Fredric Neuman
Source: Fredric Neuman

We all know men and women who do self-destructive things—the same things—over and over again. The list of these behaviors seems inexhaustible and extends into every aspect of life: work, friends, family, dating, and so on. Consequently, they suffer disappointment, rejection and failure. Often, they are reduced to being miserable. Not infrequently, they seem to have some insight into their destructive behaviors. They admit to doing “this” and suffering, therefore, from “that.” The connection is plain to them. Still, they do the same things over and over again.

They do not repeat these mistakes out of “a desire to fail” or a “wish to suffer.” Such explanations are often given by inexperienced therapists who are unable to discover the real reasons why people behave the way they do and, therefore, blame the patient. The patients are miserable out of a perverse wish to be miserable, they say. Sometimes, they go further and assume their patients have a wish to punish themselves out of a vague sense of guilt. Since everyone has a vague sense of guilt over something or other, these facile explanations can never be disproved. In the meantime, the patient continues to engage in self-destructive behaviors and continues to suffer the consequences.

Some self-destructive behaviors are seemingly easy to explain: They feel good. Among these are the following:

Drug use. Initially, the use of drugs is simply to feel especially (although unreliably) good. Then, later on, it is also to avoid the misery of withdrawal. Drug abusers know full well the consequences of their drug use, but they feel driven against their better judgement to continue their drug habit because it is very difficult to stop. Alcoholics are similarly motivated.

Similar behaviors that seem at the moment pleasurable but are obviously destructive over the long run include: compulsive gambling, philandering, petty thievery, over-eating, smoking cigarettes, and so on. Why some people seem to engage in pleasurable, but self-destructive, behaviors when others do not is not so easily explained. But, at least, the behaviors, themselves, can be seen to be pleasurable. It seems that for these individuals pleasures that are immediate outweigh suffering that will occur inevitably down the road. (Similar considerations motivate children who may prefer to misbehave now despite knowing they will be punished later on.)

What seems completely inexplicable, however, are self-destructive behaviors which are not inherently pleasurable, even temporarily. Some examples:

Road rage. What is the benefit of fighting with strangers? The potential for an untoward result is apparent. Similarly, some people will argue repeatedly with traffic police, fellow employees, a spouse, and anyone who crosses their path with the result over and over again of alienating someone from whom they wish to obtain some benefit.

Coming in to work late. Being late even for a few minutes—but constantly—will annoy fellow workers and managers. I have seen a physician who lost two jobs because of this behavior. She acknowledged to me that she was putting herself at risk constantly; but she could not, or would not, stop.

Clinging to a former lover. This sort of behavior, which borders on stalking, is more in the nature of a demand than an appeal. It serves, inevitably, to further alienate someone who might otherwise return on his/her own initiative. The abandoned lover is told by friends and others to stop, but continues anyway, sometimes in the face of legal action.

There are a host of other such self-defeating behaviors which seem inherently unpleasant—such as procrastination, withdrawal, whining or complaining, and so on, but which are engaged in repeatedly, even compulsively. It is as if these self-defeating behaviors were required to validate a person’s identity. Somehow, the ability to stubbornly persist in such a way is fundamental to the way the individual thinks of himself/herself. To behave otherwise is not to be true to oneself. It is this sort of exaggerated willfulness that leads someone to shoot a stranger who has cut in front of him in a line. I have seen someone who argued with everyone, even with a judge who was about to sentence him to jail—with the result that he served an additional two years. I think something similar motivates religious martyrs. Adherence to a particular belief and custom is more important than life itself.

In these matters, the difficult, sometimes impossible, job of the psychotherapist is to convince the self-destructive person that the behavior is not necessary to maintain self-respect or a sense of self. It is possible to be strong without being provocative. And it is possible to change without giving up.

But there are other self-destructive behaviors which seem to have nothing to do with the individual’s identity or sense of self. For example, when I first started to treat insomnia, I came to the self-evident conclusion that getting up during the night to see what time it was was anxiety-provoking. Discovering that it was 3 a.m. and then 4 a.m. was jarring and likely to interfere with going back to sleep. Furthermore, there was no possible need in the first place to know what time it was in the middle of the night. Convincing the insomniac that looking at the clock worsened the condition was usually easy, but getting him or her to stop proved surprisingly difficult. Why? These patients were coming to me for treatment of a problem which I had convinced them would respond in part to turning the clock to the wall, and yet it took weeks to get them to comply.

It is as if habit was enough to make certain self-defeating behaviors persist. Initially, the behavior might have been motivated by some obscure fear, but then habit itself took over. There are advantages, of course, to our actions being determined in large part by habit. We accomplish much without having to think about it. Habit makes life easier; but not every habit. However, it seems that people are committed in one way or another to doing the things they have always done in the way they have always done them, whether those behaviors make sense or not. Of course, it is the overcoming of this determination to keep everything the way it has been that is the central issue for psychotherapy.

© Fredric Neuman

Follow Dr. Neuman's blog at http://fredricneumanmd.com/blog/

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