Friday, August 9, 2013

Dealing with mental illness

I really enjoyed this interview between schizophrenic and author Eleanor Longden and author of The Psychopath Test: A Journey Through the Madness Industry Jon Ronson, which is worth reading in its entirety. She talks about how the first voice in her head was just narrating what she happened to be doing, and in some ways she found it calming:

[W]hat research suggests is that voice-hearing (and other unusual experiences, including so-called delusional beliefs) are surprisingly common in the general population. This recognition has led to the popularity of 'continuum models' of mental health, which suggests different traits and experiences are all part of human variation – not strictly categorical in terms of "us and them", "sane and insane", "normal and abnormal". However, I do think life events play a vital role in determining who becomes distressed and overwhelmed and who doesn't. This might include experiences of abuse, trauma, inequality, powerlessness and so on, but it can also include the immediate reactions of the people around you. If you don't have people who will accommodate your experiences, support you, and help you make sense of what's happening, then you're probably much more likely to struggle.

And she wasn't supported or accommodated, instead her friend flipped out, followed by her psychiatrist, until she was institutionalized and the voices got much worse.

[My psychiatrist] really made me feel like a walking inventory of symptoms. This forensic-like scrutiny grew to feel very frightening and de-stabilizing, and was basically sending the message that the only relevant thing about me was my deficits. Not my strengths, not my abilities or resources, just my Bad Brain. I was eventually admitted to hospital (voluntarily), and the impact of that was disastrous because it sealed my perception of myself from someone who was confused, unhappy and frightened into someone with an uncontrollable, carnivorous mental illness. Eventually, I was diagnosed with schizophrenia. The voices (which by this time had multiplied and become much more aggressive) were witheringly contemptuous about this: "You can't even SPELL schizophrenia," one of them said, "So what the hell are you going to do about having it?!"

How did she find her way back?

I don't think there was a single, defining turning point, more an accumulation and fusion of positive changes. Primarily, I was very fortunate to have people who never gave up on me – relationships that really honoured my resilience, my worth and humanity, and my capacity to heal. I used to say that these people saved me, but what I now know is that they did something even more important: they empowered me to save myself. My mum, for example, had an unconditional belief that I was going to come back to her and was willing to wait for me for as long as it took. I also met an amazing psychiatrist, who absolutely didn't subscribe to the idea of me as 'schizophrenic' – or any other label for that matter. "Don't tell me what other people have told you about yourself," he would say, "Tell me about you." 

This led her to a period of profound self-acceptance:

For the first time, I had an opportunity to try and see my voices as meaningful – messages and metaphors about emotional problems in my life – and in turn begin to relate to them more peacefully and productively. I began to understand the voices (as well as my other experiences, like self-injury, anxiety, and paranoid beliefs) in a more compassionate way. Not as symptoms, rather as adaptations and survival strategies: sane reactions to insane circumstances. The voices took the place of overwhelming pain and gave words to it – memories of sexual trauma and abuse, rage, shame, loss, guilt and low self-worth. Probably the most important insight was when I realised that the most menacing, aggressive voices actually represented the parts of me that had been hurt the most – and as such, it was these voices that needed to be shown the greatest compassion and care. Which of course ultimately represented learning to show compassion, love, and acceptance towards myself.
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But primarily it was when I stopped attacking and arguing with them, and began to try and understand them, and relate to them more peacefully. It was about putting an end to the internal civil war I mentioned earlier, because each of them was part of a whole – me! I would thank them for drawing my attention to conflicts I needed to deal with. I remember one very powerful moment, several years down the line, when I said something like, "You represent awful things that have happened to me, and have carried all the memories and emotion because I couldn't bear to acknowledge them myself. All I've done in return is criticize and attack you. It must have been really hard to be so vilified and misunderstood." There was an immensely long pause before one of them finally responded: "Yes. Thank you."

I found myself relating a lot to this last part -- part of learning to deal with any mental issues is a self-acceptance of yourself, your strengths, and your weaknesses. We all have what Carl Jung called the Shadow, parts of our personality that we would rather not acknowledge about ourselves. But in order for us to become whole, self-actualized human beings, we must not only acknowledge these aspects, but embrace them (see The Tools: 5 Tools to Help You Find Courage, Creativity, and Willpower--and Inspire You to Live Life in Forward Motion for some help on how).

