As a psychiatrist and psychotherapist, many clients seek my help handling difficult relationships. Although the old saying "it takes two to tango" is almost always true, often I am convinced that my client is not the one with the enduring problem. Instead, he or she is having a tough time dealing with a more difficult personality. Whether it be a spouse, friend, coworker, or boss, it is clear that there are some folks who are just hard to navigate. Often these individuals have what is clinically called a personality disorder. Personality disorders are marked by a longstanding pattern of beliefs and behaviors that are inflexible, maladaptive, and cause distress to the affected individual and those around him or her.

We all have our ways of dealing with conflict in our relationships. However, in a workplace setting, these methods often fail us. We cannot simply avoid a hostile boss. It would be inappropriate to motivate an unproductive employee with an ice cream cone. When confronted with personality quirks in the office, we need to maintain composure and act according to best practices. In a difficult dyad, it is very helpful to first define what kind of individual you are dealing with, then tailor your response to his or her limitations. Below are some common forms of personality disorders and suggestions for how to handle them.

Narcissistic personality disorder. The term "narcissistic" is often thrown around in casual conversation. Most of us can have some narcissistic traits, but an individual with this type of personality disorder continually seeks fame, fortune, and power. They view themselves as special, and believe they deserve to socialize with other special people. They need excessive admiration and will exploit others to achieve their own goals. When confronted with a narcissist, it is helpful to recognize that although he or she appears arrogant and impervious to criticism, underneath there is a very fragile sense of self, fear of failure, anxiety, and shame. It is therefore important to constantly acknowledge any positive contributions. Whether it is a boss or a coworker, publicly and personally commend them whenever possible. When giving negative feedback, make sure you couch criticism in a "complement sandwich." In other words, try to identify and state something positive that the individual has accomplished before and after you discuss what needs improvement.

Dependent Personality Disorder. Those suffering from this type of disorder tend to be overly clingy, need others to assume responsibility for major areas of living, and are fearful of being alone. They have a tough time making decisions, are reluctant to disagree with others, and engage in activities to receive approval and support, even when they are unpleasant. Those with dependent personalities are rarely in leadership roles, but are rather stuck in junior positions despite having certain strengths. If you are managing someone with dependent personality disorder, your job is to make he or she feel empowered. Start by introducing responsibilities just beyond their comfort zone. Acknowledge their success, or gently give one on one constructive feedback. Once your employee has had some successes, set firm boundaries. Clearly articulate expectations and your confidence in them to handle whatever emerges. Maintain a once weekly meeting or email conversation where they can consult or trouble shoot with you, but encourage independence in the interim.

Histrionic Personality Disorder. These are individuals who need to be the center of attention, are flirtatious and seductive, and use their physical appearance to gain popularity. He or she is highly suggestible, and frequently blurs the boundaries between personal and professional relationships. The most important rule in dealing with a histrionic employee is to set firm boundaries. Clearly state that certain behaviors and dress are not appropriate for the workplace, and professionalism is required for any member of your company to succeed. Do not respond to the flirtations, no matter how alluring or seductive. Be very specific and unemotional with requests and feedback. Calmly but firmly resist any gesture to extend the relationship beyond the workplace.

Obsessive Compulsive Personality Disorder. This is a very different syndrome than obsessive compulsive disorder, in which individuals engage in repetitive thoughts and behaviors to eliminate an underlying anxious condition. Those with obsessive compulsive personality disorder are overly preoccupied with rules, orderliness, neatness, and a need for perfection. They are controlling, intolerant, and inflexible. Their intense rigidity leads to preoccupation with lists, details, and rules, making them inefficient and indecisive. Encourage these individuals that they do not need to be perfect in order to be successful. Reiterate that "perfection is often the enemy of the good," and that it is more realistic to learn from experience than to foresee the ideal solution. Since these individuals are commonly overly committed to work at the expense of leisure activity and relationships, encourage them to take vacations and breaks to avoid burnout and preserve their skills.

Thankfully, most people we work with do not have full blown personality disorders, although inevitably there are a few. By targeting your coping strategies to the particular individual, you will be in a much better position to manage up or down, and succeed regardless of the difficult patterns in the relationship.