Pathometry Newsletter, June 1-2013



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.

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  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.

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.
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.

Relational Harm Reduction Radio
Every Thursday at 8:30 pm starting March 7, 2013
Call in questions taken.

RHR University: Coming soon Online Training for Professionals

Patho-Lingo  Word of the Month:
Pathognomonic—distinctive characteristics in a disorder

Narcissus Gazing?

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


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


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)


Safe Relationships Magazine (The Institute for Relational Harm Reduction & Public Pathology Education) :
Dr. George Simon :
Psychology Tools :
Dr. Don Dutton :

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


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.