Like most people, I used to ignore my shadow +90% of the time and the other part of the time I became the monster I was afraid I truly was. When I finally cared enough to get better, I knew I couldn't keep doing this, flipping back and forth between the projected-ideal-me and the indulging-every-bad-impulse me. The truth was that both those versions of myself were a distortion, and until I could acknowledge and accept the real me, any changes that I made would be superficial and not-lasting. I saw this same transition in the last season of Dexter, where he finally acknowledges that the "dark passenger" he always blamed for his killing impulse was really just a part of him that he had long ago alienated, and later personified as an external entity. People want me to feel shame for who I am, I can tell. But I'm not going to, because it would make me a much worse person (see also Ted Bundy).

Nobody chooses to be who they are. We make choices and we can define ourselves by our choices if we choose, but there will always be people defining us by other things, including things that we didn't ask for and cannot help. We can't do anything about that either. We just do the best we can and that has to be good enough. As Longden said:

I last heard voices yesterday. They were repeating something I'd read on the internet. The comment was: "I'm going to spoil the ending for you. The ending is – everything's going to be great!"

Thursday, August 8, 2013

Breaking Bad: Is Walter White a Sociopath?

AMC's hit show, "Breaking Bad" returns this Sunday and some are asking "How Walter White Found His Inner Sociopath".  The show details the exploits of a chemistry teacher turned meth kingpin who finds his hands getting dirtier and dirtier until he seems to lose most of his humanity. Or does he? A.O. Scott writes for the NY Times:

In truth, though, his development over five seasons has been less a shocking transformation than a series of confirmations. Mr. Gilligan’s busy and inventive narrative machinery has provided plenty of cleverly executed surprises, but these have all served to reveal the Walter White who was there all along. The sides of his personality — sociopath and family man, scientist and killer, rational being and creature of impulse, entrepreneur and loser — are not necessarily as contradictory as we might have supposed.
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Walter may have wanted us to believe — and may, at moments, have convinced himself — that he was a decent man driven by desperate circumstances to do terrible things, but that notion was either wishful thinking or tactical deceit. Viewed as a whole, in optimal binge conditions, with the blinds pulled down and the pizza boxes and chicken wrappers piling up around the couch, “Breaking Bad” reveals itself as the story of a man mastering his vocation and fighting to claim his rightful place in the world. 

But is he really a sociopath? He is great at lying. That's probably one of the most entertaining parts about the show. He is amazing at coming up with an answer that fits the facts, like a sort of WebMD for excuses that fit the symptoms perfectly yet innocuously. Where did all of this cash come from? He has a gambling problem. Why did his wife just have an emotional breakdown? She was having an affair and her lover is in the hospital. He is the master of deflection and playing upon not just people's emotions, but especially their expectations about him (as a loser, but ultimately harmless) and the world (that bad people are not your friends, relatives, and neighbors but people who seem "off" to you).

However, I don't think he is a sociopath. He may act like how one expects a sociopath to act (ruthless, disloyal, power hungry), but his motivations seem all wrong. If he was a sociopath, why does he constantly cling to an image that he's a good dad/husband/friend making the most of a bad situation? From the NY Times:

Walter is almost as good at self-justification as he is at cooking meth, and over the course of the series, he has not hesitated to give high-minded reasons for his lowest actions. In his own mind, he remains a righteous figure, an apostle of family values, free enterprise and scientific progress. 

For instance:

Walt: "When we do what we do for good reasons, then we've got nothing to worry about. And there's no better reason than family."

Here he extends his typical self-justification to his wife:

Walt: Skyler, you can't beat yourself up over this thing. Please. You didn't set out to hurt anybody. You made a mistake and things got out of control. But you did what you had to do to protect your family. And I'm sorry, but that doesn't make you a bad person. It makes you a human being. 

Skyler: Stop it, Walt. Just stop. I don't need to hear any of your bullshit rationales.

And an incredibly insensitive and oblivious moment of self-absorption:

Walt: So how are you feeling? 

Jesse: Okay, I guess. Broke it off with Andrea. I had to. She's gonna tell Brock. I'm still gonna take care of the rent and stuff. It's the right thing to do, but, you know-- 

Walt: (interrupting) I meant this. (gestures behind) How are you feeling about the money?

And finally the over the top but insincere display of emotions and taking huge offense when the sincerity is questioned:

Walt: I am just as upset as you are. 

Jesse: Are you? 

Walt: Really? How can you say that to me? Jesus! I mean, I'm the one who's the father here. What, do I have to curl up in a ball in tears in front of you? 

