People Perish for Lack of Knowledge


by Charles Montcrief – Times Up! Blog

These words from Hosea 4:6 were originally addressed to a people in a religious context. Taken in a vacuum, these words are applicable in our time — especially when the result of ignorance has tragic consequences.

Read more on the Times Up! Blog

When Getting Beaten by Your Husband is a Pre-Existing Condition


With the White House zeroing in on the insurance-industry practice of discriminating against clients based on pre-existing conditions, administration allies are calling attention to how broadly insurers interpret the term to maximize profits.

It turns out that in eight states, plus the District of Columbia, getting beaten up by your spouse is a pre-existing condition.

Under the cold logic of the insurance industry, it makes perfect sense: If you are in a marriage with someone who has beaten you in the past, you’re more likely to get beaten again than the average person and are therefore more expensive to insure.

Read more at The Huffington Post

Beginning at the Beginning: Personality Formation and Dysfunction

Dr. Thedore Millon, The Pioneer of Personality Science

If Freud was the ‘Father’ of Psychoanalysis, Dr. Theodore Millon is the ‘Grandfather of Personality Theory’. I couldn’t have been more thrilled to interview Freud than I did Dr. Millon (pronounced Milan, like the city)!

Dr. Millon’s biography reads like a clinical and scientific manifesto with his prolific writing of an unusually large number of books and journal articles. His career has not only spanned decades but has changed how the world has come to understand personality and the disorders of it. His contribution to the understanding of personality disorders has earned him the title of one of the ‘Pioneers of Personality Science.’

I wanted to launch the magazine with my talk with Dr. Millon because everything we do at The Institute is related to the issues of personality and personality disorders. So to begin the magazine’s focus on the right foot, it would seem fitting to begin with talking about personality, theory, development, and why this is so important to you–the survivor in a relationship with someone with a personality disorder. This discussion should also be of interest to therapists trying to help a survivor with the aftermath of the relationship. In either case, what has troubled someone enough to seek out The Institute is their relationship with someone else’s personality disorder, pathology, or psychopathy.

But first, a little trot down memory lane for me about Dr. Millon and his importance to me and you!

  • My theory books in graduate school for my course in Personality Development were Dr. Millon’s.
  • My theory books in graduate school in my psychopathology course included Dr. Millon’s and his work was peppered throughout the other course books and personality disordered trainings that I have taken in over 20 years.
  • As a young therapist in a mental health clinic working in only personality disorders, it was HIS testing instruments we used to diagnosis personality disorders.
  • It was his information I used to describe the personality formations that make up personality disorders to my interns.
  • His charts help us distinguish characteristics between the various 10 personality disorders.
  • His ideas on ‘challenges of life’ that personality disordered people face.
  • His references about violence associated with psychopathy that warned us.
  • And his clinical reference books that lined my book shelves and the pathology library associated with our mental health clinic/

For me, there could have been no one else I would rather talk to than the person who has contributed so much to the understanding of personality disorders and what I have devoted my coaching work to. He has helped you as well–any informational help you have received about narcissism, borderlines, anti-socials, and psychopaths has probably stemmed from the work of Dr. Millon.

At 83 years old, his life time of dedication to the exploration of personality disorders has brought it out of the closet of ‘mystery’ and ‘assumptions’ and under the microscope of diagnostics. So on a personal level I thank this man for his contribution to what we know so far.

So what is it that we should discuss about personality disorders? Why is the issue of personality important to you, your future, and your therapist? You can’t deal with what you don’t know—as a survivor or as a therapist and so the first step in this journey associated with personality disorders is the ‘knowing.’ The difficulty about ‘knowing’ personality disorders is that its theories are still being hashed and rehashed (as it should) and what we are left with are some differing views. While Dr. Millon has clearly helped us understand what he calls ‘personology’ and the developmental aspects of the disorders, we still have a long way to go in understanding things such as,

  • Why do these disorders form?
  • What can be done if anything?
  • Who will be affected or even harmed because of them?
  • What societal effect does personality disorders have?
  • What cultural and political effect does personality disorder have on others?
  • What relational damage is done to others?
  • What parenting damage is done through personality disorders?
  • What type of parent, partner or prodigy does a personality disordered person make?
  • What are personality disorders doing to our systems—legal system, social service system, criminal justice system, mental health system?
  • Why are some of the personality disorders more destructive than others?
  • What commonalities do personality disorders share at their core?
  • Is there a common ‘after math of symptoms’ seen in the survivors of the high destructive Cluster B personality disorders?
  • How do survivors heal? What do they need? What do the children need?
  • Who doesn’t understand this and how can we teach them—the general public, the court systems, the mental health systems, social service systems, and child welfare systems?

These are existential type questions that survivor’s live with every day. Now our world is starting to live with these questions and the problems of these unanswered questions as pathology and its tyranny rises in the world around us. As our societal systems are being challenged by pathology and hood-winked by the lack of education it’s the survivors and children who feel the most impact of our ‘not knowing enough’ about these existential questions related to these disorders. The bleed-over is a conned legal system, a blinded child welfare system, an untrained mental health system, a tapped-out social service system, and a burgeoning criminal justice system. Education about these disorders has never been more vital to our own existence than it is today.

Sandra: “Dr. Millon, where are we today in understanding this diverse diagnosis of personality disorders? What is on the horizon, for instance, in psychopathy?”

Dr. Millon: “We are still dealing with the changes that happened to the Diagnostic Statistical Manual III when they changed from a psychopathic personality to what they now call Anti-social personality disorder. There are some flaws there because Anti-social is based on illegal activities and criminality when many of these persons don’t get caught to get labeled criminal so diagnostically would be missed.”

Sandra: “So what is being discussed for the next DSM version that will be coming out?”

Dr. Millon: “From what I gather, they are still discussing expanding Anti-social to include combinations of other personality disorders. Many persons with Anti-social also have other personality disorders associated with it which can make their presentation very different from others.”

Sandra “Such as?”

Dr. Millon: “Combinations of Anti-social + Paranoid, Anti-social+ Avoidant, etc. There could be as many as 10 factors or combinations of the disorder if we look at them in these types of configurations.”

Sandra “How will that help?”

Dr. Millon “It’s a clearer picture of the overlap of the disorders combined together and shows some of the diversity that you can see in the disorder when it’s influenced by other personality disorders.”

Sandra “There is a lot of talk about the genetic transmission of some of these personality disorders. What are your thoughts?”

Dr. Millon: “I think we are still trying to understand this. There are some of the personality disorders that are more strongly genetically transmitted than others for instance psychopathy. But for some of the other personality disorders, it is more socially learned.

Sandra “You mean ‘the nurture’ portion?”

Dr. Millon “Yes, sometimes family influences, and sometimes other types of social influences. It was Koch in 1890 that discussed biological aspects of psychopathy. He called it ‘constitutionally psychopathic.’ Then Birnbaun in 1910 discussed it as a ‘sociopath’ because he felt there were more social influences that caused the disorder than biology.’

Sandra “I am sure you are aware of the brain imaging techniques that are being used now to look at some of the possible biological differences in the brains of psychopaths. Do you think there is something this can teach us?”

Dr. Millon “I think it is some years away from being able to help us. While we can look at some of the biology of it, it doesn’t help us ‘yet’ understand personality apart from biology. This is still in a very primitive stage. What we also need to look at are the cognitive processes and how the brain activity affects personality. We aren’t there yet. It’s a course tool but I do see that it holds promise.”

Sandra “What do you believe about the permanence of personality disorders. Your Institute offers treatment to various types of the disorder. What changes do you see in them?”

Dr. Millon “This is difficult now days with insurance companies giving limited amount of sessions. Personality disorders take a long time to effect some change in their behavior.”

Sandra “But how are they down the road? The partners get very frustrated with their inability to sustain positive changes.”

Dr. Million “Yes, that’s a very good way to describe that. Consistency is difficult for them. It would be most helpful if they could come back several times a year for ‘tune ups’ to remind them what they should be doing. This is where treatment effects are often lost. Of course, some of the lesser personality disorders can have more modest changes than some of the difficult Cluster B’s.”

Sandra “So what are we really doing then? It seems we are offering their partners false hope when they enter therapy and the partner believes that the change will be permanent. They are staying because they believe that.”

