Difficult Person or High Conflict Person? - HCP is Not a Diagnosis
“My mother/boss/Ex is an HCP!” We often hear this from readers and in the media, but is it true just because we think it is? the origins of the HCP term and how to better use high-conflict theories to your advantage. _________________________
A diagnosis is a term typically applied to assessing a medical problem or mental disorder, so that the proper treatment can be used by the proper professional for the patient with the problem. For example, the DSM-5 (Diagnostic and Statistical Manual) of the American Psychiatric Association lists depression, anxiety, schizophrenia, substance dependence, and narcissistic and borderline personality disorders among its many mental health diagnoses. Based on such a diagnosis, doctors and therapists apply certain treatments, including medications, individual psychotherapy and group therapies. Some people have wondered if I intended HCP to be a new diagnostic category in the DSM-5, which came out in 2013 replacing the DSM-IV (1994) and DSM-IVTR (2000). Definitely not. My intention in coining the term “HCP” was to assist ordinary people in managing their professional and/or personal relationships with possible HCPs, not treating the individual as a patient.
I initially wrote about this subject for people in family law disputes, who included lawyers, judges, mediators, counselors and ordinary people dealing with the divorce themselves (and their relatives, friends, etc.) This has expanded into my training and writing about workplace disputes involving HCPs (a growing problem in every type of occupation). My intention was to make this information accessible to anyone who needed it if they simply suspected someone might be an HCP. Tips for managing HCPs can be used with anyone, whether or not they are an HCP. But many methods of conflict resolution used with ordinary people don’t work with HCPs, such as efforts to give them insights and overly-focusing on past behavior. Focusing on future behavior and their choices and consequences can be much more effective. (See my book It’s All Your Fault! 12 Tips for Managing People Who Blame Others for Everything.)
I recommend having a “Private Working Theory” that someone may be an HCP. You DON’T tell the person and you don’t assume you are right. You simply focus on key methods to help in managing your relationship, such as paying more attention to:
- Connecting or bonding with the person with empathy, attention and respect (EAR)
- Structuring the relationship around tasks rather than reacting to emotions
- Reality testing so that you don’t necessarily believe everything you are told, but also don’t assume the person is lying because they may honestly believe inaccurate information
- Educating about consequences, as HCPs are often caught up in the moment and can’t see the risks ahead.
Of course, the HCP concept is closely related to the issues and methods of dealing with people with personality disorders, which is a DSM-5 diagnosis. But only mental health professionals can diagnosis and treat personality disorders. This doesn’t have any effect on dealing with possible HCPs – because this is not a diagnosis. It’s a description of high-conflict patterns of behavior.
Lastly, news reports indicate that labeling someone as having a personality disorder is the latest insult. This is very sad and unhelpful, as people with personality disorders have a serious problem and the people around them are often in great distress. As people with personality disorders increase in our society, some will be HCPs – but many HCPs do not have personality disorders (some may have milder traits) and would not qualify for any diagnosis in the DSM-5. There’s a lot of overlap with HCPs and personality disorders, but many people with personality disorders are not HCPs because they do not focus on a “Target of Blame,” which is a defining characteristic of HCPs.
It’s better to learn about the predictable behavior patterns of HCPs and ways to respond constructively in your professional or personal relationships. If you think someone is an HCP, use this information as a Private Working Theory and focus on changing your own behavior, not theirs.
Bill Eddy, LCSW, Esq., is the author of several books, including: High Conflict People in Legal Disputes; It’s All Your Fault! 12 Tips for Managing People Who Blame Others for Everything; and BIFF: Quick Responses to High Conflict People. He is the President of the High Conflict Institute, which provides speakers and trainers for managing high conflict people and personality disorders in many settings, including legal disputes, workplace conflict, healthcare, education and law enforcement. For information about training, books, DVDs and free articles, visit: www.HighConflictInstitute.com and www.biffresponse.com.
© 2014 by Bill Eddy, LCSW, Esq.