On character disturbance

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gabriel conroy

Gabriel Conroy [pseudonym] is an ex-graduate student. He is happily married with no children and has about a million nieces and nephews. The views expressed by Gabriel are his alone and do not necessarily reflect those of his spouse or employer.

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  1. Avatar LeeEsq
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    American society and other Western societies encouraged more social conformity in the past. You were supposed to behave as the crowd behaved. There were even PSAs about this during the 1950s. A social revolution of the 1960s and 1970s was that being different from the crowd was good. It was a big part of the Counter-Culture. A lot of character disturbance seems to be about the need to project how special and unique you are to the world if I’m reading this correctly. Social media like Facebook provides a platform to people to broadcast their specialness to the world. Maybe character disturbances are unavoidable given the move against social conformity, which is generally a good thing, and the Internet.Report

    • Avatar fillyjonk in reply to LeeEsq
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      Sometimes I wonder if the “noise” of the modern world, coupled with the drive that everyone under 60 or so has been exposed to to “be unique and matter to the world” is what makes us all so crazy and leads to the sort of look-at-me behavior that is at best annoying (the d-bag in my neighborhood who has a motorcycle as loud as a plane crash and who likes to drive it late at night) and at worst, dangerous (“TOP O’ THE WORLD, MA!!!!!” and similar desires to ‘go out shooting’).

      I suffer a fair amount of cognitive dissonance because I want to be “useful” in a good way (that is: lead a life that generally benefits people) but I confess I also kinda want attention, and sometimes those two things are more or less mutually exclusive. My upbringing’s effects are strong on me so I usually opt for being the “useful person in the background” but it drives me slightly mad when some know-nothing gets lionized simply because they’re good at self-promotion.Report

    • Avatar Gabriel Conroy in reply to LeeEsq
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      says:

      I think Simon would agree with “[a] lot of character disturbance seems to be about the need to project how special and unique you are to the world.” Or, he might say that character disturbance is taking specialness and uniqueness to extremes.

      I’m skeptical about the claim that societies prior to the 1960s/1970s tended to value conformity as much as your comment suggests, however. (Of course it’s relative. 1950s weren’t all conformity all the time and the 1960s weren’t all individualism all the time. And I realize you’re not arguing to the contrary.) At the same time, you raise a good point (if I’m reading you right) when it comes to distinguishing between what I call the “character disturbance” in the era of Jim Crow from what Simon calls character disturbance. Under Jim Crow, “lynch law” was a push to conform to a perceived racial norm, while Simon’s examples refer to people who don’t conform to some sort of norm.Report

  2. Avatar Kimmi
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    says:

    The most selfless altruist I know is a psychopath.

    Psychopathy, to be dead straight about it, is a lack of empathy — or, if you want to get really technical, the sadists enjoyment of “causing a response, ANY response” out of someone (see tickling, which is gateway sadism). You can have that and still be a damn fine person.Report

  3. Avatar Zane
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    says:

    I haven’t read Simon’s book, but your summary makes me deeply uncomfortable with his arguments. His neat division of character disorders from neurotics uses very old language and seems to reflect a deep cultural desire in the US to sort “bad” unfortunates from the “good” unfortunates (“shirkers” from the deserving poor, for example). There’s also been a revolution in thinking about some specific personality disorders that suggests that our conceptualization of them has been wrong all along.

    Borderline personality disorder was once thought to be a flaw in personality development that left one unable to form permanent, lasting self-conception and appropriate attachments. People with BPD were seen as manipulative and unstable, and there remains a fair amount of stigma against people with BPD even among mental health professionals. Now there’s growing recognition that BPD at least in part stems from a real inability to regulate (in one’s self) and appropriately evaluate (in others) emotional responses and content. Sort of the flip side of some of the symptoms of autism. If this is true, and I suspect it is, this is a disorder of brain function. Environment (including culture) may play a role in triggering the development or shaping the particular presentation, but it’s not helpful to see causes or interventions as simple or easy.