Dr. Millon “No doubt that their relationships are heavily impacted by their disorders. They don’t always have good outcomes in their relationships. I understand why their partners are concerned if their treatment will be effective over the long haul.”

Sandra “How do you know it IS effective over the long haul? Do you hear back from your client’s years down the road? Is success merely being able to hold a job? Or is there a quality of life issue, even for the partner that needs to be evaluated?”

Dr. Millon “Some do contact me from time to time. It’s not always easy to be able to tell what is happening in their lives by a quick contact. It would be optimal for them to come back several times a year so we can really gauge what is happening.”

Sandra “You aren’t referring to anti-social, psychopaths, etc. when you are discussing this type of treatment, per se?”

Dr. Million “More with the narcissists, histrionics and borderlines.’

Sandra “Are personality disorders, in essence, attachment disorders?

Dr. Millon “In some ways, many of them lack intimate attachments or the ability to have attachments as we know them. Some of the disorders have low emotionality and constitutionally or biologically experience a sort of a-social emotionality. They don’t connect on the same level which effects their attachments.”

Sandra “This seems to me to be what the partners complain about most—the essence of the attachment is marred. This could lead into a whole other conversation about Attachment Theory, couldn’t it?”

Dr. Millon “Yes, yes indeed. Personality and their disorders clearly affect a wide parameter in interpersonal relationships.”

Much of the rest of our conversation was more clinical in nature about theory and cognitive-behavioral approaches.

What I think we can take away from this conversation with Dr. Millon is how far we have come in understanding some of the disorders over the last few decades yet clearly, there is still much to understand when we consider the overlapping nature of the clustered disorders and how each personality disorder can create an almost layered effect when someone has more than one personality disorder. (According to research, 60% of people who have one personality disorder have more than one personality disorder.) Understanding how multiple types of disorders effect the overall personality presentation (and its effect on others and resulting relational health) is important for survivors and therapists to understand. There remains a lot of debate as to the ‘treatable-ness’ of personality disorder largely related to the complexity of these overlapping symptoms.

Our thanks to Dr. Millon for a life time dedicated to understanding personality and its disorders.

(All articles are copyrighted and cannot be reproduced, however feel free to put a link to this page.)


Theodore Millon, PhD, DSc, is a leading personality and developmental theorist. Dr. Millon was the founding editor of the Journal of Personality Disorders and is past president of the International Society for the Study of Personality Disorders. He has been a full professor at Harvard Medical School and the University of Miami. He is the principal author of many clinical inventories and testing instruments related to personality disorder testing. Dr. Millon has also written or edited more than 30 books and has contributed more than 200 chapters and articles to numerous books and journals in the field. Dr. Millon established the Institute for Advanced Studies in Personology and Psychopathology in Coral Gables, Florida, where he serves as dean. In 2008 he received the “Gold Medal Award for Life Achievement in the Application of Psychology” from the American Psychological Foundation. The award recognizes Dr. Millon’s distinguished career and his enduring contribution to psychology through research and the application of techniques to important practical problems in psychology. You may view Dr. Millon’s vita here:

All content does not necessarily reflect the opinions of The Institute.

Where Brain Biology Begins and Ends

Dr. Kent Kiehl, The Mind Research Lab

Survivors of psychopaths have waited a long time to find out ‘officially’ what they already suspected was true: that there are biological brain differences in psychopaths. The women we interviewed for ‘Women Who Love Psychopaths’ talked specifically about psychopath’s impulse control problems, an incomplete spectrum of emotions, unusual processing of emotional and factual information, surface attachments,  superficial (yet impassioned) relating, and poor response to punishment. Since pathology effects personality which is how a person thinks, feels, relates, and behaves, psychopathy results in exceptional negative effects on all of those pervasive aspects of personality.

These differences in brain function help partners (and us) understand beyond an assumed ‘willful behavior’ theory why biological brain differences drive psychopaths’ behaviors. We already know that brain regions affect and regulate emotions which regulate behavior such as violence. The NIH (National Institute for Health) in 2006 reported a study that an aggression-related gene weakens the brain’s impulse control circuits. In an NIH newsletter they state, “A version of a gene previously linked to impulsive violence appears to weaken brain circuits that regulate impulses, emotional memory and thinking in humans. Brain scans revealed that people with this version — especially males — tended to have relatively smaller emotion-related brain structures, a hyperactive alarm center and under-active impulse control circuitry. The study identifies neural mechanisms by which this gene likely contributes to risk for violent and impulsive behavior through effects on the developing brain…These new findings illustrate the breathtaking power of ‘imaging genomics’ to study the brain’s workings in a way that helps us to understand the circuitry underlying diversity in human temperament said NIH Director Elias A. Zerhouni, M.D… By itself, this gene is likely to contribute only a small amount of risk in interaction with other genetic and psychosocial influences; it won’t ‘make’ people violent explained Meyer-Lindenberg. But by studying its effects in a large sample of normal people, we were able to see how this gene variant biases the brain toward impulsive, aggressive behavior.”

How much more then for a psychopath who is the ultimate in impulsive and aggressive behavior? Whose lack of emotional memory and poor impulse control is likely to = relational harm to those in intimate relationships with them? The issue of biology as a contributing factor of psychopathy has been one of the single most important relational harm educational tools that The Institute has come across. Partners of psychopaths can relate to the obvious brain regulating differences in the psychopaths without having known the source of it. Understanding the degree that brain differences plays in the psychopaths thinking, feeling, relating, and behaving helps partners understand what they are up against in their decisions about their own safety in these relationships. Perhaps this very issue will eventually impact how we gauge lethality risks in domestic violence and help us make better decisions about Batterer Intervention programs.

Dr. Kent Kiehl of The Mind Research Lab is using similar MRI’s that NIH has used in their 2006 studies to specifically study the brain differences in psychopaths. In the audio interview with Dr. Kiehl he addresses what he hopes that MRI’s will provide in understanding psychopath’s behaviors and risks. We talk with him about the details of his MRI research and its relevance to the diagnosis of psychopathy and antisocial personality disorder using such tests as the Psychopathy Checklist and the DSM-IV. He also shares his thoughts on the possible use of MRI scans themselves as a diagnostic tool, and possible methods to screen out psychopaths from certain occupations. While Dr. Kiehl also hopes that MRIs will some day provide insight into ‘treatment options’ for psychopaths, The Institute is slightly less optimistic. However, we do share the optimism of deeper understanding of how pathology affects and increases behavioral harm that ultimately relates in relational harm.

Dr. Kiehl is also using MRI’s to better understand other brain responses in different mental illnesses like
schizophrenia and addictions. We asked him about the potential of one day using these MRI’s to
understand possible brain differences in other personality disorders, especially Cluster B’s in Borderlines
and Narcissists. The Institute believes one day those brain differences may be as evident as they have been
in psychopaths. As we step further into the understanding of brain function on the quality of relational health, we open doors for partner education and treatment approaches for those harmed by pathology.

We think you will find the interview with Dr. Kiehl to be enlightening and fascinating and the link for it is listed below. We also invite you to read the in depth interview with Dr. Kiehl in our Research Section done by The New Yorker. We graciously thank Dr. Kiehl for his interview, his education to the field of psychopathy, and for his profound work.

Listen to the interview with Dr. Kiehl.

You can read more about The Mind Research Network at

All content does not necessarily reflect the opinions of The Institute.

The Wizard of Oz and Other Narcissists

by: Eleanor Payson, ACSW

Interview with Eleanor Payson, Licensed Clinical Social Worker and
author of ‘The Wizard of Oz and other Narcissists.’

(Editor’s note: The Institute has continued to write about and support the idea that many of the people in relationships with narcissists are not necessarily ‘co-dependents.’  That is because we stick strickly to the addiction-based assessment of co-dependency which is the partner or an addict. In this article Eleanor uses the word ‘co-dependent’ we believe, in a slightly different idea to incorporate other emotional and behavioral aspects.)

Interview by Harrison Koehli

1.)    Why did you write your book?

In the eighties and nineties, I was dismayed by the lack of awareness and tools available for clients struggling in relationships with severely narcissistic individuals.  My goal was to create a framework of understanding that would help clients heal and empower themselves in a variety of contexts; as the partner of a narcissist, the adult child of a narcissist, the coworker or client, or the friend of a narcissist.

