|ANODYNE PSYCHOTHERAPY FOR SUICIDE: A PSYCHOLOGICAL VIEW - 00|
by Dean Terry
Do all personality disorders have a common psychodynamic source?
To what stage of personal development can we attribute this common source?
Can the paths leading from that common source to each of these disorders be charted?
Will positive answers to the above endow us with a new understanding of these pernicious conditions?
Anger is a compounded phenomenon. It has dispositional properties, expressive and motivational components, situational and individual variations, cognitive and excitatory interdependent manifestations and psychophysiological (especially neuroendocrine) aspects. From the psychobiological point of view, it probably had its survival utility in early evolution, but it seems to have lost a lot of it in modern societies. Actually, in most cases it is counterproductive, even dangerous. Dysfunctional anger is known to have pathogenic effects (mostly cardiovascular).
Most personality disordered people are prone to be angry. Their anger is always sudden, raging, frightening and without an apparent provocation by an outside agent. It would seem that people suffering from personality disorders are in a CONSTANT state of anger, which is effectively suppressed most of the time. It manifests itself only when the person's defences are down, incapacitated, or adversely affected by circumstances, inner or external. We have pointed at the psychodynamic source of this permanent, bottled-up anger, elsewhere in this book. In a nutshell, the patient was, usually, unable to express anger and direct it at "forbidden" targets in his early, formative years (his parents, in most cases). The anger, however, was a justified reaction to abuses and mistreatment. The patient was, therefore, left to nurture a sense of profound injustice and frustrated rage. Healthy people experience anger, but as a transitory state. This is what sets the personality disordered apart: their anger is always acute, permanently present, often suppressed or repressed. Healthy anger has an external inducing agent (a reason). It is directed at this agent (coherence).
Pathological anger is neither coherent, not externally induced. It emanates from the inside and it is diffuse, directed at the "world" and at "injustice" in general. The patient does identify the IMMEDIATE cause of the anger. Still, upon closer scrutiny, the cause is likely to be found lacking and the anger excessive, disproportionate, incoherent. To refine the point: it might be more accurate to say that the personality disordered is expressing (and experiencing) TWO layers of anger, simultaneously and always. The first layer, the superficial anger, is indeed directed at an identified target, the alleged cause of the eruption. The second layer, however, is anger directed at himself. The patient is angry at himself for being unable to vent off normal anger, normally. He feels like a miscreant. He hates himself. This second layer of anger also comprises strong and easily identifiable elements of frustration, irritation and annoyance.
While normal anger is connected to some action regarding its source (or to the planning or contemplation of such action) - pathological anger is mostly directed at oneself or even lacks direction altogether. The personality disordered are afraid to show that they are angry to meaningful others because they are afraid to lose them. The Borderline Personality Disordered is terrified of being abandoned, the narcissist (NPD) needs his Narcissistic Supply Sources, the Paranoid - his persecutors and so on. These people prefer to direct their anger at people who are meaningless to them, people whose withdrawal will not constitute a threat to their precariously balanced personality. They yell at a waitress, berate a taxi driver, or explode at an underling. Alternatively, they sulk, feel anhedonic or pathologically bored, drink or do drugs - all forms of self-directed aggression. From time to time, no longer able to pretend and to suppress, they have it out with the real source of their anger. They rage and, generally, behave like lunatics. They shout incoherently, make absurd accusations, distort facts, pronounce allegations and suspicions. These episodes are followed by periods of saccharine sentimentality and excessive flattering and submissiveness towards the victim of the latest rage attack. Driven by the mortal fear of being abandoned or ignored, the personality disordered debases and demeans himself to the point of provoking repulsion in the beholder. These pendulum-like emotional swings make life with the personality disordered difficult.
|Narcissistic Rage Information (Heinz Kohut) @ Grandiosity.org|
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Related video about The Iron Mask - The Common Sources of Personality Disorders
Part 03 - The Man in the Iron Mask Audiobook by Alexandre Dumas Chs 12-18
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