Pathometry Newsletter, July 6-2013

PATHOMETRY LAB NEWSLETTER

A service of The Institute for Relational Harm Reduction

Pathometry, noun, The measure of suffering; The distinction of suffering into different types; The perception, recognition, or diagnosing of different types of suffering (as we apply it to Pathological Love Relationships); The determination of the proportionate number of individuals affected with a certain disorder at any given time, and the conditions leading to an increase or decrease in this number.

The Pathometry Newsletter is designed for better understanding the Cluster B continuum range including sociopathy and psychopathy; for the correlation to other co-morbid conditions especially those with inconsistent treatment outcomes; to address the effects of these disorders on relational harm; and to see the impact on sociological systems.

 

Pathological Love Relationships: Systemic Impact and Its Relevancy for Professionals

Copyrighted© Sandra L. Brown, MA 2013

Issue 2

Background Info on The Institute

The Institute for Relational Harm Reduction and Public Pathology Education has been an early pioneer in the research and treatment approaches for Pathological Love Relationships (referred to as PLRs). For close to 25 years we have been involved in developing model- of- care approaches for survivor treatment. Additionally, we have been promoting public pathology education for prevention and intervention for survivors, awareness for the general public, and as advanced education for victim service providers.

In those 25 years, we have:

* Created and run our own Trauma Disorder Program

* Provided consultations for other programs

* Trained victim service providers in our model-of-care

* Treated hundreds and hundreds of survivors

* Spoken to thousands in the general public

* Reached millions with the message of “inevitable harm” related to Pathological Love Relationships (PLRs), through television and radio, print publications, our extensive product line of books, articles, e-books, CDs, DVDs and guest blogging on websites such as Psychology Today.

http://www.psychologytoday.com/blog/pathological-relationships

http://www.saferelationshipsmagazine.com

Our mission for the new Pathometry Lab Newsletter is simple:

   ~In order to help more survivors, we need to train more professionals.~

The mental health professionals that have been intricately trained by The Institute have lamented that graduate school, face-to-face counseling, and reading about Pathological Love Relationships (PLRs) did not prepare them for the treatment challenges of the survivor of a PLR or +the understanding of the disorders of the partner. Professionals have indicated that by far the most frustrating type of counseling cases have been the Pathological Love Relationship couple, the wounded partner of one of these relationships, and the “identified” problem pathological partner. To help professionals maneuver the challenging “obstacle course” of PLRs, we have dedicated a newsletter solely for you.

Systemic Impact

In our previous newsletter we introduced the concept of Pathological Love Relationships and the clinical relevancy for mental health professionals. We also touched on the issues that make specialized treatment approaches necessary. Over the course of the next 12 months, the newsletter will be talking about the specifics of our model- of-care and approaches that can be used by therapists with their clients.

(A Pathological Love Relationship (PLR) is a relationship in which at least one of the

partners has serious psychopathology which is likely to negatively affect his or her mate. The Institute specializes in the partners who are/were in relationships with those who have pathology of Cluster B Personality Disorders, which include: Borderline Personality Disorder, Narcissistic Personality Disorder, Anti-Social Personality Disorder, and the additional disorders of Sociopathy and Psychopathy . We will focus on these Cluster B Disorders this year in our newsletter, and in the following years we will discuss other disorders that can impact relational harm.)

In this edition of the newsletter, we are going to discuss the impact of PLRs on the major systems within our society and its psychosocial relevancy for professionals in various disciplines. In the upcoming newsletters we will discuss our theoretical framework for our work and our approaches. Today, let’s discuss the high impact of PLRs on all of us.

Our desire to make inroads in PLRs is related to the global necessity to relieve the effects of pathology which is crippling our mental health, criminal justice, social services, and health care systems. In fact, one of the most expensive impacts on our society is pathology and what it costs our national systems.

We have calculated that 60 million people in the U.S. alone are negatively impacted by someone else’s pathology costing billions of dollars a year through our societal systems.

“I consider one of the biggest public health concerns we face is that of pathology,

or more specifically, unidentified pathology.” —–
(Howard D., former Psychiatrist)

Dr. Kent Kiehl of the Mind Research Network (expert in MRIs of psychopaths’ brains http://www.mrn.org/) indicated in a recent interview that, “Psychopathy costs us 10 times what depression costs; in other words, it costs $460 BILLION a year to deal with psychopathy.” Let’s look at some of the systemic impact of not only psychopathy, but other forms of pathology as well.

Criminal Justice and Family Law Systems

How do we see pathology affecting the criminal justice and family law systems? Most assuredly, criminal courts are barraged with the undiagnosed and often unmonitored anti-socials. Jail, Prison, Probation, Court Monitoring systems, according to research, have an inordinately high number of Narcissistic Personality Disorders (NPDs) and Anti-Social Personality Disorders (ASPDs) in their populations. The more violent the crime, and/or the more times in criminal court, the greater the likelihood of the diagnosis of Cluster B is likely to be applicable. With the low treatment outcomes known for NPD and ASPD, we find a revolving door of pathologicals that keeps coming in and out of jail/prison/court programs.