On a more personal level, I am an adult child survivor (and today I would say “thriver”) of a narcissistic personality disordered (NPD) stepparent.  My own healing work in therapy coincided with entering the field of social work as a chemical dependency treatment professional.  In the eighties I worked with cocaine addicted individuals who were frequently identified as having severe narcissistic traits or full NPD, and I was fortunate to attend seminars and training programs with the experts at that time on narcissism.  All of this eventually led to my passion to write an easy to understand book for codependents or individuals who find themselves in these painful and devastating relationships.

2.)  What is the premise of it?

I believe the premise of my book is the same as my mission for writing it, which is to educate and help individuals extricate themselves from the corrosive dynamics that occur with narcissistic individuals.  The solution to most problems begins with an elevation in consciousness first.  So, I believe that when we begin to recognize and understand the dynamics that occur in these relationships, we can prevent and heal more quickly from the serious repercussions that erode our well being whether it is psychological, emotional, physical, financial, or perhaps even the loss of freedom.  I also address the inevitable dynamics of codependency that develop or worsen when we become involved with a narcissistic individual.  As we become fully conscious, emotionally and intellectually, we can steer a different course through the powerful force field of the narcissist’s personality.

Finally, I attempt to educate the lay public about the continuum of narcissism that can exist and help people to realize that it can take time for the full picture to emerge.  As the codependent deals with her own issues and learns how to insist on more respectful and reciprocal exchange, the questions about the narcissistic individual’s capacity for change will eventually come to light.   Sadly, all too often, as the codependent recovers her authentic self, the narcissistic issues in the other person are revealed to be the full narcissistic personality disorder (or a closely related personality disorder.)  The good news is that the codependent can recover her authentic and whole self and choose a very different life.

3.)  What kind of relationship dynamics do narcissists have in their relationships?

The word “dynamics” that you mention is the key to understanding these confounding relationships.  In healthy relationships, there is a dynamic of mutuality – the shared consideration of giving and receiving.  For example, it might be the consideration of noticing who arrived at a store counter first, or respectfully listening when someone is speaking and waiting one’s turn to share, or having empathy for who might be in need of a little extra support in a given context.  The boundaries between self and other in healthy relationships simply unfold with an implicit understanding of a normal give-and-take.  And typically the average person operates from a foundation of “giving the benefit of the doubt” when dealing with others, meaning a readiness to extend support and empathy to another person.

Unfortunately, as we encounter the narcissistic individual or the NPD person we discover that the implicit boundaries of mutuality are not operating, or perhaps I should say, they are only superficially operating.  The personality presentation of the narcissist invariably has an intensity or potency that initially causes us to suspend our disbelief and turn off our critical faculties that allow us to notice distortions and inconsistencies.  Intensity of presentation (either overt or covert) taps directly into the vulnerability of the codependent’s unconscious need to idealize others as a way of compensating for feelings of inadequacy and low self-worth.  In short, the narcissist literally induces others into a trance and feeds on the stolen narcissistic supplies that inherently belong to both.  Eventually, we encounter a host of painful dynamics from the narcissist’s unconscious mindset that places self as superior to other, self in competition with other and in a nutshell – self against other.

Although this mindset is a defense against a more deeply held sense of inadequacy, the narcissist’s entitlement feelings have a mighty strength of will behind them.  This tenacious iron will is due to the identification with a grandiose self – some larger than life identity (even when covert as in the identity of a minister and, therefore, more difficult to observe.)  All of this sets the stage for the narcissist’s desperate need to dominate the mental and emotional resources (narcissistic supplies) of attention, empathy, consideration, admiration and support in his/her relationships.  The exploitation of the narcissistic supplies is one reason that the codependent becomes so depleted.  In addition to depriving others of affirming and empathic behaviors, the narcissist also plays out the defense of projection – seeing his/her unwanted negative traits in others and communicates subtly or openly an endless array of devaluing messages.  Finally, as the narcissist achieves greater degrees of dominance in a given relationship, he or she can “rewrite the program,” so to speak, over the identity of the other person.  In the end, the narcissist exploits others for the additional privileges of status, money, power, and even the ability to take away the freedom of others.

4.)  What kind of problems do your clients have in their relationships with narcissists?

To be on the receiving end of the dynamics just described is to slowly and continuously lose a sense of one’s core identity or core self.  As we discussed earlier, narcissistic individuals often are drawn to individuals whose vulnerabilities are typically described as codependent.  For those not familiar with the term, codependency is an overall tendency to compensate for low self-esteem by pleasing and gaining approval from others.  Individuals with codependency issues are typically overly attuned to the feelings and needs of others at the cost of knowing and asserting their own.  Problems with depression, anxiety, low self-esteem, and neuroses of all kinds are included in the array of issues that these clients might have.  There is also a tendency to idealize others and invest trust too easily.  Invariably the codependent individual suffers from abandonment fears, attachment hunger and a subsequent confusion and inability to recognize his or her inherent rights as a person.  The good news from my perspective is that codependents more commonly fall into the neurotic level of mental disturbances, and consequently have much greater capacity for insight and motivation for change.   Therefore, the picture is really very optimistic, and it is endlessly rewarding to work with codependents as they blossom and reclaim their lives.

5.)  What if any treatment do you see possible for personality disorders – do you encourage couples counseling or for partners to wait it out while the narcissist is in treatment?

I hope you will bear with me as I attempt to answer the various aspects of your question.
Part of the problem with recommending treatment options for individuals presenting with narcissistic issues is that it is often not clear initially what level of narcissistic disturbance exists in the person.  When the narcissistic person has already been assessed (by qualified and competent professionals) as having a personality disorder then the potential for change is extremely unlikely.  However, the NPD individual can (and not infrequently does) make use of therapy in the supportive sense and sometimes also is willing to be treated for co-existing issues that are often part of the picture such as depression, anxiety disorders, mood disorders, and attention deficit disorder.  The kind of change that an NPD person is capable of in this scenario is generally superficial, and therapy is used primarily to deal with some crisis that is stressful and threatening to his/her already fragile sense of self.  I do wish, however, that mental health professionals were more willing to recognize that character disordered individuals can benefit from treatment for these co-existing issues, and we are in a unique position to advocate for this treatment.  Despite the inability for deeper change, it can be an enormous relief, not only for the NPD individual but for family members also, when these co-existing conditions are to some degree alleviated.

Having said all this, the capacity for genuine change generally exists in those individuals who are in some type of relationship with the narcissist – provided, of course, that they are not personality disordered also.  As I mentioned earlier, the changes that the codependent individual must work on involve developing a healthier sense of self alongside learning skills for effective limit setting and the implementation of firm, consistent and explicit boundaries that demand more appropriate behavior from the narcissist.  Ultimately, there may be choices that involve ending the relationship with the narcissist or seriously limiting one’s exposure to him or her.  These choices are generally necessary when the narcissist proves to be incapable of developing more appropriate behavior.  Perhaps the most important imperative for family members, friends or their partners is to become educated about the problem so that so they do not stay stuck in the confounding and corrosive dynamics of these relationships.

I also encourage the codependent partner, family member, friend, etc. to enter into therapy and to attend codependency support group(s.)  I feel proud to report that the women and men in Michigan who have been through our program over the years have started the first CONA group – Codependents of Narcissistic Individuals Anonymous (now officially sanctioned as a twelve step program by the World Service Headquarters of Alcoholics Anonymous.)  For anyone reading this, I want to emphasize how necessary it is to reach out and get help and not stop until you feel you have found someone who can validate and understand what you are going through.  If the therapist is overly anxious to dismiss the possibility that you are involved with someone with severe narcissism or perhaps a full blown NPD then move on until you find a therapist who does recognize the realities of the problem and who can offer support, validation, and empowerment strategies.  I know that I am singing to the choir here, however, it is impossible to overstate the importance of getting help from experienced professionals familiar with these issues.

