I've been given a Christmas gift that may well turn my worldview upside down. A book called The Myth of Mental Illness: Foundations of a Theory of Personal Conduct, by Thomas Szasz. Now while the gift was a tongue in cheek jab at my chosen profession, I'm actually very grateful, because while I'm familiar with some of the arguments Szasz made, I haven't yet read any of his work.
I agree with some of Szasz' arguments - it's hard to disagree given the barbarities that have been carried out in the name of 'curing' mental health issues. While we may have (mostly) moved on from believing that epilepsy is due to demonic possession, it isn't so long ago that people were locked away for 'illnesses' such as hysteria (read: women who disobey a man) being gay, being a bit different or having a learning disability. To this day, we still have to fight for equal treatment for many of the above groups, and there are dangers inherent in labelling a certain behaviour as a mental illness without accounting for biology, culture and social factors.
I firmly believe that there are medical and biological reasons for many, if not most mental illnesses. To take the post below about psychopathy, we can now see a difference in the brain structure of psychopaths thanks to brain imaging technology, and even isolate contributing genes. Psychopathy is not a myth. I feel confident that as our technology and understanding increases, we will discover far more about the true underpinnings of biologically based illnesses, and also about "problems with living", to borrow a term from Szasz, that may arise as a result of personal difficulties or social factors of our complex and highly social species.
I personally view the purpose of a diagnosis as an attempt to medicalise conditions that would have previously been written off simply as 'crazy'. The idea is to remove the stigma, and view problems with the brain with the same legitimacy as we do heart disease or diabetes. It becomes a tool because we can then tailor treatment and offer the right resources to help that person. This is a comfort to many, but does also carry the risk of labelling people as malfunctioning, and removing aspects of their free will, by enforcing help that they may not want, with the authority and legitimacy of experts and doctors. Even with the best of intentions, and without a conscious effort to exert social control, we could easily slip into overconfidence in our 'medical diagnosis' and 'psychological expertise', believing it to be for the persons own good. We've done it before, and it's distinctly possible that we may continue to do it.
I'm a little nervous about picking up this book, since my very expensive degree is based on going into the mental health field! However, I'm also excited about it. One reason I am driven to go into psychology professionally is that I've spent five years or so working as a support worker for adults with learning difficulties, many of whom also have autism; a neurological difference which has in its short history since the original description and classification been subjected to much pseudoscience and damaging 'treatments' aimed at 'fixing' the people diagnosed with it. While I love the work and the people involved, I see many flaws in the system that I was powerless to change while a lowly support worker. As a psychologist, I may be able to do more to fight the inequalities within the system.
If nothing else, it's about time I read some books by Szasz, given his influence on society. Who knows, if it has a strong impact on me, I may be handing out copies to people next Christmas myself.
Showing posts with label popular culture. Show all posts
Showing posts with label popular culture. Show all posts
Thursday, 3 January 2013
Mad? Bad? Or Charismatic Leaders and Bad Boys? (and Girls!)
When studying psychology, it's rather tempting to apply your newly-acquired knowledge to any and all around you, and mentally diagnose, in a very unprofessional way, any aberrant behaviour you come across. Of course this applies to ourselves also (I'm neurotic with just a dash of OCD, according to my own peculiar and non-professional mental DSM), but what about when the matters you are attempting to understand apply directly to your own life? Is there a danger of applying our unqualified opinion to a person in real life and doing more harm than good?
Recently a very good friend of mine became romantically entangled with a man. As the months went by, the more I heard about him, the more worried I became. Being a survivor of emotionally abusive relationships myself, I felt helpless when seeing my friend emotionally abused by this man.
My usual approach when it comes to supporting anyone else is just to listen and be there for emotional support, offer the same support that I needed during my own difficulties. I've learned that throwing unsolicited advice around isn't the most helpful approach, and is often motivated more by our own desire to give the "right" answer than as support for the person we're trying to help. They likely know as much about their options as you do, and far more about themselves and what they want to do, whether you agree with their choice or not.
