When the Psychopathology Is the Structural Basis for Domestic Abuse
by Dr. Jeanne King, Ph.D.
Domestic abuse survivors ask if abusers can really change. My belief is that in cases of well-established psychiatric disorders, it can be extremely problematic. The more severe the psychopathology, the less likely one can expect lasting behavioural change.
For example, Raymond is an expert emotional exploiter. That is another way of saying that he is a domestic abuser who most commonly reaches for the emotional abuse tactic to exert his control. And in addition to this well practiced strategy, there is a long-standing psychiatric condition that is character-logically rooted.
He has a narcissistic personality disorder, with anti-social and borderline features. The likelihood of Raymond changing his abusive behaviour is truly a function of his addressing the core psychiatric condition, as well as the domestic abuse dynamics.
The unfortunate fact with respect to prognosis in these cases is that people with advanced psychopathology, as in this particular condition, may enter into a batterer’s program without psychological treatment for the underlying psychiatric issue. You may then see the core dynamics transferred to another outlet of expression.
Separate Conditions Require Separate Treatments
Conversely, psychotherapy without domestic abuse treatment can lead to an incomplete resolution of the partner abuse dynamics. In Raymond’s case, he had already undergone psychological treatment for years and still managed to retain and perfect his battering behaviour.
The psychotherapy intervention may teach a patient how to manage their mental illness without changing the dysfunctional abusive control dynamics characteristic in their intimate relationships. In cases like this, the patient's psychopathology continues to fuel their abusive behaviour.
If the two comorbid conditions: the domestic abuse and the personality disorder are not addressed independently as two separate conditions, then successful nonviolent interpersonal behaviour change probably won’t be realised, much less sustained.
The Mind of the Emotional Manipulator
For example, Raymond may come to recognise that the use of verbal abuse and psychological character assaults are unacceptable, and remain unaware of how his use of emotional exploitation violates his partner. From his point of view, his partner’s experience is her experience and her responsibility to modulate.
His use of her sustained emotional stirring is his means for maintaining control when and where he believes he may be losing it. It is merely a leveraging technique that he views as benign, yet useful strategically in his getting his way and maintaining his power in the relationship.
He clearly fails to recognise the domestic abuse dynamics in play, all while he remains unable to comprehend the impact of his actions on his partner. These limitations are a function of the psychopathology. Expecting empathy from someone with a narcissistic personality disorder is like expecting an intimate kiss from someone without lips. It can’t happen, because the basis for an empathic response does not exist.
When you attempt to seek empathy from someone incapable of embracing another’s experience, it is much like expecting your cat to bark. Cats don’t bark. Period. The kindest thing one can do is to accept an individual with a narcissistic personality disorder for who they are, and not expect them to be any different, especially without proper intervention. These individuals simply do not have the capacity for empathy and they cannot function without yours.
They are emotionally dependent, and emotionally absent with respect to compassion for their significant other…unless “for show” as part of a manipulation. As in the case of this example, it is paramount that the core psychiatric issues be addressed as central components in the domestic abuse dynamics.
Treatment Prognosis and Expectations
One would need to effectively deal with the core psychiatric issues of entitlement, privilege, universal disregard for the rights and needs of others, affect modulation and fear of abandonment (real or imagined), independent of the domestic abuse intervention, while at the same time being mindful of how these conditions overlap wherein the dynamics of one support the other.
A major problem that people run into in their effort to remedy the domestic abuse under these circumstances is that personality disorders are highly resistant to psychotherapeutic intervention. These disorders are fundamentally immutable to change. What one can realistically expect, however, is to acquire management strategies for coping with the disorder.
If you are in an abusive relationship with someone that has severe psychiatric issues, be realistic in your expectations for change with respect to successfully interrupting the dynamics of intimate partner violence. Seek to obtain an accurate assessment of the psychiatric landscape from a qualified healthcare professional as part of your efforts to end domestic abuse in your relationship. Once you identify the underlying psychological dynamics that trigger the abuse, you are better equipped to heal and end the abusive cycle.