Dear Dr. Dan,

I manage a small group of people in a university setting and I have difficulty with one person in particular. During performance appraisals, she gets immediately defensive and behaves as though there is no truth in what I am saying. I always give positive feedback first and then areas for improvement. And I am always mindful of the feelings of others. But that doesn't seem to help. Another side effect of this type of behavior is the negative energy that it brings to the workplace.

In a continued attempt to reach her, I have reviewed this situation with our HR department, employee assistance department, and other psychologists. But no one has been able to instruct me how to communicate with someone with zero self-awareness who insists that she did nothing wrong. Any insight that you can provide would be greatly appreciated.

- A.D.

Dear A.,

Some people who appear to have no self-awareness have what's called a character disorder. A cardinal symptom is that they tend to blame their problems on the outside world.

People with these disorders can be dependent or helpless, passive aggressive, or completely self-absorbed.

What they all have in common is that the disorder is in one's character, essentially in the architecture of one's psyche. (By contrast, depression and other mood disorders are more disturbances of the mind that alter thoughts and emotions.)

These people rarely benefit from medication, and research shows the best treatment is fairly long-term psychotherapy. Of course, that is not likely to happen with someone who feels the problems are on the outside.

But there is a real possibility your colleague does not have a character disorder and that her defensiveness is about anxiety rather than a worldview.

Anxiety and insecurity can have many different faces. At one extreme, people can be almost hyper-reactive to input from the outside world. These people are easily hurt and use input to feel bad about themselves. It's almost as though their psychic nerve endings are raw. And they tend to withdraw.

But others take their insecurity in the other direction - they feel so vulnerable and fragile that they cannot tolerate any criticism. They already feel so bad about themselves that any input taps into a deep sense of shame and they react with defensiveness and aggression or they angrily withdraw.

The behaviors can be opposite, but the underlying emotions are the same. And there is one more thing that both extremes have in common. These powerful emotions have been felt, but not faced.

So let me return to your original question about what to do with such a person. The rule of thumb is that if someone is not listening to you, try listening to them. Provide a safe environment and ask them the questions you would ask anyone you really wanted to get to know better.

In the process, you may find out who this person is beyond your perceived labels of stubborn or clueless.

And please don't forget that there is another person involved in that conflict, and that's you. Besides addressing this person's behavior, I would like you to be conscious of your experience.

Clearly you feel frustrated. But you might also be feeling impotent, confused or anxious, perhaps without even knowing it. So we may have two people interacting, neither of whom really knows what they are feeling at the moment.

So just catch your breath during these interactions, let yourself feel what you feel, and perhaps you will also be less defensive.

All of this might not be practical in a work setting, and ultimately you may have to decide whether this person is right for this job. But a bit of empathy for the feelings you both have really doesn't take much time.

"InsideOut" appears every other week. Family therapist Dan Gottlieb's "Voices in the Family" airs Mondays at noon on WHYY-FM (90.9). On the Web: www.drdangottlieb.com.