Victims Affected by Abuse: The Conflicts of Therapy

Abuse victims often go to therapy to heal. For some, therapy and  a bad  therapist can  hurt the recovery process for the abuse survivor.

Disclaimer

Statistically, the majority of abuse victims are female and most abusers are male. Still, we should bear in mind that there are male victims and female offenders as well.

Ideally, after a period of combined tutoring, talk therapy, and (anti-anxiety or antidepressant) medications, the survivor will self-mobilize and emerge from the experience more resilient and assertive and less gullible and self-deprecating.

But therapy is not always a smooth ride.

Victims of abuse are saddled with emotional baggage which often provokes even in the most experienced therapists reactions of helplessness, rage, fear and guilt. Countertransference is common: therapists of both genders identify with the victim and resent her for making them feel impotent and inadequate (for instance, in their role as "social protectors").

Reportedly, to fend off anxiety and a sense of vulnerability ("it could have been me, sitting there!"), female therapists involuntarily blame the "spineless" victim and her poor judgement for causing the abuse. Some female therapists concentrate on the victim's childhood (rather than her harrowing present) or accuse her of overreacting.

Male therapists may assume the mantle of the "chivalrous rescuer", the "knight in the shining armor" - thus, inadvertently upholding the victim's view of herself as immature, helpless, in need of protection, vulnerable, weak, and ignorant. The male therapist may be driven to prove to the victim that not all men are "beasts", that there are "good" specimen (like himself). If his (conscious or unconscious) overtures are rejected, the therapist may identify with the abuser and re-victimize or pathologize his patient.

 

Many therapists tend to overidentify with the victim and rage at the abuser, at the police, and at "the system". They expect the victim to be equally aggressive even as they broadcast to her how powerless, unjustly treated, and discriminated against she is. If she "fails" to externalise aggression and show assertiveness, they feel betrayed and disappointed.

Most therapists react impatiently to the victim's perceived co-dependence, unclear messages, and on-off relationship with her tormentor. Such rejection by the therapist may lead to a premature termination of the therapy, well before the victim learned how to process anger and cope with her low self-esteem and learned helplessness.

Finally, there is the issue of personal security. Some ex-lovers and ex-spouses are paranoid stalkers and, therefore, dangerous. The therapist may even be required to testify against the offender in a court of law. Therapists are human and fear for their own safety and the security of their loved ones. This affects their ability to help the victim.

This is not to say that therapy invariably fails. On the contrary, most therapeutic alliances succeed to teach the victim to accept and transform her negative emotions into positive energy and to competently draw and implement realistic plans of action while avoiding the pitfalls of the past. Good therapy is empowering and restores the victim's sense of control over her life.

Yet, how should the victim go about finding a good therapist?

 


 

next: Intimacy and Abuse

APA Reference
Vaknin, S. (2009, October 1). Victims Affected by Abuse: The Conflicts of Therapy, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/victims-affected-by-abuse-the-conflicts-of-therapy

Last Updated: July 5, 2018

Negativistic (Passive-Aggressive) Personality Disorder

Ever meet an extremely pessimistic person? Learn about Negativistic (Passive-Aggressive) Personality Disorder and how these extreme pessimists resemble narcissists.

The Negativistic (Passive-Aggressive) Personality Disorder is not yet recognized by the DSM Committee. It makes its appearances in Appendix B of the Diagnostic and Statistical Manual, titled "Criteria Sets and Axes Provided for Further Study."

Some people are perennial pessimists and have "negative energy" and negativistic attitudes ("good things don't last", "it doesn't pay to be good", "the future is behind me"). Not only do they disparage the efforts of others, but they make it a point to resist demands to perform in workplace and social settings and to frustrate people's expectations and requests, however reasonable and minimal they may be. Such persons regard every requirement and assigned task as impositions, reject authority, resent authority figures (boss, teacher, parent-like spouse), feel shackled and enslaved by commitment, and oppose relationships that bind them in any manner.

Passive-aggressiveness wears a multitudes of guises: procrastination, malingering, perfectionism, forgetfulness, neglect, truancy, intentional inefficiency, stubbornness, and outright sabotage. This repeated and advertent misconduct has far reaching effects. Consider the Negativist in the workplace: he or she invests time and efforts in obstructing their own chores and in undermining relationships. But, these self-destructive and self-defeating behaviors wreak havoc throughout the workshop or the office.

People diagnosed with the Negativistic (Passive-Aggressive) Personality Disorder resemble narcissists in some important respects. Despite the obstructive role they play, passive-aggressives feel unappreciated, underpaid, cheated, and misunderstood. They chronically complain, whine, carp, and criticize. They blame their failures and defeats on others, posing as martyrs and victims of a corrupt, inefficient, and heartless system (in other words, they have alloplastic defenses and an external locus of control).

Passive-aggressives sulk and give the "silent treatment" in reaction to real or imagined slights. They suffer from ideas of reference (believe that they are the butt of derision, contempt, and condemnation) and are mildly paranoid (the world is out to get them, which explains their personal misfortune). In the words of the DSM: "They may be sullen, irritable, impatient, argumentative, cynical, skeptical and contrary." They are also hostile, explosive, lack impulse control, and, sometimes, reckless.

