Domestic Violence and Personality Disorders: What’s the Connection?

Domestic Violence and Personality Disorders: What’s the Connection?

 

© 2024 by Bill Eddy, LCSW, Esq.

When I first had clients who were victim/survivors of domestic violence, I was a therapist in the 1980s (Licensed Clinical Social Worker). In my training I was taught about personality disorders and it seemed to me that this might help explain domestic violence (DV). But I was told at the time that there were no mental disorders associated with DV. When I became a family lawyer in the 1990s, I was again told that there was no connection with mental disorders that explained DV.

This frustrated me, because I believed that understanding personality disorders would help in dealing with domestic violence (also known as intimate partner violence or IPV) in at least four areas:

  1. Helping dating partners be more careful in relationship choices.
  2. Helping legal professionals understand what is really happening in their DV/IPV cases.
  3. Helping family courts understand how to better manage these cases.
  4. Helping treatment professionals provide appropriate treatment for abusers.

Fortunately, by the 2000s, when I began to teach therapists, lawyers, mediators, and judges about “high conflict” personalities, there was interest in the connection of personality disorders to DV/IPV. Since then, researchers have specifically examined this connection and concluded that some personality disorders are predictors of DV/IPV. This article addresses the significance of this connection for professionals and the general public.

Personality Disorders in General

The manual for mental health professionals (known as the DSM-5-TR) indicates that approximately 10% of adults have a personality disorder, of which there are ten identified. Personality disorders are basically defined as an “enduring pattern” of dysfunctional interpersonal behavior which often includes impulse control problems; a distortion of perceptions of oneself, others, and events; and inappropriate emotional responses. (APA, 2022, 734) Does this fit anyone’s behavior that you know? This certainly occurs in many DV/IPV cases. The key phrase to understand here is enduring pattern. In other words, when someone has a personality disorder, much of their behavior comes from their own automatic pattern of thinking, feeling, and acting rather than as a response to the other person’s behavior or other external events. With a personality disorder, they will continue to think/feel/act in this same narrow way for a long time or always.

People frequently say, “Why did he do that?” The answer is often because of his internal process, not because of what the other person said or did. I hear professionals sometimes saying, “What did you do or say to your husband/wife to make him/her so angry with you?” When a personality disorder is involved, the target of the abuse may have done nothing inappropriate or something minor, yet the person with the disorder is outraged and violent (or controlling in other ways) because of their internal misperceptions.

A meta-analysis of 163 studies looked at the relationship of intimate partner violence to ten personality disorders in the manual of mental disorders and came to this conclusion: “It is clear that disordered personality plays a significant role in IPV perpetration and victimization.” (Collison and Lynam, 2021, 4) While the meta-analysis said that all ten personality disorders had an above average involvement with IPV, some had more than others, especially borderline personality disorder (BPD) and antisocial personality disorder (ASPD).

Borderline and Antisocial Personality Disorders

“With respect to the relation between PDs and aggression, a systematic review examining the relationship between PDs and violent behavior found ASPD and BPD diagnoses to be predictive of violence.” (Collison and Lynam, 2021, 1) However, the researchers cautioned that a significant percentage, possibly the majority, seem not to be violent. “Not everyone who carries an ASPD or BPD diagnosis is necessarily violent.”

In explaining why perpetrators with BPD were “more likely to commit seriously violent and aggressive acts of IPV,” they found that their “emotional processing biases (such as interpreting a partner’s ambiguous facial expression in an overly negative manner), anxious attachment, and interactional alcohol and drug use served to increase risk of both severity and frequency of IPV perpetration.” (Collison and Lynam, 2021, 3-4)

The meta-analysis also said, “the strongest effect was found for ASPD.” (Collison and Lynam, 2021, 7) While this study didn’t give specific reasons ASPD was the most likely to commit IPV, the DSM-5-TR points out: “Individuals with antisocial personality disorder tend to be irritable and aggressive and may repeatedly get into physical fights or commit acts of physical assault (including spousal beating or child beating)…. These individuals also display a reckless disregard for the safety of themselves or others.” (APA, 2022, 749)

Relationship Choices

In 2017, I co-authored a book titled Dating Radar with my colleague, Megan Hunter, Co-Founder and CEO of High Conflict Institute. In it we pointed out that people with “high conflict” personalities may have one or more personality disorders or traits that make them a higher risk for relationship conflict and possibly violence. We did an online survey and received over three hundred responses which emphasized certain dating characteristics which turned into violence or other negative behavior. Here are some key warning signs:

High conflict behavior patterns that include: a preoccupation with blaming others, a lot of all-or-nothing thinking, unmanaged emotions, and extreme behaviors. For example, if they slap their partner and say it was nothing, that could be a warning sign of a future “enduring pattern” of extreme behavior.

