There’s a lot of talk today about addictions of various kinds: to substances, gambling, sex, video gaming, etc. There’s some controversy about what constitutes an addiction and whether all of these behaviors really qualify as addictions. Whatever they are called, one characteristic that I’ve found among people with such fixations is a know-it-all attitude. You can’t tell them anything that will help them to change their behavior, minds and lives for the better, because they know it already.
It’s interesting to reflect on how this connects modern psychological and traditional spiritual values. What would be considered to be a kind of ego defense, in psychoanalytic terms, or cognitive rigidity, in cognitive behavioral psychology, equates pretty well to what would be regarded as arrogance in spiritual terms; meaning simply that the person thinks that she knows things that she doesn’t, and therefore doesn’t have important learning to do, including thinking about what is being said to her by someone whom might be saying something useful if listened to. Two qualities that are missing in such people are humility (without humiliation) and spiritual motivation (motivation for experience of relationship with divinity, higher power, higher purpose, etc.). Interestingly, these qualities are directly cultivated by 12-step programs.
It’s all about brain chemistry, at some level. Substance addiction alters brain chemistry directly, while compulsive gambling, sex, and video gaming alter it more subtly, as research as indicated. But so does humility and a proper kind of motivation for higher or deeper experience, even if we haven’t been able to measure that yet.
Paradoxically, we can know more by sincerely thinking that we know less, and identifying, with humility, with a higher power or purpose; although that involves a different kind of "knowing." It's interesting, to me, that such identification connects the individual brain with the brainwork, the thought and lives, of very many people, past and present; and, who knows, maybe future as well.
Monday, February 8, 2010
Saturday, January 23, 2010
Notes on Borderline Personality
Here are the notes I sent to a colleague who asked me for some help in understanding another colleague who has borderline characteristics. I wasn’t trying to be definitive, or to address the issues and controversies surrounding this diagnosis, just to give some practical advice. Perhaps others may find it useful.
While the borderline personality style can present in different ways, one of the most frequently encountered is the person who has genuine skills in both productive work and relationships, but whose attachment dynamics have been severely compromised at a young age, such that she (or, of course, he) cannot really attach in a trusting and trustworthy way on a long term basis aside from being on either side of a very clear dependency relationship; up or down. The individual's unconscious (and it is unconscious) formula for attachment survival is to divide others so that her alliance with key supporters is attained by their alliance with her in rejecting another or others; this is the "splitting,” “triangulating” dynamic. A borderline patient on an inpatient unit famously splits the unit by allying some staff with her against other staff, and sometimes it takes lots of work to unravel the knot the borderline person has created.
Such people can't really be wholehearted members of teams, because they can't trust colleagues; but they can be members of productive teams in which specified tasks are done by various people in order to come together into a result. However, their relational pattern as team members will still be to split, even at the expense of the success of the team, so that both their work and their tendency to split will have to be managed by the team leader.
There are different hypotheses about how borderline personality disorders come about. Barbara Oakley attributes it mainly to genetics, in "Evil Genes." Psychoanalytically oriented theorists look to early childhood experiences, in which the patient was alternately seduced (in one way or another) and rejected by a powerful parent, usually with the other parent being too weak to make a difference. As in most things psychological, probably it’s a combination of nature and nurture.
There are lots of nuances of this, of course. As a therapist, I often see patients with family histories in which a parent allied a child with himself or herself at the expense of other family members, who are rejected. Sometimes my patient is the child who was seduced, sometimes the one who was rejected. Sometimes the seduction-rejection behavior cycles, such that the parent seduced (not necessarily sexually, but emotionally) the child and treated her as very special, then rejected her and treated her as a bad person or a non-person, then cycled that treatment again and again.
The result is that the borderline tends to have a "good object/bad object" attitude toward others in his life, alternately feeling beloved and betrayed. So, those who have been "good objects" and thought they had a trustworthy and dependable interlocutor suddenly find themselves excoriated and vilified, and wonder what hit them. Of course, the cycle can turn the other way as well, so that the person who was opposed and undermined can suddenly become the special and perfect and desired one. The seduction/betrayal dynamic repeats, and people who relate with people with borderline personality styles have that “walking on eggshells” feeling, of always being about to do something wrong, without knowing it.
Working with such a person means that the working relationship has to be managed, because trust is not really available, especially if you are the person who threatens the borderline and whom he is trying to ally with others against. Over the run of time, as the borderline becomes more secure, he may alter his focus in terms of whom he tries to split off from whom.
