Behavior and Impulse Control Disorders – Part 2

In a continuation of the series on commonly misunderstood and misused psychology terms and concepts, last week’s article dealt with the fact that while there are indeed some behavior and impulse control disorders caused by factors largely beyond an individual’s ability to fully control (e.g., neurological abnormalities, traumatic brain injury, etc.), many times folks get diagnosed with these conditions when their problems primarily stem from their underdeveloped character.  Learning to manage our emotions, put the brakes on our baser impulses, and display prudence and moderation in our daily interactions are the major tasks of character formation.  And while each of us brings different innate strengths and weaknesses to the challenge of our character development, and each of us is influenced differently by our background and upbringing, it’s nonetheless a challenge we must master if we’re going to function well in all our relationships be an integral part of a civilized society.

As mentioned in the prior article (See: Behavioral and Impulse Control “Disorders”), accurately assessing the nature of a person’s problems is crucial to getting the right kind of help.  And it’s an unfortunate reality that when character disturbances either fail to be recognized or are improperly labeled as something else, the problems associated with those disturbances can be “enabled” to continue or even worsen.  I’ll attempt to illustrate this in the vignette that follows (Note: As always, names, detail, and various circumstances have been altered to ensure anonymity).

Jeff was a self-referred “adult ADHD” (Attention Deficit Hyperactivity Disorder) patient.  He came to see me because his life was a shipwreck for the umpteenth time and as he put it, he was finally “getting sick and tired of being sick and tired.”  He was not as severely character impaired as some folks I’ve worked with and he had just enough neurosis in him (and, especially, enough conscience) to both want to seek and potentially profit from professional help.

Jeff had carried an ADHD diagnosis since his days as “disruptive” child in school who couldn’t seem to keep his mind on his lessons or remember to turn in his assignments.  He was always cutting up in class, pulling pranks, and provoking the teachers.  He did manage to finish high school and secure a decent job upon graduation.  He also married (fortunately, there were no children) but things went awry fairly quickly in his relationships and he was currently divorced for the second time.  He was recently discharged from a “rehab” program where he was treated for “multiple addictions,” including gambling, drinking, and cocaine.  And it was during his stint in treatment that he began seriously reflecting on his life and problems.

I asked Jeff what he thought was wrong with him.  His answer both surprised and delighted me:  “My ex wife says I’m the kind of guy who always makes excuses.  But frankly, for much of my life I didn’t have to make many excuses because so many excuses were made for me:  I wasn’t doing my work because I had an attention deficit.  I behaved badly because my “disorder” made me act without thinking – you know, all that kind of stuff. But I think I’ve always been more of a rebel than anything else,” he admitted.  “It’s not like I couldn’t focus on my work, I just didn’t want to (In my books, In Sheep’s Clothing and Character Disturbance, I talk about the responsibility-avoidance tactic of selective attention and how it’s often mistaken for a neurologically-based attention deficiency).  In fact, I didn’t think I should have to make myself do anything that didn’t appeal to me. And it wasn’t like I couldn’t sit still, either, I just liked having a good time.  School was a complete bore to me and I just wanted to get through it and get by.  For a long time, I really thought I could.  I think I felt that way about work, too. I think I’ve always felt a little like I shouldn’t have to play by the same rules as everybody else and didn’t see the harm in getting away with things. But here I am almost middle age and I know I’ve made a pretty big mess of things.  Problem is, I haven’t a clue how about how to get my act together.  I mean, sometimes I actually do try, but I’m always falling back into old habits.  I don’t particularly want medication, because at the treatment center I learned it’s best to be substance free, and the medicine I’ve taken in the past really didn’t help all that much anyway.  But I’m willing to try whatever you say.  Can you help?”

It’s folks like Jeff who over the years convinced me that “insight” (or the lack of it) is rarely the dominant issue affecting folks of impaired character.  It’s not like they haven’t been told over and over again or haven’t known all along at some level where their problems lie.  But when folks are at war with the very rules and social expectations that can save them, can’t bring themselves to concede error, and keep on reinforcing the same old habits, it’s really hard to change.  Even when they’ve reached the point in life where they appreciate the need for change and sincerely want to do so, it’s a significant challenge.  The key time for character formation is the first six years of life.  After that, changing one’s ways is a very arduous process.  Still, when one’s motivation is high enough, it can be done.  And Jeff was one of those rare individuals ready and willing enough to do the work necessary (For more on how this is actually accomplished, see the concluding chapters in my book Character Disturbance and the articles:  Can We Change Who We Are?, Disturbed Characters: Can They Ever Really Change?, Breaking Bad Habits with the Behavioral Approach, Becoming a Better Person:  Covert Self-Monitoring and Self-Reinforcement, and Four Steps to Character Health). And after several years of active effort in therapy, put himself on a much more responsible life path.

