Personality Disorder Therapy in Washington, DC

Psychoanalytic treatment addresses personality difficulties by working on the pattern itself rather than on the crises it produces. I am a licensed clinical psychologist and board-certified psychoanalyst in Washington, DC, and I have worked with long-standing personality patterns for over fifty years. Sessions are held online by secure video.

A personality difficulty is not an episode. Depression arrives and lifts; a personality pattern was there before the trouble started and is still there afterwards, running underneath the relationships that end the same way, the jobs that sour on the same schedule, the sense of self that will not hold still.

That is what makes it hard to see from the inside. Symptoms feel like something happening to you. Character feels like you — which is why people usually come in about the fifth failed relationship rather than about the pattern producing them.

This is the work psychoanalysis was built for, and it is the reason frequency matters here more than anywhere else in my practice.

“A symptom feels like something happening to you. A pattern feels like you.”

What tends to bring people in

Relationships that begin intensely and end the same way
A sense of self that shifts depending on who you are with
Anger or emptiness that arrives faster than the situation warrants
Being told repeatedly, by different people, the same thing about yourself
Long stretches of feeling unreal, or at a distance from your own life
Previous therapies that helped for a while and then stopped
Fear of abandonment that shapes decisions before you notice it

The problem

Why these patterns survive good intentions

People with entrenched personality difficulties are usually not short of insight. They can often describe the pattern accurately, predict it, and dread it — and then take part in it again anyway, which is demoralising in a specific way that symptom disorders are not.

The reason is that the pattern is not a mistake. It was an adaptation, and generally a sound one, to circumstances that made it necessary — a way of managing closeness, or disappointment, or the risk of being left, at a time when no better option existed. It became automatic because it worked. It causes damage now because the circumstances have changed and the adaptation has not.

Advice therefore has very little purchase. Being told what to do differently addresses the behaviour and leaves the machinery running, which is why these difficulties so often outlast several courses of short-term treatment and leave people convinced that they are the problem rather than that the method was mismatched.

The method

How psychoanalysis treats entrenched personality patterns

The pattern cannot be examined reliably from memory, because memory edits. It has to be caught while it is happening, and the one relationship where I can watch it happen directly is the one between us. Sooner or later the same thing that occurs elsewhere occurs here — the idealisation, the withdrawal, the flash of contempt, the certainty that I am about to lose interest.

Working on that as it unfolds is the active ingredient. It is uncomfortable, and it is also the first time the pattern has been observed by both people at once, in real time, with nobody leaving. Repeated often enough, it stops being automatic and becomes a choice, which is what change actually consists of here.

This is why psychoanalysis at three to five sessions a week is the better instrument for this work: at weekly intervals the pattern has time to reset between sessions. Where analysis is not practical, intensive twice-weekly psychotherapy can do a version of the same work more slowly.

Which treatment fits

Which treatment fits this work

Frequency matters more here than for any other difficulty I treat. We decide together in the free consultation, honestly, including whether I am the right person.

Psychoanalysis

Three to five sessions a week. The more thorough instrument, for difficulties that have returned after previous treatment.

Psychoanalytic psychotherapy

Once or twice a week at a fixed time. Where most people begin, and enough for a great many difficulties.

Couples therapy

Ninety minutes with both people present, when the trouble lives between you rather than inside one of you.

Expected results

What changes, and over what kind of timescale

This is long treatment. What follows is the order in which change usually appears, not a schedule.

The pattern becomes visible

You start catching it during, rather than recognising it afterwards.

Reactions slow down

A gap opens between the feeling and the action taken because of it.

Relationships last longer

The usual ending point arrives and is survived rather than enacted.

A steadier sense of self

Who you are stops depending so heavily on who you are with, or on how the week went.

Two honest points. First, this is measured in years, not months — anyone promising rapid change in an entrenched personality pattern is either using the words differently or selling something. Second, if you are in crisis, in danger of harming yourself, or need urgent containment, exploratory analytic work is not the right first step: call or text 988 (Suicide & Crisis Lifeline), and a structured programme such as DBT or a specialist borderline service may be the correct place to begin. I will say so at the consultation if I think it, and I would rather refer you well than treat you badly.

Your therapist

About Dr. John J. Hartman

Dr. John J. Hartman, licensed psychologist offering online therapy for personality disorders in Washington, DC

I have practiced psychotherapy and psychoanalysis for over fifty years, and have spent much of that time teaching it — at UCLA, Michigan, and the University of South Florida, where I am currently Adjunct Professor of Psychiatry. As a Training and Supervising Psychoanalyst at the Florida Psychoanalytic Center, I am one of the analysts responsible for training other analysts.

A.B. Harvard College, magna cum laude with highest honors, Social Relations
Ph.D. University of Michigan, Clinical Psychology
Certificate Michigan Psychoanalytic Institute
FABP Board-certified psychoanalyst, American Board of Psychoanalysis
Training & Supervising Analyst Florida Psychoanalytic Center
Licensed Washington, DC (PSY200001229) · Florida · Michigan
PsyPact Telehealth authorized in participating PSYPACT jurisdictions, including Maryland and Virginia

Full credentials and appointments · scholarship and publications

Fees

What treatment costs

Individual sessions are $325 for 50 minutes; couples sessions are $475 for 90 minutes. The first 15-minute consultation is free and carries no obligation, and a sliding scale is available — ask whether you may be eligible.

Payment by cash, check, Venmo, Zelle, or wire. I do not bill insurance, but if your plan covers out-of-network mental health care you may be able to submit my bills to your insurer for reimbursement. Office hours are Monday to Friday, 10:00 am to 5:00 pm, by arrangement. Full fees and insurance details.

Common questions

Questions about treatment for personality disorders

Can a personality disorder actually be treated?

Yes. The pessimism attached to these diagnoses is a legacy of treating them with methods designed for symptoms. Long-term psychoanalytic treatment has a substantial record here, and the change holds, because what shifts is the pattern rather than the behaviour. It is slow, and it is real.

Why do I need several sessions a week?

Because the pattern has to be observed live to be worked on, and at weekly intervals it settles between meetings. Higher frequency keeps the material continuous and lets the relationship between us develop enough to show the difficulty rather than discuss it. Twice weekly is the realistic minimum.

Do you use the diagnosis in the way it appears on paper?

Sparingly. Diagnostic labels describe a cluster of difficulties usefully enough for insurers and researchers, but they say very little about how a particular pattern came about in a particular person, which is what treatment has to work with. I am more interested in the history of the adaptation than in its category.

Can I see you if I do not live in Washington, DC?

Yes. All sessions are online by secure video. I am licensed in Washington, DC, Florida and Michigan, and through PsyPact I can treat residents of participating PSYPACT jurisdictions, including Maryland and Virginia.

Ask the question properly.

The first 15-minute consultation is free and carries no obligation. Online sessions only, for residents of Washington, DC, Florida and Michigan, and — through PsyPact — participating PSYPACT jurisdictions including Maryland and Virginia.

Call (813) 787-2048 Prefer to write first? Email Dr. Hartman

Online Therapy for Personality Disorders in Washington, DC