Podcast Summary: Therapy for Black Girls – Session 431: Understanding Personality Disorders

Air Date: October 1, 2025
Host: Dr. Joy Harden Bradford, Ph.D.
Guest: Dr. Tracy Marks, Psychiatrist & Mental Health YouTuber

Overview of the Episode

In this informative session, Dr. Joy Harden Bradford invites psychiatrist Dr. Tracy Marks for an in-depth discussion on personality disorders. The conversation covers what personality disorders are, how they develop, why they are often misunderstood, their impact on relationships, treatment approaches, and the effects of misinformation on social media. Dr. Marks also touches on cultural biases and provides advice for both those living with personality disorders and their support systems.

Key Discussion Points & Insights

1. Dr. Tracy Marks’s Path to Psychiatry and Education Mission (05:04–10:45)

• Background: Dr. Marks shares her unexpected journey from engineering to internal medicine, then to psychiatry. She reveals her initial misconceptions about psychiatry’s value, stating,
  “...I had never talked to anyone who'd ever been to a psychiatrist before and really didn't see the value of it...” (06:25)
• Motivation for YouTube: Noticing patients lacked basic knowledge, she began making videos to help educate beyond one-on-one sessions:
  “...I thought, well, if they [patients] don't know these things, how many other people don't know these things?” (08:53)

2. Defining Personality Disorders (10:46–15:36)

• Clusters of Disorders: Dr. Marks breaks personality disorders into three clusters:
  • Dramatic/Erratic: borderline, narcissistic, antisocial personality disorders.
  • Odd/Eccentric: schizoid, schizotypal, paranoid.
  • Anxious/Fearful: avoidant, dependent, obsessive-compulsive personality disorder (distinct from OCD).
• Important Distinction:
  “We all have personality traits, but we don't all have disorders.” (12:01)
• Diagnosis Requires Dysfunction: A disorder is only diagnosed when clusters of traits cause significant problems in multiple areas of life.
• Development: Roots lie in both genetics (“nature”) and environment (“nurture”), including early attachments and trauma. Usually become apparent in late adolescence or early adulthood.

3. Misconceptions & Over-Diagnosis (15:37–17:23)

• On Trauma and Development:
  “It's not just one hit and then now you're impaired for life... It's a series of things and experiences...” (15:54)
• Complex PTSD vs. Personality Disorders: Complex trauma can shape or contribute to development, but not every traumatic experience results in a disorder.

4. Lack of Insight & Ego Syntonic Nature (17:24–19:44)

• Why Personality Disorders Are Hard to Self-Spot:
  “Personality disorders tend to be ego syntonic... you don't see that you have a problem because it's built in to your nature...” (17:44)
• Many seek help not for the disorder itself, but for resulting depression, anxiety, or external pressures (e.g., from relationships).

5. Treatment Approaches & Challenges (19:45–24:21)

• Therapeutic Modalities: Psychoanalytic, insight-oriented, schema therapy, dialectical behavior therapy (DBT).
• Process: Focuses on increasing self-awareness and understanding problematic patterns.
• Duration:
  “...it still takes time and patience and a lot of investment... not something that changes overnight.” (22:44)
• Biggest Hurdles: Recognizing the need for help and committing to the lengthy process.

6. Navigating Relationships & Empathy (28:36–32:38)

• Support System’s Role: Patience and boundaries are key.
  “I can love him enough. That'll help him heal... I was sacrificing my own self...” (29:20)
• Boundaries for Loved Ones: Support is warranted if the individual is actively working on change, but self-care must be maintained.

7. Cultural and Racial Nuances (32:39–34:57)

• Cultural Bias in Diagnosis:
  “It's very easy for, say, a Black male to be considered antisocial if he's the least bit assertive... pathologizing behavior because it's something you're not used to.” (33:15)
• The DSM’s definition and application have been criticized for lacking cultural sensitivity.

8. The Problem with Online Information (34:58–41:34)

• Misinformation Epidemic:
  “I cannot stand the way narcissism is portrayed online... anything that they don't like about someone into... narcissism.” (35:51)
• Overusing labels like “narcissist” dilutes meaning and has led even adolescents to fear discussing themselves.
• True prevalence of personality disorders is much lower than the internet suggests.

9. Media Representation (45:51–47:50)

• Inaccuracies in TV/Film:
  Accurate depictions are rare. “There’s more examples of it just being...what will excite people, so let’s make it look like this than true portrayals.” (46:44)
• “Beautiful Mind” cited as a positive portrayal of psychosis; most personality disorder depictions are inaccurate because dramatic portrayals “are more interesting” than reality.

10. Evaluating Online Resources (47:50–53:08)

• Advice for Listeners:
  • Know whether you’re seeking entertainment, self-insight, or answers about others.
  • Distinguish between clinician advice and personal stories.
  • Seek out evidence-based resources and check for credentials.
  • Self-diagnosed insight can be helpful, but confirmation by licensed professionals is best.
  • Notable quote:
    “If these videos help you have insight, that’s good, but still it’s good if then you can take it to the next step...” (51:37)

11. Recommended Resources (53:08–55:07)

• Focus on relatable, authoritative podcasts, books, and websites; no single recommendation due to breadth and variety.
• Mentions NAMI (National Alliance on Mental Illness) as a starting resource, though coverage of personality disorders may be limited.

12. Key Takeaways & Final Thoughts (55:07–58:38)

• “We all have personalities and not all personality traits are pathologic like personality disorders. Is pathology, meaning it causes problems in multiple areas of your life.” (55:13)
• Personality disorders persist over time and impact various life domains.
• Prevalence is much smaller than popular culture suggests.
• Personality can change, but change is gradual and requires patience and support.

Notable Quotes & Memorable Moments

• On diagnosis:
  “You probably can't just diagnose yourself with a personality disorder... we usually don’t diagnose a personality disorder with the first evaluation...”
  — Dr. Marks (13:35)

• On social media’s influence:
  “Everybody's mother isn't a narcissist...”
  — Dr. Marks (35:50)

• On self-discovery via online info:
  “It’s still a win, if you never see a psychiatrist or therapist, it’s still a win to have insight.”
  — Dr. Marks (51:46)

Timestamps for Key Segments

• Dr. Marks’s career and start in psychiatry: 05:04–10:45
• Defining personality disorders & clusters: 10:46–15:36
• Developmental pathways and complex trauma: 15:37–17:23
• Ego syntonic concept & lack of insight: 17:24–19:44
• Treatment and therapeutic approaches: 19:45–24:21
• Support system and empathy: 28:36–32:38
• Cultural and racial nuance: 32:39–34:57
• Problems with online information: 34:58–41:34
• Media portrayal critiques: 45:51–47:50
• How to evaluate information and next steps: 47:50–53:08
• Resource recommendations: 53:08–55:07
• Key takeaways and final advice: 55:07–58:38

Final Thoughts

Dr. Marks encourages listeners not to rush to labels, cautions against the spread of misinformation, and highlights the importance of lived experience and cultural context. She reaffirms the possibility of growth and change for those living with personality disorders—provided there is patience, support, and access to quality information and therapy.

How to Find Dr. Tracy Marks:

• YouTube, Instagram, TikTok: @DrTracyMarks
• Website: markspsychiatry.com

For supportive discussion, resources, and to continue the conversation, visit Therapy for Black Girls at therapyforblackgirls.com.