Can High-Conflict People Change?

  Can High Conflict People Change?   ©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 change, 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 that 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 that 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.   Borderline HCPs 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 have the 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.   Narcissistic HCPs 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