Rachel has conflict every day. She takes conflict as a personal assault. Her thinking is rigid and emotions are not managed. She blames others and never cares if she harms people or acts in lawless ways. In fact, she is among the more than 70% of people with antisocial personality disorder (ASPD) who can be found in prisons and substance abuse clinics.

With someone who has antisocial personality disorder, conflict gets escalated and resolution of issues is rare. It is not based on the issue of the moment, but targeted to a person. Problems can erupt anytime, anywhere.

The person doesn’t connect actions and consequences because there is little insight into behavior. Much energy goes into attacking others rather than reflecting on their own actions. Extreme action follows intense emotions—yelling, controlling, saying disrespectful things, the silent treatment, spreading rumors, hitting, stalking, threatening if you don’t agree, and lying. The core social skills of honesty, respect and responsibility are missing. The person doesn’t cooperate and is often hostile and callous to the feelings of others.

High-conflict people like Rachel often push others away, sabotaging their desire for satisfying relationships. Most of this is driven by trying to control and dominate. Blaming leads to feeling stronger and creates a false sense of safety. This enduring pattern makes conflict resolution nearly impossible since they are problem-solvers; they’re blamers and injurious.

Here are a few tips to help manage a high conflict interaction:

Set a structure for conflict discussion and talk about expectations. Establish fair fighting rules such as no yelling, name-calling, interrupting, etc. It may help to meet in a public place and take a mediator.

 Set boundaries. If a boundary is violated, be firm. Remind the person what the expectation was and what will be needed to continue the conversation. Although you may want to, don’t ignore the person. Ignoring usually sets the person up for even more anger because it triggers feelings of emotional neglect and abandonment. Better to revisit the rules of engagement.

 Disengage from the drama and manage your own thoughts and feelings.When someone starts accusing you, disengage and realize this will go nowhere. Take a time-out or concentrate on your reaction only.

Treatment of antisocial behavior appears grim in terms of prognosis, but the application of Cognitive Behavioral Therapy is showing some reduction in symptoms (e.g., delinquency, criminal behavior, etc.). The goal is to target the dysfunctional underlying beliefs associated with aggression, criminal behavior and self-damaging behavior. Research does not support the use of medications for this problem. However, some medications like lithium carbonate, have been shown to reduce aggression, bullying and fighting, all common problems in antisocial relationships. It’s tough to make changes but if the person is at all willing, sow and steady change can made.