Abuse, Narcissism, Borderline and Individual Therapy: Uses and misuses for addressing couple dynamics

Abuse is unacceptable and must be acknowledged by both parties and by individual therapists and couples therapists, and cease. There is no excuse for abuse. And Cluster B personality disorders (PDs), including Narcissistic Personality Disorder and Borderline Personality Disorder are real, existing on a spectrum that must be acknowledged, addressed, and treated in order for needed changes in the relationship pattern to occur and to last.

The problem is that once an understanding of narcissism or of borderline is gained, men love to charge their more emotional girlfriends or wives with being borderline, and women love to label their less-relationally-driven boyfriends or husbands as narcissists (though the conditions are not gender-exclusive). Such charges may or may not be accurate. At times they may even be projection—criticizing the spouse for what the accuser actually does, leading to complaints of a double standard.

The lexicon of abuse has grown large, now  appropriately including far more than physical violence. Whether or not that abuse stems from a personality disorder, once terminology for abuse has been gained, the unfortunate thing is that it can be used as a reason to not want to understand the abusive partner’s point of view on any matter (because they’re an abuser), nor to investigate how to improve relationship dynamics, because there is no excuse for abuse (…and there isn’t). The victimized spouse can feel relieved of any responsibility to make changes of their own for improvement of the relationship. There may only be the vague admission, “Well, I'm not perfect, either.” But such a vague confession yields nothing from which to repent; no changes to make.

In other words, labeling one’s partner can cast them as the sole problem, and may even be used to justify ending the relationship. This is especially true if abuse and personality disorders are considered hopelessly recalcitrant and therefore necessitating divorce (as some consider them to be). In our 21st century culture, in which things are replaced rather than repaired, this mindset often carries over into marriage. Like a ten year old car diagnosed with an irreparable transmission, these conditions are often treated like a terminal illness and Dr. Kevorkian is called in.

To be sure, there is a point at which to leave a relationship; even a marriage. If abuse continues and boundaries of self-protection are not respected, there is a point at which to leave. A boundary, it’s worth noting, is not telling someone else what they must do or cannot do; it’s declaring what we will and will not tolerate, and what we will do if a person acts in a way we’ve said we will not tolerate. Boundaries are the appropriate response in self-protection against narcissistic or borderline self-centeredness. Dr. Ramani, who specializes in personality disorders, uses the expression, “Lower your expectations; raise your boundaries.” Don’t expect someone with these conditions to become selfless, but selfishness must become tempered with consideration and other-centeredness (love) if there is to emerge a close, interdependent relationship.

Boundaries are a first step; the person affected by the disorder must also come to the realization that that they aren’t “just being them,” but that aspects of their emotional, cognitive, and behavioral life are not healthy and interfere with close relationships. Cluster B personality disorders (which include Narcissism and Borderline) are problematic because they’re characterized by “lack of insight.”  That is, persons who have these maladaptive ways do not think of themselves as “disordered,“ but that their ways of feeling, thinking and acting are normal, and will defend themselves. Thus, a spouse who has concluded that their partner has abusive, narcissistic, or borderline tendencies may insist that the other person get individual counseling in order to fix the marriage. Or the non-disordered spouse may enter into individual counseling to fix the marriage. Such counseling will appropriately commend boundaries against unacceptable behavior.

While individual counseling and boundaries can be beneficial to individuals, they do not necessarily improve a marriage. In fact, individual therapy can worsen a marriage. This is because individual counseling is about understanding oneself and pursuing one’s own health and self-actualization. Couples therapy is about understanding each other and “us” and our dyadic relationship, as we strive to actuate a healthy interdependent relationship. The relationship thus needs its own counselor. Couples therapy focuses on a couple’s interactive pattern, which neither individual’s therapist sees.

The individual therapist understands only their client’s perception of the relationship dynamic, with which the other partner will somewhat disagree, if not adamantly disagree. This is because there exists no objective description of a relationship, not of an incident in a relationship; there are only two subjective descriptions. Each partner will narrate a guaranteed-to-be-different experience of the same event. Given the self-focused human nature, we defend our own one-sided perspective to the neglect of voicing—or even bothering to try to understand—the other person’s perspective. We may not inquire, much less reflect empathy and understanding for the other’s feelings, perspective, and what is important to the other in a conflict or past incident. Add to this how easy it is to describe an incident in a way that makes us look pretty good and our partner look pretty bad. Since our individual therapist, friends, and family have only our perspective to go on, it’s easy for them to empathize with our experience, reinforcing our perception that our partner is mostly, if not solely, to blame.