“The results of the current study suggest that those individuals exhibiting high levels of both anti-social and narcissistic personalities are the best predictors of who will commit the majority of offenses. Based on this and other studies, these are the individuals most often incarcerated for violent crimes (Warren et al., 2002; Mamak, 1998). It is also suggested by the data that narcissism is the best overall predictor of crime.”

http://web.sbu.edu/psychology/lavin/abbey.htm

The domestic violence, batterer intervention, anger management, divorce court, and family court systems which all flow into each other, are clogged systems of new and repeat offenders, often of the Cluster B variety cloaked in the term of “high-conflict cases.” High conflict cases are often undiagnosed pathology trying to be “cookie-cutter retrofitted” to existing court programs.

High-conflict cases, as they are referred to, are recognized as “court cloggers”; however, rarely are there actual “diagnoses” connected with the terminology of “high conflict.” What are common aspects of high-conflict/PLR cases that are affecting our Criminal Justice (CJ) and Family Courts?

* Parental alienation

* Failed mediation

* 60+ appearances (on average) in Family Court, with custody battles raging for years

* Abductions

* Hundreds of thousands of dollars spent in court cases

* Abuse of partners and children

* Stalking

* Violation of protective orders

* Hidden lives

* Forensic accountants

* Private investigators

All of these are common issues for PLRs in court and relationally. Some of these are the actual behaviors, which helps courts identify them as “high-conflict cases” (but unfortunately, without the diagnosis).

But long before the identification of a “high-conflict case” was the reality of a PLR. And herein lays the “pathology-in-the-courtroom” problem: When the criminal justice system does not recognize the PLR dynamics or the disorders often associated with PLRs, we get profoundly pathological people included in legal or intervention approaches that are not designed to work for them. Not only do they fail, but they put the other partner/victim at risk and clog systems because the approaches are not working.

High-conflict cases, without the diagnosis, are being referred to what is called “Diversion Programs,” which is another legal “program-ese” for a type of case management within the legal system. Diversion programs are trying various psychological approaches with the “high-conflict population,” again, without recognizing the pathology and assessing whether that even works with these types of disorders. As clinicians we recognize “we can’t treat what we don’t identify.” But that is not always true in the CJ system.

In mental health disciplines, we recognize the need for treatment to be disorder-specific, that is, what we are offering as resources fit the disorder, thus the need. The CJ field is not that specific and tends to offer broader, more generalized, approaches to Family Court problems. These approaches may fit well for non-PLRs but do nothing but frustrate the courts when applied to PLRs. This is why we are seeing the rise of grassroots organizations that are made up of survivors who are now demanding Family Court reform because the approaches not only don’t work, but enflame the pathological.

These cases that are unrecognized for their pathology go nowhere as they are shuffled from one program to the next, one referral to the next, who passes them along because they are sick of the “go-nowhere-ness” of the cases. And each case bounces from one docket to the next as the judge hopes a program/any program will help, while yet another PLR clogs the system for years.

These are the couples that are sent everywhere—to mediation (failed), to co-parenting (failed), then parallel parenting, to court psychologists (what the heck is wrong with them?), to child evaluators (what is this doing to the child?), to anger management, to batterer intervention (if applicable), to divorce approach to a complex case then passes it on to the next program, while years tick off the calendar.

If we asked ourselves clinically, “Who does that?” and if we dropped these kinds of specific behaviors into an imaginary “DSM-IV analyzer,” while they clinked and clunked, aligning behaviors with possible disorders, it would produce a diagnosis often dealing with a Cluster B disorder in the mix, which means for the therapist:
* The client has a Pathological Love Relationship

* The end of the relationship is going to be full of risk and drama (stalking, 50B violations, repeat offending, custody problems, unending court and divorce court, higher risk of physical injury and intimate partner homicide)

* Our client has a pathological court case

* We have the nightmare of watching our client try to parallel parent or co-parent with a pathological

* The programs that are being referred for the pathological partner to attend and that normally work well for non-pathologicals, are not likely to work well with PLRs

* For treatment and support we will need a different approach when dealing with PLR survivors

Mental Health and Domestic Violence Systems

What about mental health systems and DV-oriented programs? How are they affected by PLRs? Donald Dutton, a Domestic Violence Researcher, indicates that the highest percentage of repeat abusers fall into the Cluster B disorders. According to Dutton, the more times they repeat as DV offenders, the more likely they are Cluster B. He indicates that as many as 85% of repeat offenders fall into Cluster B. http://www.drdondutton.com/

With this high a percentage, this IS who is likely to be the face of the repeat offender of DV, indicating that most repeat DV cases actually involve PLRs. Thus, we should expect to see PLR survivors in DV-based services whether public or private mental health services.

