Cincinnati Academy of Professional Psychology

Cincinnati_April2013(2)On Friday, April 19, I presented a full-day seminar near Cincinnati to members of this psychological association. Since they already had some familiarity and training with personality disorders, I briefly discussed narcissistic personality disorder, borderline personality disorder, antisocial personality disorder, histrionic personality disorder and paranoid personality disorder. Then I focused on how they behave in legal and other conflict resolution settings. I defined “High Conflict Personality” as a more practical term for all of these personalities, to use when interacting with lawyers and other non-counselors, so that non-counselors don’t try to learn diagnosis and treatment of these disorders on their own. It’s very unwise for non-mental health professionals to tell someone they have a personality disorder, as it can cause a serious rupture in the relationship and borders on practicing mental health without a license.

The three key points I made about personality disorders in legal conflict were:

1.       They lack self-awareness of their impact on others. Therefore trying to get them to reflect on their own behavior is fruitless and simply escalates conflict. In other words, forget about giving them insight and negative feedback. They just get very defensive.

2.       They don’t change their behavior. Since they have a psychological barrier against seeing that they have done anything wrong, they don’t seek to change and repeat the same behaviors over and over again – including their dysfunctional behaviors.

3.       Therefore, they focus all their frustrations on a “target of blame” – someone close to them or in a position of authority – and they attack them verbally, legally, financially and sometimes even violently. They can be very convincing. Because of the emotional intensity of their blaming attacks, they often persuade one or more professionals to advocate for them (their “negative advocates”) and sometimes they win in court for this reason. So mental health professionals have to watch out to avoid getting hooked in. I have seen this happen over and over again.

In the afternoon, I focused on methods of managing and helping high conflict clients – and clients who are not high conflict themselves, but may be dealing with a high conflict person (HCP). I included some of the counseling methods that we teach at High Conflict Institute with our New Ways for Families method. (See www.NewWays4Families.com).

One of the points that I emphasize to therapists is that the Parent Workbook for the New Ways method is designed to help them work with their clients on changing their own behavior rather than the other person’s behavior, with whom they are in conflict. It’s so easy for therapists to be pressured by clients in legal disputes – especially high conflict divorce cases – to agree with an HCP client’s complaints about the other person. The Parent Workbook enables them to listen and to empathize with their clients’ frustrations, but then to focus on the tasks in the Workbook.

In a therapeutic sense, the counselor is forming a “therapeutic alliance” with his or her client to work through the workbook tasks, rather than the usual dilemma of forming a “therapeutic alliance” with the client against the other party in the dispute. This is why it also helps in the New Ways for Families method to have a court order requiring the client to complete all of the writing exercises in the workbook with the therapist, and that the court order says this therapist is confidential.

In fact, we discussed the separate roles of a therapist who is treating a client versus an expert who is doing an evaluation and making recommendations. We have tried to manage this issue in the New Ways method by allowing the Parent-Child Counselor to testify, but only about what he or she has observed – not as an expert. We addressed the ethical risks that can occur when interfacing with courts and lawyers, and the need for legal advice when there is a question in this area. For example, they said that Ohio is similar to California, in that therapists are not supposed to send information in response to a lawyer’s subpoena unless their client has released their privilege of confidentiality or the judge orders it.

Overall, I had a great day with this group, as I got to talk about mental health issues in more depth with others who are involved in treating clients with this “high conflict” issues in their lives. And they seemed to appreciate the skills focus I brought, including teaching them BIFF Responses, Coaching for BIFF responses and helping their clients learn to practice making proposals. Even though I had quite an adventure getting home because of plane delays – including running between terminals and airlines at Chicago O’Hare – I got home the same day with memories of how gratifying this work can be.