Tuesday, July 27, 2010

Mad, Bad, Blind, or Stupid

A long time ago in a galaxy far far away, a Viennese Jewish man by the name of Sigmund Freud noticed that some of his patients would engage in the same unproductive behavior over and over again with the same bad results each time.  He called this phenomenon the repetition compulsion, and it has been observed over and over again by psychotherapists from a lot of different theoretical perspectives.  Some of them may have called it something else, but they were all observing the same baffling phenomenon.  Readers may have heard of the oft-told tales of, say, a woman with abusive parents who runs away and marries an abusive man, leaves him and then marries another abusive man, and so on over and over again.  Or another who keeps ending up with alcoholics, but only tries to meet men in bars.  Not to pick on women of course; some men have trouble, say, keeping a job because they keep picking a fight with a succession of different bosses.

Einstein said that doing the same thing over and over again but expecting a different result is the definition of insanity.  Are people who repeat the same self-defeating behavior over and over again insane?  I'm not talking about people who are psychotic here, so presumably they are somewhat sane.  Maybe they are just incredibly stupid?  If what they do hurts other people as well as themselves, maybe they are just evil.  Mad, bad, stupid.  Unfortunately most theoretical answers to the question of the reasons for the repetition compulsion presume that those who engage in it are one of these three things.  Interestingly, when the offspring of abusive parents talk about their parents' motives, they usually also attribute the parents' horrid behavior to one of these three factors.  Forgive them, for they know not what they do.

Freud thought that people repeated self-defeating behavior patterns because of unconscious motives, and were somehow not aware that they were contributing to their own misery.  The feelings were too frightening to think about and so, he opined, the feelings and accompanying thoughts became unconscious. I always wondered how people could miss the fact that their behavior was repeatedly having the same negative results.  Oh, you might rationalize what happened away the first couple of times, but then?  I would think that these results would make the consequences of specific behavior patterns rather salient.  Maybe it does make you nervous to think about it, but on the other hand, if your behavior repeatedly leads to your being hit over the head with a two by four, I think you would just have to notice.

This issue came up in a recent debate I got into on another blog called the Last Psychiatrist over the behavior of people labeled with narcissistic personality disorder (NPD).  Such people bully, dominate, and control other people, demand to be given special treatment by everyone regardless of anyone else's needs, and are constantly seeking admiration and approval.  Many posters to the blog thought these people were actually trying to get their way all the time, and were constantly striving to gain the admiration of other people.

Here is the DSM description of NPD:

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

(3) believes that he or she is "special" and unique and can only be understood by, or should associate with, other special or high-status people (or institutions).

(4) requires excessive admiration

(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

(8) is often envious of others or believes that others are envious of him or her

(9) shows arrogant, haughty behaviors or attitudes.

Gee, if your starved for admiration, can you think of a worse way to obtain it than by exploiting people, being completely unempathic for the plight of others, and acting arrogant and unjustifiably self-important?  I can't.  The English language has a word for people that behave like that:  Assholes.

So, are NPD's too blind to notice all the people around them referring to them as assholes?  Too stupid to see how their behavior contributes to that designation?  Masochists who like to be thought of as assholes?  Wait, I thought they wanted admiration.  Well maybe that part shouldn't be part of their description.  Maybe they are just evil mofo's who want to bully people to get their way because they are selfish and sadistic.

Mad, bad, stupid.  A long time ago, but in this galaxy, and more recently than Freud, I began to wonder how I might be able to explain the repetition compulsion if I assumed that people are neither mad, bad, blind, nor stupid.  What a concept!  In the case of NPD, that could only lead to one conclusion.  For some reason, NPD's were making themselves look like assholes on purpose.  Eww.  Masochists, huh?  But how can someone really enjoy pain?  Pain is supposed to be a physiological danger signal that says, "Get your finger away from the hot stove!"  It is supposed to be unpleasant, almost by definition.  Emotional pain serves a similar function.  How on earth could people have evolved to be masochists?  That trait should have been killed off, as people who cannot feel pain frequently are killed precisely because they don't have a physiological alert symptom.

What a mystery, huh?  It is also very true that people who engage in self defeating behavior do not seem to understand that their behavior is getting them into trouble.  But can they really be that stupid?  Could it be that they are just pretending to be stupid?  But they are so convincing at it!  And why would anyone want to do that? 

Some of my earlier blog posts have hinted at what I believe the answers to these questions to be.  Stay tuned.  In later posts, I will discuss more about hidden altruism, something else I call the Actor's Paradox, and another something else I call the Net Effect of Behavior.  (Or you can read my first book, A Family Systems Approach to Individual Psychotherapy, in which I spell out the early versions of some of my ideas).

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