To return to the question of capacity for change on the part of the NPD person, I think sometimes when the NPD individual does show capacity for genuine change, then we have to acknowledge the possibility that the person may have been misdiagnosed in the first place.  The real mystery cases are those individuals who seem to hover in the area between a “high functioning” personality disordered person versus a neurotic individual with strong narcissistic issues.  Within this mystery group, the big question on the table has to do with the capacity for developing mature introspection and a sustained ability for change due to the development of empathy.  Once family members or spouses develop insight and begin to change the asymmetry in the relationship with the NPD person, it becomes possible to tease out the deeper picture and to make choices that are founded on an accurate assessment of the level of functioning within the narcissistic person.

Consequently, I often recommend a combination of individual therapy (for both parties, but primarily for the codependent person because this person generally has a greater capacity for change) and marital or family therapy for the relational problems.  I also recommend that separate therapists (working in co-ordination with each other) provide the different therapy requirements.  When there are limited resources, I generally encourage the codependent person to attend individual therapy to heal and strengthen her sense of self so that the exploration for change with the narcissist or possibly ending her relationship with the narcissist is something she has the strength to do.

6.)    How many years post treatment have you followed up to see how they are doing?

As a therapist in solo private practice, I do not have the resources to conduct follow-up surveys or research.  I know that this is one of the great contributions that Sandra L. Brown, M.A. and others with The Institute are offering as they devote themselves to this important work, and I know it will continue to advance awareness and the development of effective treatment.

7.)    What kind of parents do they make?  What kind of stories do they tell you?
8.)    What do the children say about their narcissistic parents?  (Harrison, I hope you don’t mind that I combined these questions, as they are more or less the same.)

The stories of clients with NPD parents are incredibly varied and unique and yet, they are just as remarkably similar in the underlying and universally shared experience of reality.  I will never forget a beautiful woman from a foreign country who had lived in America for only a few years.  Having grown up with an NPD mother, she described her loss of self in the most poetic terms.  She described her struggle to free herself as a process of erasing her mother’s initials that were carved into every cell in her mind.  She went on to affirm how she was learning to penetrate the veil of her mother’s wants, thoughts and feelings as she discovered the choices that were her own.

Somehow, this woman’s description has stayed with me as a powerful expression of the loss of self that results when the child is held hostage to the NPD parent’s conditional expectations.  Most important, however, is the reality that this potent mourning process brings the hope for healing and renewal.  It is an amazing moment to awaken to a deeper knowing of self and to realize that we can reclaim our freedom from the unhappy tyranny of the conditional or false self.  We need to realize that we can become victims of the conditional or false self in one of two ways – an inner or internalized false self, or conforming to the false self of someone else.

9.)    What is the most troubling aspect of the personality disorder?

I would have to say that the most troubling aspect of these disorders are not just that they are life long problems for the personality disordered individuals, but too often it is a “life sentence of misery” for those who are involved with these individuals.  This brings us full circle back to your first question that raised the question about the premise behind my book.  I truly believe that we can change this reality.  With enough education and effort to raise our collective consciousness about of the predatory nature of personality disorders, not only will there be fewer victims, but we may also discover more effective treatments for this population.  In any case, I am passionate about helping to prevent and alleviate the “life sentence” for the would-be victims of individuals suffering from these personality afflictions.

10.)  What relation, if any, have you found between depression, anxiety, etc. and interaction with people with personality disorders?  Does the latter cause or exacerbate the former?  (Harrison – This first question is a little fuzzy, but I think the second question clarifies it.  I hope my answer addresses what you are asking.)

I’m not sure that anyone knows the answers to the important questions of causality with respect to personality disorders.  We do know that there is a high incidence of co-morbid or co-existing conditions with respect to personality disorders and the array of other problems such as depression, mood disorders, anxiety, ADHD, addictions, anorexia, and the list goes on.  I also think that we have to be very careful about causality interpretations, because this can very quickly take us on unnecessary detours that distort our understanding and treatment of the differences between these problems.  The clinical term “co-morbid,” meaning co-existing, is an effective term because it reminds us that these are parallel, but not necessarily causative conditions.  Having said this, it is absolutely true that these “parallel” conditions do amplify and exacerbate each other.  As I mentioned earlier, when we successfully treat a co-morbid conditions (such as depression) it can be a significant achievement in lessening the overall destructive impact of the individual’s personality disorder.

11.) Have you found that a lucid explanation of personality disorders helps in the therapeutic process?

Yes, absolutely.  After my book was released, the women and men who attended my public talks demonstrated a powerful need for greater clarification and understanding of the narcissistic personality disorder and the whole continuum of healthy to unhealthy degrees of narcissism.  Eventually, these events grew almost organically into the development of our seminar program that came to be called Discovering the Healthy Self.  I am convinced that education of these issues plays a potent role in accelerating a person’s capacity to heal and grow.

12.)    Do you see a need for a more general understanding of personality disorders?  And how do you see that happening?

Again an emphatic yes, and I know we are in great agreement about this.  Since 2002 when my book was first published there were only a handful of books on this subject for the average reader.  Since that time, a few dozen books have been published on the subject as well as important information about other personality disorders.  Your wonderful web magazine and many blog sites also are getting the word out with important information about how to identify a potential personality disorder in a person and empowerment strategies for coping with these individuals.

13.)  Can accurate knowledge about personality disorders act as a preventative measure against the negative influences of interactions with narcissists, for example?

Yes, I do think so.  Perhaps the silver lining about the tragic consequences we are experiencing as a country is another reason that the subject is getting more attention.  We now have a powerful need to understand how our government officials and experts in the banking world could have conducted themselves with such careless selfishness.  The short answer is that so many of these individuals have personality disorders.  My greatest hope for our society is that we become self aware enough as individuals that collectively we can detect what makes a healthy person healthy and conversely what clues tell us about a deeper disturbance.  When we have developed a healthier consciousness about all this, I believe it will be less likely that we will elect such disturbed people to government office or allow them to gain prominent positions over our institutions.

As a conclusion, I would like to thank you Sandra for your wonderful work and dedication to furthering people’s awareness and understanding of these important issues.  I also want to thank you for the opportunity to participate in this interview.  My warmest regards to you and your staff.

Harrison, let me also thank you for your extremely patient and helpful support in the interview process.


Eleanor Payson, ACSW,  is a licensed marital and family therapist, practicing individual, marital, and family therapy for the past eighteen years. Graduating from the University of Michigan in 1983 with her Masters in Social Work, she has continued her education on issues ranging from; chemical dependency and codependency, adult children of alcoholics, narcissism and borderline personality disorders, relationship therapy, and attention deficit/hyperactivity disorder.

All content does not necessarily reflect the opinions of The Institute.

Reality Bytes: A Survivor’s Journey – Part 1

Part 1

It’s 2:30AM on a Thursday night as I sit here developing my first message to you, dear reader. I am not accustomed to pounding my laptop keyboard in the middle of the night, but tonight I am making good use of the side effects from dealing with the aftermath of having a child with a psychopath. One of those side effects is the inability to sleep after a Strategic Traumatic Event (STE). An STE occurs when the psychopath in a custody battle performs a maneuver to knock the other parent emotionally off balance. It is designed to torment and to wear the other parent down.

As I am typing, in the background I hear CNN spilling sounds of the political battlefield of Obama vs. McCain into my living room. The battle for the White House is not even close to the war raging in some of our lives. The war we engage is with a pathological who has dropped his/her mask and unveiled the evil beneath.

Unfortunately for us, the mask is on a stick and the pathological is effective at sliding it back in place as needed. It is only when he/she realizes you are of no further value that the mask slips down and you get to see the real personality. In my experience, the pathological is a professional at “impression management,” a fancy term that means the psychopath will look and sound like Jesus Christ to others and even to you (until you believe it is Jesus Christ), while underneath it is really the devil manipulating your thoughts and perceptions.

During this journey, I have watched his face change from a loving, innocent, child-like portrait into a cold piece of stone. I have felt safe, secure and loved like never before. Unfortunately, they were these feelings of safety and love that blocked out the red flags – the times of confusion I should have paid attention to — the times I was uncertain of his acts or behaviors which were his real nature breaking through.

Now three years after the breakup, I am wondering if I might even die from the wrath of his hatred for me. I have felt the hair on the back of my neck stand up because of the piercing posture of his fiery eyes. Often his presence feels like that of an angry ghost attempting to carve a way into the depth of my soul.

