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: Helping dating partners be more careful in relationship choices. Helping legal professionals understand what is really happening in their DV/IPV cases. Helping family courts understand how to better manage these cases. 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

Calgary Judges Discuss New Ways for Families®

© 2013 By Bill Eddy, LCSW, Esq. On June 6, I met with 14 judges in Calgary, Alberta, Canada (before all the rain and flooding!), to discuss the status and procedures of the New Ways for Families program in Calgary. This program has been funded for 3 years by a Ministry of Justice grant (under their “Safe Communities Initiative”) by the Province of Alberta. The two goals are to reduce the number of high conflict court hearings regarding parenting matters and to reduce conflict in the community – ideally, reducing divorce conflict that often spills over. The grant has been managed by the YWCA of Calgary, with Allan Rosales as the Program Coordinator. I was accompanied to this presentation by Allan and also by Cassidy Sheehan, New Ways for Families Program Coordinator in Medicine Hat, Alberta, Canada. They presented some information about the 120 families who have been involved in their combined programs over the past 1 ½ years. Hopefully, early next year we will publish full research results about this method. The preliminary results are very encouraging (see blog posted June 20). The judges raised several important concerns. One was whether it was desirable to order families into the New Ways skills building method if there has been serious child abuse. For example, in cases of child sexual abuse would it be advisable for the abusing parent to meet in 3 parent-child counseling sessions with the abusing parent. This is a concern I also have had – having dealt with several child sexual abuse cases, as well as false allegations cases, as a social worker and family law attorney.  I explained two approaches: One is that some of these families are inappropriate for the New Ways program, as there will always be a few families that should be excluded. But the second approach I suggested is that in some cases it is appropriate for a parent and child to meet together with a counselor to supervise them and structure the conversation. There may always be supervised access/visitation for such a parent and child. The benefit of them having contact is that children in these situations create fantasies of what the abusive parent thinks and the power that person has over them. By having direct contact under the counselor’s supervision, the child can raise issues at his or her own pace, and the parent can respond to them – with the intervention of the counselor when necessary.  Also, it’s not uncommon for sexually abused children to have individual therapy after court decisions have been made, which may at times include an abusive parent. In short, it depends on the case. Also, we discussed how New Ways is structured for cases involving domestic violence.  This program does not in any way prevent the court from issuing Restraining Orders at the start of a case and supervised access/visitation, when necessary. At no point do the parents need to have any direct contact. With six individual counseling sessions and three parent-child counseling sessions each, they are never together unless both parents choose to have a joint session at the end. In many D.V. cases, the parents are unlikely to have direct future contact, but focusing on their individual roles and time as parents can be very helpful for the children. In reality, children almost always have contact with a parent who has engaged in domestic violence. The question is whether the contact will be supervised, limited in terms of time or other restrictions. But given the reality that there will be contact, New Ways focuses on teaching both parents the four skills to help their kids throughout their lives: flexible thinking, managed emotions, moderate behaviors and checking themselves. Several of the judges said that they really liked the purpose and structure of the program, and we hope that all of the judges will order more cases into it now that we have explained it further. It is up to each judge to decide in each case. However, we suggested that they order New Ways for Families for any case which has an application by a parent for court orders restricting the other parent. Right from the start, they can contain the case by ordering both parents to learn the skills provided in this short-term program. After all, it’s designed to help the children regardless of the personal issues of one or both parents. Children of high conflict divorce really need all the help they can get! We think New Ways helps provide that. The cases over the next year in Calgary will help us study its effectiveness. I enjoyed speaking with these judges and I really respect the difficulty of the job they have. (I also hope they can bail out of the flooding of Calgary soon, including their court buildings, which had to be closed last week!) Bill Eddy is a lawyer, therapist, and mediator. He is the co-founder and Training Director of the High Conflict Institute, a training and consultation firm that trains professionals to deal with high conflict people and situations. He is the author of several books and methods for handling high conflict personalities and high conflict disputes with the most difficult people.