    He also sees a social problem with an individual solution (psychotherapy, really?), which is really problematic. One of the really powerful books I read during my training was The Social Causes of Psychological Distress by Mirowsky and Ross. They argue pretty persuasively (with evidence to support their arguments!) that most mental distress is the predictable response to what are social stressors. Mirowsky and Ross certainly understand that schizophrenia, bipolar disorder, and some depressions are not caused by social stressors (but may be made worse by such), but indict our mental health and medical system for an emphasis on individual solutions that cannot ever measure up to the herculean task of addressing the fallout of social problems. As solutions, these individual interventions are far too weak to make a dent in the overall problem–and they’re quite expensive for the benefit gained.

    Focusing only on psychotherapy and medications as the sole appropriate interventions is part of the problem, they argue. It means we ignore structural social causes of anxiety, depression, and other mental disorders. If we want to reduce the overall prevalence, severity, and cost of mental distress, we need to include social solutions. These include a real social safety net, adequate childcare provision for everyone, the opportunity for purposeful activity for everyone (employment or volunteering), adequate and safe housing, and so on.Report

    • Avatar Zane in reply to Zane
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      says:

      By the way, does Simon explain why he uses “character disorder” and “neurotic” as terms? They’re really not used anymore in the professional literature. There must be a rationale behind his decision. The intentional use of these dated words really does grate on me.Report

    • Avatar Kimmi in reply to Zane
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      says:

      Zane,
      The perils of listening to psychologists. They always go about trying to find the “right” (most moral) way to solve everything. Believe it or not, there are ways to reduce mental distress without spending money that we really don’t have (I know, the hidden premise is always “Let’s Fix America” not “Let’s Fix the World”, but exposing it is called “have some cognitive dissonance, today”).Report

      • Avatar Zane in reply to Kimmi
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        says:

        So far as I know, the only psychologist mentioned in my reply is Simon. There does seem to be a willingness to pay billions of dollars for individual treatment because those costs appear, magically, to not be borne by society in a meaningful way. It’s also easy to ignore opportunity costs and the built-in costs of mental distress in things like work-hours lost, child neglect and abuse, etc.

        It seems a rhetorical trick to argue that Mirowsky and Ross are arguing for “moral” solutions. Their focus on costs and benefits seems to be admirably clear-headed to me. Unfortunately, I lack belief in an unseen free solution to the costs stemming from mental distress, so perhaps my problem is not wishing it to be true powerfully enough.Report

    • Avatar Doctor Jay in reply to Zane
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      says:

      I would like to endorse this post quite strongly. @zane has said what I would have said, only better.

      For instance, I was talking with a veteran clinical psychologist about narcissism recently. She described the idealization-degradation cycle. I said I always thought that the difference between neuroses and personality disorders was that in the latter, the patient didn’t suffer. She said, “Oh, I think there’s suffering”.

      I think it’s true that there’s a lot of enabling and accommodation. I have some people in my life who show some characteristics of BPD. What I have learned is that the questionable behavior is there because they want help, and that they are very much suffering. However, the best way, the most compassionate way, the most therapeutic way for me to behave isn’t necessarily to act the way they want me to act, or the way I’m inclined to act with no training.

      Simon’s hypothetical book about his own recovery seems like it would be much more interesting than this one.Report

    • Avatar Gabriel Conroy in reply to Zane
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      says:

      Simon certainly gives short shrift to social causes argument. But I do think it’s possible that his neat-ish divisions between the “disordered” and the non-“disordered” are more for reading comprehension purposes.

      There is a definite moralistic strain in his writing that I underplayed in my summary. That strain bothers me (as I think it probably bothers you). As a layperson who probably knows less about the conditions you describe than you do, I will say I like the emphasis on choices people make even if he overdoes it. And I suspect he overdoes it when he talks about the severely disturbed and not, say, about the jerks in life who don’t pose the types of dangers he’s warning against. Again, though, he seems to write off sociological factors and, by my reading, he also implicitly writes off the disordered person’s capacity to suffer. (He never says that, but I infer it from what he has written.)

