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Hi, everyone. Welcome to the lecture or third lecture of the Psychiatry series. And today we have Doctor King speaking to us on Personality and Anxiety Disorder and I'll hand over to him. Hello, everybody. Nice to meet you all. Um I can't see you but I trust that you're all there. Um I prepared this presentation sort of based on a series of talks that I've given over the past few years about personality and to a lesser extent on anxiety disorders as well. It'll be about an hour or so, but there'll be within that some time for kind of comments, questions, maybe some discussion in the chat towards the end as well. So I suppose a little bit about me just to start. So I'm a psychiatry registrar. I work in the Victoria uh Community Mental Health Team in South Westminster. I do my research at Imperial mostly on personality and personality disorder. I'm particularly interested in the way that personality shapes and interacts with other health conditions, other mental health conditions and other physical health conditions, how personality can uh lead people to engaging or not with treatment, making uh health choices that are informed or or otherwise, I am sort of reasonably involved in, uh, psychiatry personality disorder research kind of worldwide. I sit now as a secretary to the section of Personality Disorders of the World Psychiatric Association recently have been in Madrid at the European Psychiatric Association. Um about this. I don't have any confidence of interest to declare, but I am a trustee of a charity called NUSS UK, which uh you can talk a little bit about maybe the end but promotes the use of something called Nido therapy um in uh to support people with mental health problems. So without kind of any further ado this session, um will might be a little bit different to some of the other sessions in this series in that personality um psychopathology Personality disorder um has undergone quite significant revisions recently in the diagnostic criteria and our way up by thinking about personality and how that influences our, you know, thoughts, behaviors, the way we interact with the world. So in this presentation, we'll be thinking about some of the psych pathology and some of the theory behind what personality is when personality becomes problematic, if it does at all, some of the presentations of that and then also the management and we'll be doing quite a similar thing with anxiety and anxiety disorders as well, but the two will sort of merge together. So the first thing to say is that we all have a personality, you know, we all have a personality, whether we also have schizophrenia as well. You know, autistic, people have personalities, people with different physical health problems, people with diabetes, people who've had heart attacks, all have personalities. It's a fundamental aspect about being human and within that we all have strength to our personalities, but we will have weaknesses too. There are parts of ourselves, which we like about ourselves that other people like about us that help us get on with life that help us pursue our goals. But also there are parts of our personalities, all of us, which is less helpful that maybe frustrate us that other people don't like. And the point is that in some environments and some situations, our personality decompensates, you know, those things that keep us going, uh those defenses in our personality don't work quite so well and we become frustrated or we can't do the things we want to do or we can't achieve the goals that we have. And this is a real fundamental shift in the way that we've thought about personality. Over the years, there are loads and loads of different ways of thinking about personality. Um But on the whole, personality is generally thought of as, and I, I'll just essentially read out the, the definition from the American Psychiatric Association at the top, which is that personality refers to the enduring characteristics and behaviors that comprise a person's unique adjustment to life, including their major traits, interests, drives values, self-concept abilities and emotional patterns. Personality in a sense is about the um the common patterns in the ways that we think about ourselves and the world and how we respond to the external world as well. There are lots of different components to personality. You know, this again has been formulated very differently in lots of different ways. I mean, I quote, uh Claude Bernard at the bottom to say that concepts are not right or wrong, but actually some models can be more useful than others. The three sort of generally held components to personality are something called temperament. So, temperament is that biologically instantiated component to it. It's the thing that we're born with, it's that there are, you know, gender differences in personality. It's to say that, you know, you have newborn babies and a sort of good example might be the startle test that you use in newborn babies. So you have two sort of babies, maybe they're six weeks apart and you make a loud noise next to one and then the other and one baby jumps startles very quickly, you know, responds to the stimuli and the other baby might be much more, you know, passive might be much sort of indifferent to those kinds of things. Temperament is those biologically instantiated things. So it can be about, you know, impulsivity, it could be about irritability, it might be aggressiveness, these sorts of things that are all very natural aspects of a, of a human as well as most animals, um, personality structure. Ok. So character is much more about those things that we pick up along the way. It's about how our past experien past experiences shape the way that we look at the world that we understand ourselves, that we might respond to situations in the future. You know, uh, a young girl who's bitten by a dog, for example, might, uh, have that experience shape her future sort of thoughts and behaviors in response to dogs having a pet, all those sorts of things in the future, right? So it's how our life experiences kind of shape the way that we think about ourselves in the world. And identity. Lastly is much more of a sort of esoteric concept. It's to say, you know, who are we, what is the story that we tell about ourselves? Where have we come from? Where are we going, what's important to us? How do we um pursue our goals? Why do we want to pursue our goals? So, identity is much more of this sort of narrative concept about who we are and where we come from. And just because it is the most sort of, I suppose, complicated component of personality, I just wanted to touch on it a bit more briefly to say that identity and having a sense of ourselves has a few different components as well. So starting on the left, it's about this capacity for self reflection to sort of step outside of ourselves to be able to look at ourselves in the world and say, gosh, who am I? You know, am I, you know, a hard working person? Am I a nice person? Am I, you know, actually an aggressive sort of person? Am I quite impulsive? Did you see what I mean? These kinds of things? And it's about having some sort of accuracy and being able to tell this is what I'm like. And I think, you know, this is a reasonable guess about how other people might perceive me. Another sort of facet of identity is what's called agency or self direction, an agency is that capacity to pursue our goals. So once we've worked out, you know, what is meaningful for us, what we value, how is it that we quote corral our emotional and material resources towards pursuit of those aims of those goals? So it's about saying, you know, why do I get up in a morning actually? Can I sort of regulate myself? Can I go to bed on time if I've got an exam the next day? You know, can I delay my gratification for a particular thing? You know, I'm not gonna go out with my friends tonight because, you know, there is, um, you know, some classes that I want to do tomorrow or, you know, I need to go and see my family because it's Easter or, or whatever it is. So this is a, a sort of a, a faculty of, of what's called identity. And one of the third components is what's called narrative, identity or autobiographical memory. And we sort of, we all have a story that we tell about ourselves. You know, in psychiatry, you know, regularly in clinic, I will sit with someone for an hour and try and get a sense if I've meeting them for the first time about what their life story is, you know, where do they feel they've come from? What sort of background do they feel that they've come from? And this is irrespective of whether there's any objective truth or not as to the story that they tell themselves, but this is sort of part of it and some people will kind of say, you know, um, well, I'm just thinking, I'm gonna watch the, the Apprentice finales later on tonight. And so Alan Sugar has this story about, you know, being from a very working class background. He's worked very, very hard and he's got to sort of where he is. So this is a, you know, this is a, a narrative identity and people tell themselves different stories. So these are the different components to, to what identity is. Ok. So now that we've thought about what personality is. Ok, how do you me