The war I will present to you is about trying to protect the psyche of our innocent child who is at-risk. She too is a survivor of a psychopath and is being torn to pieces because she is caught in the path of his insatiable urge to “win” a custody battle, avoid child support, and destroy me. It seems his mission is to win at any cost.

He has no conscience and, worse yet, knows that I DO have one. He has no boundaries and, worse yet, neither do I when it comes to allowing him to trample on me. He has no reservation about pressing into me by hurting her physically and emotionally. He not only has no fear of getting caught, he gets excited about getting away with it.

The ordinary feelings that stop people from harming another human are devoid in him.

If you exist on this painful path, my heart goes out to you. I have been on this road for five years, lost almost everything, been to family court including dependency court nearly 40 times, been through two full ‘730 Custody Evaluations’, been investigated by Child Protective Services, been accused of a mental illness by a naive Ph.D. who fell for the ‘Jesus Christ image’ and read my reaction to the pathological’s abuse as a potential personality disorder in me, and I have been enduring and undoing my child’s behavior in reaction to his abuse. Last, but not least, I have gone through a raft of health issues, including multiple surgeries, brought on by the stress. All of these, though horrendous, are not unusual for a partner to experience in his/her relationship with a psychopath.

The column I write to you is one of reality. It is a real-time trip through the journey of a relationship with a pathological and the aftermath my child and I are navigating. I commit to give you the experience just as it is–not for me or my personal case–but for you.

I have searched and researched the country on the topic, taken classes about pathology, and established relationships with the best known minds in the field because I will do what it takes to be a survivor. I am a survivor and I am working through the stress of the most recent Strategic Traumatic Event (STE) which was a surprise visit by Child Protective Services triggered by his false allegation that I am abusing our child.

By pounding this keyboard for you tonight, I know I have become an expert. I am an expert in what the experience of a psychopath feels like, and what the damages can be. Discovery, awareness, and support by professionals is only in its infancy stages. I hope I can transfer what I have learned from this experience and research to you and save you some pain. Most of all, I hope to give you the tools that I am using to be a survivor and to protect my child. When one heals and shares that healing, we all heal.

(All articles are copyrighted and cannot be reproduced, however feel free to put a link to this page.)

* All content does not necessarily reflect the opinion of The Institute.

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Gentle Healing From Trauma– the Care and Feeding of the Nervous System

Imbalances in neurotransmitters are related to many symptoms of PTSD: anxiety, obsessions, irritability and rage responses, cravings for carbohydrates, alcohol, and other compulsions (shopping, gambling, and sex for example); insomnia, panic attacks and depression. Post Traumatic Stress Disorder, or as it sometimes feels, Ongoing Stress Disorder, effects us spiritually, emotionally, cognitively, physically and behaviorally. Of course, since we are whole persons, these aspects overlap to so some degree.

Fortunately, recent advances in brain science have created options for helping to heal trauma that are safe, non-invasive, natural and very effective. This column will provide readers of this site with information about two of these advances-amino acid therapy and neurofeedback training. As a therapist with over 35 years experience in general and with over 20 years experience helping traumatized people of all ages, I have found these two alternatives to be powerful tools in healing from trauma.

I have had my own experiences with trauma-the suicide of a family member, marital infidelity and a number of relationships with disordered men. PTSD is not an academic subject for me, and my experiences have shaped my approach to clients who come to me for help with problems related to emotional trauma.

One of the most useful ways I have found of thinking about emotional trauma is that it is a serious threat or ongoing threat to well-being that overwhelms a person’s ability to cope. Coping mechanisms just can’t do the trick, and so the person’s behavior, emotional, cognitive, and physical state show evidence of being overwhelmed.

The symptoms of PTSD, and even though they are serious and even debilitating, are just that, symptoms that something is very wrong. It is of course crucial to provide relief for the symptoms-such as insomnia, overeating, panic attacks, depression. It is also crucial to place these symptoms in a larger context so the cause(s) of the problem-being overwhelmed by a pathological relationship, for example–can also be addressed and changed.

One of the most far reaching inventions for PTSD I have seen is supplementation with amino acids and related substances. Since PTSD disrupts these fundamental physiological processes, it makes sense to provide a person with PTSD with building blocks so her body can recover, and in doing so, reduce or eliminate some of the symptoms that are directly or indirectly related to neurotransmitter imbalances created by being chronically overwhelmed.

In PTSD, the person’s physiologically, especially the nervous system is overwhelmed, and often moves into overdrive and then sometimes exhaustion. The stress response–fight/flight/freeze–can also go into overdrive and become a permanent rather than a temporary situation. This makes it particularly difficult to calm the nervous system down–it is as though the stress response has taken on a life of it’s own and is on overdrive.

It’s no wonder traumatized people self medicate with food, drugs (prescription and street), alcohol, nicotine, caffeine, shopping, and the like. The anxiety level seems to be set on “high” all the time, whether there is an external threat or not. For partners or former partners of disordered persons, of course the stress is often ongoing and severe, making it exceedingly difficult, and perhaps risky, for the person’s physiology to lower the threat response.

But the threat response, the fight/flight/freeze has its upsides as well as its downsides. From a positive perspective, this response insures that the person will react quickly to threats to safety and well-being. She or he may also overreact to situations that are not really threatening. But if this response is calmed down and essentially “reset” it will be there when needed. So being on red alert–hypervigilant–is not really healthy–we are not wired to be in overdrive all the time and when this occurs, the toll is high.

For example: Neurotransmitters are chemical messengers that insure that the person responds to and recovers from all kinds of situations. There are fundamentally two kinds–excitatory, which help us get going, and inhibitory, which help us to calm down. Prolonged stress related to emotional trauma triggers the constant release of both kinds.

Over time, the body can not sustain this and becomes depleted and out of balance. Serotonin is one of the key inhibitory neurotransmitters, and it is almost always very low in traumatized individuals. Traditional antidepressants may recycle what little there is but do not help the person to produce any more.

Reduced serotonin levels can lead to insomnia, irritability, headaches, carbohydrate cravings and depression. High levels of excitatory neurotransmitters can lead to increased anxiety (as though there weren’t enough to begin with) and insomnia.

So we can see how it is that PTSD leads to physical overdrive, which leads to many problems, neurotransmitters imbalances being an important example.

The good news is that it is now possible to measure many of the key neurotransmitter levels (directly and indirectly). However, neurotransmitter testing is sufficiently far along to often be covered by many insurance companies, and the very specific amino acids that are suggested are usually easily available.

Just as a woman who is having heavy periods may take iron tablets for a time, hopefully until the cause of the excessive bleeding is determined, so can we take supplements that will help balance out neurotransmitters. Most of these supplements are amino acids-naturally occurring substances that the body uses as building blocks for most neurotransmitters.

While there is currently some controversy about this in the traditional medical community, it may well be related to the recent nature of these discoveries as well as the limitations and blind pots of the existing medical paradigms. Time will tell.

Another naturally occurring substance in our bodies is cortisol, which is produced by the adrenal glands in response to the fight/flight/freeze response. A discussion of cortisol imbalances will be presented in a forthcoming column; suffice it to say that if a cortisol imbalance exists and is not corrected, just as is true for neurotransmitter imbalances, recovery from emotional trauma will take that much longer to occur.

In my practice, I combine neurotransmitter testing with psychotherapy as well as neurofeedback training, which will be the subject of a future column. Using the amino acid supplements alone, which I am frequently asked to do outside of the client-therapist relationship, is not advisable for many reasons.

For starters, these supplements are not a magic bullet, and the use of them alone can reinforce the belief among Americans that if we just take the right pill, everything will be OK. As Sandra L. Brown, M.A.’s research and clinical work have demonstrated, there are many, many other aspects of healing from life with a disordered person and the predicable emotional trauma that is a part of the picture.

But the very good news is that amino acid supplements, after a specific test or tests to determine if and where imbalances lie, as well as neurofeedback training in conjunction with psychotherapy and other modalities such as yoga, massage, EMDR, offer a very gentle and extremely effective path for getting your life back on track-what a blessing.

In next month’s column I will discuss some of the functions of neurotransmitters, how they effect mood, behavior and other physicological processes, as well as some of the far reaching benefits of amino acid therapy I will also discuss the role of cortisol imbalances in PTSD and from there provide some clinical examples. Information about neurofeedback training and related topics will be in future columns.

