The management and treatment of personality disorders can be a challenging and controversial area, for by definition the difficulties have been enduring and affect multiple areas of functioning. This often involves interpersonal issues, and there can be difficulties in seeking and obtaining help from organizations in the first place, as well as with establishing and maintaining a specific therapeutic relationship. On the one hand, an individual may not consider themselves to have a mental health problem, while on the other, community mental health services may view individuals with personality disorders as too complex or difficult, and may directly or indirectly exclude individuals with such diagnoses or associated behaviors.[82] The disruptiveness that people with personality disorders can create in an organisation makes these, arguably, the most challenging conditions to manage.

The golden child often grows up to be high-functioning on the outside. Many are successful, over-achieving perfectionists. Although they appear to be doing well, they are constantly haunted by a sense of void, a deep fear of failure, and an emptiness from not knowing who they are. They become excessively guilt-ridden and ashamed whenever they stumble in life. Having to constantly live up to the unrealistic and rigid expectations their parent sets and a narrow definition of success, they may break down at some point later in life.

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