What about the victims? Survivors spend time in DV agencies, private counselors, support groups and online forums, never getting close to understanding the relational dynamics they have experienced with a pathological partner whose disorder is never accounted for, but whose behaviors are often labeled generically, as “abusive.”

Many survivors of pathological relationships skip the treatment altogether and suffer silently instead of trying to withstand explanations and one-size-fits-all ideologies about their experiences and the behaviors associated with the pathological perpetrator. Survivors of PLRs do not find the Power and Control Wheel comprehensive or specific enough for what they experienced with Cluster Bs. And if their partner has had repeat violence and are Cluster B, they are not likely to have gotten specific information about PLRs from shelter care, group or individual therapy. They are no further ahead in understanding the low treatment outcome likelihood of their partner.

Having seen the profound ‘failures’ of DV treatment which often end up in intimate partner homicides there aren’t any of us who would ever advise a client that their violent partner was conclusively ‘treated’ for their problems. And yet, unidentified Cluster Bs similar to OJ or Mike Tyson fly through Batterer Intervention Programs unrecognized repeatedly. Many partners will go back after ‘treatment’ has ended believing that what was wrong with them was corrected through ‘psycho education.’

What about the offenders? Perpetrators are referred to Batterer Intervention or Anger Management programs which do not always pre-assess for pathological disorders, especially since these services are court-mandated and the offender has no choice in the decision to attend. All perps are approached with the same material that was largely designed for perps without pathology. Much of the material that is used in Batterer Intervention (BI) is designed for those who have a propensity for the ability to sustain positive and consistent change, a known deficiency within the Cluster B population. Additional chronic risk factors of low impulse control, reduced empathy, and neurological abnormalities that impact aggression, are not considered when deciding who will be most successful with the mandated treatment offered.

Instead, pathologically disordered perps are those most likely to repeat offend or repeat in other chronic ways, thus ending up back in these same programs or other programs, clogging the systems they are funneled through, undiagnosed. The low treatment outcomes for batterers then become risk factors for victims as they believe the batterers were “treated” because they attended a program (albeit, one that was not designed for their unique disorder).

A factor that is not always known about Anger Management (and sometimes BI) programs is that they are not necessarily run by mental health professionals. In a recent workshop given for CJ personnel by us, Anger Management facilitators discussed their backgrounds for performing these high pathologically- oriented community services. Many were simply 501c3s who wrote a grant and went to a few weeks of training, but had no mental health training, assessment training or tools. Many were survivors of PLRs (contributing to this writer’s concern about transference of over- and under-identification of offender status, during group facilitation).

Considering that some of the most dangerous people in the DSM-IV are likely to be attending these community mental health programs, shouldn’t the community expect that a mental health professional would be pre-assessing for whether inclusion is recommended and post-assessing for low treatment, thus a continuing risk for the victim?

Health Care Systems

It is now well understood the impact of mental health on physical health. Survivors of PLRs have a significant history of stress-related health problems, including prolific autoimmune disorders. Given the survivor’s often long history of unrelenting stress with the emotionally dys-regulated Cluster B, it is not a far stretch that these survivors have unusually high numbers of health related problems. A high percentage of untreated PLR survivors are so impacted by both poor mental and physical health that they are removed from their jobs, take voluntary time off, are hospitalized, put on Disability, or are negatively affected for years, causing them to lapse into not only the health care system, but also the social service system once their health is impacted. When Dr. Kent Kiehl quoted psychopathy costing our systems $460 BILLION, it most assuredly reflected the impact on our health care system.

Social Service Systems

The survivors of PLRs often emerge with C-PTSD (even without experiencing physical violence—the reason for this will be discussed over the course of the ongoing Pathometry Newsletter), removing them from functional life and plunging them into the social service systems. Even the survivors who were formally white collar workers and previously economically stable (not the usual service user of social services) are significantly impacted, introducing their entrance into social service support. We have had female attorneys, doctors, CPAs, CEOs, judges, all reduced to disability following a PLR.

The children are of course impacted as well, often requiring assistance and services for their own recovery. Family Courts that do not recognize the impact of pathology on children will often mandate shared custody, causing untold damage to children filtering them into child social service systems. (See our chapter on the impact of pathology on children in our book Women Who Love Psychopaths). PLRs’ impact on our social service system is incalculable.

Helping Our Society Understand and Recover From Pathological Impact

This has been a simplified overview of a complex issue of the systemic impact that pathology makes on our world. To fully discuss it would require a book regarding something like, “The Sociological Impact of Pathology on Societal Resources.” The far reaching effects of pathology are impacting our country in many of ours societal systems.

