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Diagnosing Scrooge Syndrome: What A Christmas Carol Can Teach Us About Treating Chronic Embitterment

Did Scrooge suffer from Post-Traumatic Embitterment Disorder?

A Christmas Carol

may be my favorite holiday film. There have been numerous versions based on the 1843 Charles Dickens novel, including a 2009 adaptation starring Jim Carrey as Mr. Scrooge which I still haven't seen. Just the other night I caught one with George C. Scott doing a fine acting job as Scrooge, but the earlier films I first saw as a kid are truly classic. Mr. Scrooge's ill-tempered, pessimistic, misanthropy is reminiscent of something I've written about here in the past: Post-Traumatic Embitterment Disorder. Could the contemptuous Scrooge be a poster boy for PTED? Did he suffer from an underlying anger disorder? (See my prior posts.) Chronic depressive disorder? Or perhaps a deep-seated personality disorder? How might the disdainful and selfish Scrooge be diagnosed and treated today by a clinical psychologist or psychiatrist?

A Christmas Carol

Post-Traumatic Embitterment Disorder is, at present, only a proposed diagnostic addition to the forthcoming DSM-V. Like PTSD (see my previous post) , PTED will, if included, probably apply to a person experiencing, witnessing or being directly confronted with a highly traumatic (though, unlike PTSD, not necessarily life-threatening) event or events (e.g., difficult divorce, major losses of significant others, serious illness, disability, physical or emotional abuse, etc.) leading to chronic (longer than three months minimally, but more realistically, I would recommend at least one year) feelings of embitterment, hostility, anger, resentment, irritability or rage, and the obsessive, sometimes compelling desire for revenge and retribution. I consider PTED fundamentally to be an anger disorder. As with most diagnosable mental disorders today, the degree of embitterment would need, by definition, to cause clinically significant distress or impairment in social, occupational or other important areas of functioning. Garden-variety feelings of bitterness that commonly come and go with life's inevitable existential frustrations and disappointments are not enough to warrant this diagnosis. The embitterment level must, by definition, be excessive, pervasive, persisting and debilitating. Certainly one could make a case that the bitter, cold and hateful Ebenezer Scrooge, while an affluent and shrewd business man, demonstrates significant impairment in social and interpersonal functioning. On the DSM-IV-TR's Global Assessment of Functioning (GAF) Scale, Scrooge might merit a mid-range score of about 55, based mainly on his long-standing impaired social functioning. Scrooge is a social loner, but not primarily due to extreme introversion. (See my prior post.) He has nothing but hostility and contempt for others and their problems. Psychodiagnostically, it could further be inferred that Scrooge exhibits traits of Schizoid, Narcissistic and Obsessive-Compulsive Personality Disorder, each of which, in my view, like PTED, also have their roots in repressed anger, resentment and rage. (See my prior posts on personality disorders.)

Emotionally wounded (much like Dickens, pictured here, himself had been during childhood) and unconsciously driven by traumatic losses as a child (Scrooge's mother died bringing him into the world) and rejection by his bereaved father (who blamed the poor boy for his mother's death), as a young and still vibrant man, Ebenezer takes a fateful decision to walk away from the woman he loves and who loves him, deliberately choosing instead a life devoted to business, commerce, materialism and money-making. He eventually becomes a wealthy, highly successful but deeply embittered man, totally alone and alienated from any and all intimate relationships, friends and family. His is a cynical, negative, jaded defensive posture, unconsciously motivated, it seems, by festering anger, rage, resentment and narcissistic wounding. Scrooge expresses an almost total lack of empathy or compassion for others. Or for humanity in general. He refuses to allow anyone to get emotionally close to him. presumably for fear of being once again abandoned or rejected, fending people off with his gruff, insensitive, selfish, humorless, crusty and hostile persona. Scrooge has forgotten how to play, laugh and how to love. (See my prior post.) And to accept being loved. He has long ago lost touch with his authentic self, his so-called inner child, what in his therapy I might refer to as "little Ebenezer." (See my prior post.)

