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.