This Sunday’s Character Matters program will again be a live broadcast, so I’ll be taking calls from listeners.

 

45 thoughts on “Behavior and Impulse Control Disorders – Part 2

  1. My guess is that “Jeff” doesn’t fall on the seriously impaired end of the CD spectrum or is even on the psychopathic spectrum at all and that he doesn’t live in his enabling mothers basement as he is approaching middle age. I’m sorry….. IN middle age.
    Interestingly enough, I have never once heard my brother use the ADHD diagnosis he was given as a child as an excuse for any of the trouble he’s been in. Actually I’ve never even heard him mention it period. The only time he ever bothers with excuses per say are lies to get out of doing something he doesn’t want to do or to avoid accountability for something he’s done that he shouldn’t have done or more lies to manipulate someone to give him money. If there was ever a person who could be the poster child for pathological liars he would be the one. Of course Spathtard would be in direct competition for that honor.

  2. My s-in-law refers to her Attention Deficit Disorder quite frequently. It’s amazing how the disorder kicks in when the focus is off of her and is curiously absent when she is trying to start an argument about anything anywhere with anybody.

    I will give both her and my brother this, I think they both do have some real problems with ADD. Attention deficits and narcissism, though different, provide synergy for one another. I imagine them as harmonizing.

    Oh Lord, your brother, Puddle. Really heartbreaking for your Dad and was awful for your Mom.

  3. I guess it’s the lack of willingness to concede error that wasn’t as prominent in Jeff’s character that made change possible. It must be so gratifying for therapists to be able to help people like Jeff change their ways. Working with people who truly and deeply don’t give a darn would be demoralizing as Heck if not for the few little victories. And really, even if they want to change, CD’s who are salvageable probably can’t do it without the help of someone who has a deep knowledge of the struggle involved.

    1. LisaO, I think it just another game to someone like Spathtard or my brother, being in a therapists office. Just someone else to pull one over on. Spathtard did it in a session with a relationship counselor we went to……..I didn’t “get it” of course. Just another WTF moment swept under the rug, right under my nose.

  4. Dr. Simon,I think people get attached to their long standing persona too and if they are not willing to try other ways of being a human in this world there is no where different for them to step out of their same old same old, well worn rut. For example, the bad boy image or the party guy/ life of the party image. All their companionship revolves around that life style and their roll in it. To change means giving up their stead fast circle of “friends”. I think that is the biggest benefit to groups like AA. It’s like training wheels into the possibility of a new way of being because at least there is the interaction with other people at the meetings, an opportunity to make new friends outside the party crowd and a buffer to the loneliness they would feel when they step away from the usual crowd. I think loneliness and acceptance fuels a lot of bad choices in life.
    I hope you are feeling better.

  5. So Puddle, the problem for many of these types is giving up the ‘devil may care,’ persona that interferes with long term relationships but can be magnetic for short term romantic or casual relationships. Being responsible has huge implications for this type. Their friends might lose the ‘fun guy’ they used to know. But their significant others will lose the ‘fungi’ if they change. Nobody wants to live with the human equivalent of slime mould. To change a lifetime of hedonism has got to be a huge challenge. Anyone with strong CD tendencies, who manages to do it, should be applauded. Imagine Spathtard-X changing. Really hard. He’d need a full character transplant.

    1. LisaO, to get a character transplant would require him to have one to begin with. I’ll bet he is just SO tired of acting like the dutiful son to keep in good graces with whoever. He as much told me the truth when we first met……..I’m here to help mom. My sister thinks I’m just doing it for me. Then went on to play the pitty card about how he has cared for someone most of his adult life (aka, the kids his exwife dumped on him because he broke her and with PLENTY of help from mommy I’m sure)……he tells me he is on sebaticle. WTF?? Huh? The whole thing is so disgusting to rethink and retell.

