Two psychiatrists, believe they have discovered a new, YouTube generation, delusion: believing you are in a secret reality TV show.

The article describes cases of people who believe they are secretly being filmed. 

"I realized that I was and am the centre, the focus of attention by millions and millions of people," explained one patient, an army veteran who came from an upper-middle-class upbringing."My family and everyone I knew were and are actors in a script, a charade whose entire purpose is to make me the focus of the world's attention."

The belief that they are being filmed certainly gives the person a sense of importance, or worth independent of and beyond the mundane life he lives in.  In other words, it allows for an inflation of identity without actually having to do anything.   Call it grandiosity

The patient added that he planned to climb to the top of the Statue of Liberty, and if his true love were waiting for him, the puppeteer strings would be cut. If she failed to show up, he would jump to his death.

Grandiosity is one explanation, but I submit that the important part of this delusion isn't the filming, but the "puppeteer."  The delusion isn't about self-importance, but rather an explanation for powerlessness.  I am being manipulated by the outside.  There's nothing I can do.

Consider that a delusion which enhances your importance might not be one you'd want terminated; but these cases have the termination of the delusion built in.

In "reality" (ha!) such cases are cognitive metaphors for maturity.  Only when you gain sufficient self-awareness and autonomy can you break away from the artificial, manipulated reality of adolescence.

"But these guys are 30 years old!"  Exactly.  Real adolescents don't need a delusion to tell them they're powerless.  But a 30 year old should be dealing with intimacy vs. isolation, but instead they're stuck back at identity vs. role confusion.

The delusion is the protection, not the empowerment.  It says, "don't worry, you haven't accomplished anything because the producers haven't put that into the script yet."  Ultimately, this YouTube delusion is the result of a fleeting awareness that you cannot choose your identity unless you back it up with actions-- that actions are identity.

When a narcissist has this awareness, he has two choices.  He can retreat into a protective delusion, such as this one; or he can convince-- read: force-- someone else to accept his identity even in the absence of actions.  "I am a tough cop!  Well, maybe not actually a cop, but if something went down in this mall, I could be like a cop, and that's just as good!"

You do not want to be the person the narcissist tries to convince.

With authority.

Really?  Was that the reason?

An article written by one of the test subjects in the Milgram experiments, and his explanation for why it happened the way it did.

He's wrong.

On the one hand, you have articles in the Economist saying people are spending less time at work and more at home, on the other hand Time writes about the sex-starved wife.  If they're both home more and at work less, why aren't they naked?

The answer isn't porn.

Apparently, yes.

 

 

Who's hot, and who's not?  Ok-- who's dumb and who isn't?  Were they different?

Now-- who knows way to evil power source? 

 

(This is Part 2-- click to read Part 1) 

If you behave badly because you know you'll get away with it, that's being "bad."

A Moral Hazard is different.  If you behave "worse" than you would have otherwise, solely because you know that you won't have to bear the consequences, then you have a Moral Hazard.

I'll emphasize: the key is that your behavior is in itself not necessarily "bad."  It is simply worse than your behavior otherwise would have been, because you know there won't be consequences. 

Here's why it's called a Moral Hazard: if there are no external consequences, the only thing that would prevent you from behaving worse is an internal set of rules.

Where do these internal rules come from? 

 

It's a heavy moment, the first time you realize you are older than Han Solo.

Late last night I saw National Georgraphic: Inside The Green Berets.  The platoon was having a memorial for one of the Berets who had just been killed by an IED, and the Green Beret giving the eulogy says, "he wasn't just fighting for his country, he was fighting for a higher cause-- he was protecting each of us."

Army of One, I guess.

 

 

 

 

Don't ask me about Iraq.

But I do know something about our collective response to the Iraq war, to the Bush presidency, and to our times, and it says a lot about our cultural psychology.  And it helps predict the future.

It's sometimes easier to evaluate one's personality, and thus make predictions about it, by examining the defense mechanisms the person uses.  In difficult situations, specific people will use a small set of specific defenses over and over; so much so that we often describe people  exclusively by that defense, e.g. "she's passive aggressive."

Taking Iraq and President Bush as starting points, and examining the defense mechanisms we use to cope with both, yields the unsurprising conclusion that we are  a society of narcissists.

