Click below for audio dictation of the article by Bill Eddy, or scroll down to read.
©2019 Bill Eddy, LCSW, Esq.
This is an increasingly important question in many areas of modern life, including in love relationships, in the workplace and in legal disputes. Major decisions are often made by assuming that someone will or won’t change their negative behaviors. Yet there are many factors that influence the likelihood that a difficult person will change—or not. The three most important factors are: which type of high-conflict personality they have, how severe their behavior is, and what their environments reinforce.
5 Types of High Conflict People
High conflict people (HCPs) tend to have a pattern of behavior that increases or keeps conflicts going, rather than calming or resolving them. They tend to have four key characteristics:
· Preoccupation with blaming others (their Targets of Blame)
· Lots of all-or-nothing thinking (and solutions)
· Unmanaged emotions (which often throw them off-track)
· Extreme behaviors (that 90% of people would never do)
Once you see these four characteristics, there is a lot that you can anticipate: they rarely seek counseling, they vigorously defend their past behavior, and they escalate their attacks on those they blame (which often includes new Targets of Blame over time). In other words, they are locked into their high-conflict behavior patterns and resistant to change. They see all of their problems as caused by other people, so they are not motivated to change on their own. But a small percentage do change, with a combination of coercion (family, workplace and/or court) and good programs of chanhe, as described in this article.
The more severe the patterns of high conflict people, the more likely they are to also have a personality disorder. This is a mental health disorder which shows up primarily in interpersonal relationships. There are ten types of personality disorders in the diagnostic manual of mental health professionals (DSM-5). Fundamentally, those with personality disorders have a narrower range of behavior than most people, with three traits which make them resistant to change, which is why they are called disorders:
· Interpersonal dysfunction
· Lack of self-reflection
· Lack of behavior change
Not all people with personality disorders are HCPs preoccupied with Targets of Blame. But five of the ten types of personality disorders are particularly prone to high-conflict behavior patterns: borderline, narcissistic, antisocial, paranoid, and histrionic. These five have different patterns of behavior, which make them have more or less potential to change. Overall, its harder to change one’s personality-based behavior than to recover from alcoholism or another addiction—which is never easy. Here are the five types of high-conflict personalities and their likelihood for behavior change.
High-conflict people who have traits of borderline personality disorder (BPD) usually have the following key patterns of repeated interpersonal behavior in addition to the above characteristics:
· Wide mood swings (from loving or friendly, to intense blaming or hatred)
· Sudden and intense anger (disproportionate; especially when they feel abandoned)
· Seeing people as perfect or terrible (sometimes swinging back and forth about this)
The good news is that therapies have been developed over the past twenty years or so which have had some good success for those with this disorder, if they are willing to get the therapy. Dialectical Behavior Therapy (DBT) focuses on teaching small skills in small steps, with a lot of repetition in a very supportive environment. This method ideally includes an individual therapist, plus a group therapy for learning, discussing and practicing these skills. Distress tolerance, better awareness of relationships, and learning proportional responses to interpersonal situations are among the skills learned. With weekly individual and group therapies, in two to five years many people have outgrown the diagnosis of borderline personality disorder. They may still have some traits, but have developed the ability to look at their own behavior and change their own behavior to have more successful relationships.
DBT is one form of cognitive-behavioral therapy (CBT). Other approaches that various therapists use tend to be forms of CBT, with homework and specific self-help skills to learn: cognitive(changing the types of things that they tell themselves) and behavioral(practicing changing little behaviors step by step).
Also important in any method of therapy with people with traits of BPD is having a therapist who can ride out the emotional storms of a BPD client’s anger, helping the client become self-aware and use new skills when they are upset like this, rather than getting angry back at the client or rejecting the client. Likewise, it’s important that any therapist with clients with BPD is good at setting limits and guiding the client by gently suggesting behavior change, rather than just providing support for the person as they are (which just reinforces their bad behavior).
The implications for this with borderline HCPs in families, the workplace and legal disputes, is that the person may havethe potential for change if they can be convinced of the need for ongoing counseling, such as DBT or other cognitive-behavioral skill-training types of therapy. Families can coerce their loved one to get this help by threatening to withdraw their support, as in an alcohol or drug intervention. Employers can threaten termination of employment if the person does not get some kind of help to change their behavior. Judges can order individuals with these disorders to go into treatment to stop certain behaviors, such as domestic violence treatment programs, drug or alcohol treatment programs, or other programs, as a motivation to change or else legal consequences will be imposed.