      I will say that he probably wouldn’t call schizophrenia a character disorder. He seems to recognize that there are disorders that have a physiological basis. From what he has written, however, I’m pretty sure he’d say borderline personality disorder is a character disorder. Or….he might stake a middle ground and claim that *true* BPD isn’t but that BPD is overdiagnosed. He makes a nod in that direction when it comes to the “other” BPD (Bipolar Disorder).

      To answer your second comment, I don’t believe he explains why he uses “neurosis,” “neurotic,” and “character disorder.” This is a guess, but I think he uses “neurotic”/”neurosis” to underscore what he calls the “traditional” understanding of psychology and contrast it with his “new” concept of “character disorder.” To be clear, I’m not defending his choices here.Report

  4. Avatar veronica d
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    says:

    To me this seems like total bunk.

    Most of my experience with the “Cluster B” disorders it with Borderlines, including people I’ve dated, etc., along with the fact I do DBT myself (for ADHD stuff) and have read Linehan’s books. Anyway, I think I have a good sense of its contours, at least as much as a layperson can, who does not have the disorder.

    So yeah, short version: BPD patients suffer. They suffer a lot. Do the “antisocials” and “narcissists” suffer? Gosh, I don’t know. I sense that the narcissists are quite fragile people. Am I correct? I cannot read minds.

    How many of us have known a “sociopath”? How many of us think we do because what we see in movies?

    One of the interesting tools in DBT is, quite simply, trying to find a middle path between judgment and acceptance. Which is to say, DBT is in fact dialectical in its approach. There is no true path, except that you try, explore, discern, fail, and recover, on the way to finding a path.

    On that same theme, do we really need to draw a bright line between inside-the-head “neuro/psychological” stuff and outside-the-head “social” stuff? Surely we should distinguish them. We should understand how each contributes.

    For example, there is something deeply ugly in how bigots use psychological evidence to justify increased bigotry against transgender people, when it is clear that much of our psychological trauma occurs because of the bigotry we face.

    So yeah.

    #####

    I’ve been looking through his blog. Start here. Follow the links. He seems like a smart enough person. I certainly would love to see more people follow his general advice.

    That said, is he unaware of how fucking awful people were in the past? Lynching? Slavery? Marital rape? “Corrective” rape? Genocide after genocide? Etc. Does he think life was all Mayberry and Jimmy Steward films?

    He says we’re too “permissive”. What does that even mean?

    I wonder if he would cheer as they burned me at the stake?Report

    • Avatar Kimmi in reply to veronica d
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      says:

      v,
      It’s always sunny in Philadelphia has a nice treatment of narcissism. Yeah, it is a lot about puffed out ego beyond all belief, and yeah, I think they do suffer when what they expect to happen doesn’t.

      I do know a sociopath. He’s a perfectly well-functioning individual (an altruist, if not a gentleman), but you don’t want to fuck with him. He’s quite nice to people who don’t try to cheat, lie or deceive him — in his line of work, he finds good people rather exceptional.Report

    • Avatar Doctor Jay in reply to veronica d
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      says:

      You know, one of my quick responses to the discussion of the value of CBT was “What? You’ve never heard of DBT?”Report

      • Avatar veronica d in reply to Doctor Jay
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        says:

        @doctor-jay — Yeah. I’ve been reading his blog. There is much I agree with, but it’s rather curious the things he does not talk about. What I mean is, what you neglect to say often communicates as much as what you say.

        He’s an odd duck.Report

      • Avatar Kimmi in reply to Doctor Jay
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        says:

        Doctor Jay,
        RE-ally? I’ve worked for a couple of years in psychology labs, and I hadn’t heard of it. (I rather suspect this was simply because they just called it CBT…).