While this discovery is familiar to readers of my blog, what might be a surprise is what this heralds for our society politically and economically.  It isn't socialism, or even communism, as I had feared.  It's feudalism.  It's not 2007. It's 1066.

Let's begin. 

 

A thoughtful reader concerned about backlash against the mentally ill asked me to write a piece basically saying that not all mentally ill people were homicidal maniacs. 

It's a fair request, but in this case it's counterproductive.  Here's what I mean: you want to say that "not all mentally ill people are violent."  You want counterexamples to Cho's example.  But that's a defensive posture, unnecessary because... Cho wasn't mentally ill.  He was a sad, bad man who killed people because his life wasn't validated.  There was no psychosis, there was no cognitive impairment, there was no psychiatric impairment in insight in judgment.  There was a lack of sex, but that's not yet in the DSM.

Not to reduce his life down to a soundbite, but he was a guy who thought he deserved better by virtue of his intelligence and suffering; found himself in a sea of mediocrity but couldn't understand why he couldn't therefore excel; and, worst of all, found that all the things he thought he deserved eluded him-- especially hot chicks, who not only dismissed him and found him creepy, but, worse, chose to be with the very men he thought were obviously inferior to him.  It's Columbine all over again.  It's almost even the same day.

Forget the Prozac, forget the involuntary commitment (where he was found by the court to be "a danger to himself and others"-- that's standard boilerplate, it is clinically meaningless).  Those are  red herrings.  You may as well blame wearing black t-shirts.  He's not mentally ill; he's an adolescent.

The difference, the single difference, between us and him is that when we were sulking in high school, we listened to Pink Floyd or U2.  He watched Oldboy.  We had a battered copy of a Playboy down at the creek under a rock, that was so creased we had to infer the boobs.  He had the internet.  Maybe we bought a pocket knife, or-- wow-- a butterfly knife.  He bought two Glocks.

In other words, the difference is this: he decided to shoot 30 people, and you didn't.  That's it.  I know it's not a satisfying answer, I know we want explanations, but there aren't any.  Forget genes, forget DSM.  He chose to do something bad,  he knew it was bad, but he did it anyway.

Don't worry about the mentally ill.  Worry about the nut politicians and media outlets who will look to the easy and convenient excuse of mental illness, rather than have to do the hard work of figuring out why our society is melting.

 

Older posts on Cho here, here, and here.

I still haven't had time to really look at this situation, but I have to address this nonsense about his psychiatric history: it's irrelevant.

He didn't do this because he was on Prozac, or he was Bipolar.  Look at it the other way: are we going to say that people with bipolar are more likely to go homicidal?  If so, should we do a Kansas v. Hendricks for bipolars? (in which the Supreme Court said it was ok to lock up pedophiles indefinitely, even in the absence of a crime, since "pedophilia" makes you a priori dangerous.) 

If you want to really understand why he did it that way, you have to find out what article of media he was imitating.  Take the photos, the manifesto, and google it until you find the movie the handguns came from; the book (or comic book) the manifesto came from.  He didn't come up with this stuff on his own, he is imitating something.  For Klebold and Harris it was the Matrix and Doom.  What movie is he imitating?  Find it.

Because it isn't about mental illness, or genetics. It's about identity, it's always about identity, and sometimes the identity you choose doesn't work out that well.  So, emergently, you grab an identity which has appeared to work-- you imitate a movie, a game, a comic.

I'm not saying movies made him do it; I'm saying he was looking for an excuse to do it, and he went through the usual catalog: movies, comics, games. Come hell or high water, he was going to kill someone.  But in terms of prediction, the operative question is, if this guy goes homicidal, how will he do it?  He didn't strap explosives to his chest, not because it wasn't available, but because it didn't match the identity he wanted to have-- that he got from a TV show or movie.

Ismael Ax, handgun to the head, hammer cocked like a bat to the right, knife to the neck-- all those stills from his video clips you see on CNN aren't random, they're a specific imitation of something else.  Find the thing he was imitating, and you have found him.

Because he didn't exist, that's the problem.  He picked an identity, and no one liked it, it backfired- no chicks-- so he moved to plan B: pick an identity that absolves him of the guilt of shooting 30 people. 