 

Inevitably, passive-aggressives are envious of the fortunate, the successful, the famous, their superiors, those in favor, and the happy. They vent this venomous jealousy openly and defiantly whenever given the opportunity. But, deep at heart, passive-aggressives are craven. When reprimanded, they immediately revert to begging forgiveness, kowtowing, maudlin protestations, turning on their charm, and promising to behave and perform better in the future.

Read Notes from the therapy of a Negativistic (Passive-Aggressive) Patient

Passive-aggressive Bureaucracies

Collectives - especially bureaucracies, such as for-profit universities, health maintenance organizations (HMOs), the army, and government - tend to behave passive-aggressively and to frustrate their constituencies. This misconduct is often aimed at releasing tensions and stress that the individuals comprising these organizations accumulate in their daily contact with members of the public.

Additionally, as Kafka astutely observed, such misbehavior fosters dependence in the clients of these establishments and cements a relationship of superior (i.e., the obstructionist group) versus inferior (the demanding and deserving individual, who is reduced to begging and supplicating).

Passive-aggressiveness has a lot in common with pathological narcissism: the destructive envy, the recurrent attempts to buttress grandiose fantasies of omnipotence and omniscience, the lack of impulse control, the deficient ability to empathize, and the sense of entitlement, often incommensurate with its real-life achievements.

No wonder, therefore, that negativistic, narcissistic, and borderline organizations share similar traits and identical psychological defenses: most notably denial (mainly of the existence of problems and complaints), and projection (blaming the group's failures and dysfunction on its clients).

In such a state of mind, it is easy to confuse means (making money, hiring staff, constructing or renting facilities, and so on) with ends (providing loans, educating students, assisting the poor, fighting wars, etc.). Means become ends and ends become means.

Consequently, the original goals of the organization are now considered to be nothing more than obstacles on the way to realizing new aims: borrowers, students, or the poor are nuisances to be summarily dispensed with as the board of directors considers the erection of yet another office tower and the disbursement of yet another annual bonus to its members. As Parkinson noted, the collective perpetuates its existence, regardless of whether it has any role left and how well it functions.

As the constituencies of these collectives - most forcefully, its clients - protest and exert pressure in an attempt to restore them to their erstwhile state, the collectives develop a paranoid state of mind, a siege mentality, replete with persecutory delusions and aggressive behavior. This anxiety is an introjection of guilt. Deep inside, these organizations know that they have strayed from the right path. They anticipate attacks and rebukes and are rendered defensive and suspicious by the inevitable, impending onslaught.

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

 


 

next: Therapy and Treatment of Personality Disorders

APA Reference
Vaknin, S. (2009, October 1). Negativistic (Passive-Aggressive) Personality Disorder, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/negativistic-passive-aggressive-personality-disorder

Last Updated: July 5, 2018

International Classification of Diseases (ICD) 10

Explanation of the International Classification of Diseases (ICD) and how it relates to mental health diagnoses.

The International Classification of Diseases (ICD) is published by the World Health Organization in Geneva, Switzerland. It included mental health disorders for the first time in 1948, in its sixth edition. In 1959, following widespread criticism of its classificatory scheme, the WHO commissioned a global survey of taxonomies of mental health problems, which was conducted by Stengel. The survey uncovered great disparities and substantial disagreements as to what constituted mental illness and how it should be diagnosed (diagnostic criteria and differential diagnoses).

Yet, it was not until 1968 that Stengel's recommendations were implemented in the eighth edition. The ICD-8 was descriptive and operational and did not commit itself to any theory of etiology, pathogenesis, or psychological dynamics. Still, it sported a confusing plethora of categories and allowed for rampant comorbidity (multiple diagnoses in the same patient).

The ICD10 was revolutionary. It incorporated the outcomes of numerous collaborative studies and programmes, both national and international, and included input from the American Psychiatric Association, the publisher of the Diagnostic and Statistical Manual (DSM), the ICD's equivalent in North America. Consequently, the ICD and the DSM are now broadly similar.

But, as opposed to the DSM, the ICD provides two sets of diagnostic criteria for each disorder. One list is useful to the diagnostician and allows for some latitude and for the practitioner's exercise of judgment. The other set is far more precise and strict and intended to be used by scholars and researchers in their studies. Yet a third, simplified classification is applicable to primary care settings and contains only broad categories (dementia, eating disorder, psychotic disorder, and so on).

 

The ICD10 discusses organic, substance use-related, and stress-related disorders separately. Chapter F, which deals with mental health disorders, is divided into ten groups and each group, in turn, is again divided into one hundred subunits. Thus F2 is Schizophrenia, F25 is Schizoaffective Disorder, and F25.1 is Schizoaffective Disorder, depressive type.

An international study carried out in 112 clinical centers in 39 countries demonstrated that the ICD10 is not a reliable diagnostic tool as far as personality disorder go (Sartorius et al. 1993). These findings were not repeated a year later in the USA and Canada.