Walt in all of his self-centeredness clearly thinks that not only do his ends justify any means he chooses, but it's clear that this process of justification is important to him. If he were a sociopath, why he would care at all? As a corporate executive put it upon seeing Walt and his team balk at killing two innocent witnesses, "I thought you guys were professionals." But there's hardly anything professional about them. Despite being extremely clever and calculating (he fakes an emotional breakdown in his brother-in-law's DEA office to tap his phone), he seems like a prototypical narcissist who lets his emotions rule him, particularly his feeling that his talents were never truly appreciated and so he is finally going to make them realize that he is a force to be reckoned with. A sociopath would not care what people thought of him, as long as he was getting and doing what he wanted to get/do.

Walter White is also a great example of why I don't value people's "good" intentions--because they're incredibly subjective, often misplaced, and sometimes used to justify horrible atrocities. People never feel that they have done anything wrong as long as their intentions were not malicious. It reminds me of this recent comment from a reader:

Intentions don't matter. Hitler's intentions were good. What are good intentions? It depends who you're talking to. If you talk to the chicken just before you kill it and tell it "Hey chicken, my intentions are good, I don't want to be misunderstood, I'm just gonna eat you and share you with my family."

And also from this NY Times review of Jonathan Haidt's book The Righteous Mind: Why Good People Are Divided by Politics and Religion:

Traits we evolved in a dispersed world, like tribalism and righteousness, have become dangerously maladaptive in an era of rapid globalization. A pure scientist would let us purge these traits from the gene pool by fighting and killing one another. But Haidt wants to spare us this fate. He seeks a world in which “fewer people believe that righteous ends justify violent means.” To achieve this goal, he asks us to understand and overcome our instincts. He appeals to a power capable of circumspection, reflection and reform.

Wednesday, August 7, 2013

Sociopaths as scapegoats

This was an interesting comment from a recent radio interview I did with CBC. In response to another user's (TorontoProud) comment, "I wonder if there is a connection between sociopaths and feminism because there seems to be", Doctor R replied:

@TorontoProud It's not that feminists are necessarily sociopathic. But like any mass movement, sociopaths can hijack it and turn it to their own ends. This is what happened under Hitler and Stalin. Any ideology can become a vehicle for hate-mongering and irrationaity- feminism is no different in that regard. At the same time, that doesn't mean that feminists don't have legitimate concerns. That's why a critique of feminist ideas is so necessary- to help separate the good ideas from the bad. Sadly, that kind of critique is not politically correct, which is why CBC censors so many comments that attempt to provide analysis of feminist ideas. And in the end, it's that kind of censorship that will bring feminism into disrepute, if it hasn't already.

What do you think? Is there a connection between sociopaths and feminism? Maybe I'm not as up on feminist theory, but in what ways does it seem like it has been hijacked by sociopaths? And who were the sociopaths that hijacked Hitler and Stalin's ideology and turned it to their own ends?

Another commenter, jmhaze, replied: "@TorontoProud if you equate the goal of 'equality' to being sociopathic then i guess all freedom fighters would fall under your blanket definition." Or maybe freedom fighters really are sociopaths. Che, anybody?

I ask these questions because maybe these commenters are just not doing a good job explaining themselves, or maybe theirs are just bald assertions, wholly unsupported, and a ridiculous attempt to slander an otherwise legitimate political movement? It's sometimes hard for me to tell because people associate sociopaths with a lot of the world's ills. So how am I supposed to know whether these assertions are serious and which are just politicking when they all seem misguided and ill-informed to me. So I, like economists, largely take people's preferences and beliefs seriously as they come.

I think sometimes people think it should be easy for anyone to tell the difference, that of course everyone would know that X is wrong and Y is right and anyone who says differently is just politicking or otherwise trying to gain some unfair advantage (or troll, on the internet). But it turns out that research shows most people aren't being disingenuous about their assertions of their beliefs, that they actually occupy different moral universes with different laws that they're abiding by (and judging others by). In a world in which we cannot act according to every virtue in every situation, compromises must be made and it turns out that everybody prioritizes certain values over others, e.g. whistleblowers value fairness over loyalty. One thing that has been interesting about the book is not just how polarizing it has been, but how often people remark that they can't understand why other people love/hate it as much as they do. I don't know why this is, but people seem to vastly overestimate the degree of heterogeneity in their community, much less the world. Makes me question how accurately people are actually and accurately able to feel empathy for total strangers, if they always seem to be surprised by others' legitimate beliefs.

Speaking of, my Mormon friend told me how she was hanging out with other Mormons and one of them said something about "the gay agenda." My friend shut her down quickly to which the girl replied "I thought I would at least be safe saying something like that among other members." But no, even Mormons are heterogeneous. Some say that some of them are even sociopaths? Don't get too excited or think this proves something about the Mormon church, there are sociopaths that belong to every group you belong to as well -- atheists, protestants, Buddhists, Muslims, Hindu, every political party, every profession, every gender and ethnicity, every political sphere. Can you empathize with sociopaths?