The key to managing a working relationship with a borderline is in two parts: 1. Keep your productive agenda going, and 2. Deflect splitting by refocusing attacking energy onto productive work; not by taking it personally and rising to the bait. The splitting behavior is unconsciously strategic, a substitute for healthy attachment, which the borderline person never really had. Therapy for people with borderline personality tendencies aims at establishing secure attachment. Dialectical Behavior Therapy (DBT) is a new therapy that has been developed for helping borderline patients feel a secure sense of attachment within their therapeutic relationship.
Borderlines typically feel a great deal of apprehension and anxiety, much of which is repressed and projected out onto others. They are masters at appearing calm while provoking and upsetting others by attacking them, then pointing to those whom they have provoked and saying, "What's wrong with them?" For this reason, maintaining a low-key emotional tone can be important in dealing with a borderline-type person.
Few people are severe borderlines all the time; they couldn't function in society if they were. Lots of people have borderline tendencies, and some people have them more strongly than others. Such tendencies can be exacerbated by stress that can be brought about by big life changes, even apparently positive ones like starting a new job, entering a new relationship or a more intimate level of relationship, etc.
Because the person with a borderline personality disorder may seem to be quite normal much of the time, and can be quite charming (remember, the borderline person was often seduced emotionally as a child), the observer may be fooled into thinking that the borderline pattern is over. The truth is that, without personality change so deep that it affects the foundation of the person's being, the borderline pattern is still there, beneath the surface, just waiting for the right conditions to activate it. It takes insight and wisdom for a borderline personality pattern to change.
While the borderline personality style can present in different ways, one of the most frequently encountered is the person who has genuine skills in both productive work and relationships, but whose attachment dynamics have been severely compromised at a young age, such that she (or, of course, he) cannot really attach in a trusting and trustworthy way on a long term basis aside from being on either side of a very clear dependency relationship; up or down. The individual's unconscious (and it is unconscious) formula for attachment survival is to divide others so that her alliance with key supporters is attained by their alliance with her in rejecting another or others; this is the "splitting,” “triangulating” dynamic. A borderline patient on an inpatient unit famously splits the unit by allying some staff with her against other staff, and sometimes it takes lots of work to unravel the knot the borderline person has created.
Such people can't really be wholehearted members of teams, because they can't trust colleagues; but they can be members of productive teams in which specified tasks are done by various people in order to come together into a result. However, their relational pattern as team members will still be to split, even at the expense of the success of the team, so that both their work and their tendency to split will have to be managed by the team leader.
There are different hypotheses about how borderline personality disorders come about. Barbara Oakley attributes it mainly to genetics, in "Evil Genes." Psychoanalytically oriented theorists look to early childhood experiences, in which the patient was alternately seduced (in one way or another) and rejected by a powerful parent, usually with the other parent being too weak to make a difference. As in most things psychological, probably it’s a combination of nature and nurture.
There are lots of nuances of this, of course. As a therapist, I often see patients with family histories in which a parent allied a child with himself or herself at the expense of other family members, who are rejected. Sometimes my patient is the child who was seduced, sometimes the one who was rejected. Sometimes the seduction-rejection behavior cycles, such that the parent seduced (not necessarily sexually, but emotionally) the child and treated her as very special, then rejected her and treated her as a bad person or a non-person, then cycled that treatment again and again.
The result is that the borderline tends to have a "good object/bad object" attitude toward others in his life, alternately feeling beloved and betrayed. So, those who have been "good objects" and thought they had a trustworthy and dependable interlocutor suddenly find themselves excoriated and vilified, and wonder what hit them. Of course, the cycle can turn the other way as well, so that the person who was opposed and undermined can suddenly become the special and perfect and desired one. The seduction/betrayal dynamic repeats, and people who relate with people with borderline personality styles have that “walking on eggshells” feeling, of always being about to do something wrong, without knowing it.
Working with such a person means that the working relationship has to be managed, because trust is not really available, especially if you are the person who threatens the borderline and whom he is trying to ally with others against. Over the run of time, as the borderline becomes more secure, he may alter his focus in terms of whom he tries to split off from whom.