Stop looking in the DSM.  Start looking in IMDb.

 

So the APA has come out against the sexualization of women in the media.  Praise Jesus.  And not a moment too soon.

Oh my God.  If society could just expand it's historical horizon past winter, we'd realize that women have been sexualized for centuries.  It's only in modern times that women are allowed to be in control of it.

No. I'm not worried about girls, What we should be worried about are the boys.  What happens to a  boy who is told by the media that women are sexualized, they are objects, they are sluts?  And then he goes out into the world and discovers they aren't?  That they won't sleep with him?  That, try as he might, they won't do all the things he was promised in ads, movies, porn?  But they might be willing to do it with someone else, even women?

Depression?  Or maybe misogyny?  And maybe he starts hating women so much he, oh, I don't know, shoots 30 people at a college?

Women have been tweezing and preening and primping since day uno.  Near as I can tell, porn hasn't drastically altered this.  Interestingly, it has made young men more self-conscious, not just about penis size, but also body hair, fat, fingernails, etc.  The cultural problem is neurotic, immasculated men whose only outlet is masturbation and violence. 

Are we going to be honest or political? I don't know any women who if given a choice would prefer "not sexy" over "sexy."  If I have a daughter, I would want her to be in control of her sexuality, not under the control of it (in other words, the opposite of me.)  I want her to be smart and sexy.  I just want her to be her.

No.  No, the problem isn't my daughter becomes a slut; it's that she gets beaten by some whacko who wants her to be.  Or doesn't want her to be. Or does, but only when...

The real problem for the women of our society isn't a lack of self-esteem.  It's a lack of weapons. 

And no, I'm not kidding. 

 

 

 

A commenter, who I believe is a physics undergrad (his blog here) emailed me some of his thoughts on narcissism, and wrote:

...those studies where people rank each other in a room for different attributes having never met them... I think what's going on is we assign people personalities based on how they look and force them to become a certain thing, creating a whole custom world for them...

which puts the idea of "profiling" on its head.  Do we actually ever "figure people out," or do we change them into what we think they are by the act of engaging in a relationship (on any level) with them?  It sounds a lot like a psychological version of quantum entanglement:

When two systems, of which we know the states by their respective representatives, enter into temporary physical interaction due to known forces between them, and when after a time of mutual influence the systems separate again, then they can no longer be described in the same way as before, viz. by endowing each of them with a representative of its own... By the interaction the two representatives have become entangled.

Which, unfortunately, sounds a lot like this (p. 236):

The unreflective consciousness does not apprehend the person directly or as its object; the person is presented to consciousness in so far as the person is an object for the Other.  This means that all of a sudden I am conscious of myself escaping myself, not in that I am the foundation of my own nothingness but in that I have my foundation outside myself.  I am for myself only as I am a pure reference for the Other.

You can't know who a person is without relating to them, and once you do that, you irrevocably change them.

Only in relationship to another do you get defined. Sometimes you can do it with your God; but either way, any adjective has to be placed on you by someone else.  Are you brave?  Strong?  funny, stupid, nervous?  All that comes from someone else.  So when someone relates to you, they define you.  You can try to control this-- hence the narcissist preying on the borderline to get her to see him the way he wants to be seen-- but ultimately it's up to the other person.

So we're are, or become, whatever a person thinks we are?  No, it's worse than that-- we want to be what they think we are. That's why we maintain the relationship, otherwise we'd change it.  ("I divorced her because I didn't like who I became.")

We do it because it is easier, and it serves us.   You're kind because he sees you as kind-- which in turn allows him to be seen as someone who can detect kindness.  And you accept that you're kind-- or mean/vulnerable/evil/brilliant-- because it serves you-- there's some gain there.  But a strong person accepts that on the one hand the other person gives you definition, and on the other hand you are completely undefinable, free, at any moment, to redefine yourself.  You can defy him, biology, environment and be anything.

You say: but I can't be a football star just because I want to.  But that's wanting someone else to see you in a certain way.  Do you want to play ball?  Go play ball.  "But I won't get on the team."  Again, that's wanting to change someone else.  Change you first. 