There is hope for change for borderline HCPs if the person will stick with the program. The big question for borderline HCPs (and any HCPs) is whether they can take responsibility for their part in problems, rather than just blaming others.
HCPs with narcissistic personality disorder (NPD), or just traits but not the full disorder, generally have these characteristics:
· A drive to be seen as superior; to put others down to put themselves up
· Demanding that others admire them and wanting them to be jealous of them
· A lack of empathy for others; to use others rather than have real relationships
Few narcissists seek therapy to change their attitudes and behaviors, and those that do often drop out quickly because they believe they know so much more than any therapist. However, the few that do follow through are usually driven into counseling for another reason, such as alcoholism or other addiction, serious troubles at work, or a spouse or partner who is threatening to end the relationship.
The most successful therapies with narcissists tend to also be those that emphasize cognitive-behavioral skills. These can be taught in individual counseling with a therapist who is skilled at being supportive and gently confronting of the narcissist’s self-defeating behaviors. (Supportive therapy alone reinforces their problems rather than teaching new skills.) If the person is also an alcoholic or addict and participates in a 12-step programs and groups, those tools (such as: one day at a time; looking at yourself; practicing some humility; learning from others) help chip away at narcissistic tendencies. Some do well in group therapies, while others do not. If they try to prove they are superior to the group leader, they will become disruptive and will need to leave.
As with borderline HCPs, narcissistic HCPs have a range of interpersonal dysfunction. If an individual has a narcissistic personality disorder and sticks with counseling which is focused on learning new skills and self-awareness, then in two to five years they also may outgrow the diagnosis. As with borderline personality disorder, it usually takes pressure from family, workplace, or the courts to get someone to stick with real behavior change. There is some hope for change if the person sticks with a good counselor to learn cognitive-behavioral skills, but there is less likelihood that those with NPD will actually follow through as compared to those with BPD.
Those with histrionic personalities tend to have the following key characteristics:
· Preoccupation with drawing attention to themselves
· Superficial emotions and relationships
· Dramatic stories and manner of speaking
Surprisingly, histrionic people seem to enjoy therapy. This is because they like the attention given to themselves and the opportunity to tell many stories to a sympathetic listener. However, that is not what behavior change is all about. They can benefit from individual therapy with a therapist who will gently confront their self-defeating behaviors by teaching them new skills that they can use in social situations. Such a counselor must be willing to deal with the fact that histrionic HCPs would rather spend a year telling stories and blaming others than work on changing themselves.
As with the other types of HCPs, the key question is whether they can take responsibility for their part in their problems. While some histrionic HCPs can make progress in individual therapy, they can be very disruptive in group therapies because of their drive to be the center of attention. Therefore, individual therapy may be the most recommended approach. Similar to the other HCPs, they usually will not seriously work on themselves unless they feel pressure from partners, employers, or the courts. Since they are so good at getting attention from others as they are, their likelihood of true behavior change is generally less than borderline and narcissistic HCPs.
HCPs with this personality type tend to have the following characteristics:
· Mistrust and suspiciousness of the intentions of others
· Fear of conspiracies against them by those close to them (partners, co-workers)
· A drive to attack those they fear will attack them (verbally, legally, physically)
These HCPs are even less likely to engage in a program of behavior change or even individual therapy. They are too mistrusting of others, including therapists. However, some therapists report success with this personality type. As with the other personality disorders, they need a therapist who will be supportive and will gently confront behavioral issues by offering new more effective skills. As with the others, they rarely seek treatment unless pressured by others. Getting them to stay in therapy is often quite difficult. In general, they are less likely to make behavior change than the prior types listed above.
This is the least likely HCP personality type to change. In fact, there are indications that this personality may be the most genetic and therefore in-born and “hard-wired.” They have some biological differences, including a tendency for their heart rate to slow down in a fight, misreading neutral facial expressions as hostile toward them, and the ability to beat lie detector tests by not showing anxiety when they make knowingly false statements. In general, their characteristics include:
· A drive to dominate others
· Highly-aggressive energy and risk-taking
· Constant deceitfulness (lying and conning)
HCPs with this personality can be quite dangerous, as they can be predatory in seeking revenge against those they believe have been hostile toward them. They are also skilled at manipulating professionals into thinking that they are victims, when in fact they are perpetrators of abuse. At this time, there are almost no therapies that are recommended for this personality. Individual therapy usually allows them to manipulate the therapist and to learn new psychological techniques of manipulating others. They disrupt group therapies and try to dominate the group leader.