Read more about the DSM - click HERE!

The Myth of Mental Illness - click HERE!

Personality Disorders - click HERE!

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

 


 

next: Negativistic (Passive-Aggressive) Personality Disorder

APA Reference
Vaknin, S. (2009, October 1). International Classification of Diseases (ICD) 10, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/international-classification-of-diseases-icd-10

Last Updated: July 5, 2018

Psychosexual Stages of Personal Development

Examination of the psychosexual stages of child development and how inappropriate parenting can impact child development.

The Viennese neurologist, Sigmund Freud, was among the first to offer a model of psychological development in early childhood (within the framework of psychoanalysis). He closely linked the sex drive (libido) to the formation of personality and described five psychosexual stages, four of which are centered around various erogenous zones in the body.

The pursuit of pleasure ("the pleasure principle") and the avoidance of pain drive the infant to explore his or her self and the world at large. Pleasure is inextricably linked to sexual gratification. In the oral phase (from birth to 24 months), the baby focuses on the tongue, lips, and mouth and derives gratification from breast feeding, thumb sucking, biting, swallowing, and other oral exploratory activities.

This is naturally followed by the anal stage (24 to 36 months). The baby immensely enjoys defecation and related bowel movements. But it is also the first time in his or her life that the toddler is subjected to the censure and displeasure of caretakers. Hitherto unconditionally adoring adults now demand that the infant delay gratification, relieve himself only in the bathroom, and not play with his feces. This experience - of hitherto unprecedented adult approbation - can be traumatic.

The phallic stage (age 3 to 6 years) involves the discovery of the penis and clitoris as foci of pleasurable experience. This tantalizing novelty is coupled with sexual desire directed at the parent of the opposite sex (boys are attracted to their mothers and girls, to their fathers). The child overtly and covertly competes with the same-sex parent for the desired parent's attention: boys joust with their fathers and girls with their mothers. These are the famous Oedipal and Electra complexes.

If the parent is insufficiently mature or narcissistic and encourages the attentions of the child in acts of covert (emotional) and overt (physical) incest, it could lead to the development of certain mental health disorders, among them the Histrionic, Narcissistic, and Borderline personality disorders. Doting, over-indulgence, and smothering are, therefore, forms of child abuse. Sexual innuendo, treating the child as an adult or substitute partner, or regarding one's offspring as an extension of one's self also constitute abusive conduct.

The phallic stage is followed by 6 to 7 years of latent sexuality that is rekindled in puberty. Adolescence is a period of personal development labeled by Freud the genital phase. In the previous rungs of psychosexual evolution, the child's own body was the source of sexual pleasure. Hitherto, the adolescent and young adult seeks sexual gratification from and invests sexual energy in others. This object-relatedness is what we call mature love.

This article appears in my book, "Malignant Self Love - Narcissism Revisited"


 

next: International Classification of Diseases (ICD) 10

APA Reference
Vaknin, S. (2009, October 1). Psychosexual Stages of Personal Development, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/psychosexual-stages-of-personal-development

Last Updated: July 5, 2018

Depressive Personality Disorder

Signs, symptoms of Depressive Personality Disorder, the depressive's self-image and  tendency to humiliate and punish others.

The Depressive Personality Disorder is not yet recognized by the DSM Committee. It makes its appearances in Appendix B of the Diagnostic and Statistical Manual, titled "Criteria Sets and Axes Provided for Further Study." It is not clear in what way is the Depressive Personality Disorder different to other depressive illnesses, such as Dysthymic Disorder.

The Depressive has pervasive and continuous depressive cognitions (thoughts) and behaviors. They manifest themselves in every area of life and never abate. The patient is gloomy, dejected, pessimistic, overly serious, lacks a sense of humor, cheerless, joyless, and constantly unhappy. This dark mood is not influenced by changing circumstances.

The Depressive's self-image is distorted: he holds himself to be worthless, inadequate, a loser. His sense of self-worth and his self-esteem are invariably and unrealistically low. This borders on self-hatred and self-abnegation. The Depressive chastises himself unnecessarily. His inner dialog (sometimes verbalized) is derogatory towards his self, blaming and self-critical. Freud called this inner judge the Superego. The Depressive's Superego is sadistic, unrelenting, unforgiving, self-denigrating, and, ultimate hatefully self-destructive. Dimly aware of this semi-suicidal streak, Depressives are naturally anxious and prone to excessive worrying and brooding.

The Depressive extends this propensity to humiliate and punish to his nearest and dearest. His masochism is complemented by equally exacting sadism. He is negativistic, passive-aggressive, critical, judgmental, and punitive towards others. Such recurrent outbursts are followed by feelings of remorse and guilt, often coupled with maudlin and prostrate apologies.

The Narcissist's Inner Judge - click HERE!

The Depressive Narcissist - click HERE!

Depression and the Narcissist - click HERE!

