When Relationship Counseling Stalls, it may be due to a Personality Disorder

Sound relationships require a foundation of unselfish mutual caring and protection that is fundamentally at odds with a Personality Disorder (PD). Thus, when the communication tools that normally work in relationship counseling are repeatedly fruitless, there may be a personality disorder (PD)—or strong traits thereof—at work in one or both parties.

The Foundation of Healthy Communication

Effective relationships are a tapestry of the following qualities. Where one or both partners has a personality disorder, many of these qualities are missing, making for a fabric easily rent.

• Listening: While healthy partners listen, those with PD traits dominate the conversation.

• Empathy: Sound communication requires empathy; PDs focus on repeating how they feel and struggle to identify or care how their partner feels.

• Gentleness: Healthy partners use gentleness; PDs excuse or justify harshness.

• Mutual Protection: Healthy couples protect one another; PDs are self-defensive and regard their partner’s self-protective boundaries as neglect or abuse..

• Peace through Mutual Yieldedness: Healthy partners compromise; PDs fight to win.

• Emotion Regulation: Maturation is the process of increased self-control. PDs dysregulate—narcissists like a child, borderlines like a toddler, and histrionics like a "drama queen or king."

• Accepting Perspectives: Healthy partners expect and accept different points of views. Asking a PD to voice a different point of view is like asking them to renounce their citizenship. Other perspectives are considered wrong or “against” them.

• Introspection: Maturation humbly admits faults, apologizes, and seeks self-improvement; PDs focus on what others have done.

• Truthfulness: Relationships require honesty, PDs lie by commission or omission, gaslight, delude themselves, and spin one-sided narratives, casting themselves as victims.

• Accepting Responsibility: In healthy relationships, partners own their misbehavior; PDs deny, blame-shift, and project their own selfish and manipulative motives onto others’ actions.

• Commitment: Relationships require commitment to each other and to relational health; PDs leave relationships and quit therapist after therapist when their blame-shifting is challenged.

• Consideration: Loving relationships are mutually considerate; PDs focus on their own wants and needs, manipulating others to satisfy their desires.

• Other-Centeredness: Love is other-centered, PDs run on a "me loop."

A person with a personality disorder tends not to present for couples therapy, except to have therapy “fix” their spouse, or in response to an ultimatum given by a partner who is ready to leave. If therapy is to be effective, the above positive qualities must replace the PD manifestations.

Effective Treatments for Personality Disorders

People who seek individual therapy for a personality disorder often benefit from one or more of the following forms of therapy:

• Eye Movement Desensitization and Reprocessing (EMDR): Used for uncovering and processing experiences that lead to negative self-talk, replacing them with positive beliefs.

• Cognitive Behavioral Therapy (CBT): Helps identify and change the patterned linkage between thoughts, feelings, and actions.

• Brainworking Recursive Therapy (BWRT): A form of CBT that replaces non-preferred somatic or emotional responses with preferred ones.

• Dialectical Behavior Therapy (DBT): Essential for regulating emotions, challenging interpretations, slowing reactions, and choosing relationally wise behavior.

• Schema Therapy: Discovers the sources of maladaptive ways of viewing the world and relationships, replacing them with more effective ways.

Recommended Authors and Resources

The following experts specialize in personality disorders. Most material on personality disorders is written for people in relationship with someone with a PD, helping them to establish and maintain healthy boundaries against mistreatment. A notable exception is Dr. Norman Goldwasser, who offers practical help for the narcissist (while also including a chapter for those in relationship with one).

• Dr. Norman Goldwasser (narcissism)

• Dr. Craig Malkin (narcissism)

• Dr. Marsha Linehan (borderline)

• Dr. Margalis Fjelstad (borderline)

• Randi Kreger (narcissism and borderline)

• Paul Mason (narcissism and borderline)

• Dr. Daniel Fox (narcissism and borderline)

• Dr. Les Carter (narcissism and borderline)

• Dr. Ramani Durvasula (narcissism and borderline)