The key to managing a working relationship with a borderline is in two parts: 1. Keep your productive agenda going, and 2. Deflect splitting by refocusing attacking energy onto productive work; not by taking it personally and rising to the bait. The splitting behavior is unconsciously strategic, a substitute for healthy attachment, which the borderline person never really had. Therapy for people with borderline personality tendencies aims at establishing secure attachment. Dialectical Behavior Therapy (DBT) is a new therapy that has been developed for helping borderline patients feel a secure sense of attachment within their therapeutic relationship.
Borderlines typically feel a great deal of apprehension and anxiety, much of which is repressed and projected out onto others. They are masters at appearing calm while provoking and upsetting others by attacking them, then pointing to those whom they have provoked and saying, "What's wrong with them?" For this reason, maintaining a low-key emotional tone can be important in dealing with a borderline-type person.
Few people are severe borderlines all the time; they couldn't function in society if they were. Lots of people have borderline tendencies, and some people have them more strongly than others. Such tendencies can be exacerbated by stress that can be brought about by big life changes, even apparently positive ones like starting a new job, entering a new relationship or a more intimate level of relationship, etc.
Because the person with a borderline personality disorder may seem to be quite normal much of the time, and can be quite charming (remember, the borderline person was often seduced emotionally as a child), the observer may be fooled into thinking that the borderline pattern is over. The truth is that, without personality change so deep that it affects the foundation of the person's being, the borderline pattern is still there, beneath the surface, just waiting for the right conditions to activate it. It takes insight and wisdom for a borderline personality pattern to change.
Saturday, January 2, 2010
Fear
Discussing fear with a client, we realized that sometimes the fear of death can help us to overcome the fear of life. So many things that we want to do but avoid doing because we are afraid of being uncomfortable, or embarassed, or failing, become possible when we see them with the perspective of a limited amount of time left in which to do or not do them. Fear is essential, of course, when it really is needed to save us from taking risks to our survival. But fear, outside of its use in preserving our safety and well-being, becomes an obstacle to achieving what we were born to achieve; which always involves transcending unnecessary limitations.
Sunday, December 20, 2009
Some Thoughts About Conflict Resolution
Conflict exists in all relationships and organizations, so the purpose of conflict resolution training or programs isn’t to eliminate conflict, but to provide more thoughtful and positive ways of addressing it than might otherwise be available. At best, conflict resolution can improve a relationship or an organization; at least, it can avoid increased antagonism.
Conflict resolution training or programs don’t replace the responsibility for people in relationships to work things out, and they don’t replace authority in organizations. People remain in charge. In relationships, they are responsible for themselves and their decisions. In organizations, people are responsible for the duties of their positions. Conflict resolution training or programs may help people to understand themselves and others better, and therefore to communicate more effectively and make better decisions.
Mediation can be an important function in conflict resolution, by supporting communication and negotiation among the parties. The people involved in the conflict need to express their points of view meaningfully and listen to one another; that’s the communication part. Once that’s done, the solution to the conflict may present itself, so to speak. If it doesn’t, there may be a need for negotiation. The mediator may have to teach communication and listening skills before the parties will be able to use them. While people vary in their communication and listening skills; few people without training and practice are able to think or speak clearly in conflict situations.
As a conflict resolution consultant, I’ve found that it’s often useful to speak with people separately before meeting together to try to resolve the conflict. People often haven’t thought through what the conflict is about, even from their own point of view, much less that of the other party. It can require one or even several 1:1 conversations before people can articulate what matters about this situation, from their own point of view, and then to begin to look at it from the other person’s.
Some conflict resolution consultants think that finding the truth of situations is not necessary to conflict resolution. They think that everyone has their own story, and people agree to whatever they can agree to if they're speaking clearly and listening to each another, and that's that. Other conflict resolution consultants think that the truth must be discovered in a way that everyone can agree to in order for the way forward to become apparent. My experience indicates that situations are different from one another, but in each one there’s a sort of minimum necessary truth that has to be acknowledged by everyone in order for resolution to happen.
Conflict resolution training or programs don’t replace the responsibility for people in relationships to work things out, and they don’t replace authority in organizations. People remain in charge. In relationships, they are responsible for themselves and their decisions. In organizations, people are responsible for the duties of their positions. Conflict resolution training or programs may help people to understand themselves and others better, and therefore to communicate more effectively and make better decisions.
Mediation can be an important function in conflict resolution, by supporting communication and negotiation among the parties. The people involved in the conflict need to express their points of view meaningfully and listen to one another; that’s the communication part. Once that’s done, the solution to the conflict may present itself, so to speak. If it doesn’t, there may be a need for negotiation. The mediator may have to teach communication and listening skills before the parties will be able to use them. While people vary in their communication and listening skills; few people without training and practice are able to think or speak clearly in conflict situations.
