. Each program is uniquely designed. It has to be because everyone has a different history, a unique personality, and a different set of health goals. For a more detailed look at the services we offer, please study the information on our services overview pages. You will find out how lab testing and neurotransmitter rehabilitation play an important role, as do neurotoxin removal, correction of diet, psychotherapy, and a very wide range of other therapies designed to assist you or your loved one through recovery. Call us today to find out if the orthomolecular-based treatments offered at the Alternative to Meds Center could be a good fit for your health and recovery goals or those of your loved one.


1. Chapman J, Jamil RT, Fleisher C. Borderline Personality Disorder. [Updated 2022 Oct 25]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: [cited 2023 April 11]

2. Crocq M. A. (2013). Milestones in the history of personality disorders. Dialogues in clinical neuroscience15(2), 147–153. [cited 2023 April 11]

3. Chao, Y. S., Wu, C. J., Lai, Y. C., Hsu, H. T., Cheng, Y. P., Wu, H. C., Huang, S. Y., & Chen, W. C. (2022). Why Mental Illness Diagnoses Are Wrong: A Pilot Study on the Perspectives of the PublicFrontiers in psychiatry13, 860487. [cited 2023 April 11]

4. Angstman KB, Rasmussen NH. Personality disorders: review and clinical application in daily practice. Am Fam Physician. 2011 Dec 1;84(11):1253-60. PMID: 22150659. [cited 2023 April 11]

5. Fisher KA, Hany M. Antisocial Personality Disorder. [Updated 2022 Aug 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: [cited 2023 April 11]

6. French JH, Shrestha S. Histrionic Personality Disorder. [Updated 2022 Sep 26]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from:[cited 2023 April 11]

7. Leichsenring F, Heim N, Leweke F, Spitzer C, Steinert C, Kernberg OF. Borderline Personality Disorder: A Review. JAMA. 2023 Feb 28;329(8):670-679. doi: 10.1001/jama.2023.0589. PMID: 36853245. [cited 2023 April 11]

8. Mitra P, Fluyau D. Narcissistic Personality Disorder. [Updated 2023 Mar 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: [cited 2023 April 11]

9. Hyatt, C. S., Sleep, C. E., Lamkin, J., Maples-Keller, J. L., Sedikides, C., Campbell, W. K., & Miller, J. D. (2018). Narcissism and self-esteem: A nomological network analysisPloS one13(8), e0201088. [cited 2023 April 11]

Originally Published Mar 25, 2019 by Diane Ridaeus

This content has been reviewed and approved by a licensed physician.

Dr. Samuel Lee

Dr. Samuel Lee is a board-certified psychiatrist, specializing in a spiritually-based mental health discipline and integrative approaches. He graduated with an MD at Loma Linda University School of Medicine and did a residency in psychiatry at Cedars-Sinai Medical Center and University of Washington School of Medicine in Seattle. He has also been an inpatient adult psychiatrist at Kaweah Delta Mental Health Hospital and the primary attending geriatric psychiatrist at the Auerbach Inpatient Psychiatric Jewish Home Hospital. In addition, he served as the general adult outpatient psychiatrist at Kaiser Permanente.  He is board-certified in psychiatry and neurology and has a B.A. Magna Cum Laude in Religion from Pacific Union College. His specialty is in natural healing techniques that promote the body’s innate ability to heal itself.

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