Of course, the most impact is felt on the personal, or relational, levels where individuals are most harmed. It is in the close proximity to pathology where others are so gravely impacted by another’s lack of empathy, poor impulse control, and lack of insight. Those wounded by pathology are then driven into our systems—into our social services, health care, mental health and criminal justice systems seeking restitution, recuperation, or restoration from pathology.

We believe this is where we can be of most help in our society by bringing our level of understanding to your workplace, whether it is as a school counselor, private practitioner, forensic psychologist, jail counselor, pastoral counselor, marriage and family therapist, DV agency worker, addictions counselor or legal advocate. The newsletter exists to bring specialized awareness and training to those dealing with survivors of pathological love relationships. The impact of pathology has left its thumbprint in our minds, lives, and world, requiring knowledge of PLRs to help others recover.

During our next newsletter we will look at the variety of systemic language regarding pathology and why it has hindered our ability in multi-disciplinary fields to get on ‘the same page’ with ‘Who Does That?’ Following a few introductory newsletters about the issues of pathology, we will begin discussing our research findings about the survivors, and our Model-of-Care approach. We hope you will stay tuned.

Please take a moment to check out the related research and resources regarding pathology and PLRs for your practice listed below.

To read earlier Pathometry Lab articles click HERE

Interested In This Topic?

Our Therapist Training for Treating the Aftermath of Pathological Love Relationships Model of Care Approach (next training November 2013) includes further elaboration on items related to this topic:

  •  Relationship Dynamics of Pathological Love Relationships
  •  Bonding and Attachment Differentials
  •  Drama and Communication Triangle
  •  Event Cycles of PLRS
  •  What Doesn’t Work in PLR’s
  •  The Institute’s Model of Care Approach

    Next Newsletter

    Join us for our next newsletter when we will discuss more pathocentric ideas related to PLRs.

    Do Your Part

    Public pathology education is everyone’s issue, and if you are learning about pathology, please do your part and teach others what you know.  One way is to share our survivor support-oriented newsletters with your clients. They can sign up on the front page of the main magazine site–there is no cost and it comes out every week. www.saferelationshipsmagazine.com

    You can also further public pathology education by sending your colleagues and others who might be working with PLRs to our monthly newsletter. They too can sign up on the front page of the main magazine site and it is complimentary.  www.saferelationshipsmagazine.com

    Here’s how we can help professionals…

    How The Pathometry Lab Can Help You

    This program is designed for professionals who are most likely to encounter the survivors, or the Cluster B partners, in your line of work.  Our Pathometry Lab will offer you:

  •  Articles on issues of clinical relevancy regarding treating the aftermath of Pathological Love Relationships (no charge)
  •  Information on pathology and personality disorders as it relates to survivor’s recovery, marital counseling, addictions perspectives, pastoral views, and other mental health disciplines (no charge)
  •  Recommended reading on pathology (no charge)
  •  Handouts and other pathocentric tools (no charge)
  •  Personalized Institute services for your survivor clients (fee for services)
  •  Products for Professionals related to Pathology (fee for products)
  •  Case Consultations (fee)
  •  Yearly Training Conference (fee)
  •  Tele-Events (fee)
  •  Personalized services for Professionals Wounded by Pathology (fee for services).

    Our goal is to better equip you to be able to spot, intervene, and help the recovery of survivors of PLRs. We hope you will join us monthly for our Pathometry Lab Newsletter.  Most of all let us know if we provide support or education to you in the field of Pathological Love Relationships.

    Next Institute Event

    Treating the Aftermath of Pathological Love Relationships November 2013 Hilton Head Island, SC.

    http://saferelationshipsmagazine.com/services-for-professionals/training

    Relational Harm Reduction Radio

    www.blogtalkradio.com/relational-harm-reduction

    Every Thursday at 8:30 pm starting March 7, 2013

    Call in questions taken.

    RHR University: Coming soon Online Training for Professionals

    JUST FOR FUN!

    Patho-Lingo  Word of the Month:

    Pathognomonic–distinctive characteristics in a disorder

    Narcissus Gazing?

    Sincerely,

    Sandra L. Brown, M.A.

    The Institute for Relational Harm Reduction & Public Pathology Education

    Director of Advanced Professional Education Services

    Cathy Backlund

    Pathometry Lab Newsletter Coordinator

    Nancy Bathe

    Technical Editor

    www.saferelationshipsmagazine.com

Resources

 

Clinically Relevant Articles

Personality Disorders in Relationships

The Burden of Personality Disorders

Barriers to Effective Management

Neuropsychopharmacology for Cluster Bs

Reading Suggestions

Love Relations–Normality and Pathology, Otto Kernberg, M.D.

Psychopathy: Antisocial, Criminal & Violent Behavior by Millon, Simonsen, Davis & Birket-Smith

The Everything Guide to Narcissistic Personality by Elsa F. Ronningstan

Character Disturbance: The Phenomenon of Our Age by George K. Simon, Ph.D.