As a conflict resolution consultant, I’ve found that it’s often useful to speak with people separately before meeting together to try to resolve the conflict. People often haven’t thought through what the conflict is about, even from their own point of view, much less that of the other party. It can require one or even several 1:1 conversations before people can articulate what matters about this situation, from their own point of view, and then to begin to look at it from the other person’s.
Some conflict resolution consultants think that finding the truth of situations is not necessary to conflict resolution. They think that everyone has their own story, and people agree to whatever they can agree to if they're speaking clearly and listening to each another, and that's that. Other conflict resolution consultants think that the truth must be discovered in a way that everyone can agree to in order for the way forward to become apparent. My experience indicates that situations are different from one another, but in each one there’s a sort of minimum necessary truth that has to be acknowledged by everyone in order for resolution to happen.
Monday, November 23, 2009
Attorneys and Experts
Attorneys and experts tend to approach the role of the expert from quite different perspectives. Attorneys tend to be intent on building a case, and to see the expert's testimony as slotting into the narrative which they are constructing. They are also interested in containing costs, and thus minimizing the amount of time the expert provides; except in really big cases where there's enough at stake, and enough opportunity to win, that the attorney wants the expert to do whatever is necessary to contribute to the most credible case. Experts, on the other hand--assuming they are working as experts and not as "hired guns" to produce whatever testimony the attorney is paying for--are approaching the case from the perspective that they have to find out whatever they might need to know to actually function as experts. The end results may or may not slot neatly into the narratives the attorneys are trying to construct, and arriving at them will take as long as it needs to take for the experts to find out what they need to find out.
Now, if the expert is just asked to testify to a point in his or her field--for example, whether vocational rehabilitation programs have a responsibility to supervise their clients in order to protect them from abuse by other clients, or whether children have been known to produce false claims of sexual abuse as a result of suggestive or otherwise defective interview technique, or whether blows to the head in a fight can cause brain damage--that's a pretty cut-and-dried project. An expert could reasonably give a pretty good estimate of how much time such a project would take, and wouldn't need a lot of time to complete it. However, if the expert is asked to testify about whether a particular vocational rehabilitation program was negligent in a particular case in which one client was allegedly abused by another, or whether a particular interviewer interviewing a particular child used defective technique that could reasonably be expected to have produced a false report of molestation, or whether a particular client has brain damage, which may or may not have resulted from an alleged altercation, that involves the kind of investigation about which the expert, at the start, knows neither what the end result will be nor how much time it will take to get there. The best one could do would be to give pretty wide parameters of estimate.
Now, if the expert is just asked to testify to a point in his or her field--for example, whether vocational rehabilitation programs have a responsibility to supervise their clients in order to protect them from abuse by other clients, or whether children have been known to produce false claims of sexual abuse as a result of suggestive or otherwise defective interview technique, or whether blows to the head in a fight can cause brain damage--that's a pretty cut-and-dried project. An expert could reasonably give a pretty good estimate of how much time such a project would take, and wouldn't need a lot of time to complete it. However, if the expert is asked to testify about whether a particular vocational rehabilitation program was negligent in a particular case in which one client was allegedly abused by another, or whether a particular interviewer interviewing a particular child used defective technique that could reasonably be expected to have produced a false report of molestation, or whether a particular client has brain damage, which may or may not have resulted from an alleged altercation, that involves the kind of investigation about which the expert, at the start, knows neither what the end result will be nor how much time it will take to get there. The best one could do would be to give pretty wide parameters of estimate.
Saturday, November 14, 2009
Perception and Reality
I was out walking my dog the other night, crossing a well-lit neighborhood street at a stop sign, when a car approached the intersection, slowed down but didn't stop, and then began to turn and came straight at us as we were crossing. I shouted at the driver, who stopped, lowered her window, and shouted back at me that I should have been wearing a light.
Well, I was flabbergasted. The intersection was well lit, there was a stop sign, I was crossing at the corner, and it was still my fault that she didn't stop, didn't see us, and almost hit us. There are at least a couple of things to be learned from this about how the mind works, and what the relationship is between what we perceive and what is real.
First, the job of the mind is to make sense of what happens going forward. She didn't see us in the intersection, therefore it was my fault for not wearing a light. Second, she had no capacity to retrospectively self-evaluate and self-correct.