Extreme charm. People with borderline and antisocial (and narcissistic) personalities can be extremely charming at the start. As one person told us, don’t look for a 10 on a scale of 1-10, because that creates a risk of finding someone pretending to be perfect. Instead, look for someone who is a 7 or 8 on a scale of 10, who is a more realistic person with flaws, but which are not hidden and manageable. These personalities can be very charming for a while, but then if there is going to be abuse it usually starts within 6 to 12 months. That’s why we recommend getting to know the person for at least a year before making a big commitment like getting married, having a baby, or buying a house together.

We address additional warning signs in the book for those who are interested. Remember, these are enduring patterns of behavior, so there usually are warning signs but many people ignore them or believe they can change the person. If the person has a personality disorder, that is extremely unlikely.

Professional Awareness

In general, family law professionals (therapists, lawyers, mediators, judges) are not very aware of the connection between DV/IPV and personality disorders. For this reason, they tend to play down the seriousness of DV/IPV and assume it will go away or they tend to blame the victim for being an equal partner in causing the violence. In court cases, they are often mistakenly identified as “high conflict families,” implying that the problematic behavior includes both parties. This family perspective has been a tradition in family courts since no-fault divorce was adopted in the 1970s and family counselors and mediators became involved in developing parenting plans in the 1980s. While the “family systems” approach of equal contributions to family problems has value in a majority of separation and divorce cases, it is often mis-applied when looking at patterns of DV/IPV with one partner engaged in abusive and possibly criminal behavior. Yet they can look the same on the surface, so they require closer examination and no assumptions.

In 2020-2021, I led an interview project that developed 6 one-hour videos titled Conversations About Domestic Violence in Family Court Cases with 16 Experts. (Available at: https://www.highconflicttraining.com/offers/6NACqB2m/checkout) One of the key points they made was that all professionals should ask their clients about a possible history of domestic violence. Victim/survivors rarely volunteer that they are being abused by their partner, either out of fear or out of ignorance of what behaviors are domestic violence. Without asking specific questions, clients may make a general statement that they are not being abused, when in fact they are.  

An additional problem is confusing different types of DV/IPV. Since around 2008, many family law professionals have received some exposure to or training in recognizing four different types of DV/IPV, as described in a land-mark article in the Family Court Review of the Association of Family and Conciliation Courts (AFCC) which continues to be the standard framework today and is briefly summarized here. (Kelly and Johnson, 2008, 476-499)

Coercive controlling violence: This is what most people think of as domestic violence with bruises, possibly broken bones, calls to police, and the victim living in fear even when there is no regular violence. Coercive control can mean blocking contact with friends and relatives, controlling money, sexual abuse, blocking getting healthcare, controlling what the victim eats and how much they weigh, etc. “Research on dangerousness and lethality has established that for violent male partners control issues are an important predictor of continued or increased violence.” (Kelly and Johnson, 2008, 483) It doesn’t just fade away because this is a pattern of behavior that is usually engaged in by those with personality disorders with an enduring pattern of behavior, such as borderline and antisocial.

Situational couple violence: This occurs when both partners may engage in pushing and shoving and other such violence when there is a lack of conflict resolution skills. Usually this does not involve a coercive controlling pattern, neither partner lives in fear of the other, and injuries may be minimal if any. This does not usually involve people with personality disorders. Learning basic conflict resolution skills or anger management skills can usually stop this behavior.  

Separation-instigated violence: Usually there is no history of violence between the partners, but at the time of separation there may be one or two incidents because of the emotions of the separation. Once they are apart, there usually are no further incidents.

Violent resistance: This occurs when a victim of coercive controlling violence fights back violently against their perpetrator. This is often spontaneous and may lead to serious injury for the victim, but sometimes ends up in death of the perpetrator. This is often referred to as the “battered spouse” syndrome, but that is generally not an accepted defense when a victim injures or kills their perpetrator.

Family Courts

Family courts have become increasingly involved in providing restraining orders (also known as orders of protection) and making court-ordered parenting plans related to domestic violence. However, because of the “he-said/she-said” nature of family courts and lack of experience by many family court judges, lawyers, and other professionals, these cases often shed more heat than light on what is really going on. By understanding personality disorders and the dynamics of DV/IPV, it would help courts make more informed decisions.