Evil Genes by Barbara Oakley

Women Who Love Psychopaths: Inside the Relationships of Inevitable Harm with Psychopaths, Sociopaths & Narcissists by Sandra L. Brown, M.A.

Pathocentric Tools

Wise Counsel Interview Transcript: An Interview with Otto Kernberg M.D. on Transference Focused Therapy (The Dangerous And Severe Personality Disorders–Cluster B)

Partner Related Assessment and His Cluster B Traits Checklist (Survivor Oriented)

30- Minute Lesson: Personality Disorders (Overview of All PDs)

Pathocentric Videos

Narcissistic Personality Disorder Video (Relational)

Video on Borderline Personality Disorder

Video on Anti-Social Personality Disorder

Assessments 

For Anxiety (Survivor Oriented)

Hamilton Anxiety Scale (Survivor Oriented)

Assessment and Medical Case Management in Personality Disorders (Pathological Oriented)

Partner Related Assessment and His Cluster B Traits Checklist (Survivor Oriented)

Websites

Safe Relationships Magazine (The Institute for Relational Harm Reduction & Public Pathology Education) : http://saferelationshipsmagazine.com

Dr. George Simon : http://drgeorgesimon.com/

Psychology Tools : www.psychologytools.org

Dr. Don Dutton : www.drdondutton.com

Professional Journals

 

Journal of Forensic Psychology

Psychological Trauma: Theory, Research, Practice & Policy Journal

Survivor Centered Help Aides

The Institute’s Partner Related Assessment and His Cluster B Traits Checklist

Intrusive Thoughts

Stress Management for Survivors

The Institute’s Resources

Pathological Love Relationships Archive of Articles

DVD Training Set on Cluster B and PLRs 

1. Understanding Destructive and Pathological Relationships

2.  Healing the Aftermath of Pathological Love Relationships: Help for Wounded Women

3.  Treating the Aftermath of Pathological Love Relationship: Understanding Pathology and Its Effects on Relational Harm

How to Spot a Dangerous Man Book

How to Spot a Dangerous Man Workbook

Women Who Love Psychopaths

Counseling Victims of Violence 

Maintaining Mindfulness in the Midst of Obsession 2CDs

Healing the Aftermath Relaxation CD

Trainings

Treating the Aftermath of Pathological Love Relationships: TBA, Hilton Head Island, SC

Contact us for more information

Help For Wounded Healers

Therapist Care

Are you a professional whose own personal Pathological Love Relationship is impacting your ability to help your clientele, function, or work? Do you need discrete and effective support? Long called ‘the therapist’s therapist’ The Institute provides our same Model-of-Care approach to wounded healers. Let us help you recover and come back stronger so you too can bring Pathological Love Relationship assistance to your own clientele.

_____________________________________________________________________

GENDER DISCLAIMER: The issues The Institute writes about are mental health issues. They are not gender issues. Both females and males have the types of Cluster B disorders we refer to in our articles. Both male and female can be either the disordered, the partner of the disordered, or both. Our clients, readership and user of our services are approximately 90% female therefore we write for those most likely to seek out our materials or services.  Cluster B Education is a mental health issue applicable to both genders. Our wording merely reflects our market.

COPYRIGHT INFRINGEMENT: Please be advised The Institute utilizes Intellectual Property Management Services that tracks, detects, and prosecutes the misuse of our copyrighted materials and property.

 

 

Pathometry Newsletter, June 1-2013

 


PATHOMETRY LAB NEWSLETTER

A service of The Institute for Relational Harm Reduction

Pathometry, noun, The measure of suffering; The distinction of suffering into different types; The perception, recognition, or diagnosing of different types of suffering (as we apply it to Pathological Love Relationships); The determination of the proportionate number of individuals affected with a certain disorder at any given time, and the conditions leading to an increase or decrease in this number.

The Pathometry Newsletter is designed for better understanding the Cluster B continuum range including sociopathy and psychopathy; for the correlation to other co-morbid conditions especially those with inconsistent treatment outcomes; to address the effects of these disorders on relational harm; and to see the impact on sociological systems.


Pathological Love Relationships: Why Specialized Treatment for Survivors and Training for Professionals Is Necessary

Copyrighted© Sandra L. Brown, MA 2013
Issue 1

 

 

Background Info on The Institute
The Institute for Relational Harm Reduction and Public Pathology Education has been an early pioneer in the research and treatment approaches for Pathological Love Relationships (referred to as PLRs). For close to 25 years we have been involved in developing model- of- care approaches for survivor treatment. Additionally, we have been promoting public pathology education for prevention and intervention for survivors, awareness for the general public, and as advanced education for victim service providers.
In those 25 years, we have:
* Created and run our own Trauma Disorder Program
* Provided consultations for other programs
* Trained victim service providers in our model-of-care
* Treated hundreds and hundreds of survivors
* Spoken to thousands in the general public
* Reached millions with the message of “inevitable harm” related to Pathological Love Relationships (PLRs), through television and radio, print publications, our extensive product line of books, articles, e-books, CDs, DVDs and guest blogging on websites such as Psychology Today.
http://www.psychologytoday.com/blog/pathological-relationships
http://www.saferelationshipsmagazine.com