As psychotherapists see daily, the best defense is a good offense. And Scrooge, beneath his civilized, successful facade, is about as angry, irritable, irascible and offensive as it gets. Not outwardly enraged in the same way as a blatant and abusive "rageaholic." But, rather, Scrooge is a repressed, ostensibly well-mannered, respectable yet joyless and hard-hearted man whose unresolved core resentment and pervasive bitterness poison and cripple his whole personality. He dislikes everyone, and is universally disliked in return. His is a toxic character structure. He neither desires nor enjoys close relationships or warm family ties, always chooses solitary activities, takes little pleasure in anything but making (though not spending) money, seems indifferent to the criticism of others, and demonstrates emotional coldness, detachment and blunted affect, traits closely associated with Schizoid Personality Disorder. He is haughty in attitude, arrogant, self-centered, greedy, excessively devoted to work and productivity to the exclusion of leisure activities and friendships, rigid, stubborn, stingy and exploitative of others, like his dedicated, long-suffering, good-natured but badly treated employee, Bob Cratchit. In short, Scrooge is a pathologically embittered man, and has been so for most of his adult life. Sadly, this "Scrooge syndrome" is not uncommon, and may be even more prevalent today than in Dickens' nineteenth-century England. It is comprised of a mixture of pathological narcissism, post-traumatic embitterment, and greed. In part, it is precisely this "Scrooge syndrome" against which the so-called Occupy Wall Street protesters stand. (See my prior post on greed.) Scrooge despises the poor and sees them as worthless and expendable members of society. Mr. Scrooge can be seen as a callous symbol of corporate and capitalistic greed, which was apparently precisely what Charles Dickens intended.


, which I define as a chronic and pervasive state of smoldering resentment, is one of the most destructive and toxic of human emotions. Bitterness is a kind of morbid characterological hostility toward someone, something or toward life itself, resulting from the consistent repression of anger, rage or resentment regarding how one really has or perceives to have been treated. Bitterness is a prolonged, resentful feeling of disempowered and devalued victimization. Embitterment, like resentment and hostility, results from the long-term mismanagement of annoyance, irritation, frustration, anger or rage. Philosopher Friedrich Nietzsche noted that "nothing consumes a man more quickly than the emotion of resentment." Mr. Scrooge is completely consumed by bitterness, hostility and resentment, yet doesn't even know it. He is blissfully unaware of his shadow, though it is plain for all else to see. He seems to have lost his soul. His heart is frozen by bitterness. Were Scrooge, for some reason, to come into contact with a modern-day psychiatrist for evaluation and treatment, I suspect he would most likely be diagnosed with a personality disorder and, quite possibly, a chronic mood disorder such as dysthymia or major depression, and started on some type of antidepressant medication. We do know that Major Depressive Disorder tends to be recurrent, can co-exist with Dysthymic Disorder, and often includes persistent feelings of irritability, frustration and anger, diminished interest or pleasure in most activities, and a profoundly pessimistic outlook on life. A clinical psychologist might also offer some cognitive-behavioral therapy to examine and restructure Scrooge's negative thought patterns and core schemata. Or perhaps some psychodynamic psychotherapy. (Of course, most people manifesting "Scrooge syndrome" feel no need for treatment and seldom seek it out.) In either case, this patient's prognosis would likely be considered poor, given the chronicity, characterological nature, and severity of his asocial symptoms. But, for Scrooge, who was created by Dickens a century before psychotherapy and psychopharmacology were developed, all that is about to change. In one night, he will be totally transformed. Cured. Born again. Healed. Made whole. How does this happen? What can Scrooge's journey teach us about treating and rehabilitating chronic embitterment?


Chronically embittered individuals frequently feel fate has dealt them an unfair hand, and that nothing they can do now matters. And typically fate, as with everyone at some time, has in fact been unkind. They tend to externalize their problems, insisting that the world must change rather than themselves. They protest, often passively, at life's injustice. At the same time, such people have frequently succumbed to "learned helplessness," feeling hopeless and powerless. So they hunker down and reject the world, in retribution for having been frustrated, rejected or abandoned. Their characterological embitterment cloaks a barely concealed wrath against reality. A virtual war against the world. And, in many cases, including that of Scrooge I suspect, a fuming and unforgiving anger with God, whom they feel has somehow let them down. Disappointed them. Perhaps this is why Scrooge is so opposed to celebrating Christmas and the Christmas season: He may have at one time believed in Jesus Christ, but long since lost faith, becoming an embittered and disillusioned atheist, replacing spirituality with his overweaning worship of materiality in an effort to maintain some sense of meaning in life. Such people fall easily into nihilism: the philosophical conviction that life is meaningless and that nothing much matters. "Bah, humbug," as Scrooge himself so famously exclaims. Nihilism, to its credit, does not deny the dark side of life. But it gets bitterly fixated there. Contrary to common misconceptions about existential philosophy and psychology, the philosophical negation called nihilsm is not a viable or constructive long-term solution for coping with the human condition and existential facts of life. It is, rather, an angry, bitter and resentful refusal and failure to embrace life and to love life as it is. If truth be told, nihilism is a manifestation of profound discouragement and despair. "Courage," writes existential theologian Paul Tillich (1952), "is the power of life to affirm itself in spite of. . . ambiguity, while the negation of life because of its negativity is an expression of cowardice." It is this semi-nihilistic state of embitterment we see embodied by Scrooge. And in so many around us today. What is the antidote to the bitterness of nihilism? How can someone transcend resentment and embitterment? (See my prior post on "clinical despair.")