    2. LisaO, I am attracted to the type, that’s for sure. I think I was born with that, my BioMom was the exact same. There is something all wrapped up with this part of the equation. I’ve always said I need a reformed bad boy. Guess what? There really aren’t any. I know there MAY be a couple who somehow managed to improve themselves to a degree but few and far between.

  6. Oh Puddle…who isn’t attracted to gregarious extroverts with wit and charm and soo much love to give who have been so mistreated in their lives by the blatant insensitivitynof others? LOL!! And if they just so happen to have so much in common with you, feel they were close to you in past lives, feel your distress even more than you feel it? What’s not to like? What if they are also devastatingly handsome and seem completely smitten with you; hang onto your every word; etc…add to that…what if they itemize these amazing acts of kindness they have performed, for others, in the past? Seriously…who wouldn’t be attracted to that?? Only somebody who has been burned badly in the past…and I mean…badly.

    So, it’s a universal problem, not the result of any pathology.

      1. Just so you know I wasn’t being flippant there. It’s just it’s so true and I wasn’t sure it was the right phrase. I am tired from studying and I can feel a anger starting to brew. I’ve noticed it the last couple of weeks. I don’t think I’ve expressed my anger about all this…not in the true sense…you know that deep seated anger and I think I may have been turning it in on myself…getting a little depressed. There’s a few things coming to a head I have a fear that something may happen when the order finishes soon. That’s preying on my mind too! Probably won’t but it’s there nonetheless. Sorry rambling. I’d love to find a huge screaming room, sound proof so I could let it all out!

        1. Tori, I understand the deep seated anger being turned on yourself, add to that the fear. It can almost seem like too much sometimes. The fear is awful. We have a new thing going on in our home right now, that I won’t get into the details of, but the fear and anger can be overwhelming. I’ve had a few well-wishers try to tell me not to worry about what ifs. Try to envision the best possible outcome, etc etc. that doesn’t help me at all, actually I just feel more angry when I hear those things. Mostly I know that until the outcome has passed I will have these fears. I try to “put them away” as often as I can, but they are there, underneath almost always. Right now it’s just a matter of making it through the day. Coping the best I can

          1. Sheri just remember the baby steps…take one step at a time. It must be hard when still in it to cope through these trying stages. Be kind to yourself and I wish you peace as you try to navigate these difficult times. Take care! ((hugs to you)) 🙂

          2. Thank you, right now the stuff with my CD / N husband is being put to the side, the issues are still there, other things are going on. I’m not sure how much I can say as it may involve the courts. My 14 year old daughter came forward with some “stuff” that happened to her about a year ago with someone she was dating at the time. We knew that he was a @!!? but not the extent of it. Things were triggering her and was unable to cope … she came forward to a counselor on Friday. Things have been so unreal since then. A lot of guilt at how I didn’t know, didn’t protect her. A lot of fear for her. A lot of understanding as to her emotional ups and downs that I thought was just a “hormonal teenager” thing. Really crazy!

          3. I guess I just put it out there, we are to present a united front at home, things need to be an even keel. We need to appear strong so that our daughter can heal and work through whatever it is she’s going to need to work through.

            It’s hard, so I am really grateful for this site, as thing with the CD husband have not changed, they just need to be put aside for a while. I’m still moving forward to fulfill my goals and move away from the marriage, they just may take a little longer than I have originally thought.

            Sometimes when you think that life has thrown you everything it can, you discover it has a little more to throw at you.

        2. Tori,,,,,,get in your car and let it rip! I don’t know if you have a car or can borrow one but I’m telling you it is 100% a safe place to let it flooooooow! Other than that writing is VERY good and using the very most colorful language possible!! 🙂

          1. Yes Puddle I have a car…I am assuming you mean revving it up ha ha…don’t think I could do it on the road, I might end up in the clink!! 🙂 I do a lot of writing but again I found the anger hasn’t exactly risen. Though maybe a letter to him without sending it might be a good way to really let him have it!

