Histrionic Personality Disorder – One of the Claims Arising from the Penn State Pedophilia Trial

The Huffington Post reported here that the lawyers for accused pedophile Jerry Sandusky have claimed Histrionic Personality Disorder may be a factor in his behavior.

This diagnosis would not mean he’s medically incompetent, nor does it mean he is insane, rather his ‘behavior has another label than pedophilia’.

Histrionic Personality Disorder is one of the disorders that is being removed from the newest edition of the Diagnostic Manual. But it currently has a set of diagnostic criteria which can be evaluated to determine diagnosis.

Symptoms

People with this disorder are usually able to function at a high level and can be successful socially and at work. But relationships with them are difficult because they often:

  • Dress seductively and act flirtatiously
  • Behave dramatically to ensure they are the center of attention
  • Behave as though performing for an audience with exaggerated emotions and expressions, but seems to lack sincerity in their personal relationships
  • Are overly concerned with appearance and their looks
  • Lack a reliable gauge of the depth of emotional relationships, often assuming a deeper intimacy than is real
  • Are gullible and easily influenced by others – especially those who pander to their emotional ‘staging’
  • Are overly sensitive to criticism or disapproval
  • Make rash, poorly thought out decisions
  • Blame failure or disappointment on others
  • Constantly seek reassurance or approval
  • Have low tolerance for frustration or delayed gratification; very sensitive to criticism or disapproval
  • Need to be the center of attention and often show a high degree of selfishness
  • Rapidly shift from one emotional state to another, usually appearing shallow and insincere
  • Threaten or attempt suicide for attention (this has contributed to many peoples’ failure to recognize sincere threats of suicide in a loved one)
  • Easily bored by routine, unable to complete projects and quickly loses interest in people, places and things

Persons having half of these symptoms over an extended period of time are usually diagnosed with Histrionic Personality Disorder.

Have you noticed how similar some of these symptoms are to borderline personality disorder or antisocial/psychopathic personality disorder?  Good for you.  They have many similar characteristics, which makes diagnosis and treatment a challenge. It is one of the reasons, I believe for the change in the upcoming Diagnostic Manual

As with the other personality disorders, persons with this one are very hard to live with and they can wreak havoc on their loved ones. Due to their need to be the center of attention and their inability to take any criticism, they appear to lack maturity and the ability to deal with life on life’s terms.

Treatment

Medications are often prescribed for people with this disorder. Ironically, their failed relationships may cause depression (as in other people) even though they lack the depth of the relationship of others. Anxiety is another possible outcome from their ‘failures’ and this is also treated with medication. But the disorder itself has no pill for treatment.  Rather the emotional outcomes of their experience are treated with meds and therapy is needed for recovery for the disorder. As with every personality disorder, this can be an almost impossible task, since the client does not think there’s anything wrong with them – all their problems are someone else’s fault.

Family Relationships

It doesn’t take much insight to guess at the problems a person with Histrionic Personality Disorder might cause in a family. Screaming matches, coming ‘on’ to siblings’ spouses and/or friends, always needing to be the center of attention, whether because they’re sick or elated are common manifestations of this disorder.  When this is coupled with financial and emotional immaturity, it is easy to see a wide range of problems that arise in the close and extended family.

Often one parent does not see the problem as a mental health issue, but rather buys into the explanation of ‘bad luck’ and lousy karma.  Less often this role might be fulfilled by a sibling, but regardless, this always fuels resentment, strife and stress within the family unit. Enablers abound for those with personality disorders – unfortunately they do more harm than good.

Remember, no diagnosis of yourself or others.  It’s okay to vent your frustrations if you know someone who matches these symptoms though.

Thanks to the following sites for information for this post.

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002498/

http://my.clevelandclinic.org/disorders/personality_disorders/hic_histrionic_personality_disorder.aspx and

http://psychcentral.com/disorders/sx17.htm

Posted in Louise Behiel, personality disorders, Psychology | Tagged , , , | 35 Comments

Weekend Writer: What are You Doing Today and Why Are You Doing It? oh yeah, Happy Father’s Day to all the Dads Out There

Happy Father’s Day to all the dads out there.  You know who you are and why you deserve recognition. And for those of you who struggle on this day because your dad wasn’t wonderful, please know you are  not alone.  Do something today to make it special for you – something you wish your father had done with and for you.

