What Were They Thinking? – Character Disorders and CBT

In several of my prior posts, I’ve explored the nature of character disturbance in general and outlined the most severely disordered of all characters, most recently the Aggressive Personalities.  Truly understanding such individuals can indeed be quite challenging. But attempting to help them change through therapeutic interventions is even more challenging. These days, when it comes to understanding and dealing with individuals of disturbed character, traditional psychotherapy and approaches have proved inadequate and have increasingly been abandoned in favor of what has come to be known as Cognitve-Behavioral Therapy or CBT.

CBT adopts a very different paradigm about the nature of the human condition and how to help people change. In contrast to traditional psychotherapy, CBT does not focus as much on feelings, emotional conflicts or past traumatic events. Rather the focus is on the here-and-now as well as on how an individual’s thought processes influences their behavior patterns. The principles of Cognitive Behavioral Therapy are really quite straightforward. The primary guiding principle is that our beliefs, thoughts and attitudes directly influence and predispose our behavior. Unlike adherents to strictly behavioral forms of therapy, cognitive-behavioral therapists recognize that it’s not so much the people, places, events, and things in our lives that cause us to do things, but rather the interpretations we make about these things (i.e., the thoughts we have concerning them) that lead us to act in a certain way. So, how we think determines how we act. For example, if I hold the beliefs that women are naturally inferior to men, that women who enter into a relationship with me become a rightful possession of mine, and that women will behave in an untrustworthy manner unless held on a short leash, I will likely tend to conduct my relations with women in a domineering and abusive manner. If a female tries to assert herself, I might entertain thoughts like “She doesn’t know her place,” or “She’s trying to get the better of me.” I might then take steps to assert more control in the relationship. So, the goal of CBT becomes twofold:

  1. to challenge a person’s unrealistic or dysfunctional beliefs, thinking patterns and attitudes (commonly called “cognitive distortions”) and facilitate correction of them; and
  2. to reinforce more more pro-social patterns of behavior that flow from more rational thinking.   

In recent years, researchers have examined the dysfunctional patterns of thinking common to individuals who have significant disturbances of character. A pioneer in the cataloging of the more common “thinking errors” of such individuals is Stanton Samenow, who along with Samuel Yochelson studied disordered characters predisposed to criminal conduct. During the years that I both worked with and consulted to institutions harboring some of the most severely disordered characters, I also assembled a list of thinking errors — borrowing from the research on the topic, and adding considerably to it, as well as expanding the definitions of the various thinking errors, based on observations I made. I have continuously updated and refined this list. I introduced the list in the 10-year anniversary edition of my book In Sheep’s Clothing, and I will be including a much more comprehensive version of the list in an upcoming book on disorders of character.
In several upcoming posts, I’ll be presenting some of the major errors in thinking that disordered characters of all types engage in that predispose them to act in irresponsible ways. Many times we react in shock and dismay at what appears to be the irrational way of acting such individuals display. We then ask ourselves “What in the world were they thinking? Sometimes, when what they tell us reflects what they think we ask ourselves “Do they really believe that, or are they just saying that to justify their actions?” Hopefully, the next series of posts will help address some of these questions. In addition, gaining a better understanding of the unusual but characteristic ways in which these individuals tend to think should help our readers better understand and cope with the disordered characters in their lives.

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