Our mission for the new Pathometry Lab Newsletter is simple:

   ~In order to help more survivors, we need to train more professionals.~

The mental health professionals that have been intricately trained by The Institute have lamented that graduate school, face-to-face counseling, and reading about Pathological Love Relationships (PLRs) did not prepare them for the treatment challenges of the survivor of a PLR or +the understanding of the disorders of the partner. Professionals have indicated that by far the most frustrating type of counseling cases have been the Pathological Love Relationship couple, the wounded partner of one of these relationships, and the “identified” problem pathological partner. To help professionals maneuver the challenging “obstacle course” of PLRs, we have dedicated a newsletter solely for you.

This is our kickoff newsletter, so we welcome you to The Pathometry Lab, and are glad you are considering becoming part of the educated solution for these perplexing counseling cases of inevitable harm. So let’s get started–

What Is a PLR?

A Pathological Love Relationship (PLR) is a relationship in which at least one of the partners has serious psychopathology which is likely to negatively affect his or her mate. The Institute specializes in support and treatment of the partners who are/were in relationships with those who have pathology of Axis II, Cluster B Personality Disorders, which include:
•  Borderline Personality Disorder
•  Narcissistic Personality Disorder
•  Anti-Social Personality Disorder
•  And the additional disorders of Sociopathy and Psychopathy

This year we will focus on these Cluster B disorders in our newsletter, and then in the following years we will discuss other pathologies that also can impact relational harm.
(The changes in the upcoming DSM will not derail our discussion of these trait disorders and their effect on others. While diagnostic criteria may change, their behaviors do not consequently their impact on others does not change.)

Why a Closer Look?

In the recent past, PLRs were undifferentiated as the “unique” treatment challenge they have always been.  They typically were often lumped together with other:
* Relationship counseling issues
* Domestic Violence (DV) problems (if that was applicable)
* Other forms of trauma
* Anger Management/Batterer Intervention Mandates
* Addictions.

Over the past 25 years, and hundreds and hundreds of survivors later, we have found PLR’s were continually being treated unsuccessfully with conventional associated theories and treatments. Some PLRs flew completely under the radar depending on how convincing, charming, or deceptive the pathological was. Or the PLR was missed because of the hand wringing paranoia the partner appeared to have, which lead to the belief that there was mutual pathology in the relationship.

Regardless, there has been little relationship theory, or even differentiating trauma theory to understand these complex dynamics within PLR couples and the aftermath experienced by those closest to the disordered partner.

Our research supports that pathology impacts the relational dynamics, victim injury, and future risk, resulting in the need for different treatment modalities. Simply put:
• The relationship dynamics are different
• The (pathological) partner is different
• The victim’s aftermath is different.

Attempted Approaches

What has consistently been at the forefront of problems in treatment for the couple, the survivor of PLR, or the partner, is the missed factor of the existing “pathology.” This simple fact of existing pathology can drastically change what needs to be done differently, and will greatly impact treatment outcomes and client safety.

Historically, when pathology is unrecognized, professionals tend to utilize the theories and approaches most known for their general effectiveness but which do not work with the survivor, the couple, or the pathological partner. In fact, some of the more popular “approaches” are damaging, or even place the survivor at risk of future harm.

The problem is of course, that few of us received training on how to identify and work with partners of the personality disordered while in graduate school. I don’t know about your training on personality disorders, but mine was combined into a Psychopathology class with all the other types of psychopathological disorders. Personality Disorders was given one lecture period to discuss all ten disorders, and of course nothing about their impact on others was even brought up. The lack of applied information in the classroom certainly contributes to the problems mental health professionals find once they are in the field.

To add to that issue, personality disorders are not rare so each of us is likely to have clients, couples, or others, affected by the disorder.  The latest numbers from the NIMH indicated “1 in 5” in a college setting have a personality disorder. This is not “1 in 5 has a Cluster B Disorder’” but 1 in 5 for any of the clusters.  However, this should alert us to the high probability that as mental health professionals we will be dealing with this issue.

During these Pathometry Lab Newsletters, we will be going into more depth about the actual model- of- care approach for survivors but for now, let’s look at what has been traditionally attempted with these high- risk couples, survivors and partners.

Traditional Approaches

Please follow along, and think of one of your cases you suspect as a ‘PLR’ and see if the list below outlines some of the treatment issues you were initially targeting with more traditional theories. Perhaps you were approaching it as a couples counseling issue, a victim of DV (if applicable), a batterer intervention issue (if applicable), an addiction, a divorce, a co-parenting issue, depression from a break- up, or other counseling focus.