          2. Tori, no I mean shouting it out in the car……saying anything and everything you possible can with zero self judgement……just say it, screen it, sing it! If you are in an area that is quiet, not hectic, not a fast speed limit……bellow it out! I have a road between me and town that was perfect. I have been up and down this road so many times I could possible do it blindfolded. I would be on my way to town and just think of something awesome that I wish I would have said to his highness and i would say it, which would open the gates…….it was ALL R- rated. Out came my hatred, disgust, righteous anger,,,,,,I just pictured him sitting in the seat next to me and not being able to walk out the door and home to mommy, which was the standard for him.

  7. Hi Tori,

    Perfect word, “touché”! It is so sad that you have to go through the anger phase, but it is probably necessary. I find because I am somewhat physically compromised I couldn’t even punch a punching bag without suffering repercussions. That inability to strike something, with ease, was difficult, so I did it in my head once or twice. The bonus of doing it in my head was imagining I was Sheena, warrior princess, vanquishing evil with a big club. So easy to swing it under those conditions, plus…. I looked hot.

    Try to use your imagination in a way that minimizes the worst ‘what if’ scenarios, or at least keeps them in perspective. And don’t let anybody tell you, in a holier than thou way, that anger is a ‘negative emotion’ that is somehow spiritually backward. Indulging anger and making yourself angrier in the process, is one thing; expressing it is another.

    1. LisaO,

      While I may not relate the best to others’ experiences here, there are things that stand out to me here.

      ” Indulging anger and making yourself angrier in the process, is one thing; expressing it is another.”

      Times ago, I was on a site about different kinds of media and fiction. I liked to edit as well as chat on its forums. There was one guy, who really seemed to find any excuses, even smallest, stupidest and most tangential ones to indulge in “righteous” anger, like he was the one with common sense and others were idiots. That’s what it seemed to boil down to: he wanted to emphasize how much he thought he had common sense. He acted immature, sniped at people and was quarrelsome. He got warnings from moderators for many inflammatory comments.

      Interestingly, he seemed ultimately more self-defeating than anything and many of his comments oozed defeatism. It didn’t even look like he was fishing for pity. He had gotten along pretty well with some on-site frequenters before, but seemed to have more and more trouble tolerating some things he found upsetting in people and getting along well with others and to be feeling more and more like he didn’t belong. He got into many fights with others, most of which he started by grumbling, whining and mouthing off aloud. He eventually left, more disillusioned than ever. Can’t still say I miss him.

      “who isn’t attracted to gregarious extroverts with wit and charm “?

      I agree. I think many, many others would agree with you, too.

      The girl I know, who ended up in a relationship with Viper, would agree with you, too.

      Also one woman I got to know, who said she had been married to an abusive narcissist, would agree with you. She had known her husband from ever since they were children.

    2. LisaO thank you…you made me smile with the vision of the warrior princess! I could imagine myself doing that, I might try it! I think the last twelve months have been one for getting my life back together logically, concentrating on practicalities for survival and I haven’t allowed myself to fully come to terms with all my emotions. Now that I am settled I guess they are starting to surface a bit. My counsellor has been good she knows that I need to express it. I have a big canvas maybe I could slash at that with some paint and then throw it away, that might help! Thanks again 🙂

    3. LisaO and Tori,

      The woman, who’d known her husband from childhood, clearly had no reason to suspect anything would ever go to hell. She suffered dissociation, as she recognized and told me and others afterwards. I met her at some point with no prior history with her whatsoever and she’s told her story forward to many, many people.

      Her husband had just happened to have bipolar and she had mistaken that for the true cause of his abusiveness(which I don’t think she recognized as abuse back then). Then one psychiatrist or psychologist had actually told her that bipolar illness doesn’t make anyone abusive. It had started to click from then on.

      He had been one of those “look at what you made me do” -types. If anything, bipolar illness just surfaced and made worse the narcissistic personality disorder that had always been there.

    4. Viper was very charming and affable at the start of the relationship, as the girl he’d dated told me. It would then degenerate to nasty digs, verbal assaults and subtle belittling, just to name some things he said and did.

      I’ve told about Viper in length in the comments of http://www.drgeorgesimon.com/mental-illnesses-and-disorders-the-autistic-spectrum/ . (Dec 31, 2014)

      Viper even downright said some similar things to what you’ve said as an example, LisaO, both to her and to some other people on isolated, separate occasions. But then Viper also showed himself as a hypocrite. He got slightly tipsy one night with some half-familiar guys(without notifying his then-girlfriend beforehand). They were in a semi-public fringe area at some point the same night. One of these guys had disagreed with him and been skeptical over something he’d said(it’s not clear to me what exactly). Viper got rowdy. These guys told him to behave himself. One gentleman also did, in passing, to which Viper responded by cussing at the man. Such hypocrisy.