So here we have an example of how we can misperceive reality without realizing it at the time, and how we can still not realize it even after it has been pointed out to us in a situation in which a potential disaster, which would have been entirely our fault, has just been narrowly averted.
Saturday, October 17, 2009
Medill News Service Article w. Interview
Study says they're happy, but young people say they're stressed
by JESSE CURTI
Oct 15, 2009
Past pimples and prom, a recent study says adults 18 - 25 have the highest happiness rating.
The survey by Gallup based on more than 600,000 interviews revealed that happiness is highest among younger Americans and lowest for those in their 50s and late 80s.
Young adults may be happier because of the obligation-free days of youth, said Kathryn C. Keller, a licensed clinical social worker.
"They have a future ahead of them and nothing bad has happened," she said.
Upbringing can also play a role in the happiness, said Dr. Lisa Razzano, a professor of psychiatry at the University of Illinois at Chicago.
"They've [parents] become more engaged," Razzano, said. "This creates positive affect, which we associate with happiness."
Even with a recession, young Americans in college can stay on the bright side, said Dr. Michael Bricker, clinical psychologist.
"Those individuals are experiencing the downturn in a different way than those who must work and provide," he said. "There's a little more freedom in youth."
Those assessments are in contrast to how some young adults feel.
"There's a lot of pressure on us," said Gevorg Azizi, 20, a DePaul junior. "Yeah we're happy and we go out, but there's also a lot of pressure, and that can lead to unhappiness and depression."
Paul Evangellu, 20, explained the pressure.
"We're in college right now during some of the worst times right now during this recession," the DePaul sophomore said. "Hopefully by the time we graduate it will be over, but right now, we can't really tell."
One psychologist expressed doubts about the study, which asked people if they had smiled, laughed or had positive feelings the previous day.
"There are two different kinds of smiles," Dr. Jay Einhorn, a clinical psychologist, said. "One that's genuine with involuntary movements, then a conscious smile that means, 'I'm not hostile and I want you to like me.'"
Nonetheless, Einhorn emphasized the importance of mental self-care with regular exercise, deep relaxation and self-observation.
"If we're more aware of ourselves, we have more psychological freedom, which allows for more behavioral choices," he said.
Related Links
Gallup polls
©2001 - 2009 Medill Reports - Chicago, Northwestern University. A publication of the Medill School.
by JESSE CURTI
Oct 15, 2009
Past pimples and prom, a recent study says adults 18 - 25 have the highest happiness rating.
The survey by Gallup based on more than 600,000 interviews revealed that happiness is highest among younger Americans and lowest for those in their 50s and late 80s.
Young adults may be happier because of the obligation-free days of youth, said Kathryn C. Keller, a licensed clinical social worker.
"They have a future ahead of them and nothing bad has happened," she said.
Upbringing can also play a role in the happiness, said Dr. Lisa Razzano, a professor of psychiatry at the University of Illinois at Chicago.
"They've [parents] become more engaged," Razzano, said. "This creates positive affect, which we associate with happiness."
Even with a recession, young Americans in college can stay on the bright side, said Dr. Michael Bricker, clinical psychologist.
"Those individuals are experiencing the downturn in a different way than those who must work and provide," he said. "There's a little more freedom in youth."
Those assessments are in contrast to how some young adults feel.
"There's a lot of pressure on us," said Gevorg Azizi, 20, a DePaul junior. "Yeah we're happy and we go out, but there's also a lot of pressure, and that can lead to unhappiness and depression."
Paul Evangellu, 20, explained the pressure.
"We're in college right now during some of the worst times right now during this recession," the DePaul sophomore said. "Hopefully by the time we graduate it will be over, but right now, we can't really tell."
One psychologist expressed doubts about the study, which asked people if they had smiled, laughed or had positive feelings the previous day.
"There are two different kinds of smiles," Dr. Jay Einhorn, a clinical psychologist, said. "One that's genuine with involuntary movements, then a conscious smile that means, 'I'm not hostile and I want you to like me.'"
Nonetheless, Einhorn emphasized the importance of mental self-care with regular exercise, deep relaxation and self-observation.
"If we're more aware of ourselves, we have more psychological freedom, which allows for more behavioral choices," he said.
Related Links
Gallup polls
©2001 - 2009 Medill Reports - Chicago, Northwestern University. A publication of the Medill School.
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