January 2018 - Personality disorders need not be the death knell for a relationship

It is possible for someone with a personality disorder to be functioning well and managing their disorder appropriately

Tuesday, January 2 2018

Relationships, even those that seem utterly blissful, can, at times, take their toll on one or both partners. But should you discover that your partner suffers from a personality disorder, it may well impact the relationship negatively, even possibly leading to a complete and final break-up.

This need not be case, stresses Megan Hosking, Psychiatric Intake Clinician at Akeso Clinics.  “It is possible for someone with a personality disorder to be functioning well and managing their disorder appropriately, which means the possible negative impact would be far less, if any. In fact, breaking up with someone because they have a mental disorder is not necessary, however, it is important to look at the bigger picture and the effect their illness has on both or one of the partners, particularly if it’s not sufficiently understood or managed,” she explains.

She adds that there are many factors that need to be considered when choosing whether to remain in such a relationship - or to end it.

Managing conflict, support

  • “First and foremost it would be important to understand what personality disorders are, as well as their symptoms and signs.
  • It would also be important to know more about the treatment they are going through, any medication they’re on and the places to reach out to, should they need additional help.
  • Being aware of possible signs of relapse would be important to know too.”

According to Hosking, as with any relationship, the potential for conflict exists but may be more prevalent with a partner with a personality disorder. “Managing conflict effectively is far better than trying to avoid it; this should preferably be done in a safe environment using statements such as ‘I feel’ rather than pointing fingers with a ‘You are…’ (which is then followed by a negative labelling word).

“You can, for instance, support your partner through finding out how they are doing or feeling, how their treatment is going and also finding out what they may need from you in the relationship too. Support can vary, so it’s best to have an open and honest discussion with your partner about the expectations in your relationship and your active role in their ongoing recovery. This could include support groups or sessions, or participating in mindfulness exercises together,” Hosking explains.

Understand your own wellbeing
On the other hand, not only your partner’s, but your own mental health and wellbeing will also need to be understood well by yourself, as should your understanding of your own emotions and responses, Hosking advises.  “If you find that the relationship is wearing you down, or you feel tired and drained from it, or you feel anxious and worried, these could all be signs that the relationship is not beneficial to you and may be causing unnecessary stress in your life.”

In his book “The Seven Principles for Making Marriage Work” (Orion, 1999), Dr John Gottman, clinical psychologist and relationship researcher affiliated to the University of Wisconsin in the USA, identifies “the four horsemen of the apocalypse” or factors of doom in relationships:

  • Contempt
  • Criticism
  • Sarcasm
  • Stonewalling

Over the past four decades, Gottman has studied thousands of couples in a quest to figure out what goes wrong in relationships, and, conversely, what makes relationships work. Based on his observations of how couples interact with each other, he can tell within a minute whether or not a relationship will survive, Sandy Lewis, Head of Therapeutic Services at Akeso Clinics points out. She says: “Irrespective of whether or not there is a diagnosable personality disorder within one or both of the partners in a relationship, when the relationship style is characterised more often than not by any of the above factors, then the relationship has an extremely poor chance of survival without intensive intervention and a 100% commitment and willingness to change behaviour.”

Another researcher in the field of relationships, Dr Brene Brown of the University of Houston, in her book “Daring Greatly - How the Courage to be Vulnerable Transforms the Way we Live, Love, Parent and Lead” (Penguin Life, 2012) says that the death knell for any relationship is the point at which one or both partners “disconnect and disengage”, adds Lewis.
“This usually happens long before any other symptoms of disquiet or dysfunction emerge. The reasons for disconnection, according to Brown, are associated with shame. She defines shame as ‘the intensely painful feeling or experience of believing that we are flawed and therefore unworthy of love and belonging’ (page 69). For people who might be described as personality disordered, the early psychological underpinnings are almost always a deep self-hatred arising from both biology and adverse early circumstances. One can say with some certainty that it is impossible to build a lasting and satisfying relationship with someone who is not capable of self-love,” Lewis stresses.

Negative effect
Indeed, one partner’s personality disorder can profoundly affect the other’s mental wellbeing in a negative way, says Lewis. “Where both partners are psychologically compromised, there is little possibility of a happy outcome - usually the spiral of suffering simply becomes increasingly vicious.”
Hosking reiterates: “In order to prevent such a situation, it is best to discuss your partner’s wishes for your involvement in their treatment directly with him/her. Couples sessions on occasion could be helpful in having a third party assist and facilitate tough discussions.”

Support vs co-dependence
While support is important, “it must be borne in mind that there is a difference between support and co-dependence. This needs to be explored as the latter can lead to an unhealthy relationship,” Lewis points out.

“Co-dependence can be defined as ‘an emotional and behavioural condition that affects an individual's ability to have a healthy, mutually satisfying relationship. It is also known as ‘relationship addiction’ because people with co-dependency often form or maintain relationships that are one-sided, emotionally destructive and/or abusive’.” (

In view of the issues raised above, Lewis recommends the following to make the most of a relationship:

  • To take care of your health and to seek help if you think any aspect of your health is less than optimal (physical, psychological, spiritual).
  • To build a life for yourself that is full and satisfying separate from any other person so that you can maintain your identity and find value day to day irrespective of your relationship status.
  • To work continuously on loving and taking care of yourself - this is a daily practice.
  • To be in a relationship where the positive interactions outweigh the negative ones in a ratio of 5:1 (John Gottman).
  • To know your partner’s love language (as described by Dr Gary Chapman) or their love map (as described by Dr John Gottman) and use these to enhance fondness and admiration.
  • To turn towards each other rather than away - be vulnerable, but don’t disconnect from each other (Dr Brene Brown).
  • To solve the problems that can be solved.
  • To create shared values and meaning in the relationship.
  • To let your partner influence you - don’t get stuck in a gridlocked power struggle for who prevails.
  • Above all, be kind!


  • Reference Dr John Gottman “The Seven Principles for Making Marriage Work”, Orion, 1999
  • Dr Brene Brown of the University of Houston, in her book “Daring Greatly - How the Courage to be Vulnerable Transforms the Way we Live, Love, Parent and Lead” (Penguin Life, 2012

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