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Overview:
Personality disorders are often poorly understood, especially regarding healthy relationships. We at YesLove! want to provide helpful and inclusive information to help individuals who may have received one of these diagnoses or those who love them.
‘Personality disorder’ is the clinical umbrella term the American Psychological Association (APA) uses to define and diagnose groups of symptoms. These groups are broken down further into three clusters, which we will delve into in this article.
However, this article is not to diagnose yourself or your partner. That should be left to a medical professional. We aim to bring awareness to this subject, so you can make informed decisions about how to look after yourself or a loved one who may be struggling. We also offer support if you choose to seek help.
Some researchers and patient advocacy groups disagree with labelling individuals altogether, so from here on out we will use the term ‘personality difficulties.’
What are personality difficulties?
Firstly, it may be beneficial to define what a personality is. We all have one, but it can be challenging to describe. The APA defines personality as our unique configuration of behaviours and characteristics, built from our life experiences(1).
The development of our personalities can be influenced by various factors, including our genetics, the way we are raised, how we interact with the wider world, our inner beliefs, and patterns of behaviours(2).
During childhood, our personalities are malleable and affected by our surroundings. Traumatic childhood experiences can lead to the development of maladaptive coping strategies and increase the likelihood of developing personality difficulties. As we grow into adolescence and adulthood, our personalities solidify and tend to remain fairly consistent. That doesn’t mean they can’t be changed; it just means it can be more challenging.
To diagnose someone with a personality disorder, that individual must present continuous patterns of behaviour which cause significant distress to that person and deviate drastically from cultural norms(3).
What is the difference between a personality trait and personality difficulties?
We all have a collection of traits that create our unique personality. They make us who we are, and it’s important to know that having a specific trait doesn’t mean you have personality difficulties.
There are different trait theories, but one of the most common is the five-factor model, which organises personality into five key aspects(4). If you have tried one of the online tests, you will have received a score on the following five dimensions: Openness, Conscientiousness, Extraversion, Agreeableness, and Neuroticism.
These dimensions are scored on the high-low spectrum. For example, someone high in extraversion would be more outgoing and excitement-seeking, whereas someone low in extraversion would be more reserved and observant.
Traits fluctuate depending on the social setting, the individual’s mood, and other factors. A good example would be the difference in someone’s behaviour when they’re around family vs giving a presentation.
When traits become rigid or disconnected from societal norms to the point of causing distress and disruption, that’s when someone may run into personality difficulties.
Diagnosing personality difficulties:
Only a mental health professional can diagnose a personality disorder, which is why we refer to them as personality difficulties. But for educational purposes, these are the criteria a diagnosing clinician would use(5).
The individual will need to be evaluated to assess their thoughts and behaviours and how they affect their life. Diagnoses are only given to adults (over the age of 18) because up until that age, personality is still developing.
The individual must be significantly struggling in at least two of the following areas:
There are ten different personality disorders, which are split into three categories or clusters, and share commonalities in how their symptoms affect their lives(6).
Cluster A:
Described as odd or eccentric and have difficulties relating to others.
Cluster B:
Described as dramatic or erratic and have difficulties controlling their emotions.
Cluster C:
Described as anxious or fearful and have difficulties managing those feelings.
The rest of this article will try to bring awareness to the patterns of behaviours linked to these difficulties. If you notice any of these behaviours or thoughts in yourself or your partner, you can get in touch with our qualified mental health experts here and you can get help as an individual or a couple.
Cluster A
Paranoid personality difficulties:
Common thoughts and behaviours(7):
How paranoid personality difficulties can affect your relationship:
Having this type of difficulty in a relationship can be extremely upsetting to both partners. Despite the lack of evidence, paranoia can feel completely justified and that can lead to controlling behaviours as they try to reduce the risk of the perceived betrayal of trust.
A paranoid partner may insist on monitoring their partner’s phone, track their location, follow their partner, and other behaviours fuelled by their distorted perception.
As frightening and stressful as it might feel for the individual with these personality difficulties, it can also be highly stressful and upsetting for their partner, too. It can feel like no matter what they do, they can’t alleviate their partner’s concerns. This can become exhausting, and lead to anger and resentment if the couple doesn’t receive help.
The cause of paranoid personality difficulties is unknown. Some research suggests a genetic link and higher instances are found in families with psychotic diagnoses(7).
How to get help:
It can be challenging to encourage someone with paranoid personality difficulties to get help, due to their mistrust of others.
Taking a compassionate and gentle approach to the subject can help, and it can be beneficial for both romantic partners to enter individual and couples therapy. This can show the partner with paranoid difficulties that you’re united in this together.
