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“Over the years, the significant other can come to feel shame, even though this was not part of their coping mechanisms. Shame can therefore be used by the significant other. Either consciously or unconsciously, they may use shame in interaction with the AVP. Part of this is due to the fact that the significant other fears being guilty (hurting the AVP). When communication becomes more and more difficult in relationships, shame increases in both partners. The other may find that, without using shame, the AVP doesn’t respond in any meaningful way: What is wrong with you? One of the major struggles of the partner of the AVP is in the area of whether they need to hold the AVP responsible for his or her actions. This is a truly difficult piece for the spouse. They have a sense that the AVP is not deliberately trying to hurt them. June often is confused. She doesn’t know if Doug is understanding the hurt he is inflicting.” — Dr. Sandra Smith-Hanen