For example, if a judge doesn’t understand coercive controlling violence and personality disorders, he might deny a restraining order, which is exactly what occurred in the following case. The victim said she was in fear for her life because of ten years of prior violence and multiple death threats. But then she recently let her abusive former partner ride in the car with her to the grocery store to buy food for the children with his food stamps. The judge looked narrowly at her apparent lack of fear in that incident and denied the restraining order.

The court of appeal reversed this decision, saying: “All women exposed to violence and abuse in their intimate relationships do not respond similarly, contradicting the mistaken assumption that there exists a singular ‘battered woman profile.’” The court of appeal said the judge needed to reconsider the “totality of the circumstances.” (Vinson v. Kinsey, 93 Cal. App. 5th 1166, 1176 and 1180)    

It helps to understand that someone this controlling and aggressive for over a decade is likely to have a personality disorder and remain a threat for years to come—even if there were moments when the potential victim was around the perpetrator to feed her children. They need to look at the pattern.

Treatment for Abusers

When those who engage in DV/IPV have personality disorders, legal professionals and mental health professionals need to understand that behavior change may be rare or not at all. Therefore, when personality disorders are involved, the most effective treatment is long-term. Short-term anger management programs are ineffective for them. The option that I have seen have the most success is a 52-week group therapy treatment program designed for perpetrators of DV/IPV.

One of the experts we interviewed for our 6 one-hour videos on domestic violence (see above) runs such group programs and said that about 70% of those men who participate improve their behavior. This appears to include many of those with personality disorders, including BPD. The remaining 30% appear to include psychopaths (a subgroup of those with ASPD who are particularly aggressive) who are therefore stuck in their behavior with no change even after all these weeks of treatment. They need restraints and consequences, which in some cases means jail or prison for their actions to protect their victims and society.

Conclusion

Throughout this article, I have shown some key characteristics of personality disorders that contribute to domestic violence and cause them to be resistant to change. They have an enduring pattern of behavior, therefore lectures by professionals and tolerance by ordinary people will have little or no impact on them. They are aggressive because of their personalities and lack the ordinary self-controls that helps most partners not engage in abusive behavior. They are preoccupied with blame, not because of what their partner says or does, but because it is a strong part of their personalities and distorted perceptions. They lack impulse control, but some may be able to learn it in a long-term program, such as a 52-week treatment group.

Understanding the connection between DV/IPV and personality disorders helps us make more sense of this problem and how to be more effective in solving it, individually and professionally.

References

American Psychiatric Association (APA): Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2022, 734. (DSM-5-TR)

Collison, Katherine L. and Donald R. Lynam, “Personality Disorders as Predictors of Intimate Partner Violence: A Meta-analysis,” Clinical Psychology Review 88 (2021): 1–2.

Eddy, B. and Megan Hunter, Dating Radar: Why Your Brain Says YES to “THE ONE” Who Will Make Your Life HELL. (Scottsdale, AZ: Unhooked Books, 2017).

Kelly, Joan B. and Michael P. Johnson, “Differentiation Among Types of Intimate Partner Violence: Research Update and Implications for Interventions,” Family Court Review, Vol. 46, No. 3, July 2008, 476-499.

 

Bill Eddy headshotBILL EDDY, LCSW, Esq. is a family lawyer, therapist, mediator, and the Co-founder and Chief Innovation Officer of the High Conflict Institute based in San Diego, California. He is a family lawyer, family therapist, and family mediator. He trains professionals worldwide about high conflict personalities and situations, presenting in over 35 states and 13 countries. He is the author of twenty books and manuals, including High Conflict People in Legal Disputes; Splitting: Protecting Yourself While Divorcing Someone with Borderline or Narcissistic Personality Disorder; and BIFF for Lawyers and Law Offices. He writes a blog for PsychologyToday.com with over 6 million views. He is on the Advisory Board of the Divorce Coalition. His website is www.HighConflictInstitute.com.   

His newest book is Our New World of Adult Bullies: How to Spot Them – How to Stop Them, which will be released on June 11, 2024, and includes several domestic violence examples. It can be ordered at any time on Amazon.

Share This Post

Recommended Articles

Lorem ipsum dolor sit amet, consetetur sadipscing elitr, sed diam nonumy eirmod tempor invidunt ut labore et dolore magna aliquyam erat, sed diam voluptua.