Personality Disorders

Stalemate: When Couples Get Nowhere Fast

Allan Schwartz, LCSW, Ph.D.

 Remember the old saying about opposites attracting? Well, based on the information in this essay the conclusion is likely to be that the old saying is a myth. In fact, for most people, opposites do not attract. In the cases discussed here, not onlydo opposites not attract but they drive one another away. Think about whether you recognize any people you know?

Cases:

The following six cases are fictionalized composites.

1. One wife complains that whenever she asks her husband for help with household tasks he promises to provide that help but never gets around to it. He retorts that his wife is not accurate and that she does not allow for how busy at work he is.

2. A girl friend complains that her boy friend always reneges on anything he promises to do. She wants more of his time and he refuses, giving thousands of reasons why he can’t. Most of his reasons for not providing her with more time are that he is busy at work. He works late into the evenings, and even works on weekends. He resents her nagging. The result of his refusals is that she feels rejected and crushed. In order to please him and win his approval, she does everything for him, including washing his clothes, ironing his shirts, and bringing his suits to the cleaners. These are no small tasks since they don’t live together and she has a full time job and many chores of her own. After suffering what she perceives as his rejections, she goes home at night feeling worthless, tearful, and depressed.

3. A wife reminds her husband to purchase the airplane tickets for an important trip he must take. She wants him to make the purchase early so that he locks in the lowest airfares possible. He says he will but it never happens. For one, he keeps waiting for even better prices than are currently available. He obsessionally looks at airline tickets on the Internet and always fears that he may make the wrong choice. Ultimately, he buys the tickets at the last minute and at higher prices than if he had made the purchase earlier. When asked how this could happen, he, in his characteristic way, takes a long and circuitous verbal path to the explanation. The result is that both his therapist and wife feel extremely frustrated. One of his main characteristics is that he can never make a decision without going through a long and agonizing process.

4. A married couple argues over where to go on vacation. She knows where she wants to go but he keeps hemming and hawing. He wants to choose the best possible vacation spot. However, there are so many choices that he fears he will make the wrong choice. The time for vacation passes and they go nowhere. She is utterly frustrated with what she perceives as his passivity. What soon emerges during the sessions is that he didn’t want to spend the amount of money that the vacation would have cost. Besides, he believes she wastes money and spends too much. She complains he never gives her enough money for the groceries and home expenses.

5. A husband has lost his job. His wife, filled with anxiety about their house and their future, nags him to re-write his resume and pursue opportunities in his field. He says he will but never does. Instead, he becomes furious with her. In marriage therapy, she savagely attacks him for being utterly passive. He smiles pleasantly and admits that he is. She is left steaming and is even more mad and frustrated. However, part of his problem, according to his own report, is that his resume never looks good enough to him. He demands perfection of himself. In fact, part of the reason he lost his previous job is that he takes too long to get things done. What slows him down is his need for perfection. Despite the fact that she is usually steaming with anger at him for being so passive, she keeps most of her feelings to herself. She does not want to risk losing him by nagging and complaining too much. Depression, frustration, and hopelessness are emotions with which she is too familiar.

6. Lastly, a couple is referred for marriage counseling because they are at an impasse. They sullenly enter the office and sit opposite one another. The atmosphere in the room is thick with rage. When the wife begins to speak, she tearfully begins to explain that her husband always works and never has time for her or their children. She is now pregnant with another child. He responds with the attitude that his wife is crazy and is never satisfied with anything he does. There is no tenderness left in these two and they are at the end of their marriage. Anything that is suggested, such as they take time to get baby sitters and go out for dinner with one another, is never accomplished. He is too busy at work to take her out or to spend much time with the children. In point of fact, when she was tearfully talked about his failure to be available to her or the children during the joint sessions, he sat impassively. He was emotionally the direct opposite of his wife. She was emotionally expressive and stormy. He was cool, controlled and unemotional.

Definitions:

Do these scenarios sound familiar to you? These are just a few examples of the kinds of complaints I, as a therapist, have heard repeatedly over more than twenty years of working with couples. Some people refer to this behavior as passive-aggressive. In actuality, the men represented in each of these fictionalized case studies are examples of people with Obsessive-Compulsive Personality Disorder(OCPD). Women are equally afflicted with this type of personality disorder.

Some of the women in the cases above represent another type of personality disorder referred to as Dependent Personality Disorder(DPD). Men are equally capable of having this type of personality disorder.

According to the DSM 1V of the American Psychiatric Association, A Personality Disorder is defined as "an enduring pattern of inner experience and behavior that deviate markedly from what is expected of the individual's culture. It is pervasive and inflexible and remains stable over time. Personality disorders begin during early adolescence or childhood and lead to distress and impairment." In other words, an individual with a personality disorder engages in fixed and unchanging patterns of behavior.

 DSM 1V Definition of Obsessive-Compulsive Personality Disorder(OCPD)

There is a pattern of preoccupation with orderliness, perfectionism, details, work, and the inability to spend money. All of this is at the expense of flexibility, openness, and efficiency.