        This seems like a slightly technical term. And like a lot of slightly technical terms, it’s something you almost had to hear about. (In short: it’s a mexican hat, not a gaussian blur).Report

        • Avatar veronica d in reply to Kimmi
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          says:

          @kimmi — DBT is mostly a”thing” in BPD circles, inasmuch as it works better for BPD than standard CBT approaches. That said, if this cat wants to present himself as an expert on personally disorders, and in particular on the tensions between acceptance and change, it is a topic I’d expect him to mention.Report

          • Avatar Gabriel Conroy in reply to veronica d
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            says:

            I’ve heard it’s also helpful for people with self-injury problems but who don’t really have BPD.Report

            • Avatar veronicad in reply to Gabriel Conroy
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              says:

              @gabriel-conroy — Honestly, it is helpful for a lot of things. It is very much not helpful for clinical depression. Certainly it will not help with things like psychosis or schizophrenia. But it helps muchly with ADHD related stuff, along with all kinds of anxiety issues. Self harm and suicidality are well within its frame. Also anything on the PTSD spectrum.

              That said, I’m a raving DBT fangirl. Apply grains of salt generously.Report

    • Avatar Doctor Jay in reply to veronica d
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      says:

      I think that what you are hinting at is that there are certain markers in his speech and writing that seem like threats to you. And to me.

      And, the best book on being around a person with BPD is “Stop Walking On Eggshells”. It is meant to help you be more direct to the person with BPD about how what they are doing affects you, in a way that is helpful to them, and to you.Report

      • Avatar veronica d in reply to Doctor Jay
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        says:

        @doctor-jay — I’ve dated two people on the BPD spectrum. The first was undiagnosed (but did have the corresponding CPTSD dx), but was almost for sure full-on mega BPD. The second was oddly enough both dx’ed and explicitly not dx’ed. (Two different therapists disagreed.)

        Anyway, a relationship with the first woman was freaking impossible. Yeah, eggshells, but also a complete inability to deal with her shit. It was awful. The second woman — she’s a gem. She has issues. But she knows how to apologize — really apologize. Likewise, she’s not afraid to self-criticize or do hard work.

        (Sadly, she’s been resistant to starting DBT. But whatever. Baby steps.)

        The thing is, personality disorders are not an all or nothing thing. With the first woman, the eggshells were constant. With the second, the eggshells are only sometimes. And I know enough about BPD to negotiate the meltdowns.

        Plush she’s HAWT.

        #####

        Regarding Simon, I’ve read more of his blog (but not yet watched the video). My main problem: he seems ultimately banal. First, sure we should be wary of narcissists. For example don’t elect them to high office (good grief). On the other hand, I already knew that. Second, yes character matters. It matters a lot. In fact, I think he is correct that we underemphasize it these days.

        It is actually this latter point that bugs me most about him. I want someone to talk about character in useful ways. However, with him I feel like we’re seeing poorly disguised traditionalism instead of a decent, modern approach to character. His focus on “permissiveness” is something of a red flag to me. I would want him to spell that out more.

        Take this article on sexuality: https://www.drgeorgesimon.com/sexual-irresponsibility-illness-addiction-or-character/

        Okay, the thing is, he says nothing about queerness or polyamory or anything similar. It is as if, in his view, these things do not exist.

        I am willing to concede that perhaps most of his patients and readers are following the “het-normative” lifeplan. Fine. But this is not universal, and insofar as he wants to speak to a modern audience, I would want him to at least acknowledge these things exist and matter.

        So is he a thinly disguised traditionalist? Maybe. I don’t know. I’m pattern matching. All the same, it is bothersome. It limits his views to fuddy-duddy str8s. Is that deliberate?

        Queer people exist. We struggle to define character the same as str8 people do.

        Secondly, I wonder how useful his ideas will prove to be. For example, DBT actually works. It is complicated. It takes hard work. But it is effective.

        Does he have something similarly effective? Lukewarm gestures toward CBT are fine, but I already knew that. Is he moving the ball forward, or is he just pontificating without substance?