The time to seek behavior change for those with this personality is before they become adults. About half of them show signs of antisocial behavior or “conduct disorder” (petty theft, harming animals, fire-starting) by age ten, when there is still a chance to steer them in a more positive direction. Even as teenagers, strong group programs have had some success at changing their behavior. For young adults, there are reports of some institutional programs, such as prison programs, that have had some limited success with strict point systems based on earning privileges for positive behavior and receiving positive support. Some individual therapists recently report progress with a relatively new approach called Moral Reconation therapy, which teaches the benefits to them of using more moral behavior. But the results are questionable.
Testing the Potential for Change
As was said above, those with each of these personality patterns may be more or less dysfunctional. It’s a continuum. Some are so dysfunctional that they can’t work and don’t have any stable relationships in their lives. Others may be highly successful in some areas of their work and have a few stable relationships, although they may not be satisfying and instead may be filled with frequent conflict.
With this in mind, it’s worth it to try to coerce the individual into some program of behavior change or counseling. There are those who will improve their behavior, even if its just enough to keep a job or to stay connected to their children. It’s not clear in advance whether someone has the ability to change until they participate in an ongoing program of change. A single session with a therapist, or a promise to change, or a manager’s or judge’s lecture, or one major insight, is usually not enough to teach someone to practice a new behavior. However, the less dysfunctional the person, the better chance that they may make some efforts at behavior change, and it may be easier for them to succeed.
Teaching New Ways
One test is to see whether they can learn new ways of dealing with their stress, their negative thinking and their extreme behavior in a short-term structure. To this end, High Conflict Institute has developed two short-term programs which teach simple skills to take the edge off of high-conflict behavior:
New Ways for Families®for separation or divorce. This method teaches four big skills (flexible thinking, managed emotions, moderate behavior, and checking yourself—rather than blaming others) to both parents, who then each teach the skills to their children. In the full counseling model of this method, each parent has six individual sessions with a separate counselor and a workbook with exercises, followed by three parent-child sessions each. The parents never have to be together, so that they can focus on learning and practicing the skills. There is also a 6-12 session online version of this method, which judges have reported has changed the level of conflict to one that is much more manageable if they see them back in court. The majority of these families become able to work out their issues out of court after learning the four big skills.
New Ways for Work®is a coaching method for employees or managers who need to work on their behavior in a conflict, otherwise they may be at risk of losing their position or their whole job. This coaching method also uses a workbook to teach the same four big skills (flexible thinking, managed emotions, moderate behavior, and checking yourself—rather than blaming others), but with workplace scenarios and exercises. It can involve as few as three individual sessions with an Employee Assistance Professional, or it can go up to eight or more sessions with a trained outside therapist. Then, after the coaching, decisions can be more realistically made about the employee’s future: stay put, change positions, or leave the organization, by seeing how much change has occurred.
The Social Environment
Making behavior change and sustaining behavior change take an environment that supports it, rather than one that values the old negative behaviors instead. This is similar to the struggles of those in recovery from drugs or alcohol. If they are married to an addict, or work with a group of actively-using addicts, or live in a neighborhood that reinforces addictive behavior, it is much harder to change and relapse is very common.
Likewise, for those who are trying to change their personality-based behavior, the problem is even harder. It only takes one “negative advocate” to reinforce their old way of blaming and treating people negatively. Therefore, the family environment, the workplace environment and the community environment will be a significant factor in whether an HCP can change their blaming and extreme behavior. Exposure to today’s media culture of blame (high-conflict celebrities and politicians in drama programs and the news from around the world) may be too much for some HCPs, so that they will simply imitate what they see. This makes it much harder for people to change.
Yet by changing family dynamics, by changing work groups, and sometimes by moving out of the neighborhood, some HCPs have been able to change their behavior and to take more responsibility for making their lives work.
Changing personality-based behavior is hard for anyone. For those with high-conflict personalities and traits of personality disorders, it can be almost impossible. However, some people are having success at making their lives happier and more successful by learning good social skills. In most cases, it’s worth a try to see if some high-conflict behaviors can change. But it’s better to do it sooner rather than later, so that these negative behaviors don’t spread to others in the family, workplace, or legal environment. Hopefully, this knowledge will help people make more realistic decisions.
BILL EDDY, LCSW, ESQ. is the co-founder and Chief Innovation Officer of the High Conflict Institute in San Diego, California. He pioneered the High Conflict Personality Theory (HCP) and is viewed globally as the leading expert on managing disputes involving people with high conflict personalities. He has written more than twenty books on the topic and has taught professionals in the U.S. and more than ten countries.