Alone, as usual, in his comfortable apartment on Christmas Eve, Scrooge experiences a series of strange, scary yet wondrous or numinous visitations: first, by the pathetic ghost of his former partner, Jacob Marley; followed by the spirits of Christmas past, present and future. How can we understand this psychologically rather than literally? We could say that Scrooge's unconscious has been activated, and starts speaking to him on that chilly and lonely evening via his dreams. Dreams, as Sigmund Freud discovered, are the via regia or "regal road" to the unconscious, and can be understood as forms of communication from the unconscious. The unconscious, as Carl Jung pointed out, is compensatory to the conscious attitude. So it is high time for Scrooge to individuate and adjust his embittered and self-defeating attitude toward life, to become the greater man he was meant to be. His vivid and very real hallucinations (possibly during what today might be diagnosed as a brief and transitory episode of psychosis) and vivid nightmares--with their harrowing visitations and visions of his traumatic childhood, current life-style, and inevitable mortality--show him the way. His dreams point out the present problem and what needs to happen to improve it. But, to Dickens' enduring credit, it is still clearly Scrooge's decision, his existential choice, as to whether to heed their insight, dire warnings and potentially healing wisdom or not. He, and only he, is responsible for deciding what attitude to take toward these sobering and disturbing messages from the unconscious. And whether to follow through or not on their immense implications.

This is always the case with our dreams: We can choose to take them seriously and carefully consider what they have to say, or ignore and dismiss them. Obey or reject the dream's uncanny guiding wisdom. Scrooge's experience is similar to what occurs during the course of psychotherapy for some patients, though the process and time-frame tends to take longer. But dreams can play a powerful role in personal growth and transformation. (See, for example, C.G. Jung's prolonged self-analysis and resulting individuation based largely on working with his own dreams and visions, as documented in the Red Book.) Nonetheless, suddenly life-altering epiphanies do sometimes dramatically happen both in therapy and without. Scrooge, materialist and rationalist that he was, initially dismisses his dreams as merely the meaningless product of an "undigested bit of beef." But he later becomes convinced of the inescapable reality and truth of these dreams and their spiritual and psychological significance. He is shown, in some quite painful, shocking and terrifying forms, the embittered, cruel, despicable and despised person he had become.

This is also what happens in real psychotherapy. By which I mean psychotherapy that doesn't just focus on suppressing symptoms. Self-reflection. Looking closely and brutally honestly at oneself, who one has become, may be the most difficult thing to do. Recognizing, acknowledging and owning one's shadow is always disturbing. It is easier and more convenient to simply project it onto others, as Jung professes. This is one, often unconscious reason we resist real psychotherapy. Or run away from it prematurely. Real psychotherapy is always an uncomfortable confrontation with one's self. And with the existential realities of evil, finitude and death. But such self-reflection is absolutely necessary if any true inner transformation is to occur. One must, like Scrooge, come face to face with his or her inner demons. In treating pathological embitterment, first the embitterment--and its negative consequences--must be acknowledged by the patient. And then the underlying causes of this embitterment--the repressed anger or rage and its psychological and existential roots--must be brought to consciousness and closely examined. Finally, the patient must recognize that he or she has a choice to either hang on to embitterment or let it go. To continue to reject life or to embrace it. This is precisely what happens with Scrooge. In that one highly accelerated life-changing moment, which no doubt felt like months or years of therapy, the old Scrooge dies and is reborn on Christmas day: the day, of course, on which the birth of Christ--who died and was, for Christians, miraculously resurrected or reborn--is traditionally celebrated. A kind of incredibly condensed psychotherapy process. With the ghosts or demons of the unconscious serving as his helpful guides and therapists. And we witness in Scrooge's rejuvenated personality the inclusion or integration of all he had formerly excluded and ridiculed. The polar opposite qualities to his previously constricted self. We could even say his positive shadow. He rediscovers the child-like capacity for lightness, awe and joy, for love and compassion for his fellow man, for generosity, warmth and good will. Scrooge's faith in life (and God) is renewed during that truly therapeutic and spiritually symbolic Christmas Eve. Which is ultimately what needs to happen in the efficacious psychological treatment of chronic embitterment: a rediscovery or renewal of faith in life. And in one's ability to fully live it.

