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 threads. In relationships where one or both partners has a personality disorder, many of these threads are missing, making for a fragile 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.
Gentleness: Healthy partners use gentleness, while PDs may excuse or justify harshness.
Mutual Protection: Healthy couples protect one another; PDs focus on self-protection.
Peace through Mutual Yieldedness: Healthy partners compromise; PDs fight to win.
Emotion Regulation: PDs often dysregulate—narcissists may act like a child, borderlines like a toddler, and histrionics like a "drama queen or king."
Accepting Perspectives: Healthy partners value other views, but PDs often "split"—seeing issues as black or white and people as either "for" or "against" them.
Introspection: Instead of looking inward, PDs tend to project, accusing others of their own motives and tactics.
Truthfulness: Relationships require honesty, PDs may deny, lie, gaslight, or delude themselves.
Accepting Responsibility: In healthy relationships, partners own their misbehavior; PDs gaslight or blame their partner for their behavior.
Commitment: Relationships require commitment to each other and to improvement. PDs have serial relationships and quit therapy when their blame-shifting is challenged.
Consideration: Loving relationships are mutually considerate relationships. PDs manipulate others to serve their own ends.
Other-Centeredness: Love is other-centered, PDs run on a "me loop."
Persons with personality disorders tend not to present for couples therapy, except to “fix” their spouse, or in response to an ultimatum. Effective therapy requires both parties to understand where their feelings are rooted, how their interpretations of their spouse and of events may be distorted, and how they contribute to and can change unhealthy communication.
If a person with a personality disorder can admit to a disordered way of perceiving and interacting in relationships, the following forms of therapy may be effective.
Effective Treatments for Personality Disorders
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 designed to help those in relationship with a person with a PD to erect and maintain healthy boundaries against mistreatment. A notable exception is Dr. Norman Goldwasser, who offers piratical help for the narcissist.
Dr. Norman Goldwasser (narcissism)
Marsha Linehan (borderline)
Margalis Fjelstad (borderline)
Randi Kreger (narcissism and borderline)
Paul Mason (narcissism and borderline)
Daniel Fox (narcissism and borderline)
Les Carter (narcissism and borderline)
Ramani Durvasula (narcissism and borderline)