This article appears in my book, "Malignant Self Love - Narcissism Revisited"


 

next: Psychosexual Stages of Personal Development

APA Reference
Vaknin, S. (2009, October 1). Depressive Personality Disorder, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/depressive-personality-disorder

Last Updated: July 5, 2018

Definition of Abuse: Emotional, Verbal, and Psychological Abuse

Find out about the different types of abuse, the psychological tools used by the abuser, and how to deal with your abuser.

Emotional, Verbal, and Psychological Abuse, Domestic and Family Violence and Spousal Abuse

Violence in the family often follows other forms of more subtle and long-term abuse: verbal, emotional, psychological sexual, or financial.

It is closely correlated with alcoholism, drug consumption, intimate-partner homicide, teen pregnancy, infant and child mortality, spontaneous abortion, reckless behaviours, suicide, and the onset of mental health disorders.

Most abusers and batterers are males - but a significant minority are women. This being a "Women's Issue", the problem was swept under the carpet for generations and only recently has it come to public awareness. Yet, even today, society - for instance, through the court and the mental health systems - largely ignores domestic violence and abuse in the family. This induces feelings of shame and guilt in the victims and "legitimizes" the role of the abuser.

Violence in the family is mostly spousal - one spouse beating, raping, or otherwise physically harming and torturing the other. But children are also and often victims - either directly, or indirectly. Other vulnerable familial groups include the elderly and the disabled.

Abuse and violence cross geographical and cultural boundaries and social and economic strata. It is common among the rich and the poor, the well-educated and the less so, the young and the middle-aged, city dwellers and rural folk. It is a universal phenomenon.

Abusers exploit, lie, insult, demean, ignore (the "silent treatment"), manipulate, and control.

There are many ways to abuse. To love too much is to abuse. It is tantamount to treating someone as an extension, an object, or an instrument of gratification. To be over-protective, not to respect privacy, to be brutally honest, with a sadistic sense of humour, or consistently tactless - is to abuse.

To expect too much, to denigrate, to ignore - are all modes of abuse. There is physical abuse, verbal abuse, psychological abuse, sexual abuse. The list is long. Most abusers abuse surreptitiously. They are "stealth abusers". You have to actually live with one in order to witness the abuse.

There are four important categories of abuse:

Click HERE forA Classification of Abusive Behaviors

I. Overt Abuse

The open and explicit abuse of another person. Threatening, coercing, beating, lying, berating, demeaning, chastising, insulting, humiliating, exploiting, ignoring ("silent treatment"), devaluing, unceremoniously discarding, verbal abuse, physical abuse and sexual abuse are all forms of overt abuse.

II. Covert or Controlling Abuse

Abuse is almost entirely about control. It is often a primitive and immature reaction to life circumstances in which the abuser (usually in his childhood) was rendered helpless. It is about re-exerting one's identity, re-establishing predictability, mastering the environment - human and physical.

The bulk of abusive behaviors can be traced to this panicky reaction to the remote potential for loss of control. Many abusers are hypochondriacs (and difficult patients) because they are afraid to lose control over their body, its looks and its proper functioning. They are obsessive-compulsive in an effort to subdue their physical habitat and render it foreseeable. They stalk people and harass them as a means of "being in touch" - another form of control.

To the abuser, nothing exists outside himself. Meaningful others are extensions, internal, assimilated, objects - not external ones. Thus, losing control over a significant other - is equivalent to losing control of a limb, or of one's brain. It is terrifying.

Independent or disobedient people evoke in the abuser the realization that something is wrong with his worldview, that he is not the centre of the world or its cause and that he cannot control what, to him, are internal representations.

To the abuser, losing control means going insane. Because other people are mere elements in the abuser's mind - being unable to manipulate them literally means losing it (his mind). Imagine, if you suddenly were to find out that you cannot manipulate your memories or control your thoughts... Nightmarish!

In his frantic efforts to maintain control or re-assert it, the abuser resorts to a myriad of fiendishly inventive stratagems and mechanisms. Here is a partial list:


 


Unpredictability and Uncertainty (Intermittent Reinforcement)

The abuser acts unpredictably, capriciously, inconsistently and irrationally. This serves to render others dependent upon the next twist and turn of the abuser, his next inexplicable whim, upon his next outburst, denial, or smile.

The abuser makes sure that HE is the only reliable element in the lives of his nearest and dearest - by shattering the rest of their world through his seemingly insane behaviour. He perpetuates his stable presence in their lives - by destabilizing their own.

TIP

Refuse to accept such behavior. Demand reasonably predictable and rational actions and reactions. Insist on respect for your boundaries, predilections, preferences, and priorities.

Disproportional Reactions

One of the favorite tools of manipulation in the abuser's arsenal is the disproportionality of his reactions. He reacts with supreme rage to the slightest slight. Or, he would punish severely for what he perceives to be an offence against him, no matter how minor. Or, he would throw a temper tantrum over any discord or disagreement, however gently and considerately expressed. Or, he would act inordinately attentive, charming and tempting (even over-sexed, if need be).

This ever-shifting code of conduct and the unusually harsh and arbitrarily applied penalties are premeditated. The victims are kept in the dark. Neediness and dependence on the source of "justice" meted and judgment passed - on the abuser - are thus guaranteed.

