People with personality disorders tend to exhibit problems with impulse control. These problems can manifest as either over-controlled or under-controlled impulses. (Under-controlled impulse control is commonly called a “lack of impulse control”). In the same manner that people with personality disorders may have problems with over- or under-controlled affective (emotional) regulation, they also tend to have problems regulating their impulses. Here, too, we can think of impulse regulation along a continuum ranging from over-control to under-control, with healthy personalities falling somewhere in the middle between these two extreme poles.
Consider the issue of self-control and the need for a healthy balance between overcontrol and under-control:
• On the one hand, we need to control our impulses and to consider the consequences of acting upon an impulse.
Having considered the consequences, we then decide how to act accordingly. We determine whether to allow ourselves to indulge the impulse, or whether to inhibit it.
The inhibition of certain impulses enables us to behave in ways that are both responsible and socially acceptable.
Therefore, in some circumstances the inhibition of our impulses serves to promote our success in both relationships and in the workplace.
Two areas of particular concern are aggressive and sexual impulses. If we were to act on our every aggressive or sexual impulse, we would easily get ourselves into a great deal of trouble.
• On the other hand, a certain amount of carefully considered risk-taking is necessary to reap the benefits of creative expression, rewarding relationships, and successful problem-solving.
Some amount of risk-taking is part of the excitement, fun, and spontaneity associated with an enjoyable life.
With too much impulse control, we end up feeling restricted, bored, and dull; with too little we can get ourselves into a great deal of trouble. Clearly, a balance between these two extreme poles of over- and under-control would represent a healthy personality.
The challenge to strike the right balance of impulse control affects everyone from time-to-time, including people with healthy personalities. We all have had occasions where we behaved irresponsibly, or unwisely chose to act upon an impulse. At other times, we may have been too controlled, failing to take a risk that would have ultimately benefitted us. Once again, flexibility enables healthy personalities to achieve the proper balance of impulse control most of the time.
People with personality disorders are distinguished by the rigidity of their pattern of over- or under-control, and the severity and persistence of their impulse control problems.
• Rigid and persistent over-control of impulse can manifest itself as inhibition, reluctance to do anything that involves any type of uncertainty or risk, reluctance to start new things or try new activities, and over-conscientiousness or scrupulousness.
• Rigid and persistent under-control can manifest itself as recklessness and a disregard for rights and needs of other people. This pattern can lead to troublesome or dangerous problems such as drug use, dangerous or risky sexual liaisons, over-spending, assault, or self-injury.