I have been working with people with borderline, narcissistic, and schizoid adaptations, and their mates, for over 40 years. One of the challenges all people with these personality disorders face is how to form intimate, safe, satisfying, long-term relationships.
My goal in this article is to describe a characteristic interpersonal challenge for each of these personality disorders and show how this issue impacts the couple’s relationship.
I will be describing each challenge from two points of view—from the point of view of my clients who have a personality disorder and what they have told me they were thinking and feeling, and from the point of view of their partners and what they have described of their experience in the situation. My clinical examples are derived from things my clients and their mates have told me.
Note: In this article I will be using the term “adaptation” as synonymous with the term “personality disorder.” I believe it is less pathologizing and has the advantage of acknowledging that most personality disorders arise out of the child’s attempts to adapt to his or her home environment.
My theoretical stance is based on the work of the well-known object relations personality theorist James F. Masterson combined with my knowledge of Gestalt therapy. Masterson has written many books on the diagnosis and treatment of disorders of the self. I was on the faculty of his training institute (Greenberg, 2004).
From Masterson’s point of view, one of the distinguishing features of all people who qualify for a personality disorder diagnosis is that they lack whole object relations. Their lack of whole object relations makes their sense of identity and their relationships with other people inherently unstable (Masterson, 1981).
Whole object relations (WOR) is the clinical name for the ability to see oneself and other people in a realistic, integrated, and stable way that includes both liked and disliked aspects of the person. Without WOR people can only see themselves and other people as either all-good or all-bad or switch back and forth between these equally unrealistic views.
A lack of WOR is one of the main causes of intimacy problems when one member of a couple has a personality disorder. However, in addition to lacking WOR, each personality disorder presents its own specific and characteristic intimacy challenges.
I have chosen one key relationship challenge for each of these personality disorders and a clinical example that illustrates it. I first present the challenge from the perspective of the person with the disorder, and then from that of their mate. I have limited it to one central issue per diagnosis for reasons of brevity.
One of the central issues described by my clients who have made borderline adaptations is the fear that they will be abandoned by their romantic partner. Here is how one of my clients with BPD described her situation:
Barbara: I feel inherently unlovable and am always afraid that my mate will abandon me for someone better. When I start dating someone new, everything goes fine when they are showering me with constant attention. However, almost anything can trigger my fear of abandonment. If they do not reach out to me at least once a day, I start to worry that they no longer want me and are pulling away. I am always prepared for them to leave me.
If they stay and reassure me that they love me, I find it hard to believe them. I need concrete proof of some kind. So, I test them. I might ask them to call me every day because that makes me feel good and lessens my anxiety. If they resist or make excuses, I say, “People who love each other want to be in touch frequently. If you love me like you say you do, why wouldn’t you want to call me every day?”
But even if they do call me, I still feel insecure. Then I devise another test that I think will diminish my insecurity, such as suggesting we move in together or get engaged to be married.
Here is her boyfriend’s reaction.
Sam: I am really hurt and confused. I love Barbara and would do almost anything to please her and keep the relationship going. But she seems to doubt my feelings for her, and I don’t know why. We are great together. We have a lot in common and also are lucky to have great chemistry.
I don’t see any problems. But Barbara keeps devising tests for me to pass to prove I love her. I feel rushed and pushed to do things faster than feels good. We have only been dating exclusively for a few months. I want to enjoy this courtship stage. However, Barbara wants me to propose marriage and take her shopping for an engagement ring. She says that if I really love her, why wouldn’t I propose? I am trying to figure out what to do.
As you can see from the above example, Barbara’s fear of abandonment is causing her to push Sam to move faster than he is comfortable with. Her attempt to soothe her own fears might drive Sam away and bring about the abandonment experience her love tests are designed to avoid.
One of the central challenges faced by people with NPD is a lack of emotional empathy. They cannot feel their mate’s pain or joy. This contributes to them being indifferent to their mate’s feelings. Here is how one of my narcissistic clients described his situation.
Jack: My wife is giving me a hard time over playing golf this weekend. She wants me to go with her to the hospital when she has an MRI to try and figure out why her back hurts. She could easily do that by herself. Why do I need to be there?
Here is his wife’s point of view:
Jenny: All my husband cares about is golf. I am in excruciating pain and really scared. I don’t want to be alone all weekend or when I go for the MRI. I don’t understand why he doesn’t care about what I am going through or how frightened I am.
Jack’s lack of emotional empathy for Jenny’s fear and pain is causing him to minimize her back issues and the MRI as unimportant. He also has no idea that his uncaring attitude is leading him down the path to divorce.
One of the central challenges faced by people with SPD is that intimacy brings with it the fear that they will be trapped and enslaved by their partner. They never learned how to negotiate differences or advocate for themselves. Instead, they try to protect themselves by finding ways to create distance between them and their mate (Klein, 1995). Here is how my schizoid client described his relationship dilemma.
Edward: If it were up to my wife, we would do everything together. She doesn’t understand how much I need my space. I will be reading my book and she will interrupt me to say, “I love you” or to share some thought she just had.
I love Lori, but, when she interrupts my reading or anything else I am doing by myself, I don’t feel loving. I feel resentful that she is being so intrusive. I also feel powerless.
Lately, I have been trying to solve this problem by spending less time in the same room with her. Sometimes I have to leave the house and go for a walk just to get away.
Here is his wife’s view of the situation:
Lori: I feel like I have to chase my husband to get any contact. He is always reading or going out by himself. I know he loves me, but I don’t understand why he doesn’t want to be with me. Aren’t married couples supposed to want to be together?
The issues that I am describing do not go away on their own. However, they can be helped if the partner with the personality disorder gets appropriate psychotherapy. Here are some suggestions on how to proceed:
Long-term intimate relationships can be challenging for most people. Many couples simply give up and break up. Unfortunately, people with borderline, narcissistic, or schizoid adaptations face even more relationship challenges than the average couple due to the issues associated with their diagnoses. These issues do not go away on their own and may become worse over time. The good news is that there are existing psychotherapies that can help save these struggling relationships.
To find a therapist, visit the Psychology Today Therapy Directory.
References
Masterson, J. F. (1981). The Narcissistic and Borderline Disorders: An Integrated Developmental Approach. NY: Brunner/Mazel.
Greenberg, E. (2004). The Masterson Approach: Defining the Terms. `In J. F. Masterson & A. R. Lieberman (Eds.), A Therapist’s Guide to the Personality Disorders: The Masterson Approach—A Handbook and Workbook. Phoenix, AZ: Zeig, Tucket & Theisen, Inc. (Chapter 3, pp. 24-33).
Klein, R. (1995). The self in exile: A developmental, self and object relations approach to the schizoid disorder of the self. In J. F. Masterson & R. Klein (eds.), Disorders of the Self: New Therapeutic Horizons—The Masterson Approach(Chapters 1-7, pp. 3-142). NY: Brunner/Mazel.
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