One would hope that a trained therapist would understand this and withhold judgment on the absent partner until able to verify the conclusions drawn by their client. But, that is not always the case. Some therapists will so thoroughly validate their clients’ feelings and point of view as to adopt them as fact. They might accept their client’s interpretation of the partner’s meanings and motives behind words and actions. A therapist may even adopt a client’s mental health diagnosis of their partner. They might even loosely suggest a diagnosis of their own for the absent partner, having never met them, nor seen the couple interact. A therapist might even listen to their client’s secret recording of their partner’s dysregulated eruption at the conclusion of a toxic conflict and draw conclusions from it without knowing the broader context. These possibilities within individual therapy can feed the perception that the entire relationship problem is the fault of the absent partner. Such validation can feel wonderful to the solo client. The problem is that our interpretations of our partner’s meanings and motives are rarely accurate.

I witness this inaccuracy in every couples’ therapy session where I ask each spouse to state to their partner’s satisfaction the feelings, point of view and complaint of the other, and to describe what “fixed” would look like from the other’s perspective. Rarely does the listening partner say, “That’s right.” Almost always, the listening partner offers clarifications and corrections which they need to hear the other reflect out loud before they can say, “Yes, I feel understood.”  Spouses misunderstand and draw inaccurate conclusions about one another. That’s what causes conflicts to spiral out of control; neither person is feeling understood. The antidote is to verbally reflect empathy and understanding—without minimization, derision, sarcasm or contempt—reflecting each other’s differing subjective perspectives.

This clarification does not occur in individual therapy. Individual therapists risk buying into their client’s one-sided perspective and give relationship advice based on it. By contrast, in couples therapy, the relationship is the client. The therapist will observe the couple’s interactions for a glimpse into the relationship pattern, each person’s role in it, and offer interventions to bring about healthy change.

Every relationship can benefit from understanding a systems approach to their relationships. This approach identifies destructive patterns to which every relationship is prone, and the principles practices that work. It is the responsibility of both partners to identify and excise from the  relationship their own destructive habits and to do their part to build into the relationship the principles and practices that make relationships work. If one partner changes, the system changes. If one partner erects boundaries, the system changes. If a disordered or abusive person makes changes, the system changes. When both partners identify and change ineffectual ways of interacting, the relationship changes for the better.

The person who does not want to accept any responsibility for improving the relationship pattern (whether the person with the PD or the other), will typically quit couples therapy, again and again with counselor after counselor. For, once a therapist identifies the couple’s relationship pattern (which every couples therapist will) and the modifications required from both partners in order to communicate and effectively manage conflict, the partner who wants to hold the other partner solely responsible for the relationship problems will not be able to do so. They will then quit couples therapy, charging that the therapist was taking their partner’s side.

Let me reiterate that there is no excuse for abuse. And a relationship with someone with strong narcissistic, borderline, or other personality disorder traits, will be crazy-making. Boundaries must be erected and respected and behavior must change. But at the end of the day, there will always be two imperfect people interacting to form a unique relationship, based on who they are and how they show up in the system. To the extent that either imperfect partner is showing up in ways unhealthy to the relationship, that partner needs to exchange unhealthy ways for healthier ways. The system must change from both sides, even if more heavily from one side. If a couple has children together, divorce won’t erase this reality; the same systemic changes will need to occur if there is to be amicable coparenting.

So, to sum up, abuse, narcissistic, borderline, and other mental health conditions are real. Their harmful manifestations must stop if there is to be a healthy relationship. Until a mutually-protective, healthy relationship exists, a victim of these forms of abuse must be self-protective while the couple learns other-protective behavior. In that learning process, both partners need to recognize and change their part of unhealthy system dynamics. This will occur not in individual therapy, but requires the full picture visible in couples therapy.