Dennis B. Kottler, MD

Westlake Village, CA

Appointments:   818-991-8376 


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See also:  Relationships - Part II


Important note:  Relationships, like all human behaviors, involve many complex factors.   Many times the problems that arise need the intervention of a trained professional.  However, there are certain general principles involved in relationships and these will be discussed below and in:  Relationships - Part II.    "Relationship" can designate any number of arrangements between individuals of either sex, whether romantic or just  friendly (not the opposite!).


The problems which arise in relationships generally fall into three broad categories:

1 -- Problems in the dynamics of the relationship itself

2 -- Problems involving psychopathology of one or both individuals in the relationship

3 -- Problems related to difficulty in dealing with "external realities"

Of course all these problem areas may coexist and interact, producing an ever more complicated web of dysfunction.



Relationships are fundamentally about the interaction of individuals' needs.   Among these are:

There are of course other needs, such as sexual gratification, financial security, and perhaps the occasional back rub.   However, these secondary needs do not directly sabotage the relationship, but rather suffer from problems in the more basic first list.

Emotional Support

Problems often arise when one individual does not feel emotional support from the other.  Either partner can be the "distancer," although frequently in a heterosexual relationship it is the male.   There are probably societal influences at play here.  However, even a committed "distancer" can learn to share in the benefits of mutual emotional support.   Sometimes this requires the threat of divorce or "being dragged into the therapist's office."  Sometimes the underlying reasons for distancing relate to problems with intimacy and problems showing feelings.


For many people loneliness can be painful.   A good relationship can provide a ready partner for any number of pursuits, from pure recreation to a business start-up.  Companionship should not be underestimated as a powerful bond in a relationship.


This need should be obvious to both parties, however, many times one individual will ride roughshod over the other, hurling insults and disparaging remarks, sometimes in front of other family members or friends.   Often this signals a problem with the bully's self-esteem.  In other cases, the "passive member" may be so passive-aggressively submissive that even a reasonable partner gets drawn into the dominating role...filling the power vacuum (see empowerment below).


Empowerment is closely related to "Respect."  Most healthy people like to feel they have some impact in their little microcosm.  And they enjoy receiving some external acknowledgement that they matter. 

Individuals vary in the means they use to overpower their "adversary," ranging from direct aggression, in the one extreme, to the "meekest" passive-aggressiveness at the other end of the control spectrum.  The obvious one "in charge" is often not so obvious.  Excessive control, by whatever means, sours any relationship.  Even if both parties remain together (perhaps for financial reasons or fear of the outer world), massive unhappiness is the usual fate of both individuals.   Children frequently get "triangulated" into this mess with each side hoping to win an ally.   

The healthy opposite of this sorry state involves a "cooperative" relationship, perhaps with sharing of different functions.  Thus, by mutual consent, one party may make the investment decisions (the one transfixed by the nonsense syllables racing across the TV screen) and the other may be more involved in arranging social engagements.  These divisions of labor often develop naturally, nonverbally.  However, many times, they need to be renegotiated.



Of course any significant psychiatric disorder in either individual can sabotage a relationship from the outset.  The person with the problem is often not the one to come in for help.

Psychiatric disorders can include such problems as depression, bipolar disorder, severe anxiety, attention deficit/hyperactivity disorder, drug or alcohol addiction, obsessive-compulsive disorder, and of course, personality disorders.  Sometimes the psychiatric problem does not fit into a neat descriptive category.

These kinds of problems must be addressed before relationship counseling can be effective.   Here the hardest part involves getting the troubled person to acknowledge he has a problem.   Sometimes only drastic measures will motivate this person to get help. 



Finally, there are any number of difficult situations that arise which can complicate any relationship.  Some of these problems involve health issues, children with psychiatric or other health problems, severe financial pressure, legal issues, or work stress.  These complications challenge even the best relationships.  However, when the relationship is basically healthy, the odds favor surviving these assaults. 

Suggested Readings

The following link will take you to a list of recommended titles which you may purchase online.  

Suggested Readings

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Appointments:   818-991-8376