TIP

Demand a just and proportional treatment. Reject or ignore unjust and capricious behavior.

If you are up to the inevitable confrontation, react in kind. Let him taste some of his own medicine.

Dehumanization and Objectification (Abuse)

People have a need to believe in the empathic skills and basic good-heartedness of others. By dehumanizing and objectifying people - the abuser attacks the very foundations of human interaction. This is the "alien" aspect of abusers - they may be excellent imitations of fully formed adults but they are emotionally absent and immature.

Abuse is so horrid, so repulsive, so phantasmagoric - that people recoil in terror. It is then, with their defences absolutely down, that they are the most susceptible and vulnerable to the abuser's control. Physical, psychological, verbal and sexual abuse are all forms of dehumanization and objectification.

TIP

Never show your abuser that you are afraid of him. Do not negotiate with bullies. They are insatiable. Do not succumb to blackmail.

If things get rough - disengage, involve law enforcement officers, friends and colleagues, or threaten him (legally).

Do not keep your abuse a secret. Secrecy is the abuser's weapon.

Never give him a second chance. React with your full arsenal to the first transgression.

Abuse of Information

From the first moments of an encounter with another person, the abuser is on the prowl. He collects information. The more he knows about his potential victim - the better able he is to coerce, manipulate, charm, extort or convert it "to the cause". The abuser does not hesitate to misuse the information he gleaned, regardless of its intimate nature or the circumstances in which he obtained it. This is a powerful tool in his armory.

TIP

Be guarded. Don't be too forthcoming in a first or casual meeting. Gather intelligence.

Be yourself. Don't misrepresent your wishes, boundaries, preferences, priorities, and red lines.

Do not behave inconsistently. Do not go back on your word. Be firm and resolute.

Impossible Situations

The abuser engineers impossible, dangerous, unpredictable, unprecedented, or highly specific situations in which he is sorely needed. The abuser makes sure that his knowledge, his skills, his connections, or his traits are the only ones applicable and the most useful in the situations that he, himself, wrought. The abuser generates his own indispensability.

TIP

Stay away from such quagmires. Scrutinize every offer and suggestion, no matter how innocuous.

Prepare backup plans. Keep others informed of your whereabouts and appraised of your situation.

Be vigilant and doubting. Do not be gullible and suggestible. Better safe than sorry.


 


III. Control and Abuse by Proxy

If all else fails, the abuser recruits friends, colleagues, mates, family members, the authorities, institutions, neighbours, the media, teachers - in short, third parties - to do his bidding. He uses them to cajole, coerce, threaten, stalk, offer, retreat, tempt, convince, harass, communicate and otherwise manipulate his target. He controls these unaware instruments exactly as he plans to control his ultimate prey. He employs the same mechanisms and devices. And he dumps his props unceremoniously when the job is done.

Another form of control by proxy is to engineer situations in which abuse is inflicted upon another person. Such carefully crafted scenarios of embarrassment and humiliation provoke social sanctions (condemnation, opprobrium, or even physical punishment) against the victim. Society, or a social group become the instruments of the abuser.

TIP

Often the abuser's proxies are unaware of their role. Expose him. Inform them. Demonstrate to them how they are being abused, misused, and plain used by the abuser.

Trap your abuser. Treat him as he treats you. Involve others. Bring it into the open. Nothing like sunshine to disinfest abuse.

IV. Ambient Abuse and Gaslighting

The fostering, propagation and enhancement of an atmosphere of fear, intimidation, instability, unpredictability and irritation. There are no acts of traceable explicit abuse, nor any manipulative settings of control. Yet, the irksome feeling remains, a disagreeable foreboding, a premonition, a bad omen. This is sometimes called "gaslighting".

In the long term, such an environment erodes the victim's sense of self-worth and self-esteem. Self-confidence is shaken badly. Often, the victim adopts a paranoid or schizoid stance and thus renders himself or herself exposed even more to criticism and judgment. The roles are thus reversed: the victim is considered mentally deranged and the abuser - the suffering soul.

TIP

Run! Get away! Ambient abuse often develops to overt and violent abuse.

You don't owe anyone an explanation - but you owe yourself a life. Bail out.

APPENDIX: A Classification of Abusive Behaviors

Abusive conduct is not a uniform, homogeneous phenomenon. It stems and emanates from multiples sources and manifests in a myriad ways. Following are a few useful distinctions which pertain to abuse and could serve as organizing, taxonomical principles (dimensional typologies) in a kind of matrix.

1. Overt vs. Covert abuse

Overt abuse is the open and explicit, easily discernible, clear-cut abuse of another person in any way, shape, or form (verbal, physical, sexual, financial, psychological-emotional, etc.).

Covert abuse revolves around the abuser's need to assert and maintain control over his victim. It can wear many forms, not all of which are self-evident, unequivocal, and unambiguous.