That being said, I also feel that part of the duty of being a friend is giving an honest opinion. We've all had friends who will tell you only what they think you want to hear, and while that feels pretty good, it doesn't help when you want an honest opinion. Another friend of mine is wonderfully kind and will do anything for anyone, but is also a very plain speaker. If you look like hell in a new dress, she'll tell you so. Then pick out a better one for you. She was an unfailing support when I was stumbling from bad relationship to worse relationship, but also baldly stated some harsh truths I needed to hear. While her statements sometimes stung, I also highly valued her honesty, and I resolved early on to always adopt the same approach when it comes to interpersonal relationships (rather different from professional ones).
It's a fine line to tread, will vary on a case by case basis, and I am far from finding the right blend of direct and honest opinion sharing and non-judgmental support, but, as with all things, I stumble through just trying to give my best at the time based on my current knowledge, with the disclaimer that my opinions are just that: opinions, and only one of many possible viewpoints.
Back to the first friend involved with an emotionally abusive man - the reason this particular example bought this issue up for me was the genuine fear that this man might well be a psychopath. Seeing a friend being hurt in a relationship is hard enough, but with the ever growing anecdotal evidence against him, I became convinced, and remain convinced, that he displays patterns of behaviour consistent with the Dark Triad, traits that indicate a serious personality disorder: the triad consisting of narcissism, Machiavellianism and psychopathy. http://en.wikipedia.org/wiki/Dark_triad
Superficially charming and adept with language, yet also over a period of many months, admitted to enjoying playing mind-games, wanting total and utter loyalty and vulnerability from her but not wanting to give her the same, and demanding that she keep his loyalty and his alone, asking her to deceive everyone else in her life while being loyal only to him. Those things alone are cause for concern from anyone, displaying a level of control and selfishness that screams of an abusive partner and distinctly unhealthy patterns of relating, but there were other, even more sinister clues. His behaviour was consistent with his beliefs, demonstrating a willingness to lie to whomever he needed to, a violent temper, a keen desire to present a favourable image of himself above all other desires, unreliable and impulsive, and highly manipulative (self-reported as well as demonstrated in behaviour), and perhaps most crucially, an absolute absence of remorse or empathy.
What to do under those circumstances? All I could do was to warn her that while I certainly am not qualified to make a diagnosis, that his behaviour was most definitely not acceptable, regardless, and that continuing to be involved with him might even be dangerous? Fortunately, she is no longer involved with him, but this brush with a suspected pathology that has so much Hollywood myth and legend surrounding it has raised more academic questions for me, now that my friends well-being is no longer under threat.
The word psychopath has us picturing serial killers in movies, or Ed Gein and Jeffrey Dahmer. Psychopath = killer. We may refer to someone as a psychopath as a linguistic short-hand for someone who behaves in a very anti-social way, while also not really imagining that they are indeed psychopathic.While there is good reason for us to leap straight to those images since those killers do indeed exist, and are often diagnosed as psychopaths, current thought is that psychopathology is more common than we imagine, and certainly doesn't mean that all psychopaths are killers. In fact, there are theories that psychopathology has been a successful mating strategy, which would go some way to explaining why the rate of psychopathology in the general population may be as many as 1 in 100 people, and that the superficial charm and skillful manipulation employed by psychopaths makes many of them successful businessmen.
1% of the population. That sounds like a relatively small figure, but when you consider how many people you interact with on a regular basis over the course of your lifetime, it seems that all of us will have dealt with one at some time or another. Consider how many people you pass as you walk along a busy street; the statistics suggest that at least a couple of them will be psychopaths.
My personal interest in the dynamics of abusive relationships gives me a desire to understand psychopathology that goes beyond the intrigue that many of us feel when confronted with Hollywood ideas about serial killers. The danger psychopaths and sociopaths pose goes far beyond a primal fear of serial killers, because while the odds of being targeted by a serial killer are extremely low, the odds of becoming entangled in a relationship that is either physically and/or emotionally abusive are considerably higher. That psychopaths engage in manipulation without remorse while being extremely good at deception and superficial charm makes their victims even more vulnerable to exploitation.
But in general, how aware are we of the prevalence of psychopathology? Are we on guard against these types of behaviours and do we raise our children to be aware of the warning signs? Do we take the idea of these types of personality disorders seriously, or do we see them as Hollywood monsters, a very rare breed that we would spot if we ever encountered one in real life? Can psychopaths ever be treated? What do we really know about psychopathology when we separate out the reality from Hollywood scenes and our own mental pictures of what the word psychopath means?
