For the past 20 years, I’ve worked with countless men navigating relationships with women who exhibit Borderline Personality Disorder (BPD), Narcissistic Personality Disorder (NPD), Histrionic Personality Disorder (HPD), or other high-conflict personality traits. A recurring theme? The massive gap between what therapists claim should work and what happens in real life outside the therapy office.
If you feel like nothing you do helps, that setting boundaries with a borderline partner only fuels the chaos, or that therapy has made things worse instead of better—you’re not imagining things. Many of my clients have had the same experience.
For reasons that baffle me, many mental health professionals insist that BPD is highly treatable, unlike other Cluster B personality disorders. They promote Dialectical Behavior Therapy (DBT) as the gold standard, almost as if it’s a magic cure. Let’s be clear: BPD is just as resistant to treatment as NPD and HPD—despite what some therapists claim. DBT is not a cure—because there is no cure for personality disorders, only symptom and behavior management.
That’s not to say DBT is worthless. It’s built on solid cognitive-behavioral therapy (CBT) principles. But here’s the problem: Theory doesn’t always translate into reality. Concepts like radical acceptance, co-regulation, and empathetic listening may sound great in therapy, but in real life—especially with an emotionally abusive or manipulative BPD partner—it’s often a different story. Worse, many DBT practitioners enable borderline abuse, acting as apologists instead of holding their clients accountable.
If you’ve been told DBT will “fix” your borderline partner or that setting boundaries will magically solve your toxic relationship, you’ve been misled.
Why DBT Fails in BPD Relationships: The Theory vs. Reality Gap
You may have heard of the theory-practice gap—the difference between learning something in a controlled environment and applying it in the unpredictable chaos of the real world. It’s like learning to scuba dive in a swimming pool versus plunging into the open ocean, where currents, visibility, and marine life add layers of complexity. The theory-practice gap assumes the theory is sound, but requires adjustments to account for real-world variables.
Why the Theory Breaks Down in Real Life
The theory-reality gap, however, is something else entirely. It highlights a significant disconnect in the theory itself—such as DBT (Dialectical Behavior Therapy)—when applied to intimate relationships with high-conflict personalities like those with BPD. The problem isn’t just that the theory is hard to implement; it’s that it often implodes in the face of the chaotic, manipulative, and emotionally dysregulated dynamics of living with or co-parenting with a BPD or NPD partner. What works in a structured therapy session rarely holds up at home, where there’s no therapist present and the BPD partner feels free to unleash their true self without fear of consequences.
Take, for example, clients who’ve attended couples therapy with their BPD or NPD partners. Many therapists, while trained in the theory of personality disorders, only truly “get it” when a borderline or narcissist dysregulates live in the session. It’s one thing to read about borderline or narcissistic rages in a textbook; it’s another to sit across from a BPD client in full dysregulation, weaponizing their rage to attack both their partner and the therapist.
This is often where rubber (theory) meets the road (reality)—and has a blowout. One client shared his experience: “The therapist kept saying they understood BPD until my wife started yelling at him for ‘taking sides’ when he suggested I set better boundaries. He tried to calm her down, and she turned her rage on him. We never had another session after that.” For this client, the session confirmed what he already suspected: Even so-called skilled therapists can be blindsided by the reality of dysregulation, projection, and grievance rages.
This dynamic often leads to predictable outcomes. The BPD or NPD partner either walks out mid-session, blaming everyone else, or splits on the therapist entirely, never returning. Meanwhile, the non-disordered partner is left feeling invalidated and hopeless—stuck in a dynamic where even professionals can’t seem to help. It’s no wonder so many of my clients feel like they’re fighting an uphill battle in therapy.
DBT: The Promises vs. The Reality
Many clients place their relationship hopes in getting an accurate diagnosis and Dialectical Behavior Therapy treatment for their BPD/NPD wives or girlfriends—only to see those hopes dashed. The obstacles start with the diagnosis itself. Most refuse evaluations, deny the diagnosis, or threaten to sue the evaluator.
Even when a diagnosis is secured, the next hurdle is getting them into treatment with a competent DBT therapist who isn’t a BPD enabler-apologist. Online, DBT is hyped as a miracle fix for what is, in reality, a lifelong, incurable personality disorder. But DBT only works if the borderline commits to the hard, grueling work it requires and—most importantly—takes personal responsibility for their behavior. That means no blaming, no deflecting, and no hiding behind victimhood. For many, that’s as unnatural as the faces of “The Real Housewives of (insert city here)” cast members.
The Thankless Role of the Parent-Partner with Unwavering Positive Regard No Matter How Destructive the BPD/NPD Behavior
Unfortunately, for most of my clients, DBT doesn’t save the relationship. Their wives may attend therapy, but the marriages still end in divorce. Why? Because DBT often places the non-disordered partner into what I call the “parent-partner” role.
