Masochistic or Self Defeating Personality Disorder
The New York Times for Tuesday, March 23 published an article written by psychiatrist Richard A. Friedman, MD, titled, "Sabotaging Success, but to What End?" The article can be found in the Science Section of the newspaper for that day.
Dr. Friedman points out that, while terrible things do happen to people, when there is a repeated pattern of terrible things, there is more than chance or accident at work. Rather, there are people who repeatedly bring about their own defeat. At one time this was referred to as the "masochistic character."
Unfortunately, concepts and diagnoses such as, masochistic character or self defeating personality disorder, were eliminated from the Diagnostic and Statistical Manual, Part IV. The reasons for this omission had more to do with politics and social pressures than any sound psychiatric and scientific thinking. Yet, over and again, I have seen and worked with this type of personality disordered individual in my private practice. I like to refer to this pattern of self defeat as, "rescuing defeat from the jaws of victory."
Hypothetical Case Studies
The following two vignettes are fiction but provide a clear example of this type of self defeating pattern of behavior. If you see yourself in these descriptions please know that its completely coincidental. Remember, these fictional vignettes represent the types of self destruction that many of us visit upon ourselves.
1. A man is a successful musician. However, he is having conflicts with his manager. However, he is aware that his career is taking off and that he is doing well and promises to do even better. Therefore, he does not want to confront his manager.
While he is on the Internet one day, he decides to compose an E. Mail letter to his manager but with the intention of getting his anger off of his chest without actually sending it. As soon as the E. Mail is completed he presses the send button and the E. Mail is on the way. Needless to say, the manager fires him as a client. He beats and chastises himself but cannot undo the mistake he made. The problem is that this "mistake" represents a type of behavior that he has repeated in many different ways and in different scenarios all through his life.
2. A woman was so proud that her abusive and alcoholic husband had stopped drinking as a result of their psychotherapy that she gave him a can of cold beer. Needless to say, he was unable to refuse and the entire pattern of alcoholism and abuse happened again. This ended her third divorce to men with the same abuse and drug addiction problem.
In typical fashion, personality disorders are such that people are unaware of their behaviors. As a result, they tend to blame others when things do not work out. However, part of difficulty of working with people with this "self defeating personality" is that, when their patterns are pointed out they feel criticized and blamed.
It should go without saying that none of us can change the things we do not know about. If they do not want to know about it how can they want to change. After all, nothing is wrong in the mind of this type of individual. How can that be? How do the explain all the bad things that happen to them? The answers to these questions is that they engage in a variety of rationalizations: 1. They blame others, 2. They blame their fate or karma, 3. They blame racism, 4. Religious prejudice, 5. Sexual orientation, 6. Age, 7. Married or non married status, 8. The economy, 9. The President. 10. The weather and so it goes on and on.
There is no single reason for an individual building failure into their lives. Here are some possible explanations:
1. We know that people fear change, even when it is to their benefit to change. Remember, change is unknown while the familiar is comfortable.
2. A sense of guilt or of not deserving success stops many people. Million dollar lottery winners do not have a good record after collecting their new found wealth.
3. Self hatred and wishing punishment for some unknown sin can lead to self defeat.
4. Failure can represent success if the aim of the failure is to cause loved ones to suffer.
5. Masochism or the wish to suffer.
There is no medication for self defeat or masochism. However, therapy helps. Psychotherapy is helpful whether its the cognitive behavioral or psychodynamic type. Regardless of the type of therapy, the client will bring to the therapist the strategy of constructing one more defeat. This is where the skill of the therapist comes in helping the client to change but in ways that are non-confrontational and non-judgmental. Regardless of the type of psychotherapy used, it requires long term treatment because the client remains blindly invested in defeat.
Following is a list of the criteria for self defeating personality disorder that was excluded from the DSM IV. Please note that a person need not be feeling depressed, experiencing abuse or undergoing a crisis. This repetitive behavior happens on its own.
Potential Diagnostic Category for Self Defeating Personality:
A)Pervasive pattern of self-defeating behavior, beginning by early adulthood and present in a variety of contexts. The person may often avoid or undermine pleasurable experiences, be drawn to situations or relationships in which he or she will suffer, and prevent others from helping him, as indicated by at least five of the following:
chooses people and situations that lead to disappointment, failure, or mistreatment even when better options are clearly available
rejects or renders ineffective the attempts of others to help him or her
following positive personal events (e.g., new achievement), responds with depression, guilt, or a behavior that produces pain ( e.g., an accident)
incites angry or rejecting responses from others and then feels hurt, defeated, or humiliated (e.g., makes fun of spouse in public, provoking an angry retort, then feels devastated)
rejects opportunities for pleasure, or is reluctant to acknowledge enjoying himself or herself (despite having adequate social skills and the capacity for pleasure)
fails to accomplish tasks crucial to his or her personal objectives despite demonstrated ability to do so, e.g., helps fellow students write papers, but is unable to write his or her own
is uninterested in or rejects people who consistently treat him well, e.g., is unattracted to caring sexual partners
engages in excessive self-sacrifice that is unsolicited by the intended recipients of the sacrifice
B) The behaviors in A do not occur exclusively in response to, or in anticipation of, being physically, sexually, or psychologically abused.
C) The behaviors in A do not occur only when the person is depressed.
Your comments and questions are encouraged.
Allan N. Schwartz, PhD