- 1817 Queen Anne Ave, Suite 202, Seattle, WA
- 707-440-9288
- ian@ianmackelvie.com
- 707-440-9288
- ian@ianmackelvie.com
This type of work can be the most difficult because it interfaces with an aspect of ourselves that we accept as being normal. Most people don’t walk into therapy saying “I think I have a personality disorder.” Instead, they come in feeling confused about their relationships, disconnected from themselves, or stuck in patterns that never seem to change.
Although you may not be coming in to address this type of work, some find it helpful to learn more about it and feel confident that someone is interested in this. I personally find character based work to be very rewarding, despite how difficult it can feel.
These patterns were built for a reason. They often form early, as a way to manage overwhelming feelings or unmet needs. In many cases, they helped you survive something. Over time, though, they can harden. They can shape how you see others, how you see yourself, and how you respond to closeness.
The very safety and stability of a relationship can become the trigger. The closer you get to someone, the more threatening it feels. This is why support often feels dangerous, and why many people push away the very connection they long for. Whether or not this is actually serving you well will become a question worth exploring.
Clients that are unknowingly dealing with deeper personality structures are often times struggling for far too long. Complaints often go misdiagnosed and might be treated with medications that don’t match. Some take matters into their own hands and self medicate just to make themselves not deal with the intensity of their emotions. Therapy that identifies these issues and treats them can help someone feel more deeply understood. I often times will encourage clients to read books by James Masterson (e.g. Disorders of the Self) as a starting point.
Borderline Personality Patterns
Emotional intensity, fear of abandonment, difficulty staying grounded in a sense of self. Relationships often feel either all-in or all-out. There’s a deep need for connection, but it can feel unbearable once it arrives.
Narcissistic Personality Patterns
Struggles with vulnerability, self-worth, and seeing others clearly. There may be a strong outer presentation of control, confidence, or superiority but underneath, it often feels fragile and full of self-doubt.
Obsessive-Compulsive Personality Traits (OCPD)
A need for control, perfection, and order that can feel impossible to turn off. Relationships may become secondary to productivity, efficiency, or doing things the “right” way. Emotional needs often get buried under tasks and performance.
Schizoid Personality Tendencies
Emotional detachment, fear of being seen, and a strong desire for solitude. These clients often appear calm, logical, and unaffected—but underneath is often a deep loneliness and fear of contact.
So important to state, these are NOT labels I rush to assign. We are capable of moving in and out of these relational structures throughout our lives. These are merely patterns of protection that are built around very real emotions.
What makes this kind of work difficult is that it usually gets activated in the relationship with the therapist. That is also what makes it so effective. When the pattern shows up in the room, we don’t avoid it. We get an opportunity to observe it together. Therefore, we build your tolerance to stay in contact with what has always felt threatening.
Committing to this kind of therapy means that you are willingly choosing to go through some of the worst pain you have ever felt in your adult life. Funny enough some of my earliest advertising had the phrase “Therapy Sucks. Do it Anyway.” It really captures that, yes, this will be difficult. But the goal of therapy is to be able tolerate with clarity this pain in a manner that reduces how we get activated, and perhaps experience a more energetic life.
You don’t need a diagnosis to benefit. You might just feel like relationships are harder for you than they should be. You might feel like you’re watching yourself live a version of life that feels out of sync with what you actually want. You might be trying to manage everything through thought alone, and it’s not working anymore.
Therapy won’t solve everything. But it can give you a place to examine your patterns without rejection and practice something different in real time.
I check my emails and office line Monday thru Friday, and typically reach out within 24 hours to let you know if I have availability. You won’t be left wondering.
After a brief conversation, and an explanation of my process, we can find a time that works for both of us.
Whether in person or remote, making a commitment to therapy takes guts. Together, we will explore your wants and find the path to get there.
No. Many clients come in unsure if what they’re experiencing fits a personality disorder. We’ll explore together what makes sense for you. If you are using insurance for reimbursement we will have to include a diagnosis, but we can explore that together.
It can be, but never in a rejecting way. I believe in honesty, clarity, and naming what’s happening. That can be challenging, but it’s also where real change begins.
Depth psychotherapy is not quick-fix work. If you are wanting support for structural patterns that are deeply entrenched and feel difficult to understand it may be longer term. That being said, I believe people can benefit a lot by just beginning the work. We go at the pace that feels comfortable, and many see progress along the way.
I believe every person has acres of emotional material that is ready to come out. That intensity can seem like being too difficult, and that can be absolutely terrifying to face. In fact, feeling better can mean betraying the way we decided to be in order to survive. This feeling of being too difficult, therefore, is at the center of this work, and is something that would be addressed during your therapy.
Yes. I see clients throughout Washington remotely, and also offer in-person sessions in Seattle’s Queen Anne neighborhood.
Use the Contact Form to give me some brief details of what you’re experiencing. You can also call or email me. I try to respond to all contacts and inquiries within 24 hours, Monday thru Thursday.