This means staying calm during toxic dysregulation episodes, practicing “radical acceptance,” and training yourself not to take their abuse personally. Your well-being and emotional needs? Permanently sidelined. Worse, they’re seen as selfish or even threatening to the BPD/NPD and the relationship itself. It’s still a one-way street relationship paved with double standards—just with fewer potholes, fewer muggings, and marginally improved road maintenance. But you’re still the one paying the toll and it’s forever “Infrastructure Week.”
And yet, it gets worse. When my clients shared what was happening at home—manipulation, emotional abuse, and relentless dysregulation—the DBT therapists told them they must not be using the techniques correctly. Talk about victim-blaming. Instead of addressing the borderline’s abusive behavior, the focus shifted to shaming the non-disordered partner for not being a better punching bag, blame receptacle, and emotional dysregulation janitor.
Why This Matters
While DBT can work in the controlled environment of a therapy office, it rarely translates to the chaos of daily life with a borderline or narcissistic partner. The structured exercises and techniques that seem effective in session often unravel when faced with the unpredictable, emotionally charged dynamics of intimate relationships.
The same is true for high-conflict co-parenting situations. Boundaries, for example, are essential—but enforcing them with someone who views boundaries as rejection, “being mean,” or attempts to control them often leads to escalation, not resolution. You’re not just “setting a boundary”; you’re triggering a BPD/NPD episode.
The idea of “healthy co-parenting” becomes laughably unrealistic when you’re dealing with someone who prioritizes control, revenge, or image management over their child’s well-being. But good luck explaining that to Louise the LMFT or the latest self-proclaimed YouTube “expert.”
In practice, these situations are messy, exhausting, and often impossible to navigate using traditional therapeutic advice. That’s why it’s critical to understand not just the theory but the reality of living with or co-parenting alongside a high-conflict personality.
The Theory vs. Reality Gap and the DEAR MAN Dialectical Behavior Therapy Technique
DEAR MAN is a core DBT technique for “assertive communication” and “interpersonal effectiveness.” It’s designed to help people express their needs clearly while maintaining boundaries and reducing conflict. It’s supposed to be useful when dealing with emotionally volatile individuals, such as those with Borderline Personality Disorder.
The key word here? SUPPOSED.
Each letter represents a step in the framework:
D – Describe the situation objectively, without exaggeration or blame.
E – Express your feelings clearly and calmly.
A – Assert your needs or boundary directly.
R – Reinforce the benefits of cooperation (why it’s in their interest to respect your request).
M – Mindfulness: Stay focused on the main point and don’t get sidetracked.
A – Appear confident: Use a calm, steady tone and maintain self-assurance.
N – Negotiate if necessary, but without compromising your core needs.
Sounds reasonable, right?
Reasonable being another key word. This technique would likely work with a partner who is a mostly reasonable person, but gets a little needy from time to time.
DEAR LORD! Theory vs. Reality in Action
Here are some common examples that many of my clients face. For instance, a lot of these men have BPD/NPD partners who demand constant texts throughout the day while they’re at work. When my clients can’t immediately respond, borderline tantrums and rages ensue.
The “You Didn’t Text Me Back Immediately” Meltdown
Here’s how DEAR MAN typically works in reality outside the DBT office:
[D] Client: I’ve noticed that you feel anxious when I don’t respond to your texts immediately.
BPD: Quit calling me crazy! You’re such a narc! Husbands who love their wives return their texts! Quit acting like I’m unreasonable!!!
[E] Client: I understand that waiting for a response is frustrating, and I care about you.
BPD: Don’t tell me how I feel! I’m not frustrated! You show me everyday I’m not your priority! How do you expect me to trust you when you can’t even reply to my texts!!!
[A] Client: I can’t always reply right away because of work, so I won’t be able to immediately reply to your texts during the day.
BPD: I. AM. YOUR. WIFE. You promised to put me first! You care more about work than me!!!!!
[R] Client: If we set expectations now, hopefully you’ll feel more secure, and we’ll avoid upset.
BPD: [Word salad rage,shame, accusations of cheating, and wanting to have sex with your sister.]
[M] Client: I care about you. That isn’t what this is about.
BPD: You always put everyone ahead of me! Your family! Your friends! your whore ex-wife and your bratty daughter from your whore ex-wife!
[A] Client: (Speaking calmly) I’ve told you how I feel about name-calling. It’s not okay no matter how upset you are. If you continue, I’m going for a drive.
BPD: HOW CAN YOU BE SO CALM!??!?!? Our marriage is on the line!! FINE!!! Run away you fucking pussy!!!