However, insisting or demanding that your partner gets help can be counterproductive. No one can force someone to change, and taking a heavy-handed approach could trigger their paranoia.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Schizoid personality difficulties:
Common thoughts and behaviours(8):
How schizoid personality difficulties can affect your relationship:
People who struggle with these difficulties may have no interest at all in forming romantic relationships and may avoid them altogether. They may choose to spend as much time as possible alone which can limit the likelihood of developing any relationships.
Some researchers have highlighted the overlap between schizoid personality characteristics and other diagnoses, like schizotypal PD, avoidant PD, and autism(8)(9). This is another reason why it is important not to try and diagnose yourself or others.
The research is sparse regarding the cause of schizoid personality difficulties, but like many other conditions, nature and nurture play their part. Some studies highlight links between brain legions or injury, cold or emotionless primary caregivers, and family members with schizophrenia(10).
How to get help:
If you suspect that you or someone you care about is struggling with schizoid personality difficulties, there are a few treatment options available. Some individuals with this kind of personality may not feel like they have a problem. They may have survived a troubling childhood and grown to be a very private person.
It is important to understand that you cannot force people to seek help, but you can foster a safe environment and build trust, so they might feel comfortable enough to ask for help in the future.
Talking therapy can be useful to explore a traumatic past safely. Cognitive behavioural therapy may help challenge unhelpful beliefs and thought patterns and provide a more beneficial way of looking at the world. A good therapist will work at your pace but encourage you to push yourself.
Group or couples therapy can also help an individual with schizoid personality difficulties. In a couple or group setting, the therapist can facilitate learning and practising interpersonal skills. It can also allow you to form trusting relationships with others who can relate to what you’re going through.
There are no specific medications for schizoid personality difficulties, but antidepressants and antianxiety medication can help with those symptoms.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Schizotypal personality difficulties:
Common thoughts and behaviours(11):
How schizotypal personality difficulties can affect your relationship:
Someone who has schizotypal personality difficulties may never want to form relationships with others. Other people can seem confusing, scary, and untrustworthy. They may also feel like they simply cannot understand others and feel like they don’t belong in any group(12).
If you identify with these thinking patterns, it might feel unnecessary to build relationships with others. But we live in a social world, and it may improve your quality of life if you seek help and develop healthy relationships.
If you care about someone who exhibits these difficulties, it can be difficult and frustrating to try and get close to them. Educating yourself on the difficulties and reassessing your expectations can help protect your mental health.
Similarly, to the previous personality difficulty, researchers aren’t clear on a specific cause for schizotypal personality difficulties. This may be due to people with this cluster of difficulties tending to avoid therapy or research into the condition(13).
Risk factors include having a close blood relative with schizophrenia, chronic stress, and psychological trauma. Around half of the individuals who are diagnosed with schizotypal personality difficulties have also struggled with depression.
How to get help:
As mentioned above, it can be extremely difficult to encourage a loved one with schizotypal personality difficulties to get help. They may feel like they’re fine as they are. If they struggle with paranoid feelings, they may assume any insistence to get help has sinister motives. Be kind, understanding, and gentle with them.
If you or your loved one do decide to get support with these difficulties, cognitive behavioural therapy has been effective in helping to change thoughts and beliefs leading to more sociable behaviour and relationships(14).
If you are in a relationship with someone who is struggling with schizotypal personality difficulties, you may want to seek therapy for yourself to help you cope, and also couples therapy to promote better communication and understanding between you.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Cluster B
Narcissistic personality difficulties:
Individuals who exhibit narcissistic personality difficulties can fall into different subcategories. For this article, we will look at clinical narcissism as a whole. People who struggle with these difficulties may experience the following thought patterns and behaviours(15):
Much like other personality difficulties, there isn’t a definitive cause of narcissistic personality difficulties. But researchers indicate environmental links, such as poor attachment styles, and a critical, over-protective, or neglectful caregiver. There are also genetic and neurobiological links(15).
How narcissistic personality difficulties can affect your relationship:
If you love someone who struggles with narcissistic personality difficulties, it can be a rollercoaster of emotions. Some days they can see you as the perfect partner, and other days it can become abusive.
Here are some features to watch out for, either in yourself or in your partner (these can also be found in individuals who don’t have narcissistic personality difficulties):
Love bombing – This is a manipulative tactic commonly used at the start of a relationship. The love bomber will appear to be everything their partner wants and is often described as ‘too good to be true.’ It can involve extravagant excessive gestures of affection, but these quickly fade into more overt kinds of abuse(16).
Mirroring – Similar to love bombing, the narcissistic individual will take on their partner’s behaviour, clothing, and speech patterns, and seem to morph into their partner. This can be due to their unstable identity. It’s also used to fake intimacy with their partner(17).
Gaslighting – This is an abusive method used to twist facts and reality. It can lead to their partner questioning their perceptions and memories, and leave them feeling unsure about their own sanity(18).
