Indications for Couple Therapy

Couple therapy for individuals with severe personality disorders is beginning to be recognized as a valuable therapeutic approach that could meaningfully impact the individuals' personality pathology. This paper highlights the potential role of couple therapy with couples with histrionic/obsessive-compulsive personality disorders and introduces the “paradox” of couples with “healthier” personality features. In spite of healthier personality styles, these couples are often more difficult to engage than couples with more severe personality pathology. Using the attachment concept to understand this paradox, the histrionic/obsessive-compulsive personality disordered couples have more options than more disturbed individuals to resolve marital distress. These options or patterns of relationships will inform the therapist about