[N] Client: I’ll be back in a couple hours. I’m going to the gym and won’t respond to texts. We can talk about this later when you’re not so upset.
BPD: FUCK YOU!!!
(And by the following week, the BPD wife is sleeping with their son’s soccer coach.)
Why DEAR MAN Fails in the Real World
This is why DBT skills only work with people who are capable of regulating themselves to some degree. DEAR MAN and many other DBT techniques assume the other person is capable of reason and compromise. A borderline in full-blown dysregulation is capable of exactly none of these things.
Instead of responding with mutual problem-solving, they escalate, rage, twist words, project, and, ultimately, attack their partner. Essentially, many DBT “communication strategies” are different ways to ask your partner to stop emotionally abusing you. DBT practioners won’t call it that, but that’s what it is.
All the while asking the partners of BPD individuals to support and co-regulate them while they’re actively being abused by them. And that, as far as I’m concerned, is the biggest part of the theory vs. reality gap. When therapy techniques assume emotional regulation from a partner who is fundamentally incapable of it, the only thing they “improve” is the borderline’s ability to keep you stuck in their abuse cycle longer.
In Case of Emergency: Walk Away
When all else fails, DBT therapists tell partners of BPDs to calmly say, “I’ll come back when we can talk respectfully,” and walk away.
Sounds simple, right?
Except that it isn’t. Walking away doesn’t extinguish a borderline meltdown. It throws gasoline on it. For many of my clients, walking away doesn’t end the conflict. Instead of defusing the situation, it triggers more rage, name-calling, and accusations of abandonment.
Common BPD responses include:
- You coward! Go run home to your mommy!
- You’re stonewalling me! That’s emotional abuse, you narcissist!
- If you really loved me, you wouldn’t leave! Real Christian leaders don’t abandon their wives!
Then comes the punishment—because if you won’t engage directly with them, they’ll find another way to make you suffer:
- Silent treatment—not because they’re done fighting, but to hurt you.
- Cheating out of revenge—because if you won’t give them attention, someone else will.
- Smear campaigns—rewriting the narrative to make you the abusive one.
So what DBT practitioners don’t tell you is that walking away doesn’t end the conflict—it just postpones it. I do tell my clients this, however.
I also tell them that IF this technique is going to work, it’s because:
- It removes the BPD’s control. If they can’t control your attention, they lose power.
- It can force emotional regulation. If they want to talk with you, they have to calm down.
- It keeps you sane. Engaging in their chaos only destroys your peace.
Basically, the BPD has to be able to learn that if they want engagement, they have to behave better. They really, really do not like this. Even so, you should do it anyway.
Let them call you names, scream, or threaten—these are tactics to keep you emotionally engaged and trapped. They don’t respect you more if you stay and fight—they learn that you’re easy to manipulate. At best, it forces them to control themselves for a little while. At worst, it builds anger and resentment until the inevitable final blowup.
And for most of my clients, that final blowup is divorce.
Conclusion: DBT Isn’t the Problem—False Hope Is
I’m not saying don’t support a partner who is genuinely committed to DBT and being less abusive if that’s what you want to do. But you need to set realistic expectations. Specifically:
- DBT is not a magic cure.
- It only works if the BPD individual takes full responsibility for their emotions and behavior.
- If you’re doing more work than they are to regulate their emotions, DBT isn’t working—it’s just repackaged codependency.
Additionally, you must be very clear with the DBT practitioner from the start (and yes, you must be able to communicate with them—BPDs lie and distort. Release forms must be signed.):
- BPD and DBT are not excuses for ongoing abuse.
- You will not be manipulated into being the “co-regulator” for their emotional chaos.
- Therapy needs to focus on them taking accountability—not just you learning to “handle” them and tolerate their abuse better.
To that end, you need to work with your own therapist who understands what you’re experiencing and the common traps that keep partners of BPD individuals stuck in a cycle of abuse. Because the biggest danger in these relationships isn’t just the borderline’s behavior—it’s the false hope that if you just work hard enough, it will get better.
It won’t—because DBT only works when the BPD takes full responsibility for themselves. If they can’t or won’t, therapy won’t fix them, and neither can you. That’s the real theory vs. reality gap.
Counseling, Consulting and Coaching with Dr. Tara J. Palmatier, PsyD
Dr. Tara J. Palmatier, PsyD helps individuals with relationship and codependency issues via telephone or Skype. Since 2009, she’s specialized in helping men and women break free of abusive relationships, cope with the stress of ongoing abuse and heal from the trauma. She combines practical advice, emotional support and goal-oriented outcomes. If you’d like to work with Dr. Palmatier, please visit the Schedule a Session page or you can email her directly at shrink4men@gmail.com.
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