2. Explicit vs. Stealth or Ambient abuse (Gaslighting)

A more useful distinction, therefore, is between explicit (manifest, obvious, indisputable, easily observable even by a casual spectator or interlocutor) and stealth (or ambient) abuse, also known as gaslighting. This is the fostering, propagation and enhancement of an atmosphere of fear, intimidation, instability, unpredictability and irritation. There are no acts of traceable explicit abuse, nor any manipulative settings of control.

3. Projective vs. Directional abuse

Projective abuse is the outcome of the abuser's projection defense mechanism. Projection is when the abuser attributes to others feelings and traits and motives that he possesses but deems unacceptable, discomfiting, and ill-fitting. This way he disowns these discordant features and secures the right to criticize and chastise others for having or displaying them. Such abuse is often cathartic (see the next pair of categories).

Directional abuse is not the result of projection. It is a set of behaviors aimed at a target (the victim) for the purpose of humiliating, punishing, or manipulating her. Such abusive conduct is functional, geared towards securing a favored and desired outcome.

4. Cathartic vs. Functional abuse

While pair number (3) above deals with the psychodynamic roots of the abuser's misbehavior, the current pair of categories is concerned with its consequences. Some abusers behave the way they do because it alleviates their anxieties; enhances their inflated, grandiose self-image; or purges "impurities" and imperfections that they perceive either in the victim, or in the situation (e.g., in their marriage). Thus, such abuse is cathartic: it is aimed at making the abuser feel better. Projective abuse, for instance, is always cathartic.

The other reason to abuse someone is because the abuser wants to motivate his victim to do something, to feel in a certain way, or to refrain from committing an act. This is functional abuse in that it helps the abuser to adapt to his environment and operate in it, however dysfunctionally.

5. Pattern (or structured) vs. Stochastic (or Random) abuse

Some abusers heap abuse all the time on everyone around them: spouse, children, neighbors, friends, bosses, colleagues, authority figures, and underlings. Abusive conduct is the only way they know how to react to a world which they perceive to be hostile and exploitative. Their behaviors are "hard-wired", rigid, ritualistic, and structured.

Other abusers are less predictable. They are explosive and impulsive. They have a problem with managing their anger. They respond with temper tantrums to narcissistic injuries and real and imaginary slights (ideas of reference). These abusers appear to strike "out of the blue", in a chaotic and random manner.

6. Monovalent vs. Polyvalent abuse

The monovalent abuser abuses only one party, repeatedly, viciously, and thoroughly. Such abusers perpetrate their acts in well-defined locations or frameworks (e.g., at home, or in the workplace). They take great care to hide their hideous exploits and present a socially-acceptable face (or, rather, facade) in public. Their are driven by the need to annihilate the object of their maltreatment, or the source of their frustration and pathological envy.

In contrast, the polyvalent abuser casts his net wide and far and does not "discriminate" in choosing his prey. He is an "equal opportunity abuser" with multiple victims, who, often, have little in common. He is rarely concerned with appearances and regards himself above the Law. He holds everyone - and especially authority figures - in contempt. He is usually antisocial (psychopathic) and narcissistic.

7. Characteristic (personal style) vs. Atypical abuse

Abuse amounts to the personal style of most Pattern, or Structured abusers (see point 5 above). Demeaning, injurious, humiliating, and offensive behavior is their modus operandi, their reflexive reaction to stimuli, and their credo. Stochastic, or Random abusers act normatively and "normally" most of the time. Their abusive conduct is an aberration, a deviation, and perceived by their nearest and dearest to be atypical and even shocking.

8. Normative vs. Deviant abuse.

We all inflict abuse on others from time to time. Some abusive reactions are within the social norms and not considered to be indicative or a personal pathology, or of a socio-cultural anomie. In certain circumstances, abuse as a reaction is called for and deemed healthy and socially-commendable.

Still, the vast majority of abusive behaviors should be regarded as deviant, pathological, antisocial, and perverse.

It is important to distinguish between normative and deviant abuse. A total lack of aggression is as unhealthy as a surfeit. The cultural context is critical in assessing when someone crosses the line and becomes an abuser.


 

next: The Gradations of Abuse

APA Reference
Vaknin, S. (2009, October 1). Definition of Abuse: Emotional, Verbal, and Psychological Abuse, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/definition-of-abuse-emotional-verbal-and-psychological-abuse

Last Updated: July 5, 2018

Masochistic Personality Disorder

Learn about Masochistic Personality Disorder, self-destructive, masochistic behaviors and what turns a person into a masochist.

The Masochistic personality disorder made its last appearance in the DSM III-TR and was removed from the DSM IV and from its text revision, the DSM IV-TR. Some scholars, notably Theodore Millon, regard its removal as a mistake and lobby for its reinstatement in future editions of the DSM.

The masochist has been taught from an early age to hate herself and consider herself unworthy of love and worthless as a person. Consequently, he or she is prone to self-destructive, punishing, and self-defeating behaviors. Though capable of pleasure and possessed of social skills, the masochist avoids or undermines pleasurable experiences. He does not admit to enjoying himself, seeks suffering, pain, and hurt in relationships and situations, rejects help and resents those who offer it. She actively renders futile attempts to assist or ameliorate or mitigate or solve her problems and predicaments.