But what about-- identity?  That's the mistake, that's bad faith.  Thinking that our past is us; what we did defines us.  Our past can be judged-- what else is there to judge?- but it can't-- shouldn't--  define us, because at any moment we are free to change into something, anything else.  And so, too, we can be judged for not changing.

Ultimately, you are responsible for everything you do and think.  Not for what happens to you, but for how you choose to react.  Nothing else made you be.  Nothing else made you do.

Trinity said it best: The Matrix cannot tell you who you are. 

Many intresting and varied reactions to my post, "What Goes Wrong In A Psychiatrist's Family?"  It struck a nerve with a lot of people, and others couldn't relate to it at all.  But I would like to clear up one element:

It's not that even handed, calm, unemotional criticisms ldirected only to the child's behavior is wrong; it is that no one does it well.  And that's where it all falls apart.

 

 

 

I'm no Lost expert, and I doubt the writers were thinking along these lines.  But yesterday's episode got me thinking about how we become who we are.

So maybe I am generalizing a bit, but I'm trying to get at something that isn't easily explained by science: why do so many psychiatrist families go bad in the same way?

In my experience (see, there's my disclaimer) psychiatrist-parents go wrong in a very specific way. They judge behavior, not the person.  It sounds like a good thing, I know.  For kids, it's a disaster.

Psychiatrists identify the behavior, but then focus on changing not the behavior directly, but the underlying cause of the behavior-- which is still not something intrinsic to the person.  If a guy with bipolar spends $10,000 in a week, psychiatrists link the behavior to the bipolar, and then try to medicate the bipolar.  (NB: "the patient has bipolar," not "the patient is bipolar.")

The obvious problem here is that maybe the guy spent $10,000 in a week because he doesn't give a damn? Or he wanted to impress some girl? i.e. just because someone has bipolar, doesn't mean every breath he takes is related to bipolar.  Psychiatrists are going to deny that they make it so simple, but in actuality they do: the moment you raise the dose of Depakote, you are sending the message that the behavior was related to bipolar. 

The psychiatrists with children-patients handle their kids in the same way.  They teach them what they are allowed to do and what they are not, what is acceptable and what is not-- but make no judgment on the kids themselves. This is a disaster, because doing this denies the kid's identity, which is the whole purpose of childhood to begin with. Rules then exist in an invented framework, or worse, in a vacuum.  There's no internalization of the rules; there's no superego.  Just some arbitrary limits on id.

If you tell a kid that a behavior is unacceptable, the kid has learned nothing about himself; he's only learned that this one thing is something he can't do.  The information is in a vacuum. But if you make the kid own it-- make the behavior part of his identity, then he has a chance to change his identity.  Instead of learning it is unacceptable to take his brother's potato chips away, he can learn that he has a choice: to be the kind of person who takes chips, or the kind of person who doesn't. 

I understand the trickiness of this; you don't want to make the kid feel like he is a bad person.  But you do have to find a way to teach him that if he does that thing again and again, then he is being a bad person.  Is that what he wants?  Who are you, kid?  Who do you want to be?  This also allows his to take personal credit for doing something good:

Your good behavior doesn't make you a good person; you are a good person, and that's why you did that.  (NB: Sartre can go to hell.)

And you can see the creation of a future borderline here.  For God's sake, will someone please tell me who I am?  Give this storm of emotions some context?  Right now, I get angry/sad/thrilled/terrified over nothing, it just comes over me-- I wish I could be angry/sad/thrilled/terrified over something.  But all people ever do is tell me what I can and can't do.  If I do something bad, people freak. If I do something good, no one even notices.  No one likes me for me, they just overreact to what I do.

There's a second cause for disaster: parents' control of their affect. 

The psychiatrist isn't supposed to get mad at his patient; but then he comes home, and tries very hard not to get mad at his kid-- just tells him the behavior is unacceptable, gives him a time out, whatever.  But guess what?  The psychiatrist is exhausted, eventually his patience runs out, and BAM! a tsunami of anger.

calm&firm...calm&firm...calm&firm...EXPLOSION.

