I often get asked whether disturbed characters are more prone to “addiction” and to other kinds of disorders. Generally, these inquiries come from folks in relationships with someone who appears to be “struggling” with or has been diagnosed with some kind of disorder, and the other person in the relationship, although considering ending it, is consumed with guilt over possibly abandoning someone who is suffering under the weight of true illness. Recently, I was asked this question by three different individuals, a student studying these issues, a woman debating whether to end her marriage, and a husband who for years had endured the torment associated with his wife’s substance abuse. So I thought I’d comment on this, though I might caution the readers in advance that my comments and experience are not necessarily in agreement with the dominant position among my colleagues.
Most of the official “disorders” listed in the official Diagnostic Manual that do not arise out of purely developmental, neurological, physiological, or biochemical anomalies do not occur in personalities who are otherwise well-adjusted. Rather, many “disorders” actually represent various manifestations of a person’s personality maladjustment. I’m not saying that everyone who exhibits some kind of behavioral condition necessarily has a full-blown personality “disorder”. But most behavioral problems are intimately connected with and often stem directly from a person’s enduring and preferred style of perceiving things and relating to the world (which defines their personality), and it’s their typical approach to things that gets them into trouble. There are exceptions, to be sure. For example, a person can develop a true biochemical depression purely as the result of a spontaneous and otherwise un-caused biochemical imbalance that’s developed in their brain. Similarly, a very-well adjusted individual can become inadvertently addicted to certain pain killing medication appropriately prescribed by a physician unaware that the combination of the high addiction potential of the medication and the person’s vulnerable physical constitution placed them at high risk for becoming hooked even after short-term use. But the kind of situation I just described is not only rare, but also radically different in character from a scenario in which a person knowingly and despite the well-known risks, freely decides to “try” meth a few times, likes the effect, continues to use and abuse it despite the consequences, maybe even “cooks” it and shares it and sells it to others, and before long turns into a total monster. While such a person might end up becoming genuinely addicted, their decision to play with fire and allow themselves to proceed down the road to disaster is a very definite character issue. And such character issues can become magnified greatly when a person is under the influence or has developed a pattern of use. Moreover, even if intervention puts a dent in the person’s pattern of use, if their underlying character issues are not dealt with, they’re quite likely to exhibit other potentially problematic behaviors in the future.
I could provide more examples and get into a more sophisticated discussion about the relationship between various behavioral disorders and character dysfunction, but that would probably take a whole series of articles. Suffice it to say that when it comes to most of the behavioral syndromes that cause problems in life, at work, or in relationships, there’s almost always a character issue or two lurking underneath. And the fact that some helping professionals turn a blind eye to these issues, even to the point of inaccurately framing every behavior problem as the outgrowth of a disease the person cannot help, is, in my humble opinion, a true travesty. That’s why it’s so imperative for folks entering relationships to become better judges of character and why I’ve devoted so much effort in my writings (especially in Character Disturbance) to presenting an easy to comprehend framework for understanding and dealing with the character of someone with whom you might be involved.