While it will not be possible to answer individual or personal inquiries, I am interested in your questions as a way to provide clear information and opinions that meet the needs of the readers of this column, so please send me your comments and questions and I will incorporate as many as possible next month.

Your Cup Runneth Over and How to Put a Lid on It

Your cup runneth over therefore you are at risk…but because it runneth over you can survive.

There are some who see their cup as half full with the perspective that life is full of opportunity and hope.  There are some who see their cup as half empty with the perspective that life is a struggle and trouble abounds.  But…. what if your cup “runneth” over?  What if you have so much to give, so much to share that your cup spills into the lives of others?  Sounds good-all of these great qualities…sharing, giving, generosity, just spreading their power and joy to all whom you meet.  But here’s the catch-and there is always a catch – what if someone has an empty (or nearly empty) cup? What if someone came into your life and nuzzled (or pushed) their cup right up against yours? What if they NEED what you have to experience excitement, to feel powerful?  This “empty-cup” person will surely catch the spill over, they will surely gather up and collect all that they can.  Now, think about this from the opposite perspective: an empty cup moving through life SEEKING an over-flowing cup, finds it, takes from it (in fact, empties it) until they are full and you are empty…what results is inevitable harm.

Sandra’s research has taught us that you posses temperament traits to a higher than average degree than other women (there’s your cup-running over).  In fact, the research showed that in most of the traits you scored 85-97% higher than other women in these traits.  That means a lot.  It means that if someone is normally empathetic they clearly understand others perspectives.  But for you, empathy means feeling the feelings that others feel….and wanting to do something about it.  It means that you NEED to feel purposeful, responsible, loyal or trustworthy just to feel like yourself-not because you lack it.  This is not just WHO you are it is WHAT YOU DO.  The good news is that these qualities are the things that people want to and should have.  These are the temperament traits that create strong, conscientious, goal-directed, focused people.  These are the traits that allow you to be successful in both your personal and professional life.

So, here’s the bad news-they are also the traits that psychopaths need.  They are the traits that attract empty-cups.  They are the traits that let psychopaths know that you will play the game with them.  They are even the traits that keep you in the game…that keep you fighting for the relationship.

This may be new news to you.  I have worked with many women who have said to me “I needed something…that’s why I stayed with him.”  I get that…there is a feeling of something missing when you are in a relationship with a psychopath.  But it is not because you do NOT HAVE these things…it is because HE TOOK THEM from you.  Here’s the evidence – look at your life before the psychopath.  Look at your life outside of the psychopath.  What do you see?  I am guessing it is a pretty good life.  Without being too presumptuous let me guess that you have friends and family who love you and whom you love; you have a great career that you created based on what you love and what you are good at; you are sociable, friendly, giving and often find that others like to be around you.  This is you- either before him or when you are not in his presence.  This is true because this is who you are.  Shocking?- I hope not!  That thing you needed was not something he had-it could have been the fantasy relationship you created with him-but it is not something he brought to the table.

I am going to use this column to talk in detail about all of the traits identified in Sandra’s research as risk factors.  But be clear, they are also the things that will get you out and keep you out.  They are the things that have allowed you to create a great life before him and will allow you to re-build a great life after him.  We will examine each one looking at how it put you at risk and then examine ways in which you can use it to begin detachment from the relationship and create a healing path.  Finally, I will provide techniques for building each trait.  But before we begin that process I need you to PUT A LID ON IT!  If your cup is over-flowing it is time to put that lid on.  Here’s what I want you to do:

  1. Get the information.  Once you know better you have to do better.  Read the materials provided on this site and by Sandra to begin to understand the dynamics of these relationships and what your risk factors are.  Read Chapter 7 of Sandra’s Book “Women Who Love Psychopaths”, 2nd Edition.  We will talk more next time about how these traits have played out in your life and ways you can re-build them.
  2. Use your traits.  I know that your cup may “feel” empty but it really isn’t.  These are character traits that cannot change-they don’t go away.  But you get used to not using them so it feels like they are gone.  They are not-you probably do it at work, with other loved ones, with friends-they are there.  (Another great benefit to using them is that if you haven’t done it in a while it will confuse your psychopath and he won’t know how to react.)  Finally, the more you use them the more your cup will re-fill itself.  You will begin to re-gain your confidence and personal power and that brings detachment and healing from the relationship.
  3. Most importantly-Only use them when someone deserves it or earns them through time demonstrated and behavior.  These traits are precious.  Now you know how precious they are and if you are not careful you will end up in an endless cycle with an empty cup.  There is no need to throw trust, empathy, responsibility, or even helpfulness around to every person you meet.  You can take a moment, breath and evaluate each situation using time, reason and demonstrated behavior as determining factors.  Be good to yourself and treasure who you are…you owe it to yourself.

Peace to you-Jennifer


William James, an early writer on psychology from the late 1800’s wrote about happiness and reality. I think what he has to say applies a lot to the issues that women face in pathological relationships. Let’s see how…

The crux of James’ pragmatic approach to happiness was rooted in his belief about expectation and its effect on how we come to feel about whether we are happy or depressed. The shortcut to his analogy about beliefs and happiness is:

‘If your reality lives up to your expectations, you experience happiness. If it doesn’t, you are depressed.’

Women who enter into relationships with pathologicals who are notorious for their hidden lives and covert disorders are not dealing with his reality. In her defense, how could she be? She doesn’t even know what his reality is–his disorders, his hidden life, or his pathology that is yet to annihilate her. His charming presentation is anything but real but is effective because it simply hands back to her a mirrored image of all her desires. This mirroring back increases her sensation of attachment because it comfortably reflects herself. Humans feel most at home with the traits that are most like them. However in a pathological, the mirroring, the traits and the resulting connection are not authentic–it’s merely her reflected traits she is attracted to IN him. His mirrored traits are nothing more than a magician’s illusion.

But what impacts her most is not that it is a sham–it’s that she believes it IS real. William James said “The value of any truth is utterly dependent upon its use to the person who holds it.” The value of him being normal is critically important to her in the beginning of the relationship. She will be relationally dependent about his portrayal of himself as true and real. Why? The women we surveyed tested extremely high in relationship investment. What she puts in and gets out of her relationships is almost the single most important thing in her life. The value of the psychopath’s truth is dependent on how much she wants it to BE true. In essence, she sees what he portrays AND she sees what she is invested in: this relationship.

What this creates with a pathological however, is that the first brick laid in the building of this relationship is flawed with all the corrosiveness of his disorder but pressure washed with the glow of his impression management. His mask and skillfully skewed image is built on sand with nothing to build off of. Upon that first brick of reality (or in pathology’s case, unreality), her next brick, which is expectations, is laid.

Her concept of reality about him and the relationship, in the end, can never live up to her expectations she has for them as a couple. Her foundational belief upon which all of this is built is that he is who he says he is, and that he is normal. Her expectations are based on normalcy. Such as–the relationship is going to bring the love, attachment, and joy that she perceives she is experiencing. What woman doesn’t expect that there isn’t potential in the relationship initially? After all, his best performance is always his matinees! Expectations are of a shared life, building a business, buying a home, raising children, growing old together–normal life stuff. Except–the first brick of reality wasn’t what it seemed.

What are realistic relationship expectations for covert pathology? How DO you build a healthy relationship with a narcissist or psychopath?

Most women will never choose in-your-face-pathology for a partner. However, not consciously choosing pathology still does not deter what she ends up with. Her expectations for their relationship are eventually pitifully ignored if not sabotaged. Her time, youth, love, loyalty, finances, trust, and sexuality were all poured into an expectation of a life together. None of this, of course happens for long.

Instead, pathology produces what it always produces: infidelity, a thief of all things sincere, loathing, financial disaster, distrust, and robbery of sexuality and spirituality. As its psychological signature and imprint, it marks her with the all the signs of Aftermath symptoms. Intrusive thoughts, flashbacks, obsessive thinking, stress disorders/PTSD, cognitive dissonance are her hallmark signs of having truly experienced a pathological love relationship.

In retrospect, it is easy to see in pathology how expectations have everything to do with the eventual outcome of unhappiness. When reality is skewed and he is not as he seems, and normal expectations for happy life are unfortunately with an abnormally disordered person, the outcome is misery.

