Who am I talking to?

Originally published in the Santa Monica Daily Press January 30, 2014

Dear Life Matters,

I am experiencing some really difficult times with my loved one. She has been my partner for almost a decade now and I love her dearly.

Most of the time things are good, but when I need some space or I have to leave her for some time, she goes into a rage and it’s as if she has a totally different personality! I am not kidding; her facial expressions are completely different, even the sound of her voice is completely different. It is like she is a completely different person; it’s like she’s possessed.

We saw a marriage counselor and in the session she admitted feeling like she had something like a psychotic break. The therapist said that she has some kind of a personality problem or disorder. The therapist also said couples counseling was probably not going to work.

I’m a pretty tough guy, but these episodes hurt me deeply. Is there anything that can be done or anything that I can do, other than “man up?”

I don’t think I can take much more.

Thank you,

Baffled

Dear Baffled,

Your situation does sound serious. Let me see if I can’t educate you a bit and make some suggestions that might help. I cannot say what is happening with your partner because I have never met her. I will, however, give you some information based on what you have said here.

There are people who have been deeply traumatized, usually when they were quite young and/or during their childhood, who do their best to bury the trauma and all the associated feelings. It’s maybe what we might think of as compartmentalizing. They attempt to move forward in the world just like the rest of us, but every so often the traumatized self comes out and screams out with the excruciating pain that it feels.

Sometimes this is referred to as Dissociative Disorder, formally called Multiple Personalities, but more often is diagnosed as Borderline Personality, which is someone who has great difficulty with emotional regulation.

Some of the classic symptoms of this are emotional instability; difficulty if not inability to tolerate separation; extreme reactions to abandonment, real or imagined; extreme difficulty with interpersonal relations; and often some history of substance abuse, shopping sprees, sexual promiscuity and also, self injury. Having said that, there are varying degrees of this and some people are far more functional than others. The bottom line, as you can see, is a real inability to control their moods and emotions.

I liken it to the construction of a home. If we build one, we hope it is on solid ground and that it is well constructed. From there it is about décor and fixtures, maybe later a remodel.

Our personalities are built on the temperament that we are born with, although it can be modified with good parenting and attunement to our babies. Then we build personalities with that and other environmental factors, but primarily the experience of our interpersonal world.

If our house is not well built, it is going to blow apart or suffer some serious damage when a strong storm comes along. The same is true for this type of personality. If everything is wonderful, things can go smoothly, but with any gust of wind, there can be a real shake up.

People who have these types of problems are not at fault. It is because of the trauma they experienced. The good news is that the field of mental health is coming up with new treatments every day that are successful. The bad news is that sometimes these people are too scared, and untrusting to try therapy.

If you can get your wife into treatment, it sounds like she might benefit from what is known as DBT or EMDR or Somatic Experiencing, to name a few specialized treatments for trauma. Talk therapy alone will not be enough. Unfortunately, there are no medications that target this specifically so it has to be therapy with a specialized trauma therapist.

Couples therapy won’t work except to move her towards seeking the trauma therapy. If you can get through to her that you deeply love her and she trusts you and the therapist enough, you might be able to get her into trauma treatment. Then I would say couples counseling was a success, but it won’t be a success in the classic way that we think of, helping the relationship to be better. It needs that missing ingredient.

As far as “man up,” I hope you don’t mean keep taking it like a man and pretend it doesn’t hurt. If you point out her defects and criticize her she wont hear you. But if you share your hurt feelings, you have a good chance of being heard because that it something she understands.