In most cases, psychotherapy is the treatment of choice for HCP, whether in an individual or group setting. Since HCP Clients have been helped by both psychodynamic and cognitive-behavioral treatment modalities, therapists have several tools at their disposal. One, in particular, dialectical behavioral therapy (DBT), a method of psychotherapy originally developed to treat Borderline Personality Disorder, has been effective for Clients with HCP, as the two disorders have many characteristics in common. While medication may not be the treatment of first resort, it can be appropriate for some Clients, especially for those who may be suffering from other psychological issues, especially mood disorders, in addition to HCP.
High-conflict personalities are fundamentally adversarial personalities. They don’t see their part in their own problems and instead are preoccupied with blaming others—possibly you. In this blog series, I offer many tips for dealing with high-conflict people (HCPs). Today, I describe the basic features of 5 types of high-conflict personalities, so that you can be aware of them, in order to avoid them or deal with them more effectively.
They all have the basic HCP pattern of:
1) Targets of Blame,
2) a lot of all-or-nothing thinking,
3) unmanaged emotions and
4) extreme behaviors.
In addition, they also have traits of 5 personality disorders. Some may just have traits and others have a full disorder. This can make them very difficult, but also more predictable. Here is a very brief overview of some of their common patterns of behavior:
1. Antisocial HCPs: These are also known as sociopaths or psychopaths—aggressive people without a conscience. Antisocial personalities can be extremely charming and deceptive, combined with being extremely cruel to get what they want. Antisocial HCPs blame their Targets for causing their many frustrations, interfering with their schemes or simply because they got in the way. They are con artists, often involved in criminal schemes and loyal to no one—not even each other. (This does not include people who just “don’t feel social” this weekend.)
They punish their Targets in relationships and then expect sex and affection even after hurting them. They seem to be more biologically energized to harm people without remorse. For example, the Texas shooter in yesterday’s mass church shooting was reportedly angry at his estranged wife’s parents, and so went to kill everyone at the church they attended. Would he fit here?
2. Narcissistic HCPs: Most people are familiar with the self-absorption of narcissistic personalities, but narcissistic HCPs focus intensely on their Targets of Blame. They are constantly putting them down, often in public, in an effort to prove they are superior beings. They use a lot of insults with their partners, yet at the same time they demand admiration and affection. They claim their behavior is justified because others treat them so unfairly. Yet they have no real empathy for their Targets of Blame or anyone else. In the workplace, they are known for “kicking down” (on those below them) and “kissing up” (to those above them), so that management won’t realize how bad they really are. Bullying and sexual harassment may fit right into their drive for power and superiority.
3. Borderline HCPs: They are preoccupied with their close relationships and cling to them. However, sooner or later they will treat their partners, children, parents, co-workers, bosses, and others as Targets of Blame for any perceived abandonment. Their rages can be quite dangerous: physically, emotionally, legally, financially, reputationally or otherwise. Yet their moods swing both ways, so you may feel whip-sawed by how quickly they go from friendly to rage to friendly again (and then rage again).
As a therapist and lawyer, I have seen many borderline HCPs fighting for custody in family court against their Targets of Blame with extreme behavior including domestic violence, child alienation and/or false allegations. They are both men and women, driven to cling to their children (and each other) to avoid feelings of abandonment.
4. Paranoid HCPs: They can be suspicious of everyone around them, and believe there are conspiracies to block their careers at work, their friendships and their family relationships. They can carry grudges for years, and then punish their Targets of Blame. Paranoid HCPs may believe that those around them are about to harm them, so they may pre-emptively attack their Targets. They easily feel treated unjustly and in the workplace, some experts say “the majority of lawsuits are filed by this type of coworker.” (Cavaiola & Lavender, 2000)
5. Histrionic HCPs: This personality is most often associated with drama and endless emotional stories. Yet histrionic HCPs often accuse their Targets of Blame of exaggerated or fabricated behavior, to hurt them or to manipulate them. They assume relationships are deeper than they are so that they are constantly feeling surprised and hurt by how others react to them. They demand to be the center of attention and attack their Targets of Blame when they are not. They often involve others in their many complaints, which can lead to public accusations and humiliation for their Targets of Blame.
Overview: None of these HCP personality patterns have anything to do with intelligence, as they range from super smart to not very smart at all, like the rest of the population. There are some personality disorders in every occupation, geographic region (although slightly more in urban areas) and income group (although lower income has slightly more, the higher income ones can attract more attention).
It’s important to note that many people with personality disorders are not HCPs, which means that they do not have Targets of Blame who they attack or purposely injure. But if you see someone with a high-conflict personality, the fact that they also have traits of a personality disorder means that they are unlikely to have insight into their own behavior and unlikely to change. This means that you should be careful to avoid the mistakes I mentioned in my last blog. You also may want to consider using the methods I describe in the coming weeks.
A psychiatrist explains its relationship to depression.
When I was first diagnosed with borderline personality disorder I felt validated ..