• The issue of violence was lumped together with general domestic violence theories and intervention approaches as the primary consideration (not the Cluster B Disorder as the primary consideration).
• The victims of these types of relationships were assessed using existing Victimology theories for both victim etiology and victim treatment approaches. Traditional forms of DV explanation about the perpetrator’s behaviors were given to the partner/victim.
• The unusual relationship dynamics of PLRs were explained with the Power and Control Wheel and the victim response was thought to be related to “codependency” or “Dependent Personality Disorder.” Victim personality traits were often associated with levels of dependent disorders, collapsed boundaries, enmeshment, or assumed to be primarily associated with trauma reactions.
• The couples were treated with traditional forms of relationship counseling.
• Relationship and/or sexual addiction were also often a common view of the dynamics of “intensity of attachment” by the partner/victim. Relationship/sexual addiction were also a possible reason for the cheating/sexual acting out of the partner.
• State dependent learning was sometimes assumed to be dissociation or Stockholm Syndrome.
• Anger management and/or batterer intervention was therapist- recommended or court referred as an accountability approach and an education for the perpetrator on the power dynamics.
• Criminal behavior was mostly equated with familial environments, or sociological and economic factors.
• Drug and alcohol addictions and their impact on relational harm factored in heavily towards understanding the relational dynamics.
• For some, the spiritual abusiveness of relational leadership was also identified and considered as both an individual and marriage problem.
• Traumatology of early childhood, or previous adult unprocessed traumas was searched for.
• Shoring up boundaries, straightening out cognitive distortions, equalizing power distribution, and medication, when applicable, were also considered.
• Communication techniques were used for the struggling couple or approaches like Imago Therapy.
• Co-parenting techniques were attempted with divorcing/divorced couples.

I’d like to say, all of these could be good practices EXCEPT when you are dealing with Pathological Love Relationships. Why is that? How can the pathology of one (or more) partners in the relationship so drastically change the risk factors, treatment approaches, and outcomes?

The reasons behind relational harm in PLRs and solutions for approaches are what we will be systematically approaching through our newsletters.

But intimate partner relational harm is not the only “harm” that happens from this group of disorders. In our next newsletter we will continue our introduction into the topic of PLRs and why we feel specialized training is necessary, by looking at the systemic impact pathology makes to all major societal systems such as the mental health system, the criminal justice system, social service systems, and health care systems.

To find out more about these issues, please take a moment to check out the related research and resources regarding pathology and PLRs for your practice listed below. Our Pathometry Lab will be an accumulative library of resources for you on pathology beginning with the links listed below. The accumulated library will be housed on our main website www.saferelationshipsmagazine.com.  It is the research and resources that are added to each newsletter that will help you educate yourself more fully regarding PLRs.

Interested In This Topic?

Our Therapist Training for Treating the Aftermath of Pathological Love Relationships Model of Care Approach (next training November 2013) includes further elaboration on items related to this topic:
• Relationship Dynamics of Pathological Love Relationships
• Bonding and Attachment Differentials
• Drama and Communication Triangle
• Event Cycles of PLRS
• What Doesn’t Work in PLR’s
• The Institute’s Model of Care Approach

Next Newsletter
Join us for our next newsletter when we will discuss more pathocentric ideas related to PLRs.

Do Your Part
Public pathology education is everyone’s issue, and if you are learning about pathology, please do your part and teach others what you know.  One way is to share our survivor support-oriented newsletters with your clients. They can sign up on the front page of the main magazine site—there is no cost and it comes out every week. www.saferelationshipsmagazine.com

You can also further public pathology education by sending your colleagues and others who might be working with PLRs to our monthly newsletter. They too can sign up on the front page of the main magazine site and it is complimentary.  www.saferelationshipsmagazine.com
Here’s how we can help professionals…

How The Pathometry Lab Can Help You
This program is designed for professionals who are most likely to encounter the survivors, or the Cluster B partners, in your line of work.  Our Pathometry Lab will offer you:

• Articles on issues of clinical relevancy regarding treating the aftermath of Pathological Love Relationships (no charge)
• Information on pathology and personality disorders as it relates to survivor’s recovery, marital counseling, addictions perspectives, pastoral views, and other mental health disciplines (no charge)
• Recommended reading on pathology (no charge)
• Handouts and other pathocentric tools (no charge)
• Personalized Institute services for your survivor clients (fee for services)
• Products for Professionals related to Pathology (fee for products)
• Case Consultations (fee)
• Yearly Training Conference (fee)
• Tele-Events (fee)
• Personalized services for Professionals Wounded by Pathology (fee for services).

Our goal is to better equip you to be able to spot, intervene, and help the recovery of survivors of PLRs. We hope you will join us monthly for our Pathometry Lab Newsletter.  Most of all let us know if we provide support or education to you in the field of Pathological Love Relationships.