I was going to post the following yesterday but time slipped away on me, which seems fitting, doesn’t it?

Urgency Matrix, with thanks to Dr Stephen Covey

Dr Stephen Covey made popular the matrix plotting how we spend our time: on urgent matters or important ones.  As writers, it is easy to let life lead you away from the time we need to spend writing. After all, no one is dying for you to publish or sell your next book.  And it is important to:

  • fertilize the lawn
  • pick up the puppy ‘presents’ in the back yard
  • kill the dust bunnies under the bed
  • dust the far reaches of the crystal chandelier you’ve always hated
  • read one more blog or follow Facebook for a few more minutes. (I am not playing games, really.)

The matrix asks us to consider all potential activities in terms of our long term goals.

Of course, this implies you know what your long term goals are.  Do you know? What are they?  (That’s a rhetorical question, but if you can’t make a list of them right now, they’re not clear enough.)

One of my long term goals is to be a multi-published, best selling author of both fiction and non-fiction. Hmmm.  How am I doing at that?  How about you?  Where are you on the path to your dreams?

With all the focus on social media and promotion, I’ve spent a lot of time blogging and building a blogging community.  I’ve loved every minute of it and every minute of getting to know so many of you.  I’m honored at the details you’ve shared in comments, emails and phone calls.  I’ve learned so much reading your blogs.

Ditto for all the other shiny social media tools out there.

But I’m not writing as much as I need to.

So I’ve made a decision to make my writing both Urgent and Important on the Covey matrix. That means I need to start paying more attention to the time I spend with my hands on the keyboard writing fiction.

I don’t know about the rest of you, but those ‘para-writing’ activities can take a lot of time.  I need to accept my realities:

  1. I have a full time job that keeps me from being homeless
  2. I have family commitments I’m not willing to short change
  3. I need to walk and move this aging body regularly.
  4. I need to write
  5. I need to edit
  6. I need to focus on my direction and goals

I haven’t been doing a particularly good job on any of those, except the second one.  And I’m publicly committing right here and right now that this is going to change.  I don’t feel great if I’m not creating. I don’t work as well if my creativity is clogged.  I don’t rest as well when the words are jammed in my brain.

If I don’t get as many words on the page as I need to, my life seems to fall apart rather quickly.  Hmmmm.  I guess that makes me a writer. Go figure.

By the way, since I wrote this on Friday evening, I’ve edited 30 pages of my next novella and put down some notes about my  next book, so public admissions and commitments seem to work.

What about you?  Where are you on the matrix with your writing? What do you need to change to make sure you are in the quadrant that best serves you?

Posted in Louise Behiel, writing | Tagged , , , , , | 29 Comments

Borderline Personality Disorder: 1 Personality Disorder with a Successful Treatment

A short reminder: if you have been diagnosed with Borderline Personality Disorder, please do not read further. It is important you work with your medical team to ensure you the best possible outcome.  This information is provided for the general population and writers in particular, to provide a base of knowledge and understanding.

As discussed in an earlier post, Borderline Personality Disorder (BPD) is confusing, hard to treat and hard to live with – for both its victims and their families.  BPD is an illness of ‘extremes’, all or nothing and/or black and white thinking, and because it is a personality disorder, that is, it affects how a person sees the world, it is hard to treat.  Many forms of therapy can help this client, but the single greatest predictor of success in the therapist/client relationship is trust. That is hard to build with a BPD patient and it’s hard to sustain over time.  But a stalwart therapist can go a long way in helping these clients.

Many psychiatrists prescribe drugs to alleviate the symptoms of this disorder.  For example, anti-depressant drugs (Cylexa and Zoloft), mood stabilizers (Depakote), and/or anti-psychotics (Zyprexa and Resperidol) are samples of the many drugs that may be prescribed.  Each one usually has some success (many would say limited success), but on their own, none of them work to give the BPD patient a rich and rewarding life.  At best they decrease symptoms so that the patient has time for psychotherapy to work.

