(See our page, The Undetected Victim, for a detailed discussion of mis, dis, and non-identification of the victims and partner pathology).

What has been absent in this new emerging genre of counseling psychology regarding NPD/Anti-Social/Psychopathy survivor treatment, is a cohesive theory about how these relationship dynamics are different and why.

The Institute’s history of various forms of research over the 30 years of treating both the personality disordered partner and/or the survivor partner, as well as other pioneer therapists in this genre including the Association’s Board of Advisors, have indicated there are significant considerations for practitioners to understand. While the similarities of traditional domestic violence and resulting trauma ‘theories’ about dynamics and psychological impacts should be evident in the application to this population, what has been less evident is the fact that there are differences in not only the relational dynamics but the trauma presentation and outcomes affecting treatment approaches.

How these relationships and traumatic aftermath are different significantly impacts treatment approaches in intervention, psycho-education, trauma treatment, future relapse potential, and community prevention.

• Researchers such as Donald Dutton have contributed to our understanding of Cluster B (and psychopathy) pathology as inevitable recidivistic behavior increasing lethality risks for victims.
• New neuro research on the brains of psychopaths (and resulting neuro research on the Cluster B brain) have highlighted the very real threats of impulse control and non-sustained positive change from neuro impact on relationship safety and quality.
• Research on genetics and heritability have supported the role of ‘nature theory’ and challenged long held beliefs of personality disorders as primarily ‘nurture theory’ etiology excessively focused on in-treatment and psycho-education in the past.
• Crime stats and recidivism studies continue to point to repeating patterns of ‘who does that’ within our DSM diagnosis.
• The DSM5 alternative model of personality disorder highlights the personality deficits in self-identity and self-direction, and interpersonal deficits in empathy and intimacy which elevates some of the differences that partners with self-identity, empathy, and intimacy disorders would have on relational quality.
• Increasing trauma research takes us deeper in understanding the wide, systemically-reaching impact of trauma on survivors and unique needs in treatment.

These developments translate to better understanding of the relationship dynamics that create such devastating trauma. In fact, much of our understanding about Pathological Love Relationships, including relationship dynamics and subsequent impact, has been influenced by multiple fields such as:

• Forensic Sciences—Criminal and Victimological Sciences
• Psychological Sciences (Trauma Treatment)
• Developmental Psychological Science
• Criminal Justice and Legal Services
• Technological Sciences (Stalking and cyber stalking behavior)
• Neuro Science (Pathological Partners and Victims)
• Personality Science (Pathological Partners and Victims)
• Risk Analysis Science
• Genetic and Heritability Science of Personality Disorders

It is multi-field contributions that have helped us understand the specific vulnerabilities of a sub group of trauma survivors—Cluster B partner survivors.

The non, mis, and dis-identification of these relationships as highlighted in the chapter on this website called ‘The Undetected Victim’ show us how many questions have remained about a sub group of the domestic violence and/or trauma population. Non, mis, and dis-identification of a partner’s pathology with the same identification problems with relationship dynamics and victims, creates an invisible population. Hidden psychopathology, unknown victim personality constellations, and missed relational dynamics all contribute to the problem that has plagued this sub group of trauma clients—the absent trauma-specific approach for their relational dynamics and traumatic aftermath.

While Narcissism, Anti-Social, and Psychopathy could arguably be noted as the most dangerous behavioral group in the DSM with the Cluster B group being formerly called ‘the dangerous and severe’ group before renamed the ‘dramatic and erratic’—it still had not warranted its own study of relational dynamics or impact until recent years.

Recent years have seen a rise of survivor bloggers taking to the internet byways to provide information as the movement created their own lexicon of relational dynamic related language to differentiate some of the nuances of Pathological Love Relationships (PLRs). At our last count, there were over 800 types of social media oriented or websites on Cluster B relationships and subsequent trauma. This staggering number of sites, in a short period of time, points to the void of professional services and the need the survivors are attempting to fill on their own outside of Trauma Informed Care. Many traumatized survivors are offering coaching services to fill the overt lack of a counseling approach that understands both the relational dynamics and subsequent trauma in trauma specific ways.

While admirable, trauma survivors need Trauma Informed Care unique to their sub group of trauma experience. Our research indicates over 60% of survivors have lingering traumatic reactions or disorders in need of care. It is estimated that Pathological Love Relationships have affected 60 million persons in the U.S. alone not including children. The equation is calculated utilizing the US population, the prevalence rate of Cluster B and psychopathy disorders, and the average partner ratio. In addition, the societal system impact is estimated at $580 BILLION a year to tax payers and systems involved with perpetrator, victim, or children.

With those crushing numbers in mind, it is imperative that we recognize the relational patterns that lead to such widespread interpersonal and societal impact. The Association has formulated a four-step process for identifying these relationships of ‘inevitable harm’ and have delineated the patterns of relationship development and how these differ from the domestic violence model or other dysfunctional relationships. The identification process includes partner pathology, unique relational dynamics, survivor personality constellation, and traumatic aftermath symptomatology.