Devaluation – Once the narcissistic individual has drawn a partner in, they may begin to project their own negative traits or insecurities onto their partner. This can lead to emotional attacks on their partner’s perceived flaws, so the partner feels as insecure as the narcissistic individual(19).
Breadcrumbing – Giving mixed signals or behaving hot then cold. It is a way to keep their partner, or ex-partner, thinking about them. By giving just enough attention to feel wanted and then taking it away, partners can feel compelled to ‘earn’ the narcissist’s affection(20).
Future faking – Making someone believe in a future that will never happen. It can range from small things like promising to pick up milk from the shop with no intention of doing it, to planning a holiday or a family. It can be a way to keep their partner from ending the relationship, by believing there could be a happier future(18).
Baiting – Deliberately causing arguments. It can be used to get their own way or to further dominate their partner(21).
Triangulation – Utilising another person to maintain control. The narcissistic person may lie or discuss personal problems with the other person, to gang up against the partner. It can also be used outside of a romantic setting, for example in the workplace or friendship group(22).
Hoovering – If the narcissistic individual suspects their partner is going to leave, they may use hoovering to reel them back in. They can tell friends, family, or even children how important and special their partner is, and how they never should have let them go.
Trauma bonding – An attachment between an abuser and their partner. A repeated pattern of psychological, emotional, or physical abuse, followed by praise and positive reinforcement can lead to a powerful bond. It can be identified by wanting to excuse abusive behaviour, blaming themselves for ‘triggering’ the abuse and feeling an intense need to please the abuser(23).
How to get help:
Talking therapy can help someone who struggles with narcissistic personality difficulties become aware of their behaviours and how they affect others. However, it can be extremely difficult to encourage that person to get help and therapy can be used as a way to blame others for their problems.
If successful, therapy can help the individual understand themselves and learn to manage their emotions.
Couples therapy has the potential to help both partners, but it is important that it doesn’t become weaponised by the individual with narcissistic traits.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Antisocial personality difficulties:
Common thoughts and behaviours(24):
How antisocial personality difficulties can affect your relationship:
As the individual with antisocial personality difficulties has very little empathy for others, the partner can feel like it’s a one-sided relationship. It is easy to become emotionally and psychologically exhausted, and there is also the risk of physical violence(24).
People who have antisocial personality difficulties can display a lot of the same features we described in the narcissistic section. The two conditions are often diagnosed together, so the patterns of behaviour can look very similar(25).
If you suspect you or your partner is struggling with antisocial difficulties, it is important to seek help to keep you both safe.
There is no definitive cause, but factors like childhood abuse or a caregiver with an antisocial personality play a role in the development of these difficulties.
How to get help:
In the past, researchers have questioned the effectiveness of treating antisocial personality difficulties. The individual may not believe they have a problem, so would be unlikely to seek help(26).
However, cognitive behavioural therapy can be helpful. If the clinician can show that behaving in pro-social ways is beneficial to the individual, it is more likely to be accepted.
If you’re in a relationship with someone who has these difficulties it is important to seek help for yourself, too. Individual therapy can help you cope, and couples therapy can improve the quality of your relationship.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Borderline personality difficulties:
Common thoughts and behaviours(27):
How borderline personality difficulties can affect your relationship:
A person with these difficulties can be intense in every sense of the word. They can be intensely loyal, loving, devoted, and caring, and want to display that love. For some partners, this may be ideal, but for others, it can feel too much to handle.
When an individual with borderline personality difficulties feels their relationship is threatened it can lead to erratic, aggressive, and dysfunctional outbursts.
This can feel scary for the partner, but for the person struggling with these difficulties, it can feel like a matter of life and death. It is important for both partners to seek help if they’re finding it hard to navigate the relationship.
Some researchers have pointed to differences in brain scans between neurotypical people and those with borderline personality difficulties. The areas of the brain affected are involved with the regulation of emotions and impulsivity. There are often genetic components, strong links to childhood abuse, and caregivers with mental health issues(27).
How to get help:
As with other personality difficulties, getting help as an individual and as a couple can be beneficial. Couples therapy may be even more important for this difficulty, and it can build stability and a greater understanding of each other’s needs.
Some of the talking therapies which are the most useful include: dialectical behavioural therapy (DBT), cognitive behavioural therapy (CBT), cognitive analytic therapy (CAT), and mentalisation-based therapy (MBT).
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Histrionic personality difficulties:
Common thoughts and behaviours(28):
How histrionic personality difficulties can affect your relationship:
Some people may like a partner who is the life and soul of the party. But for others, it can lead to unpredictable and over-dramatic situations that they find hard to deal with.
The individual struggling with histrionic personality difficulties can react in explosive ways if they feel they aren’t getting the attention they crave.
These difficulties are linked to a number of potential causal factors in childhood, such as learnt behaviours from a caregiver with histrionic difficulties, unpredictable attention, lack of punishment, being rewarded for attention seeing, and familial history of anxiety or depression.
