Aggressive Behavior: Is it PTSD or Personality Disorder?

Reader’s Question

My fiancée and I have agreed to go to counseling. He told me a year ago he was abused sexually as a child and since he confided in me our relationship has been awful. He has control issues and is super hyper-vigilant about what he deems a threat from me, usually resulting in him getting ridiculously angry each time something “normal” arises in our live together relationship. The anger, directed at me, is cruel, unusual and not manageable anymore (I can not reason with him at all). When it passes he doesn’t always remember the things he has said or the weird things he accuses me of. I personally believe most of our problems are stemming from abuse he suffered, abuse he kept a secret since he was 5 years old.

For myself, I love him very much; he truly is a nice person and I feel sick for him about his past. I feel badly because he has caused so many emotional problems for me now with his behavior so I am finding it hard to be really here for him. Also I am very nervous because I know if he cannot resolve this I have to leave him as his “episodes” are getting more extreme and he is becoming a danger to myself and himself when he gets in what I call a dangerous defensive mode.

I am not sure what kind of therapist to pick for us. Is he suffering PTSD or is it something more specific because of the abuse (he hasn’t told me much just that it was very frequent and went on for over a year and was quite horrible and left him a very ill child)?

Our Consulting Clinical Psychologist’s Reply

While he would certainly have good reason to have symptoms associated with Post-Traumatic Stress Disorder (PTSD) related to childhood sexual abuse, it’s unlikely to produce all the symptoms and behaviors he’s sending in your direction. Control issues, hypervigilance, severe jealousy, angry outbursts, and such may be more related to personality problems than PTSD.

In personality problems, look for these characteristics:

1. Self-centered and selfish — looking at all situations only as they pertain to him,
2. Aggressive, abusive and intimidating behavior,
3. They take no personal responsiblity for their behavior and typically blame others (especially you) as though you made him misbehave for some reason,
4. They have a sense of entitlement — as though they are entitled to punish you when they feel you’ve done something wrong,
5. They are extremely offended when you challenge their behavior, mood, or attitude and
6. They are not bothered by the way their behavior distresses, upsets, or traumatizes others (because they actually feel the person deserved it).

I’ve listed about 20 indicators of a Personality Disorder in an article entitled Identifying Losers in Relationships on this website.

I would look for a highly qualified therapist — psychologist, clinical counselor, psychiatric social worker, etc. If he does have a combination of PTSD and personality issues, a high level of skill will be needed to separate and treat both conditions, especially in the context of a relationship.

As you suspect, this is a high-risk relationship. With each emotional beating you are taking from him, he is apologizing, yet the beatings continue. Each emotional beating and temper tantrum weakens you emotionally and psychologically. You will soon find yourself changing your lifestyle In-Anticipation-Of an emotional beating — avoiding places where he might become jealous, not discussing certain topics, etc. You, as a person, can easily become overwhelmed by this level of aggressiveness and drama.

You must be prepared to protect yourself…and even leave if necessary. You already know it’s getting worse…and that’s not a good sign. I would advise placing the relationship on a type of probation — agreeing to work to solve or improve the relationship over the next several months. If things have not improved or especially if it’s getting worse — then you need to develop an exit plan to leave to protect yourself. People who truly love us will seek to protect us. People who love themselves first (personality disorders) seek to protect themselves more than their loved ones.