These self-penalizing behaviors are self-purging: they intend to relieve the masochist of overwhelming, pent-up anxiety. The masochist's conduct is equally aimed at avoiding intimacy and its benefits: companionship and support.

Masochists tend to choose people and circumstances that inevitably and predictably lead to failure, disillusionment, disappointment, and mistreatment. Conversely, they tend to avoid relationships, interactions, and circumstances that are likely to result in success or gratification. They reject, disdain, or even suspect people who consistently treat them well. Masochists find caring, loving persons sexually unattractive.

The masochist typically adopts unrealistic goals and thus guarantees underachievement. Masochists routinely fail at mundane tasks, even when these are crucial to their own advancement and personal objectives and even when they adequately carry out similar assignments on behalf of others. The DSM gives this example: "helps fellow students write papers, but is unable to write his or her own".

When the masochist fails at these attempts at self-sabotage, he reacts with rage, depression, and guilt. She is likely to "compensate" for her undesired accomplishments and happiness by having an accident or engaging in behaviors that produce abandonment, frustration, hurt, illness, or physical pain. Some masochists make harmful self-sacrifices, uncalled for by the situation and unwanted by the intended beneficiaries or recipients.

The projective identification defense mechanism is frequently at play. The masochist deliberately provokes, solicits, and incites angry, disparaging, and rejecting responses from others in order to feel on "familiar territory": humiliated, defeated, devastated, and hurt.

Self-defeating and Self-destructive behaviors - click HERE!

The Delusional Way Out - click on HERE!

Read Notes from the therapy of a Masochistic Patient

This article appears in my book, "Malignant Self Love - Narcissism Revisited"


 

next: Depressive Personality Disorder

APA Reference
Vaknin, S. (2009, October 1). Masochistic Personality Disorder, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/masochistic-personality-disorder

Last Updated: July 5, 2018

Sadistic Personality Disorder

Discover the characteristics of Sadistic Personality Disorder and the sadist. Plus the different types of sadists and why people become sadists.

The Sadistic Personality Disorder made its last appearance in the DSM III-TR and was removed from the DSM IV and from its text revision, the DSM IV-TR. Some scholars, notably Theodore Millon, regard its removal as a mistake and lobby for its reinstatement in future editions of the DSM.

The Sadistic Personality Disorder is characterized by a pattern of gratuitous cruelty, aggression, and demeaning behaviors which indicate the existence of deep-seated contempt for other people and an utter lack of empathy. Some sadists are "utilitarian": they leverage their explosive violence to establish a position of unchallenged dominance within a relationship. Unlike psychopaths, they rarely use physical force in the commission of crimes. Rather, their aggressiveness is embedded in an interpersonal context and is expressed in social settings, such as the family or the workplace.

This narcissistic need for an audience manifests itself in other circumstances. Sadists strive to humiliate people in front of witnesses. This makes them feel omnipotent. Power plays are important to them and they are likely to treat people under their control or entrusted to their care harshly: a subordinate, a child, a student, a prisoner, a patient, or a spouse are all liable to suffer the consequences of the sadist's "control freakery" and exacting "disciplinary" measures.

Sadists like to inflict pain because they find suffering, both corporeal and psychological, amusing. They torture animals and people because, to them, the sights and sounds of a creature writhing in agony are hilarious and pleasurable. Sadists go to great lengths to hurt others: they lie, deceive, commit crimes, and even make personal sacrifices merely so as to enjoy the cathartic moment of witnessing someone else's misery.

Sadists are masters of abuse by proxy and ambient abuse. They terrorize and intimidate even their nearest and dearest into doing their bidding. They create an aura and atmosphere of unmitigated yet diffuse dread and consternation. This they achieve by promulgating complex "rules of the house" that restrict the autonomy of their dependants (spouses, children, employees, patients, clients, etc.). They have the final word and are the ultimate law. They must be obeyed, no matter how arbitrary and senseless are their rulings and decisions.

 

Most sadists are fascinated by gore and violence. They are vicarious serial killers: they channel their homicidal urges in socially acceptable ways by "studying" and admiring historical figures such as Hitler, for instance. They love guns and other weapons, are fascinated by death, torture, and martial arts in all their forms.

The Monk-sadist

In broad strokes, there are two types of sadists: the Monster and the Monk.

We are all acquainted with the first type, the habitué protagonist of horror films, as described above, in this article.

Far less known and acknowledged is the Monk-sadist. He tortures people by confronting them with a personal example of unparalleled and unsurpassed morality, rectitude, virtue, asceticism, and righteousness. His saintly conduct is intended solely to inflict pain by allowing him to criticize, berate, and chastise from a position of high moral ground. His soapbox is his weapon as he poses and imposes impossible demands and untenable standards of behavior, setting up his victims to failure and humiliation.

Having thus secured their fall from grace, he then proceeds to harp on their shortcomings, errors, peccadilloes, and vulnerabilities, labelling them "moral turpitude" and "decadence". He dispenses punishment with relish and basks in the agony and writhing of his flock, charges, or interlocutors.