How to get help:
Talking therapy, especially psychotherapy, can help the individual understand themselves better and recognise their need for attention before it gets out of hand.
Couples therapy can help build trust and understanding in the relationship and may be beneficial to both partners.
There are no medications to treat histrionic personality difficulties, but as the symptoms can lead to anxiety and depression, medication to treat those may be helpful.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Cluster C
Avoidant personality difficulties:
Common thoughts and behaviours(29):
How avoidant personality difficulties can affect your relationship:
A partner may feel like they are trying to love someone who isn’t truly present. An avoidant individual can have a difficult time expressing emotions, committing to another person, relying on others, or being vulnerable with their partner.
It could be challenging to feel connected to someone who has avoidant difficulties, and they may rely on maladaptive coping strategies, such as substance use.
There is limited evidence of the cause of avoidant personality difficulties, but some researchers have noted a genetic component. It can also be linked to environmental factors, such as childhood rejection, poor self-worth, and extreme shyness(29).
How to get help:
Similar to histrionic difficulties, psychotherapy or cognitive behavioural therapy can be beneficial in addressing unhelpful thinking and behaviour.
If you or your partner struggle with avoidant difficulties, couples therapy can help you both express your feelings in a safe environment. Both partners can learn new skills to alter problematic or triggering behaviour and foster a deeper connection.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Dependant personality difficulties:
Common thoughts and behaviours(30):
How dependant personality difficulties can affect your relationship:
If someone struggles with these difficulties, they may feel like all their self-worth comes from their partner, and if they perceive their partner pulling away that can trigger terrifying feelings of abandonment.
For the partner, it can be challenging to deal with clingy and attention-seeking behaviour, and they may get burnt out by having to make all the decisions in the relationship. It may feel one-sided and that can foster resentment.
There are no definitive causes of dependent personality difficulties, but some researchers have found correlations in certain circumstances. Childhood abuse or severe illness in childhood has been linked to the development of these difficulties. Also, a family history of dependent or anxious difficulties, and there have been connections with individuals who have a history of being in abusive relationships(30).
How to get help:
Like many other personality difficulties, talking therapy can help. Cognitive behavioural therapy and psychotherapy are recommended by professionals to encourage individuals to explore their feelings and discover better ways to manage them.
Couples therapy can be extremely useful, too. It can help both partners navigate the intense feelings of dependency in a loving and healthy way.
Again, it is usually recommended that both partners seek individual and couples therapy to foster independence and resilience.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Obsessive-compulsive personality difficulties:
Common thoughts and behaviours(31):
How obsessive-compulsive personality difficulties can affect your relationship:
Partners with these difficulties can be very driven to succeed, excellent with finances, and dependable in their beliefs. That consistency may be ideal for some partners.
Although, due to black-and-white or all-or-nothing thinking, individuals with obsessive-compulsive personality difficulties can struggle to relate to others. It can be a challenge to empathise or to understand that others have different perspectives.
To those struggling with obsessive-compulsive difficulties, it can seem impossible that their rules aren’t universally accepted.
This can lead to frustrating arguments where neither partner feels heard, and the only way to end the disagreement is for the neurotypical partner to give up. This is not ideal and can foster resentment toward the partner with these difficulties.
Some researchers highlight a potential environmental link to obsessive-compulsive difficulties, although it is not a concrete causal pathway. If a child was raised with extreme rules and harsh punishment, they may become obsessed with rules and routines in the future. Other researchers have indicated a possible genetic link, between relatives with obsessive-compulsive difficulties(31).
How to get help:
It can be a challenge to encourage a loved one with these difficulties to get help. They have a rigid attachment to their set of rules and their worldview, and they may not feel that it needs changing.
However, if they can see the impact their behaviour is having on their partner, they may agree to seek help.
Cognitive behavioural therapy is a common approach. Therapists can challenge their core attitudes and beliefs and encourage them to find a less concrete way of thinking. In therapy, the individual may learn how to express emotions that they have kept bottled up and hidden behind their rules.
Couples therapy can also be beneficial. There may be certain actions that trigger the obsessive-compulsive partner, that the other partner was completely unaware of. It can be a healing and bonding experience for both partners and lead to a more secure, healthy relationship.
Contact our qualified mental health experts here if you would like assistance as an individual or a couple.
Summary:
Personality difficulties can be extremely challenging to those who struggle with them and those who love them. We at YesLove! hope that this information has been useful in identifying potential characteristics in yourself or your partner that may have been causing issues in your relationship.
We believe in promoting healthy romantic relationships and we know there is a wide and beautiful spectrum of love.
If you or your partner decide to get help, YesLove! is here to support you both on your journey. We provide compassionate, qualified experts who will be happy to offer psychological and emotional assistance while you navigate these challenges.
