When you're dealing with someone that has a personality disorder, bear in mind that they don't see their rigid patterns of thinking as a problem. It's always someone else's fault and trying to get them treated would feel invasive.
These are the types that would have their significant others being burned out being with them and still don't realize they are the problem. So it's no surprise that they tend to drop out from therapy or say therapy doesn't work on them. How can you convince someone that they have a problem when it's ingrained in their world view that they're fine.
That's why I always take things with a grain of salt whenever someone says X therapist is bad and the patient keeps doctor hopping. I made a post about doctors with perfect social media star ratings and the gist behind there is that if you're in a healthcare profession and are doing what's best for your patient, you're going to be the bearer of bad news and say the stuff patients don't like to hear sometimes, or say no.
Even if it's for their own good, you can still get a bad review post encounter. Because this profession turned into customer service conscious, now physician would rather avoid the necessary confrontation and shut up for fear of backlash.
I've encountered patients who I have strong suspicion of having pathologic personalities in different encounters but there's no helping someone who refuses to acknowledge they got a problem in some area. It does make it difficult to navigate their treatment a lot of times.
You get to see pop culture terms like Narcissism and antisocial personality disorders thrown around but it puzzles me sometimes that some patients that do have these traits on themselves fail to see that they may actually be one.
For training purposes, you don't truth bombs lightly on people that aren't ready to process them. Spelling out the answer before the person can process the stuff you already knew is counterproductive. You don't spell it out, you let them realize it themselves.
Thanks for your time.