  8. J, the forum poster you mention seems to be largely motivated by ego, in the guise of, “for your own good,” or, ” you people can’t handle the truth,” on and on (and in the case of forums, where no digital bouncer is there to pitch them out the door, on and on and on and on and on!!) A back and forth among many participants about controversial subjects is going to create a certain amount of drama. That is inevitable and people can express emotion, even some pent up irritation and anger but in a healthy way. It is actually not a bad way for people who need to develop social skills to engage in limited conflict and work to resolve it. From what I have witnessed there are some people who just don’t know when to back down, don’t understand that there is such a thing as agreeing to disagree. When I was frequenting forums years ago, if I found another poster was getting to me, I would suggest we took our squirmish to the private message feature and try to resolve it. It always worked. Some of my best online buddies were former public forum antagonists. . Some of them were easily triggered because their lives are so horrendous they just needed somebody to talk to. One fellow I got to know had a disabled son, his ranch had been hit by drought, etc..etc…oh and his wife’s cancer was back.

    Sad. He wasn’t a CD. He was just easily triggered. I am so glad I stayed calm in that situation. The worst for me is seeing somebody undercut and bully people who are already hurting in the guise of ‘tough love’. I overreact in that situation and have to really watch my mouth, or uh…fingers!

    But there are definitely people on forums who just like to grab attention by going into anger mode all the time. That type of indulged anger seems to gather strength, like a tornado, leaving self destruction in its wake. Not to mention how it affects other people. Still, this type of over the top blowhard is easier to deal with on forums and real life than the smooth talking covert, so into impression management, that they rarely let anyone see their feathers ruffled. I am thinking of the expression these types use when you know they are furious. Instead of saying, “I am angry,” they will say, “I am disappointed.” I am thinking Nurse Ratched in ‘One Flew Over the Cuckoo’s Nest’. They end up making everyone around them furious and have people flying off the handle. Then they sit back and watch with bemused patronizing ( or matronizing?) calm. Sheri has described it well with her CD. That type will drive you completely bonkers.

    People who are having a really tough time can be challenging to be around. A litmus test for the super stealth covert manipulator is whether those exposed to them feel like banging their (own) heads against the wall.

    1. LisaO, Very well put. You have such a deep insight, very measured and very accurate I might add. That ability is really a gift and I’ve heard it in your words many times. Great example Nurse Ratched in the movie and I can picture the scene when the whole unit went Cuckoo!!! she just smiles and calmly walks away? If I’m remembering it right. I never put that movie together with the Spath experience but it really is on target! Instead of the word “angry” or “disappointed”, Spathtard used the word “frustrated” and “disgusted” which were WTF moments in themselves for me…….doggie head tilt? Huh?

    2. LisaO, I think that forum poster also liked to grab attention a lot. Seemed to be envious towards some for what seemed like trivial reasons. I actually tried addressing some things with him in pm, but he simply returned a message telling me to not talk to him(hypocritical considering how he liked to make immature, subtly provocatory or grumbling remarks at others with no provocation or as much “provocation” as saying hi to him) and threatening to report me to the mods(never mind that he had been notified for his behavior, by mods nonetheless). The guy seemed to have pretty poor social skills overall. He clearly had so many things gone and going wrong for him in his life. Poor coping skills?

    1. A very interesting article. And very peculiar that you should present this for consideration at this time, inasmuch as it fits nicely with the article I’m planning to post tomorrow. Perhaps you’ll glean my perspective then.

    2. Very interesting J, the social inequality created by technology certainly has had an impact. It leaves many disenfranchised and so people search for meaning or control in their lives and turn to fundamentalist ideals. I wonder if the Sentinelese are in a better place, spiritually, psychologically and socially than the rest of us?

      1. Who knows?

        Living in one’s own small, limited world, no outside influences. If that was better off, what unfortunate implications would that have? Not that many truths aren’t unfortunate, of course.

        Then again, everyone living in isolated tribes doesn’t sound very good, either.