Skewed reality + Unadjusted Expectations = Misery!

Pathological relationships always end in this way. It’s their trademark. While you can’t adjust what their impression management did to you initially, you can adjust what you come to expect from someone this disordered. When he lies, does it one more time, steals, cheats, hides his life—the only adjustment that can be made is ‘were you expecting normal behavior from an abnormal disorder?’ What part of him ‘doing it one more time’ is really a shock? The expectation (once you know his pathology) is what keeps you stuck in the cycle of your intrusive and obsessive thinking. If you dig down into what you are really thinking, you are expecting ‘this time’ the pathological will be different. He will be honest, he will tell the truth, he will pay the taxes, he won’t cheat, he’ll stop porn, he will stop splitting the children against you….

Your expectation of a permanently disordered and low-conscience abnormality is creating your continued depression. Adjust your expectation and you will adjust your future.

If your reality lives up to your expectations, you experience happiness. If it doesn’t, you are depressed.

Weekly Reality Check Audio

Finding Competent Help for Your Recovery

By now if you have been trying to heal from a pathological love relationship and can’t find effective and knowledgeable counseling you have probably figured out what we have…that the pathological love relationship is NOT widely understood.

Frustrated women hear unhelpful advice from family, friends and even therapists who label their attachment to pathological men as “codependent” or “mutually addictive” or merely “emotional abuse.” Women jump from counselor to counselor and from group counseling experience-to-group counseling experience looking for someone, ANYONE, who understands this intense attachment to a dangerous and pathological man.

She looks for some understanding at ‘what’ is wrong with him. Labeling him an ‘abuser’ doesn’t quite cover the extensive array of brilliant psychopathic tendencies he has. Why was SHE targeted by him? Why does she feel both intense attachment and loathing for him at the same time? Why do her symptoms more resemble ‘mind control’ than mere ‘abused woman syndrome?’ Why is the bonding with this man more intense and unshakeable than any other man? Is it abuse if he never physically harms you but has the mental infiltration of a CIA operative?

What we are finding out from our research about women who have been in pathological love relationships is that all the normal dynamics of regular relationships DON’T apply to these types. All the normal dynamics of addictive relationships, codependent relationships and dysfunctional relationships DON’T apply to these types either. No wonder women can’t find the help they need…it hasn’t been taught YET! Our research is pointing towards women who DON’T fit into the stereotypes of women we normally see in shelters, counseling centers and in other abuse situations. These are not women who have the kinds of histories we normally associate with abuse nor do they have the kinds of current lives that fit the demographics of most counseling programs and shelters. Their personality traits and behaviors fit no other ‘typologies.’ And their current symptoms don’t match the simply ‘dysfunctional’ love relationship.

Could it be that the dynamics in a pathological love relationships really ARE different than other types of relationships? Could this be why women in these types of relationships aren’t helped by the more prevalent types of intervention offered to other types of abusive relationships? Why does the Power & Control Wheel model seem ineffective with these types of women? Why are these women LESS likely to seek traditional counseling? And if they do, why are they less likely to be helped by it? Why are these women’s personality traits so vastly different then shelter women? Or abused women?

Too many women have been through the ringer of counselors-not-understanding-psychopathology/family-lumping-all-relationship-types-together/ friends-saying-‘just-get-over-it’/ and counseling-programs-telling-she’s-just-codependent. Too many women have stopped seeking help because they are tired of too many people ‘not getting it.’ Psychology has to allow itself to grow beyond a one-size-fits-all approach when dealing with women emerging from pathological love relationships because all relationships are not created equal. Especially when one of them is pathological. Not understanding the effects of pathology on relationships, self concept, and recovery deters a woman’s ability to heal. Understanding the DIFFERENCES in these types of relationships is critical.

The Institute developed programs and materials exactly for this reason. We developed our telephone coaching program for women in immediate need of validation of their experiences, our retreat programs specifically geared to ‘Healing the Aftermath of the Pathological Love Relationship,’ our Therapist Affiliate Program training which provides other therapists nationwide the clinical training to help women heal from these types of relationships, and our 40+ products all developed to teach pathology to others.

Why? Why all the effort in treatment related issues? Because the absence of trained counselors is screamingly evident. Our mailing list writes us week after week asking “Can you recommend someone in Florida, Michigan, the United Kingdom, Canada, California, Oregon…? Why don’t other counselors understand this? Why can’t anyone explain to me what is going on! If one more counselor or family member suggests I am codependent or a relationship addict, I’m going to scream! Why is this so hard to understand?”

Much like the beginning phases of the addiction field, the pathological love relationship field is feeling the same ‘misunderstanding phase’ that other theories of counseling have gone through. When the field is new or the knowledge is groundbreaking, there is an overt lack of trained responders. Unfortunately, those that suffer the new phases are the victims/survivors that wish there were more trained service providers.

The Institute operates as a public psychopathy education project which means we try to train anyone and everyone in the issues of pathology–that includes the women in the relationships AND those who are likely to be emotional supports to women recovering from these relationships. Please bear with an entirely new emerging field of psychology that is trying to race to catch up to the knowledge of what is needed for this population of people. After all, until us no one had even bothered to STUDY the female partners of psychopaths and partners of other pathological types. No one created research projects to study the personality traits, histories and chronic vulnerabilities of women who have been in these relationships. So to that degree, we are virginal in our exploration of these issues.

As an Institute, we try to be immediately responsive to needs. In the last year we have exploded in growth in our outreach–our weekly newsletter continues to reach more and more people, our blogs we write for other websites such as Psychology Today and Times Up! helps us to reach an even larger audience with the educational value of our expertise, our list of books, CDs and DVDs that are in every country of the world, our expanded retreat format, private 1:1’s with Sandra, our telephone assessments and coaching which doubled in size this year, our weekly teleconferencing support groups, and our Therapist Training Program–all are born out of our desire to reach YOU! As needs are repeatedly identified by our mailing list, we try to quickly ascertain how to develop a program to meet the need. That’s because we recognize that the services available out there are slim. We provide what we can knowing that we are a drop in the bucket to the need that exists. So unless we duplicate ourselves through products and services many women will go untreated.

I know for many women who are struggling to recover from the diabolical aftermath of a pathological relationship that it seems that too few services exist. Please remain hopeful that not only this Institute but other therapists and agencies hear your cry and are reaching out for training so they can help you. We too are always looking at how we can expand our scope and reach.

Over the past year or two there has been a proliferation of survivor-based websites, blogs, newsletters, blog radio shows, and chat forums that have jumped in to fill the need between what you need and what ‘is’ out there for support or assistance. (We appreciate that every new blog is pathology information reaching new victims!) Lately we have been asked what constitutes effective help for the aftermath symptoms. Those suffering with stress related disorders, intrusive thoughts/obsessional thinking as well as PTSD and other anxiety-based disorders are often surprised to find that chat forums INCREASE their symptoms. It seems counter-intuitive that the thing you want most to do (process it, talk about it, and roll it around in your head) may be the very thing that increases intrusive thoughts and autonomic adrenaline response in your body. “But it’s the first time someone has understood” or “I feel so at home with others like me” is a common feeling associated with the huge relief after finding a forum that you resonate with. And I am sure lots of people will disagree with me about the use of chat forums. Unfortunately, we have spent a great deal of time ‘cleaning up’ symptoms that have increased in survivors while surfing the net, chatting in forums or finding survivor-support blogs that don’t clinically understand PTSD or what helps/hinders it.

While survivor blogs and websites may have the ‘right heart’ when it comes to offering a ‘place for survivors’ please be aware that these sites are not professional clinicians. They may have lived through a pathological relationship, but it is questionable if they are competent to offer guidance on your array of mental health problems. In fact, if what they do offer triggers you, they are not likely to know what to do or be able to provide it.

While we exist to help all survivors, it is increasing difficult for us to clean up the emotional meltdowns caused from too much exposure to things that trigger your autonomic response of adrenaline, depression or anxiety generated from non-clinical websites. It’s also a reason we only used master degreed professionals for our phone support.

Here are our recommendations:

We suggest that you find a trauma therapist skilled in PTSD. We are happy to provide a training DVD to her that helps her get up to speed on Pathological Love Relationships so she can understand why your aftermath is so severe.