The explosion part can come at any time, depending on how much patience the parent has that day.  And that's exactly the problem.  What does the kid learn? That this ethereal rulebook for what is acceptable and unacceptable only has two, binary results: no affect, or all affect-- and you never know what you're going to get.

In the biz, this is called inconsistent parenting.

What the kid needs to know are the rules of the game; they need the parent to be consistent, predictable, so that they can be safely chaotic, experimental, exploratory off of your foundation.   You want her to know exactly how you'll react if she tries pot, you want a superego so well constructed you're superfluous.   And you want levels of emotion, different things get you more or less angry.  We know you went berserk because your boss is a big jerk whose been riding you all day, but your two year old thinks you went berserk because she spilled the milk.  Geez, sorry.  May as well try heroin, what's the difference?

It doesn't necessarily mean you have to be an angry parent-- your predicted reaction could be anxious acceptance or loving disappointment-- but it has to be predictable.  And it has to be about the kid, not the behavior.  The kid needs to know you're connecting with them, not what they do, or else they'll think that the only way to connect is by behaviors.

You can see the further development of a borderline here: what the hell do I have to do to get some emotional response from you?  Kill myself?  Keep pushing until you finally blow up?  I don't even feel like I'm alive, but I'm not sure that you are either-- or is it just me, that I matter so little that I can't even get a little affect? You're insanely jealous if I talk to another guy, but you treat me like crap when I'm with you. At least with jealousy you're being real with me. Etc.

Trust me on this: at age 2, a kid feels your rage and your love the same.  It's exciting, and they haven't yet learned to fully differentiate the two feelings.  What counts is the amount of emotion, not which emotion.  (Horror movies and porn are the same to a 14 yo for this reason.)  Fast forward 20 years-- that all out screaming match with your boyfriend felt weirdly relaxing.

And so you have a scenario: busy psychiatrist, often tired, can't generate much emotion past anger-- and it can come at any time.  No deep connection with the child as a person-- as their kid, yes; as the sum total of their behaviors, yes-- but not as a developing individual.  The kid learns that as long as some things are done correctly-- e.g. school-- they can get away with other things that the parent won't notice, e.g. pot.

Oh, and this is the best part: when the kid (adult or child) becomes a psychiatric patient, they now have a bond with their parent-- and the parent's over-involvement in their kid's psychiatric care is the framework for a relationship.  It's analogous to helping them build a go cart. 

And that's all the kid ever wanted anyway.

I have another unrelated post coming, but a quick word on insults vs. narcissistic injuries, and why this distinction is so important.

Narcissistic injuries have nothing to do with sadness.  They are always and only about rage. 

The narcissist says, "I exist."  A narcissistic injury is you showing him that he does not exist in your life.  Kicking him in the teeth and telling him he is a jerk is not a narcisstic injury-- because he must therefore exist. 

Let's say I'm a narcissist, and you send me a 10 page letter explaining why I suck, I'm a jerk, I'm an idiot; you attack my credibility, my intelligence; and you even provide evidence for all of this, college transcripts, records from the Peters Institute, you criticize my penis size, using affidavits from past and future girlfriends-- all of this hurts me, but it is not a narcissistic injury.  

A narcissistic injury would be this: I expect you to write such a letter, and you don't bother. 

This is most easily seen in the failing marriage of a narcissist. 

The reason it's important is because the reaction of the narcissist to either "insult" is different.  In the first example, he will be sad and hurt, but he will yell back, insult you, or cry and beg forgiveness or mercy--he will respond-- maintain the relationship.   He'll say and do outrageous things that he knows will cause you to respond again, to prolong your connections, even if they cause him misery.  He doesn't care that it makes you and him miserable-- he cares only that there is a you and him.

But in the latter case where you ignore him, humiliate him-- an actual narcissisitic injury-- he will want to kill you.

 

----

And before everyone flames me, I am not trying to give a scientific explanation of the pathogenesis of narcissism.  This is simply one man's opinion of how we can specify what it is, and what it may predict, past or future.  Nor am I suggesting this isn't "treatable"-- anyone can change.  It may not be easy, but it is always possible.

And I also do not mean to imply that all narcissists will kill everyone who injures them.  The point is rage.  They may never act on it, or they may break a window, or attempt suicide, etc.