Scrooge's experience sounds alot like a naturally-occurring, spontaneous and instantaneous religious conversion or awakening. The sudden and unexpected spiritual awakening of what appears to have been a confirmed atheist. Psychologically speaking, personality development sometimes happens this way, and is not all that uncommon. Though what appears to be some spontaneous, overnight and isolated shift in the personality is typically preceded by an almost imperceptible unconscious process leading up to the dramatic event. This may also be why psychodyanamic psychotherapy takes as much time as it tends to: most of the alchemical process takes place invisibly as the new self slowly gestates within until ready for birth. To cite the great philosopher and psychologist William James (1902) on the subject: " It is natural that those who personally have traversed such an experience should carry away a feeling of its being a miracle rather than a natural process. Voices are often heard, lights seen, or visions witnessed; automatic motor phenomena occur; and it always seems, after the surrender of the personal will, as if an extraneous higher power had flooded in and taken possession. Moreover, the sense of renovation, safety, cleanness, rightness, can be so marvelous and jubilant as well to warrant one's belief in a radically new substantial nature." Certainly Scrooge's sudden reclamation bears striking similarities to such miraculous religious conversions. But had Mr. Scrooge's radical change of heart, behavior and personality resulted in some sort of psychological evaluation by concerned and confounded observers, as it might today, the additional possibility of Bipolar Disorder (in a manic or hypomanic phase) could easily (if incorrectly) be applied to his uncharacteristic excitement, jubilation and elation. And promptly treated with lithium carbonate or some other mood-stabilizing agent.

Scrooge is an archetypal character. He takes many forms. We all possess a potential "inner Scrooge," the capacity to become embittered, selfish, cynical, greedy and misanthropic. To be seduced and mesmerized by the material world. And disillusioned by our fellow man. To lose faith in life. And you may know or work with someone suffering from this all-too-ubiquitous "Scrooge syndrome." From chronic embitterment. Is there hope for them? Are they beyond redemption? This is exactly what Scrooge wonders aloud about himself during his awesome and impressive visitations. Could he choose to change? Or was he destined to die prematurely, as dreadfully foretold by the Ghost of Christmas Yet to Come? So just what is it that saved Scrooge from himself? It's not about believing in Christmas per se. Or even in God. It's about believing in life. And fully participating in it. It is what one author (Leuba, cited by William James) has called a "faith-state," pithily concluding that, "The truth of the matter can be put. . . in this way: God is not known, he is not understood; he is used--sometimes as meat-purveyor, sometimes as moral support, sometimes as friend, sometimes as an object of love. If he proves himself useful, the religious consciousness asks for no more than that. Does God really exist? How does he exist? What is he? are so many irrelevant questions. Not God, but life, more life, a larger, richer, more satisfying life is, in the last analysis, the end of religion. The love of life, at any and every level of development, is the religious impulse." This sometimes elusive "faith-state" seems to have been Ebenezer Scrooge's antitdote to his chronic embitterment. With the help of his dreams, Scrooge metamorphoses--and the story tells us this change was permanent--from embittered, miserly, hard-core misanthrope incapable of love, to a kind, caring, generous and much happier human being. And, psychologically speaking, all thanks to the healing powers of the unconscious!! It often happens that a dream or series of dreams is what precipitates someone seeking psychotherapy. Or some other existential crisis that forces the person to carefully examine or question themselves, their values, life choices, emotions and motivations. In such instances, dreams, often nightmares, can be considered symptomatic of some imbalance within the personality, and an attempt by the unconscious to compensate for this one-sided development. During the psychotherapy process, paying attention to dreams and taking seriously the vital and telling messages they convey from the unconscious can bring about similarly liberating and fortifying results.

So pay particularly close attention to your dreams, especially this time of year. They may be trying to tell you something that could potentially alter your destiny. And restore your faith. For this is the miraculous season of death and renewal, of endings and beginnings, of darkness and light. It is a truly transitional, spiritual time of year. Chanukkah, the festival of lights, the "miracle of the oil," starts this week. Christmas, with its miraculous conception and resurrection is nigh. And, New Year's Eve, marking the passing of, what, for many of us, has been a trying twelve months and beginning of what we perennially hope will be a better, more fruitful and happier year yet to come.

A Happy Chanukkah, Merry Christmas and Happy New Year to All, and God Bless Us Every One.

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