I still believe that the man my friend became involved with had a serious personality disorder, consistent with the Dark Triad. Whether psychopathic, sociopathic, or neither of them, his behaviour is none the less unhealthy and dangerous to the emotional health of those he manipulates, if nothing else. I'm also confident that in my history of extremely unhealthy romantic relationships, at least one of the men I myself dated was a psychopath. It took me a long time to recover from the aftermath of that relationship, and I strongly suspect that other people with a history of engaging in emotionally unhealthy relationships will have a higher likelihood of having had a close encounter with a psychopath. However, this is very unscientific speculation on my part, and I have so far not been able to find much relevant research to support my hypothesis. In fact, despite the fact that rates of psychopaths are high in the criminal population and the fact that it's such a fascinating area of study and popular culture, there are more questions than answers in the literature.
Dr. Robert Hare is perhaps the leading expert on psychopathy, having devised the psychopathy checklist and written several books on the subject, he also has some rather alarming warnings to give based on his research. http://www.psychologytoday.com/articles/199401/charming-psychopath
I do not wish to scaremonger. That's my last intention, and I do not think that sensationalism is either helpful or necessary. But I do believe that more research on the nature of these particularly dangerous personality disorders is needed, and that as a society we need to converse more about the realities of psychopathy, rather than dismiss the odd case of a serial killer as a rare and unfathomable mystery. There is much I could add about genes, nature vs. nurture and fMRI scans of individuals with a diagnosis of psychopathology, and it's fascinating stuff that I'm happy to supply links to should anyone want them, but since this is pretty long as it is, so I shall leave it at that, and say that I'd love to hear from anyone who believes that they have encountered a psychopath in their own lives or comes across any research that relates to unhealthy patterns of relationships and personality disorders.
Recently a very good friend of mine became romantically entangled with a man. As the months went by, the more I heard about him, the more worried I became. Being a survivor of emotionally abusive relationships myself, I felt helpless when seeing my friend emotionally abused by this man.
My usual approach when it comes to supporting anyone else is just to listen and be there for emotional support, offer the same support that I needed during my own difficulties. I've learned that throwing unsolicited advice around isn't the most helpful approach, and is often motivated more by our own desire to give the "right" answer than as support for the person we're trying to help. They likely know as much about their options as you do, and far more about themselves and what they want to do, whether you agree with their choice or not.
That being said, I also feel that part of the duty of being a friend is giving an honest opinion. We've all had friends who will tell you only what they think you want to hear, and while that feels pretty good, it doesn't help when you want an honest opinion. Another friend of mine is wonderfully kind and will do anything for anyone, but is also a very plain speaker. If you look like hell in a new dress, she'll tell you so. Then pick out a better one for you. She was an unfailing support when I was stumbling from bad relationship to worse relationship, but also baldly stated some harsh truths I needed to hear. While her statements sometimes stung, I also highly valued her honesty, and I resolved early on to always adopt the same approach when it comes to interpersonal relationships (rather different from professional ones).
It's a fine line to tread, will vary on a case by case basis, and I am far from finding the right blend of direct and honest opinion sharing and non-judgmental support, but, as with all things, I stumble through just trying to give my best at the time based on my current knowledge, with the disclaimer that my opinions are just that: opinions, and only one of many possible viewpoints.
Back to the first friend involved with an emotionally abusive man - the reason this particular example bought this issue up for me was the genuine fear that this man might well be a psychopath. Seeing a friend being hurt in a relationship is hard enough, but with the ever growing anecdotal evidence against him, I became convinced, and remain convinced, that he displays patterns of behaviour consistent with the Dark Triad, traits that indicate a serious personality disorder: the triad consisting of narcissism, Machiavellianism and psychopathy. http://en.wikipedia.org/wiki/Dark_triad
Superficially charming and adept with language, yet also over a period of many months, admitted to enjoying playing mind-games, wanting total and utter loyalty and vulnerability from her but not wanting to give her the same, and demanding that she keep his loyalty and his alone, asking her to deceive everyone else in her life while being loyal only to him. Those things alone are cause for concern from anyone, displaying a level of control and selfishness that screams of an abusive partner and distinctly unhealthy patterns of relating, but there were other, even more sinister clues. His behaviour was consistent with his beliefs, demonstrating a willingness to lie to whomever he needed to, a violent temper, a keen desire to present a favourable image of himself above all other desires, unreliable and impulsive, and highly manipulative (self-reported as well as demonstrated in behaviour), and perhaps most crucially, an absolute absence of remorse or empathy.