Next Institute Event

Treating the Aftermath of Pathological Love Relationships November 2013 Hilton Head Island, SC.
http://saferelationshipsmagazine.com/services-for-professionals/training

Relational Harm Reduction Radio

www.blogtalkradio.com/relational-harm-reduction
Every Thursday at 8:30 pm starting March 7, 2013
Call in questions taken.

RHR University: Coming soon Online Training for Professionals

JUST FOR FUN!
Patho-Lingo  Word of the Month:
Pathognomonic—distinctive characteristics in a disorder


Narcissus Gazing?

Sincerely,
Sandra L. Brown, M.A.
The Institute for Relational Harm Reduction & Public Pathology Education
Director of Advanced Professional Education Services
Cathy Backlund
Pathometry Lab Newsletter Coordinator
Nancy Bathe
Technical Editor
www.saferelationshipsmagazine.com

Resources

Clinically Relevant Articles

Personality Disorders in Relationships

The Burden of Personality Disorders

Barriers to Effective Management

Neuropsychopharmacology for Cluster Bs

Reading Suggestions

Love Relations—Normality and Pathology, Otto Kernberg, M.D.

Psychopathy: Antisocial, Criminal & Violent Behavior by Millon, Simonsen, Davis & Birket-Smith

The Everything Guide to Narcissistic Personality by Elsa F. Ronningstan

Character Disturbance: The Phenomenon of Our Age by George K. Simon, Ph.D.

Evil Genes by Barbara Oakley

Women Who Love Psychopaths: Inside the Relationships of Inevitable Harm with Psychopaths, Sociopaths & Narcissists by Sandra L. Brown, M.A.

Pathocentric Tools

Wise Counsel Interview Transcript: An Interview with Otto Kernberg M.D. on Transference Focused Therapy (The Dangerous And Severe Personality Disorders—Cluster B)

Partner Related Assessment and His Cluster B Traits Checklist (Survivor Oriented)

30- Minute Lesson: Personality Disorders (Overview of All PDs)

Pathocentric Videos

Narcissistic Personality Disorder Video (Relational)
Video on Borderline Personality Disorder
Video on Anti-Social Personality Disorder

Assessments 

For Anxiety (Survivor Oriented)
Hamilton Anxiety Scale (Survivor Oriented)
Assessment and Medical Case Management in Personality Disorders (Pathological Oriented)
Partner Related Assessment and His Cluster B Traits Checklist (Survivor Oriented)

Websites

Safe Relationships Magazine (The Institute for Relational Harm Reduction & Public Pathology Education) : http://saferelationshipsmagazine.com
Dr. George Simon : http://drgeorgesimon.com/
Psychology Tools : www.psychologytools.org
Dr. Don Dutton : www.drdondutton.com

Professional Journals

Journal of Forensic Psychology

Psychological Trauma: Theory, Research, Practice & Policy Journal

Survivor Centered Help Aides

The Institute’s Partner Related Assessment and His Cluster B Traits Checklist

Intrusive Thoughts

Stress Management for Survivors

The Institute’s Resources

Pathological Love Relationships Archive of Articles

DVD Training Set on Cluster B and PLRs 


1. Understanding Destructive and Pathological Relationships
2.  Healing the Aftermath of Pathological Love Relationships: Help for Wounded Women
3.  Treating the Aftermath of Pathological Love Relationship: Understanding Pathology and Its Effects on Relational Harm

How to Spot a Dangerous Man Book

How to Spot a Dangerous Man Workbook

Women Who Love Psychopaths

Counseling Victims of Violence 

 

Maintaining Mindfulness in the Midst of Obsession 2CDs

Healing the Aftermath Relaxation CD

Trainings

Treating the Aftermath of Pathological Love Relationships: TBA, Hilton Head Island, SC
Contact us for more information

Help For Wounded Healers

Therapist Care
Are you a professional whose own personal Pathological Love Relationship is impacting your ability to help your clientele, function, or work? Do you need discrete and effective support? Long called ‘the therapist’s therapist’ The Institute provides our same Model-of-Care approach to wounded healers. Let us help you recover and come back stronger so you too can bring Pathological Love Relationship assistance to your own clientele.
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GENDER DISCLAIMER: The issues The Institute writes about are mental health issues. They are not gender issues. Both females and males have the types of Cluster B disorders we refer to in our articles. Both male and female can be either the disordered, the partner of the disordered, or both. Our clients, readership and user of our services are approximately 90% female therefore we write for those most likely to seek out our materials or services.  Cluster B Education is a mental health issue applicable to both genders. Our wording merely reflects our market.

COPYRIGHT INFRINGEMENT: Please be advised The Institute utilizes Intellectual Property Management Services that tracks, detects, and prosecutes the misuse of our copyrighted materials and property.