Several models of talk therapy have been used in treating BPD, each with varying degrees of success.  The two most well known models are:

  1. Cognitive Behavior Therapy, which helps people to identify and change their core beliefs and behaviors that are at the root of their inaccurate self-perceptions and their problems interacting with others. Because CBT is known to reduce a range of mood and anxiety symptoms and reduce the number of suicidal or self-harming behaviors, it is a great aid in treating Borderline Personality Disorder.
  2. Dialectic Behavior Therapy grew out of CBT and was developed by Marsha Lineham who ‘came out’ as a survivor of mental illness in 2011.  Her story can be read here. http://www.nytimes.com/2011/06/23/health/23lives.html?pagewanted=all

This treatment model is an evolving growing method of helping BPD patients and is a beacon of hope for so many.

According to GoodTherapy, Dialectic Behavior Therapy (DBT) is founded on the belief that undetermined causes (likely environmental and biological) cause some people to respond to emotional states more quickly, and they remain in this aroused emotional state for extended periods of time before returning to normal. This is logical since BPD includes symptoms of lives peppered with crises and drama – both highs and lows.  DBT teaches these people coping techniques that they did not receive in their invalidated childhoods.

According to Lineham, therapy must accomplish five goals:

1) Expand and sustain the motivation the client possess to facilitate transformation

2) Provide opportunity for skill-development in the client

3) Assimilate the client’s new skill set so that it can be applied across a broad cross-section of situations and circumstances

4) Develop the therapist’s own abilities and desire to effectively and willingly treat people

5) Provide a nonjudgmental and secure environment in which healing can occur

DBT is always provided in a team environment and includes individual and group therapy, coaching and ‘homework’. Because of the difficulty and long timelines of this work, it is imperative a team approach is adopted, ensuring the therapist receives the support, encouragement and direction needed to effectively continue providing psychotherapy.

In the 1993 training manual, Lineham says that DBT is taught as a series of skills in four modules: mindfulness, interpersonal effectiveness, emotional regulation, and distress tolerance. The first of these modules makes this treatment very different from any other for mindfulness is based in Eastern Zen philosophy, and it includes Western contemplative practices. Mindfulness is an awareness of thoughts, feelings, behaviors, and behavioral urges. By learning mindfulness, we are empowered to be in charge of ourselves in a different way. It has been proven that awareness assists in emotional regulation. As we understand ourselves, we accept ourselves and change ourselves. It is a practice of attention and intention.

In DBT, core mindfulness begins with the concept of states of mind. According to the theory, there are three states of mind that everyone is in at varying times: wise mind, logical mind, and emotional mind. Wise mind is the ideal state of mind that we strive to reach to make good decisions. The other two states of mind combine to form wise mind. Logical mind is used when doing math, reading a map, and a wide variety of concrete tasks. Last is emotional mind. which is the state in which we feel emotions and then act from that emotional state. For example, we’re in this state of mind when we react out of anger without regard to consequences. This is considered the “hot” state of mind.

For people who live life out of the ever-changing kaleidoscope of emotions, living in mindfulness is the first step in overcoming BPD.  By accomplishing this goal, the other three develop and evolve and result in a rich and productive life.

Dialectic Behavior Therapy is not simple to explain, but it works. It is interesting to me that it combines successful, disciplined therapy with meditation to achieve results.

Posted in Louise Behiel, personality disorders | Tagged , , | 20 Comments

Borderline Personality Disorder is Confusing to Everyone – Including the Patient

Let me begin by saying that if you have this disorder, stop reading right now.  It is much more important that you follow the directions of your mental health professional than read a blog which might be confusing. We are going to talk in generalities about this disorder.  It may or may not match your symptoms or your experience.  You are the expert of your life, so don’t let anything you read here upset or confuse you.