Tuesday, August 6, 2013

Medicated sociopath

A sociopathic reader recently wrote to me telling me about how he spent the past year being heavily medicated. First he was given stimulants and amphetamines, including Ritalin, which made him hallucinate as well as making him more callous. After he stopped those he was left taking antidepressants and tranquilizers, which dulled his experience, but he said that the drugs helped him reset his mind towards a more pro-social way of viewing the world. He asked me my thoughts on the possibility of sociopaths benefiting from medication:

I have never really been on any medication.  I’m curious what tranquilizers you have been taking.  Do you think some of the mellowing out is also just due to age and/or acquiring enough in your personal life that you are a little more hesitant to risk it on risk-seeking impulses?

To answer your questions, my impulse has traditionally been that it would be that it is better to be a loose cannon then to be a dumbed down version of myself, although if I were faced with ultimatums from loved ones or started to feel a little out of control, I wouldn’t hesitate to mellow out through the use of drugs.  I don't know if it is necessarily a self image issue, but depending on what I'm doing, I feel like I am barely smart enough to keep one step ahead in my exploits.  I already don’t do a lot of things I would like to do (boxing, other violent activities that involve possible head injuries) because of that, and I would have a similar reluctance to take meds because it might make me lose that part of my personality that helps me fulfill the role that I often choose in my life.  Plus I guess I am comfortable being me and it would be weird to feel like something else besides me is my puppetmaster.  So I guess the feeling of a loss of control would bother me a bit.

On the other hand, sometimes I feel like being a lot more passive, taking a break. I am sort of feeling like that right now, actually. And I go through cycles of being this way, on and off. Maybe several years on, one year off? It's sort of like sleep to me, and I like to take meds to sleep that deep restorative sleep. So maybe when I'm off I should be on meds too, just to give my mind a break. And I really like trying new things, so maybe I will try this.

I understand what you mean about the medication "resetting" your brain. The mind gets in habits of thinking and it's hard to break those habits, but I can see how being on meds would by their very nature be a disruptive force in your mental patterns. Once a pattern is disrupted, I think it is much easier to start a different pattern. That's why it's hard for me to get too sad about my life falling apart.

Your question “Is it weaker to latch on to one's emotions as a source of identity and meaning, or to accept them as a liability and turn them off?” is a really interesting one.  I have a shadow of a memory of choosing the latter and I don't really think it’s reversible, but I don’t really have opinions anymore about which is better.  I guess the answer is that it is better for the world to have some of each.  And for each individual, it probably depends on your circumstances, like choosing which airport security line you think is going to be best for your particular needs. The default for sociopaths is to not identify with their emotions as a source of identity and meaning, and the default for empaths is to see their emotions as a reflection of the truth about themselves and the world around them. Both of them are incomplete approaches to discerning reality, probably. Both would do well to learn something from the other.

Has anyone else had good experience with meds? It would actually be great if there was a medication that worked with sociopaths. Then we could be like schizophrenics -- as long as we were thought to be taking medication, people would likely not discriminate against us. It's sad, really, because I think a lot of sociopaths have found non-medicated ways to achieve the same ends (e.g. resetting out mindsets towards more pro-social ends through mindfulness, meditation, found spirituality, etc.). And we know that this can also change brain chemistry -- as my friend's doctor told her regarding postpartum depression, you can treat it either with medication or with therapy and both work to the same goal. But would people trust that a sociopath had made this sort of internal change sans meds? Would the sociopath eventually be able to be given the same benefit of that doubt, that although he remained a sociopath, he had it "managed"? The problem with figuring out a non-medicated way of resetting your mindset or controlling your thoughts/behavior is that people put way more trust in the power of medications than they do the power of the mind to change. Or am I wrong? 

Monday, August 5, 2013

Can we eliminate evil?

A reader suggested this Morgan Freeman narrated special "Through the Wormhole: Can We Eliminate Evil?" Not surprisingly, it features sociopaths and studies on the brain that give interesting insight to how we decide what to do and what constitutes evil.

The first clip is about empathy, and illustrates well the recent study that found that sociopaths feel empathy when directed to put themselves in the shoes of others.




If you have the genetics of a killer and the brain anatomy of a killer, are you destined to become a killer? James Fallon.




And finally this was an illustration of this experiment regarding the moral lives of babies.





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