        Sadly, I suspect the latter.Report

      • Avatar Gabriel Conroy in reply to Doctor Jay
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        says:

        “…there are certain markers in his speech and writing that seem like threats…”

        I didn’t mention this in the OP–both because it was too long already and because I wasn’t quite sure how to fit it in–but I do detect a “Christian” element to his message. At a couple of points he says it’s important to acknowledge a “higher power” but also hastens to add that the higher power need not be god. Still, that kind of language lurks in the background.

        I wish he were more upfront about it. While I don’t agree that something is less valid once it’s been demonstrated to have been “religious” or “Christian,” I’d like his cards on the table. And I can certainly understand how someone would react to his tone with suspicion. And I don’t mean “tone” dismissively. There is something to it that’s almost substantive.Report

        • Avatar veronicad in reply to Gabriel Conroy
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          says:

          @gabriel-conroy — Exactly this.

          That said, there was a place on his blog (which I saw today but didn’t save a link) where he explicitly says that same sex attraction is not evidence of a psychological defect. So while I suspect he’s operating from a theistic frame, he is certainly not a militant anti-gay activist.

          On the other hand, queerness is definitely a thing, as are a broad spectrum of various social dislocations and identity issues. He seems to make little space for these things within his frame. The result is, his frame will have limited application to quite a few people.

          In other words, Therapy for Average White People will have some value, I suppose, inasmuch as white people are the majority and most are definitionally “average”. However, it’s a big world out there. I want my models to generalize.Report

        • Avatar Kimmi in reply to Gabriel Conroy
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          says:

          Gab,
          That sounds more like a recovering alcoholic (organized brainwashing with self-selection and government participation! fun fun!).Report

    • Avatar Gabriel Conroy in reply to veronica d
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      says:

      I think the last part of your comment hits on the head where I stand. He has some useful things to say (or, which is not exactly the same thing, some of the things he says are useful). But he seems way too focused on calling the present day unique.

      For the first part of your comment, I can only say I appreciate your perspective, not having engaged personally in DBT (although I have heard of it). While I certainly haven’t had your experiences, I’ve had others that I haven’t chosen to share in a public forum, at least not yet. And some of them might be considered behavioral issues, although they’re mostly self-directed, so probably wouldn’t qualify for Simon’s “character disturbance” diagnosis.Report

  5. Avatar Pinky
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    says:

    I found this where Simon lays out his position on “the phenomenon of our age”:

    Report

    • Avatar Gabriel Conroy in reply to Pinky
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      says:

      That opening anecdote is almost verbatim from the opening of Simon’s book. And I suppose in the *discipline* of psychology, “character disturbance” is a phenomenon of our age in a way that “neurosis” was the phenomenon of the Victorian or “classical” era. Again, that’s if we’re talking about psychology as a discipline, although those here who know the history better than I can correct me if I’m wrong.

      Simon carries it much further, however, and beyond the history of the discipline itself. Therefore, I’m more inclined to agree with Dr. Jay below in his critique of the “phenomenon of our age” phrasing. In the book, he does at places seem to suggest that now character disturbance is a “near epidemic.”

      ETA: to be clear, though, that clarifies Simon’s point. One does get most of that in his book, too.Report

  6. Avatar Kimmi
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    says:

    We have people on television, on fact-based television, telling outright, obvious lies and not being called on it.
    Our entire method of discourse incentivizes the liar and the serial exaggerator.

    This needs to change, but won’t change simply because some shrink thinks he can fix it on a small scale.
    For one thing, the Drama Queens have been deliberately invited in by outside agitators.

    [Sorry for folks on the right, this is a distinct critique of the left, and is because the pernicious lying is so newly founded, and easily uprooted. Your lies are longer-standing, and believed by more people. They also tend to be more on-message and less self-aggrandizing].Report

  7. Avatar dragonfrog
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    says:

    The high-prison-population argument seems especially weak (he said, not having read the book) unless “character disturbance” is supposed to be a very USA-specific disease, that stops at the Canadian and Mexican borders as well as the Atlantic and Pacific coasts.