Ottawa Addresses Divorce and Family Violence

© 2013 By Bill Eddy, LCSW, Esq. This week, on May 13 and 14, I presented a 2-day training on managing high conflict personalities in divorce and family violence to over 75 social workers, therapists, lawyers and mediators in Ottawa. It was a very experienced group, and we had several good discussions of the overlap of divorce and violence. I emphasized my belief that people who engage in ongoing spousal abuse and/or child abuse have personality disorders, especially borderline personality disorder, narcissistic personality disorder and antisocial personality disorder. Of course, this has been controversial in the past, as some abuse professionals have said for years that there is no mental disorder associated with domestic violence and child abuse. However, I believe that we are seeing research now that explains that “coercive controlling violence” may be associated with personality disorders, although lesser forms of family violence may not involve personality disorders, such as “situational couple violence” (in which both partners engage in pushing and shoving when they have conflicts) and “separation instigated violence” (1-2 incidents which occur at the time of separation, but there is no prior history of violence in the relationship). Any of these types of “intimate partner violence” may be involved in a divorce. Understanding the difference between cases involving personality disorders and those that don’t is important. When a case of domestic violence involves a personality disorder for the “perpetrator” or “dangerous person,” then verbal directives from a judge or other professionals will have no impact. Long-term change is needed, which takes long-term practice of new behaviors, such as managing impulsive behavior, changing how one thinks in conflict situations and managing one’s own emotions (and not blaming them on the victim or other people). Batterers’ treatment groups have been shown to make a difference in 26 weeks or 52 weeks, precisely because they address long-term change with lots of practice changing thinking, emotion management and restraining one’s own impulsive behavior. On the other hand, those who don’t have personality disorders and who may be involved in situation couple violence or separation instigated violence generally don’t need such intensive programs and may instead need conflict resolution skills and restraining orders to stay away from the other partner. Of course, one of the overall lessons of this training was that most partners, even those with personality disorders, appear able to change their behavior with an emphasis on learning small skills in small steps, with lots of repetition and encouragement. What doesn’t work is shame and blame, because it triggers the “defensive brain” which shuts down logical thinking and problem solving, and makes it very unlikely that the person will learn and change. Unfortunately, our adversarial system of dispute resolution (family court) often triggers more defensiveness (and less learning) than out-of-court methods. Since I had two days, I had time to give the family professionals present some practice opportunities for teaching clients skills for managing their own emails (BIFF Responses), making proposals and practicing structured mediation – some of the skills that we teach in the New Ways for Families method and the New Ways for Mediation method. What was interesting about Ottawa is that three family service agencies have been trying out the New Ways for Families method with clients over the past two years, even though the court has not been involved up to now. One evening, about 25 people gathered to discuss their experiences with New Ways and to ask me questions about how it is working in other locations. It was exciting for me to discuss New Ways with counselors with actual experience with the method. I look forward to them communicating more with family courts and showing them that this method can divert a significant portion of their high-conflict court cases if the courts will give it a try. Over lunch on the second day, we also had a presentation by the local Collaborative Practice Ottawa group, which included discussing how this method may be more appropriate than court for many cases in which there are concerns about family violence. The benefit of this collaborative approach is that all team members can help calm the parties and reinforce using positive skills, as compared to family court where the parties are placed in an adversarial structure, which tends to escalate their negative behavior more than it manages it. Overall, it was a great visit to a new city for me! I didn’t realize how beautiful and relatively small and manageable Ottawa is, given that it’s the national capital of Canada. Everyone was very welcoming and they gave me some brief daily tours. Most of all, they showed a very strong commitment to helping children, families, victims and perpetrators to overcome violence and to protect children from future family violence. Bill Eddy is a lawyer, therapist, and mediator. He is the co-founder and Training Director of the High Conflict Institute, a training and consultation firm that trains professionals to deal with high conflict people and situations. He is the author of several books and methods for handling high conflict personalities and high conflict disputes with the most difficult people.