My husband sometimes violently loses his temper. He usually loses his temper when he feels somebody has insulted him or when he feels that people around him are not giving him enough respect and that nobody cares about him. He quite often tells me that I don’t care about him and that I don’t obey him. Quite often when he loses his temper it can go to heights where he verbally abuses the person involved with aggressive words and with the residual temper remaining for two or three days. These explosive tempers happen at intervals.
Is this some sort of a disorder or just a problem of his temperament? Should I seek medical help? I really don’t know how to manage this.
— Desperate Housewife
First, here’s a quick set of definitions to inform the conversation. We’ll get to your specific situation in a moment.
Temperament is something that you’re born with. It describes infant behavior but lasts throughout our lifetime. One can be easy (that is, regular, sleep well and cyclically, and warm to others), difficult (does not sleep regularly or eat regularly, can be cold to others and cranky), or slow to warm up (good natured but shy or reserved, and somewhat in between the other two styles in terms of regularity).
Personality disorders, on the other hand, are developed during the early years of childhood. Although influenced by one’s temperament and biology, developmental pressures mostly determine one’s personality style (or disorder). Now, temperament is not something that can be changed, at least not by psychological intervention. Personality disorders can be treated by long-term intensive therapy if a person is a good candidate for that type of treatment. Although some of the behavioral symptoms or superficial depression that often accompanies a personality disorder can be treated medically, the disorder itself cannot be treated medically.
Your husband’s behavior cannot be explained as ‘just his temperament’. Sure, one can have a short fuse (poor frustration tolerance) as a part of their temperament, but then one would get over it quickly too. What you are describing is someone who is easily offended, takes the offense deeply and personally, and then broods on the slight to his self-esteem for days. He seems to have a lack of concern for the feelings of others and is not overly aware of or concerned with the way people react to his antics. I doubt, in fact, that he is aware that you are desperate.
What kind of disorder could this describe? He could have a personality disorder, since his behavior makes sense to him (that is, his behavior is ego-syntonic). He thinks other people are the problem, and that he is the victim. Because he seems brittle, unempathetic, and is easily wounded, I would guess that his might be a Narcissistic Personality Disorder — although naturally, I cannot make that diagnosis. It would be consistent with that disorder that he does not personally present for treatment. Rather, the spouse presents for treatment. If he does need treatment, then he needs to be amenable to it. That is, treatment needs to be something that he wants for himself, not for you or anyone else. I don’t hear that he wants treatment. Therefore, this becomes a question of problem ownership. Whose problem is this? Yours, I’m afraid, because you can’t manage the situation and you are in distress.
I’m concerned about you because you mention that he gets violent. I don’t know the extent of his violence — we might be talking about breaking dishes in the kitchen, or something felonious. If he has ever hit you, then all bets for improvement are off. You must get to a safe place and stop being a punching bag. You cannot enable his violence by taking it and making him think it’s OK to treat you that way. In fact, when one takes firm action against violence, you may be giving him the best help possible — a reality check. Forensic data support this: the best way to prevent violence is to have the perpetrator arrested immediately. It doesn’t matter whether he’s prosecuted or not. The act of being arrested is enough of a punishment to discourage future acts of violence.
I urge you to make yourself a priority. Do yourself a favor. Exhaust all possibilities to help him and your relationship, but take care of yourself. If he is not going to love, honor and cherish you, then you need to take back that responsibility and do it for yourself. It’s a sad thing to do, but it may be the only way you survive.
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