Dear Patti, 

My cousin, Charlotte, is like a sister to me. My mother and my aunt are twins. When they both had daughters less than a year apart, they were thrilled and practically raised us together. I’ve always loved, admired and worried about Charlotte. By the time we reached high school, she was in a steady, intense relationship with Jacob and has been living with him for several years now. They’ve always seemed deeply in love but are also known to have loud, extreme fights. Jacob can be overly jealous and controlling but it doesn’t seem to be entirely his fault. Charlotte is exciting, wildly beautiful and sexy, and sometimes quite a handful. She has always talked and flirted with other guys and seems to thrive on attention. She recently started counseling and was diagnosed as having a histrionic personality disorder. I’m not sure what that means.

Last week, she shocked me by admitting Jacob has always been physically abusive toward her, resulting in multiple emergency room visits. She partially blames herself because of her personality disorder; apparently Jacob blames her, too. No matter what her diagnosis is, I just don’t understand why she’s staying in an abusive relationship. It breaks my heart to think of her suffering. I’m hoping if I better understand the psychology, maybe I’ll be better equipped to help her leave.

 — Layla

Dear Layla,   

Histrionic personality disorder is recognized by the American Psychiatric Association, the word itself meaning “dramatic or theatrical.” People with this disorder tend to be excessively emotional, have a powerful need to be the center of attention and get approval — sometimes to the extent of being self-centered and self-indulgent — and are often inappropriately seductive, leaning toward provocative dress. Coupled with a low tolerance for dissatisfaction or delayed gratification, they’re easily influenced by others and may have difficulty achieving emotional intimacy in romantic relationships. There may also be a tendency to try to control a partner via manipulation, seductiveness and strong dependency. On the positive side, they’re usually able to function at a high level, be successful socially and professionally, and can be vivacious, enthusiastic and lots of fun.

Common traits of a battered woman can include learned helplessness, low self-esteem, social isolation and a mindset that if she only tries harder to please, she can stop her batterer from having angry outbursts against her. Reasons for staying include fear of retaliation, humiliation, financial hardship, belief that the abuser can be “fixed,” and defeatism by feeling there’s no one to turn to for help. Another common belief is that she is the one at fault and deserves punishment. This goes along with the false idea Charlotte is physically abused due to a personality disorder.

Battering relationships similar to what Jacob and Charlotte are experiencing often follow a three-stage cycle of violence. First comes the building of tension when the batterer reacts to his partner. Secondly is the explosion of violence in which the batterer loses control and engages in physical assault. In the third cycle, the “honeymoon period,” the batterer becomes deeply apologetic, kind, loving and promises the violence will never happen again. The couple makes up and the cycle repeats. This may be the pattern Jacob and Charlotte have been experiencing since high school and can continue for many more years until either or both learn to interrupt the cycle, often with the support of a trained psychotherapist.

I’m glad to hear Charlotte is in psychotherapy. A therapist will often help a victim of spousal abuse by encouraging her to talk about or experience her feelings and to acknowledge and understand the true reality of her situation.    

It’s a sign of very good progress that she broke her silence and isolation by confiding in you. The pain of leaving her relationship may initially seem unbearable, but continue to support her to get help. Stay positive and express to Charlotte how valuable she is to you. The average battered woman has three to five attempts to leave home before actually leaving and insisting her spouse receive treatment before she returns. Until that time comes, be there for her and continue to be her best cousin/sister/friend that never gives up on her. 

Patti Carmalt-Vener, a faculty member with the Southern California Society for Intensive Short Term Psychotherapy, has been a psychotherapist in private practice for 23 years and has offices in Pasadena, Santa Monica and Canoga Park. Contact her at (626) 584-8582 or email Visit her website,