    Also, I’m not sure how “character disturbance” is different from “being an asshole”. Because the world has always had assholes, probably in approximately the same ratio of humanity. More likely what’s happening is that our standards of acceptable behaviour have risen over time, such that someone who was just doing what was normal to get along in past centuries, would now be considered an asshole.

    Like, going to a bear baiting or a dog fight, beating animals for entertainment, beating one’s children as a necessary part of parenting, beating one’s wife sooner than let her win an argument, taking part in collective public humiliation (the ducking stool, pelting a stocked person with refuse, etc.) – all of these were seen as, not just acceptable, but central to normality to the point where refusing them would be a deviancy. Society expects better of us, but we’re the same species we always were.

    More and more behaviours get lumped into unacceptable things only assholes do. To some extent, we collectively pull our behaviour up to the new standards, but maybe to some extent we don’t manage to, so more people are assholes now under the rising standards of behaviour than used to be.

    ETA: as often happens, @veronica-d made much the same point before me and more eloquently.Report

    • Avatar Pinky in reply to dragonfrog
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      says:

      Please watch the video I attached.Report

      • Avatar dragonfrog in reply to Pinky
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        says:

        I did, and it does rather clarify things.

        I still wonder to what extent this is less the emergence of a new disorder that wasn’t prevalent before, and more that disorder, which had always existed, becoming visible because (1) a lot of the guilt and neurosis disorders are receding, and (2) a lot of the behaviours associated with that disorder are being de-normalized.Report

  8. Avatar Gabriel Conroy
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    says:

    I’d like to thank everyone here for their comments so far. Thanks to Pinky for finding the video and thanks to Veronica for delving deeper into Simon’s blog than I have.

    Hearing your thoughts clarifies for me–at least a little more–why I’m ambivalent about the book.Report

  9. Avatar Michael Drew
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    says:

    Your first two paragraphs say nothing about what he may say is to be felt guilty about (presumably harm to others – but if so, how much of it matters, and when can we pursue our interests even though it doesn’t take every effect on others fully into account?), almost as if

    simply [to] do what they do to get what they want as soon as they can and with the least amount of work possible

    is inherently something to have guilt over. (Rather than a perfect description of healthy rationality, as some might regard it at first blush ahem.)

    Which is a belief I once heard about some people latently, perhaps not fully consciously, holding. This one time.

    Just sayin’.Report

    • Avatar Gabriel Conroy in reply to Michael Drew
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      says:

      Simon would probably say that the key is harming others. For him, the “simply [to] do what they do to get what they want as soon as they can and with the least amount of work possible” is probably not inherently wrong–although he’s not 100% clear on that–but it does mean that these “disordered characters” treat people as means rather than ends. It’s also worth noting–which I didn’t do in the OP–that the “work” he’s referring to is the “interpersonal work” of having to deal with people respectfully to live in a society. It’s not just “work” as in working for wages. (To be clear, the part you quoted from my OP isn’t a direct quote from Simon, but I think it captures what he means. He does mention that “disturbed characters” don’t work.)

      And when they treat people poorly, then they are acting bad. (If I recall correctly, some “disturbed characters,” according to Simon, harm others just for the sake of harming others. And in those cases, I suppose even the thing you quoted from me doesn’t apply.)Report

    • Avatar Pinky in reply to Michael Drew
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      says:

      “simply [to] do what they do to get what they want as soon as they can and with the least amount of work possible”

      I don’t know where that statement comes from, so I might be reading too much into it. That said, if you drop the word “simply” from the quote, and add something about normal societal constraints and decency, I’d say it’s fine. But if there are no constraints on that approach (as the word “simply” implies) then it’s a description of selfishness.Report

      • Avatar Gabriel Conroy in reply to Pinky
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        says:

        To be clear, that phrasing is mine. It’s a paraphrase of what Simon says* in the book, and he does use the word “work” to describe what disturbed characters don’t want to do. So…..my “simply” is probably doing a little too much work. Still, I think you got my meaning (and Simon’s, if I represented him right).

        *I find it really hard to say “Simon says” and not think of the children’s game.Report

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