On Willful Alienating Behavior Versus Illness-Driven Alienating Behavior: Differences—and Similarities
By Ken K. Gourdin
It seems to me that there’s a big, big difference between being “a few fries short of a happy meal,” which seems to imply that some condition (mental, psychological, what have you) prevents someone from relating relatively normally to other folks on the one hand, and simply being a narcissistic, manipulative, perhaps sociopathic user who values other people only for what one can get out of them on the other hand. (While my indictment of the latter group might seem extreme, far too many people in this world value things and use people, rather than using things and valuing people.) I have people who fit the latter description in my family. I limit my contact with them. Another family member has told them that we love them and would like a more consistent relationship with them … but that kind of relationship is hard to achieve when the only time we hear from them is when they’re in trouble and/or when they need something.
Calling someone “a few fries short of a happy meal” when there might well be much, much more to it than that seems like an attempt (wittingly or not) to justify bad behavior by attributing it, essentially, to illness rather than to willfulness. It does a disservice to those whose dysfunction in relating to others is attributable to the former rather than to the latter. (To be fair, the line between illness and willfulness often is very, very indistinct, and it makes for special problems: you want to help the person on the one hand because s/he is ill, but you don’t want to risk being manipulated on the other).
All of that having been said, as a person with a complicated psychological history, I have engaged in behavior which largely has been illness-driven rather than driven by a willful desire to hurt others. However, as much as family, friends, doctors, nurses, therapists, and psychosocial rehabilitation professionals (et al) want to help, the best they can do is provide me with tools to help me help myself. They are not responsible for my recovery, nor are they responsible for retreating when hurt by my behavior, even though the behavior is illness-driven. I am responsible for my recovery, and I am responsible for changing illness-driven behavior which has harmed both other people and my relationships with them, and for repairing those damaged relationships. Yes, the hardest parts of recovery are (1) getting people to admit they have a problem; and (2) getting them to accept help for it. But the minute they do those things they (and they alone) become responsible for their recovery. The bad news is that change is hard; the good news is that it’s possible.
Update, October 24, 2014: In response to a letter to the editor from someone whose father committed suicide and who, therefore, urged people with depression to not suffer in silence and to get help, another poster stated that beginning with President Ronald Reagan, “mental illness was dumped in the gutter.” I WISH! (I believe what the commenter meant to say is that those who SUFFER from mental illness have been dumped in the gutter.) The letter can be found here, last accessed today:
I responded to the aforementioned commenter thus:
As you yourself admit when you say the problem “start[ed] with” Reagan, it’s not as though we haven’t had any Presidents with (D) following their name since Reagan. Not only has Reagan been out of office for 26 years, he’s been dead for ten. Presidents Clinton and Obama will have served for a collective 16 years by the time the latter leaves office: surely they’re due a good share of the blame for the problem?
I am all for people with psychiatric diagnoses being treated in the least restrictive environment where they can be successfully treated; I am not a stranger to such treatment myself. But perhaps the pendulum has swung too far in the opposite direction from when the favored course for treating such disorders included, more often than not, institutionalization: it wasn’t Reagan who suggested that the only difference between behavioral illness and behavioral wellness is a matter of perspective, or that behavioral illness is simply a different, equally-valid way of seeing the world and that, as a consequence, mental hospitals could mostly be emptied. Those ideas are of the sort usually championed by many on the left, and the resulting decline in institutionalization began long before Reagan.
In any event, while I agree that the debate over whether more resources could be devoted to addressing the problem is in no danger of abating anytime soon, all of the resources in the world aren’t likely to address the problem if the people those resources are intended to help do not: (1) realize they have a problem; (2) believe they can be helped with that problem; and (3) desire to be helped with that problem. Even the best behavioral health system in the world cannot address the issue if those three conditions are not met on an individual level.