Read about these two subtypes of Monk-sadists:

The Misanthropic Altruist

The Compulsive Giver

The Narcissist as a Sadist - Click HERE!

Read Notes from the therapy of a Sadistic Patient

This article appears in my book, "Malignant Self Love - Narcissism Revisited"

 


 

next: Masochistic Personality Disorder

APA Reference
Vaknin, S. (2009, October 1). Sadistic Personality Disorder, HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/sadistic-personality-disorder

Last Updated: July 5, 2018

Personality Disorder Not Otherwise Specified (NOS)

What does Personality Disorder Not Otherwise Specified (NOS) really mean? Find out.

It is a sign of the inadequacy of our current knowledge of personality disorders that both the American Diagnostic and Statistical Manual (DSM) and its international counterpart, the ICD, maintain a "Personality Disorders Not Otherwise Specified (NOS)" diagnostic category. It is a catch-all, meaningless, "diagnosis", a testament to the diagnostician's helplessness and ignorance in the face of human complexity which often defies neat classification.

Even the rudiments of this diagnostic category are in dispute. There is no agreement as to what traits and behaviors it applies to. The ICD, for instance, includes the Narcissistic Personality Disorder in the NOS category, insisting that it is not a full-fledged personality disorder.

The NOS diagnosis is a laundry list of all personality-related dysfunctions, signs, symptoms, and complaints that do not fit a specific personality disorder. Some people satisfy one or more diagnostic criteria of a few personality disorders ("mixed personality"), but do not run the full gamut of any of them. The only requirement is that the personality be somehow impaired and cause distress and dysfunctions in one or more important areas of life: social, occupational, sexual, interpersonal, and so on.

Personality disorders not yet recognized by the DSM Committee - e.g., depressive, negativistic, or passive-aggressive - are also NOS.

This article appears in my book, "Malignant Self Love - Narcissism Revisited"


 

next: Sadistic Personality Disorder

APA Reference
Vaknin, S. (2009, October 1). Personality Disorder Not Otherwise Specified (NOS), HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/not-otherwise-specified-nos-personality-disorder

Last Updated: July 5, 2018

Obsessive-Compulsive Personality Disorder (OCPD)

Description of Obsessive-Compulsive Personality Disorder (OCPD)  and the perfectionists and workaholics who suffer from it.

Obsessions and compulsions are about control of self (mental) and others (interpersonal). People with the Obsessive-Compulsive Personality Disorder (OCPD) are concerned (worried and anxious) about maintaining control and about being seen to be maintaining it. In other words, they are also preoccupied with the symbolic aspects and representations (with the symbols) of control.

Inevitably, OCPDs are perfectionists and rigidly orderly or organized. They lack flexibility, openness and efficiency. They tend to see the world and others as at best whimsical and arbitrary and at worst menacing and hostile. They are constantly worried that something is or may go wrong. In this respect, they share some traits with the paranoid and the schizotypal.

It is easy to spot an Obsessive-Compulsive. They are constantly drawing up and dreaming up lists, rules, orders, rituals, and organizational schemes. They demand from themselves and from others perfection and an inordinate attention to minutia. Actually, they place greater value on compiling and following rigid schedules and checklists than on the activity itself or its goals. Simply put, Obsessive-Compulsives are unable to see the  forest for the trees.

This insistence on in-depth scrutiny of every detail frequently results in paralysis.

OCPDs are workaholics, but not because they like to work. Ostensibly, they sacrifice family life, leisure, and friendships on the altar of productivity and output. Really, they are convinced that only they can get

the job done in the right manner. Yet, they are not very efficacious or productive.

Socially, OCPDs are sometimes resented and rejected. This is because some OCPDs are self-righteous to the point of bigotry.

I described it in an article I wrote for the Open Site Encyclopedia:

"They are so excessively conscientious and scrupulous and so unempathically and inflexibly tyrannical that it is difficult to maintain a long-term relationship with them. They regard their impossibly high moral, work, and ethical standards as universal and binding. Hence their inability to delegate tasks to others, unless they can micromanage the situation and control it minutely to fit their expectations. Consequently, they trust no one and are difficult to deal with and stubborn.

OCPDs are so terrified of change that they rarely discard acquired but now useless objects, change the outlay of furniture at home, relocate, deviate from the familiar route to work, tweak an itinerary, or embark on anything spontaneous. They also find it difficult to spend money even on essentials. This tallies with their view of the world as hostile, unpredictable, and "bad".

Read about the Compulsive Acts of the Narcissist - click HERE!

Read Notes from the therapy of an Obsessive-Compulsive Patient

This article appears in my book, "Malignant Self Love - Narcissism Revisited"


 

next: Not Otherwise Specified (NOS) Personality Disorder

APA Reference
Vaknin, S. (2009, October 1). Obsessive-Compulsive Personality Disorder (OCPD), HealthyPlace. Retrieved on 2024, October 10 from https://www.healthyplace.com/personality-disorders/malignant-self-love/obsessive-compulsive-personality-disorder-ocpd

Last Updated: July 5, 2018