Finding an EMDR or Hypnosis Therapist are considered ‘gentle therapies’ and easiest on your own biological system as you can work through your symptoms.

When your symptoms have minimized, consider finding a support program (phone group or in person group).

STOP group whenever/if ever your are re-triggered (recovery is about pacing your level of exposure to things that are triggering).

Limit your exposure to triggering events such as chat forums or too much ‘other victim-oriented’ story sharing.

Practice a stress relieving lifestyle (you have a stress disorder!)

Find beauty in things that instill hope for a future.

Most of all, don’t give up hope. We are an emerging new psychology field! We are where Domestic Violence was in the 1970’s and 80’s–we are blazing a new frontier!

Hopefully these tips will help you select competent services for your own recovery. Let us know how if we can be of help.

Intense Attachments

Women in these relationships and their family members who watch her relationship dynamics all wonder about **why** this dangerous guy is so hard to leave. While all the people around her have the easy and rational answers of how and why she should leave, the disengagement and detachment is harder with pathological persons than anyone else.

No one knows this better than her. At the heart of the attachment is the intensity of bonding produced in a relationship that has an ’emotional vortex’ pull. Much like magnets pointed towards each other, the draw and pull and staying power of pathologicals is not like other relationship dynamics. As we study these particular attachments we see that there are unusual qualities to the relationships that even the women can’t define or adequately describe. This includes the dichotomous thinking often seen in ‘mind control,’ the hypnotic engagement often seen in trauma, and the betrayal bonding often seen in sexual addiction. Combined, this power cocktail renders her not only entranced by paralyzed from action.

Normal motivations do not motivate her. Not her current roller-coaster mental health, her other family relationships, her declining health, her children, her

job or any other force that would usually rally her to her own self care. No wonder people who care about her are baffled that a high functioning, bright, proactive woman has been reduced to a catatonic/hypnotized/brain washed version of her former self.

An hour a week at the counselor’s office has done little to unwedge her from this super-glued relationship. It hasn’t recognized the hypnotic en-trancement, the growing PTSD symptoms, the cognitive loops and entrenched dichotomous thinking. It hasn’t unveiled the death grip that pathologicals can have on a squirming victim. Or the mind control that sucks the willpower and brain function from her.

Physically and emotionally exhausted from the too-many-go-rounds with him, there isn’t enough left of her to fight her way out or even think her way out. Many women now suffer from Chronic Fatigue from the wearing process with the pathological. Without the emotional resources and physical strength, her lethargy just ‘allows’ the relationship to roll like waves over the top of her. Without help or intervention, she is likely to have a complete physical break down including severe medical problems, sleep disruptions, mental confusion, panic attacks, anxiety, depression and more. Women have developed auto immune disease and cardiac problems in the middle of these acutely stressful relationships.

With all of their resources sapped and their concentration at a near record low, many have had to quit their jobs, have been fired, been in car accidents or sporting injuries because of the inability to concentrate. Taking an inventory of just ‘what it has cost her’ to be in a relationship with a pathological is often the first step towards education.

The disengagement process is a supported function often by counselors or The Institute in which education, acceptance of his diagnosis, self care re-initiation, symptom management and then the full recovery process is necessary. Some need short term programs that help them kick start their own recovery such as our retreats or intensives with Sandra.

Many of the women have PTSD now from the exposure to the pathological. PTSD worsens without treatment, with added stress, and with time. Some where she has to find the counseling resources in order to return her to a life she use to know before the pathological. This includes finding support people, support groups, coaching, specific focused books and audios on the subject, and if needed, retreat or residential programs. If this describes your current situation, get what you need to heal now–to minimize the effects of intrusive and ping ponging thoughts. Most of all, the intensity of attachment in order to be broken must first be understood. Healing the Aftermath of Pathological Love Relationships is a great tool for loosening the pathological’s emotional death grip.

Using the Performing Arts to Prevent Domestic Violence


The founders of Fix the Hurt, Linda and John King, are dedicated to using the performing arts, education and training to prevent domestic violence. By teaming up with Loren Marsters, a talented writer, and composer, Anne Hinton Pratt, the Kings have created and produced Domestic Violence the Musical? that will not allow the audience to go home and forget. To date, this powerful and interactive performance has been performed for over 20,000 people in Arizona, Texas, New Mexico, and Japan with requests for Korea, Florida and more.

– Read more at the Fix the Hurt Website

My Anniversary of the Plunge into Pathology

The month of May which we just exited, marks my fairly ‘official’ date (at least in my mind) in which I was thrusted into the field of pathology–totally without consent, without warning and without return to the normal life I knew before May 13, 1983. 27 years ago my father bled out in a grungy gutter in Cincinnati after a psychopath plunged a knife into his aorta outside of his jazz club. I was initiated into a victim-hood that would turn my life and career in a direction I hadn’t much interest in on May 12, 1983.

Much like pathology in anyone else’s life, you don’t get to pick how it plays out. The best you can do is to learn how to ride the rollercoaster that goes along with the serious group of disorders in pathology. And so I did.

27 years later I still feel like I am just skimming the surface of what can and should be done in education, awareness, survivor services, and advocacy. Thousands of pages later of writings (books, newsletters, websites, workbooks, e-books, quizzes), hours and hours of lectures ad nauseum, over a thousand hours in broadcasts (radio and TV), stacks of cds and DVDs created—and still we are in the infancy of a new understanding about pathology–the virtual edge of just starting what one day will be a momentum marker that shows ‘when’ the world turned a corner in a better and very public understanding of pathology.

We’re not there yet, but the day IS coming. Every new blog that goes up, every newsletter, every website, every talk, every social networking post, every private moment of your knowledge shared with another victim, every coaching session, every class taught, every therapy hour, every group gathering, every prayer muttered, every radio show aired, every celebrity living it and bringing notice, every TV show about it, every newspaper or women’s magazine article taunting it, —is another message to another ear that has heard the message. You learned it because someone cared enough to make sure you learned it.

Every May 13 for the past 25 years I have halted my life to remember that life altering second when my life went from normal everyday life -to-a homicide survivor. This is when my reality was ripped through by pathology–a disorder so conscience-less that altering history is just another day in their lives. While my pathology story includes a brutal ending, yours no less includes something similar–all the things lost in the moment of deep betrayal–the kind of betrayal that only pathology can bring.

(If I don’t brighten this newsletter up, I’ll get complaints about ‘too much reality’ or ‘too much negativity’) So, I will say this–while none of us ‘choose’ to become survivors at the hands of very disordered pathologicals, what we ‘do’ with what we were dealt is up to us. Every so often I like to send a message to you that encourages you to ‘pass it forward.’ Whatever you have learned from the magazine, the newsletters, or the books is probably more than the woman who is sitting next to you knows. You don’t need to wait until you ‘understand it more, take a class, get a degree, read one more of our books, take the coaching training. That doesn’t help the woman you sit next to at work. The knowledge in your head is life saving to her. Next year ‘when you get better trained’ isn’t the year to share what you know. Today is!

If we want to move from living on the virtual edge of changing pathology education in the world, we have to open our mouths and tell what we know. Every pathological out there hopes you DON’T do this–they hope you keep what you know to yourself. So many women with so many tears had said “If I had only known….I would have left earlier, I wouldn’t have left my children with him, I wouldn’t have _______.”

Every May is a time I renew my commitment to what changed me. Every May I bother people with my message and prod them and push them to make victim’s rights and survivor education important in the world. If I don’t, the image of my dad laying in that gutter haunts me. His death should never have been for nothing–and as long as people have been helped, it hasn’t. Frankie Brown has touched so many lives with his death through the message of psychopathy. You’re one of them! Help me celebrate my father’s death anniversary in a way that brings meaning and hope to many. Tomorrow, share what you know with just ONE person–someone that you have felt in your gut needs to know about the permanence and the pain of pathological relationships. Then email me and say ‘I passed it forward’ so I can count up how many people celebrated Frankie! If this email offended you, I’m sorry. Pathology offended my entire life.

Thank you for growing in the knowledge of pathology so you are prepared for the day when you can give someone the life changing information that you’ve come to know!

If we can help you with your healing, please join us for our next retreat June 7-11. Healing is possible and we can help lead you there.