What to do under those circumstances? All I could do was to warn her that while I certainly am not qualified to make a diagnosis, that his behaviour was most definitely not acceptable, regardless, and that continuing to be involved with him might even be dangerous? Fortunately, she is no longer involved with him, but this brush with a suspected pathology that has so much Hollywood myth and legend surrounding it has raised more academic questions for me, now that my friends well-being is no longer under threat.
The word psychopath has us picturing serial killers in movies, or Ed Gein and Jeffrey Dahmer. Psychopath = killer. We may refer to someone as a psychopath as a linguistic short-hand for someone who behaves in a very anti-social way, while also not really imagining that they are indeed psychopathic.While there is good reason for us to leap straight to those images since those killers do indeed exist, and are often diagnosed as psychopaths, current thought is that psychopathology is more common than we imagine, and certainly doesn't mean that all psychopaths are killers. In fact, there are theories that psychopathology has been a successful mating strategy, which would go some way to explaining why the rate of psychopathology in the general population may be as many as 1 in 100 people, and that the superficial charm and skillful manipulation employed by psychopaths makes many of them successful businessmen.
1% of the population. That sounds like a relatively small figure, but when you consider how many people you interact with on a regular basis over the course of your lifetime, it seems that all of us will have dealt with one at some time or another. Consider how many people you pass as you walk along a busy street; the statistics suggest that at least a couple of them will be psychopaths.
My personal interest in the dynamics of abusive relationships gives me a desire to understand psychopathology that goes beyond the intrigue that many of us feel when confronted with Hollywood ideas about serial killers. The danger psychopaths and sociopaths pose goes far beyond a primal fear of serial killers, because while the odds of being targeted by a serial killer are extremely low, the odds of becoming entangled in a relationship that is either physically and/or emotionally abusive are considerably higher. That psychopaths engage in manipulation without remorse while being extremely good at deception and superficial charm makes their victims even more vulnerable to exploitation.
But in general, how aware are we of the prevalence of psychopathology? Are we on guard against these types of behaviours and do we raise our children to be aware of the warning signs? Do we take the idea of these types of personality disorders seriously, or do we see them as Hollywood monsters, a very rare breed that we would spot if we ever encountered one in real life? Can psychopaths ever be treated? What do we really know about psychopathology when we separate out the reality from Hollywood scenes and our own mental pictures of what the word psychopath means?
I still believe that the man my friend became involved with had a serious personality disorder, consistent with the Dark Triad. Whether psychopathic, sociopathic, or neither of them, his behaviour is none the less unhealthy and dangerous to the emotional health of those he manipulates, if nothing else. I'm also confident that in my history of extremely unhealthy romantic relationships, at least one of the men I myself dated was a psychopath. It took me a long time to recover from the aftermath of that relationship, and I strongly suspect that other people with a history of engaging in emotionally unhealthy relationships will have a higher likelihood of having had a close encounter with a psychopath. However, this is very unscientific speculation on my part, and I have so far not been able to find much relevant research to support my hypothesis. In fact, despite the fact that rates of psychopaths are high in the criminal population and the fact that it's such a fascinating area of study and popular culture, there are more questions than answers in the literature.
Dr. Robert Hare is perhaps the leading expert on psychopathy, having devised the psychopathy checklist and written several books on the subject, he also has some rather alarming warnings to give based on his research. http://www.psychologytoday.com/articles/199401/charming-psychopath
I do not wish to scaremonger. That's my last intention, and I do not think that sensationalism is either helpful or necessary. But I do believe that more research on the nature of these particularly dangerous personality disorders is needed, and that as a society we need to converse more about the realities of psychopathy, rather than dismiss the odd case of a serial killer as a rare and unfathomable mystery. There is much I could add about genes, nature vs. nurture and fMRI scans of individuals with a diagnosis of psychopathology, and it's fascinating stuff that I'm happy to supply links to should anyone want them, but since this is pretty long as it is, so I shall leave it at that, and say that I'd love to hear from anyone who believes that they have encountered a psychopath in their own lives or comes across any research that relates to unhealthy patterns of relationships and personality disorders.
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