  9. J, I just gave the article a quick glance. The author made some good points. What he doesn’t seem to understand is that fundamentalism is an extreme that feeds off of the polar opposite; a society unmoored from any moral constraints, judgements. There should be a middle ground. It’s just finding that middle–applying the golden rule, when we, as a species, are under pressure. It’s not so much Facebook, it’s the real problem of automation and technology replacing human beings and all that that implies that is so difficult while population increases. What would Jesus do? As a carpenter he would likely be unemployed, on food stamps. He would have an Internet account and might go viral on youtube. But what would he do and suggest for how we should be leading our lives. I know I am doing my best to help as many people in a significant way, as I can. I hope this is enough. Plus I don’t eat much meat! I don’t know what else to do.

    1. I read somewhere that the reason that middle eastern ( men for the very most part) are so fired up and prone to violent extremism is because they power down extremely strong coffee all day long and are suffering from caffeen induced psychosis. That’s my two cents! One more cent would be that Hitler was addicted to methamphetamine. I’m not sure what this has to do with psychopaths though…..yet, other than they are all quite disturbed control freaks.

    2. Puddle, your caffeine comment could very well be on spot.

      In this article Dick Supthen says, when describing the decognition process:

      “The controllers cause the nervous system to malfunction, making it difficult to distinguish between fantasy and reality. This can be accomplished in several ways. POOR DIET is one; watch out for Brownies and Koolaid. The sugar throws the nervous system off. More subtle is the “SPIRITUAL DIET” used by many cults. They eat only vegetables and fruits; without the grounding of grains, nuts, seeds, dairy products, fish or meat, an individual becomes mentally “spacey.” ”

      Margaret Singer recounts the role of diet in Cults in our midst(pg. 132-133). It elaborates on the “spiritual diet” without proper proteins or amino acids, also causing deficiency of vitamin B12 needed to produce red blood cells. “[E]x-members report that if one is not a dan of dried beans, the amino acids may not get into one’s daily fare.” Digestive pains and churning are made out to be effects of battle with Satan, for instance, and especially “[s]ome of the neo-Hindu groups reframe the digestive upsets as the working off of past-like karma.” Wen the body adapts to vegetarian diet, leaders claim members to be “properly submitting to the leader or – achieving a higher level of awareness”. If a cult member takes on a leadership position, they’ve been groomed and instructed to tell the same thing they’ve themselves heard to new members.

      Sugar buzzing “helps overcome low feelings and makes people temporarily feel energized”.

      Some thoughts from Puddle’s caffeine psychosis comment.

      1. J, I did read some of that link you posted and it was very interesting. Many years back I went to an ashram in India and MANY of the “techniques” that were described in your link were “used” there. including, limited access to food, incense, meditation, limited sleep, on and on and on. I don’t KNOW that any of those things were being used to try to absorb people into “the fold” but they wanted supporters, I’m sure of that. Since i was there I have read some, shall we say……interesting things about that group. It’s all in my past, and I count the experience in my life as a positive so, as we say……”no harm, no foul”!

      2. There are various reasons why people seek out these experiences. It’s understandable why they join groups. Many reasons for that, too.

        Meditation seems funny. It definitely can be beneficial, but apparently it can be used to take someone into trance.

        I recently ordered Jiddu Krishnamurti’s This light in oneself. Pretty anti-fundamentalist, should I say. Krishnamurti’s got his own idea of meditation.

  10. I have to put in a few good words for Islamic radicals here. Unlike Christian fundamentalist, who, by and large, haven’t been abused, except economically, the Islamic people provide a pool of cheap labor in Europe, when needed, provide convenient scapegoats for social tension, when needed. In their own lands they are subject to literal targeting through drone attacks and civil wars that are products in part, of covert manipulation.

    Little wonder some of them have become radicalized. I don’t like the way Islamic cultures treat women, either, but the answer isn’t to bomb them back to the Stone Age and expect different results. Their two tiered gender system generally vanishes with education. It seems to me that as soon as any country in the Middle East starts to actually improve, grows a middle class, starts educating its people, they get pulverized.

    1. Some excellent points LisaO. It saddens me that many Islamic people who are not radicals or extremists live in fear in the new countries they call home. Calls to ban the burqa go against all the freedoms that were ever fought for in the past by so many. It is through education and understanding things change on all fronts.

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