In a manner of speaking, the person with this disorder "sees individual trees, but fails to see the forest." They are so focused on details that they are blind to the "bigger picture."

DSM 1V Definition of Dependent Personality Disorder(DPD)

There is such an excessive need to be taken care of that those with this disorder become submissive and clinging. They fear separation, and making any decisions lest they anger loved ones. They cannot disagree with anyone and will go to any lengths to gain approval from others.

Discussion:

The quintessential Hollywood example of what it can be like to live with OCPD was the Jack Lemmon, Walter Matthau movie, The Odd Couple, that went on to be an equally successful television series. Both the movie and television show were versions of the original Broadway Neil Simon play of the same name. The two main characters were Oscar Madison and Felix Unger. Each of them is divorced and shares an apartment in Manhattan. Felix Unger is the extremely obsessional character who demands that everything be neat and orderly with regard to the apartment, cooking, clothes, work, etc. He is also hypchondriacal and constantly worries about germs and health. Felix' obsessional preoccupations and behaviors drive Oscar, who is his opposite in every way, to the brink of either insanity or homicide. The two characters, at opposite ends of the neatness poll, get into conflicts with one another that are hysterically funny. While Felix is neat, Oscar is a slob. While Felix is heath conscious, Oscar smokes, drinks, and overeats. Felix is driven just as crazy by Oscar's behavior as Oscar is Felix’. The reason for the popularity of the play, movie and television show is that it tapped into a lot of truth about certain types of human relationships. Anyone married to an obsessional person knows just how maddening it can be to deal with them.

However, it is not amusing when someone must deal with an individual who has an obsessive personality disorder. It is even more difficult when that person has a personality disorder of his/her own. For example, two personality disordered individuals, who are headed for marital disaster, are a Dependent Personality Disorder married to an Obsessive Personality Disorder.

Why is this so?

The more an individual who is dependent asks for reassurance, the more the obsessional person refuses to provide it. Try to imagine the women in a few of the above cases attempting to get love and approval from their spouse or boy friend who is not able to give them what they want. Desperately looking for approval, the DPD asks that the OCPD show proof of love by such behaviors as being taken out to dinner, being given flowers, gifts for their birthday, or other such romantic behaviors. The OCPD may promise to do some of these things, but never actually does. When confronted with why this didn’t happen, the OCPD explains, in rational and logical terms, why it couldn’t happen. If the DPD becomes tearful and feels hurt, the OCPD responds with righteous indignation. The more emotional and desperate the dependent person becomes, the more the obsessional individual views his/her partner as out of control and insane. They simply cannot understand the outpouring of emotion or understand why this person is so angry with them. People with OCPD never see themselves as being wrong. In fact, they see others as wrong while they are always correct. The DPD, always clinging and always hopeful, continues onward, attempting to get love from this rejecting person. It is an example of the proverbial attempting to get water from a stone.

In psychotherapy, when asked by the husband or wife why the other will not meet their wishes, I often use the metaphor of the clam when referring to OCPD? The harder one attempts to open the clam shell, the tighter it pulls itself closed. Hitting it with a hammer will not work any better than attempting to use a knife to "shuck" it open. The clam remains tightly closed because it needs to. Obviously, it is protecting itself from something.

If the OCPD protects him/herself from something by remaining rigidly shut, why is the DPD stubbornly pursuing love from the "clam"? Perhaps this is also a defensive type of behavior or a repetition of frustrations suffered from early childhood onward. Perhaps the child who never felt given to goes through life attempting to prove self worth by continuing to try to get love and approval from the ungiving in the hope that they will finally succeed.

Despite my years of therapeutic experience with people who have these types of personality disorders, I am always baffled by the way in which the dependent person will persist in their pursuit of love from the obsessional individual. On one occasion, a dependent woman stated that she loved her boy friend despite twenty years of stubborn refusal on his part to marry. In fact, he barely fit her into his busy and neatly organized schedule. He both worked at his career and worked out at the gym seven days per week. He had time to go to the gym but never had time to take her out to dinner, a movie, or a play. While she lived separately in her own apartment, she cleaned his as well, yet never received any acknowledgement for this. If she became angry, he would stop calling and she would become extremely anxious. Again, this went on for twenty years before she began to realize how the entire situation was causing her to feel extremely depressed.

Treatment

The nature of personality disorders is such that they are very difficult for therapists to treat. The real hope for change comes when the individuals with any type of personality disorder are so unhappy that they are willing to enter treatment. Part of the problem is that obsessional people rarely see the need for help for themselves because they blame everyone else for being unreasonable. Even when their spouses succeed in dragging them into therapy, they are often stubbornly unwilling to see the need for change.

However, there are those who do want therapy, even those who are obsessional. The types of therapy available range from marriage therapy to individual therapy based on psychodynamic or psychoanalytic principles or cognitive-behavioral therapy. Anti depressant medications do help relieve feelings of depression but do not help the person learn about and change their behaviors. Depending on the seriousness and type of personality disorder, treatment can take a very long time as people tend to resist learning how they are behaving, let alone changing that behavior.

Your comments, opinions, questions and experiences are invited.





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