Borderline Personality Disorder is a much misunderstood disorder.  It is confusing and hard to diagnose.  No one really knows what causes it, although some specialists feel that it might arise in a confluence of circumstances which include some or all of the following:

  • Abandonment in childhood or adolescence
  • Disrupted family life
  • Poor communication in the family
  • Sexual abuse

There is a higher prevalence in women and among hospitalized psychiatric patients. See http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001931/

There are only two diagnostic criteria in the DSM-V: significant impairments in personality functioning and pathological personality traits.  These have multiple sub-heading and limiters, so be sure to check out this site for complete information:

But of course, nothing in psychiatry is simple.

People with this disorder may be uncertain about their identity. Imagine not being sure who you are and what you stand for.  Your interests may change quickly. And this is combined with an ‘all or nothing’ view of the world. A friend is a saint one day and a bum the next. A husband is a kind loving partner tonight and an abusive SOB tomorrow. Of course, this makes it very difficult for them to maintain relationships.

Ironically, in the midst of these rapid and wide changes of opinion and behavior, the person with Borderline Personality Disorder has frequent displays of overwhelming anger.  While getting mad at the world and everyone in it, they are equally terrified of being abandoned – they behave in a way that causes their greatest fear to be made real. And they have a real, intense, and almost overwhelming fear of being alone.

If you consider that what you value today can be the opposite of what you value tomorrow, it is easy to see a cascading waterfall of problems.  Sexual behavior will not be consistent; use of money will swing from frugality to licentiousness. Extreme dieting to binge eating. Rigid honesty to brazen theft.

And overlaying all those behavior problems is a pattern of self-abuse and self-harm including cutting and overdosing.

As with any disorder, the degree of impairment and the prognosis for successful treatment vary by individual. But treatment is critical since extremes in behavior are their norm, making relationships with others and themselves very difficult. For some, the disorder is life threatening.

One example: An individual came to me because he was upset with his wife but was confused. They had a large family of small children and his wife had been feeling overwhelmed and needy of adult companionship. They agreed she should go out one night a week and chose Wednesday. After a couple of weeks, she didn’t come home.  When she arrived in the morning, they discussed it and she had a good reason for her behavior. The overnighters continued, even though he didn’t like it, but she always arrived on time for him to get to work. A few weeks pass and they’re settling into this new ‘normal’ routine when she comes home on Thursday morning in hysterical grief.

Once he got her calmed down, she disclosed that she’s upset because her boyfriend died.  Needless to say, he’s devastated and starts yelling at her that she can’t have a boyfriend because she’s married to him.

She replies: “Isn’t that just like you. Everything has to be about you and your rules.” And without another word, she walked out, never to return to see him or the children again.

He was confused about his role in their altercation and what to do about the future.

This is an extreme example of the behavior of a woman with BPD. But it shows the changing values, the changing sexual standards, the inability to be alone and the fear of rejection.

And yes, his behavior was normal, considering the circumstances.

The next post will look at treatment modalities and outcomes.  While this disorder seems overwhelming, there are some excellent results being obtained from a combination of therapies.

What do you think? Know anyone with this confusing illness?  Please share your experience but remember no diagnosing yourself or others.

Posted in Louise Behiel | 35 Comments

You Don’t Have a Personality Disorder, Do You?

Given the comments on the last few blogs, I realized I should probably put in some introductory comments, just to ensure we’re all on the same page.

Personality disorders have been defined as the cause of long term patterns of inner experience and outer behaviour that deviate from the expectations of society. They are all-encompassing, rigid and rarely change over time. They may lead to distress or impairment.

If we look at the terms of this definition we see:

Inner experience: Persons with a personality disorder see the world differently than the rest of us.

Outer Behavior: they behave differently than the rest of us. Because behaviour is usually determined by our inner world, this is to be expected.

All encompassing: these behaviors affect all areas of their lives

Rigid: behaviour is predictable because it is what it is and doesn’t change

Rarely change or time: Personality disordered people don’t understand what all the fuss is about.  They think their view of the world is the correct one, so what’s your problem. And why would they change if they’re right?

This area of the Diagnostic and Statistical Manual continues to evolve and change.  Certain disorders move into the DSM and then move out and sometimes they move back in. Or, more often, their names are changed to confuse the rest of us. For example, Psychopathic personality Disorder became Antisocial Personality Disorder and now is Antisocial/Psychopathic Personality Disorder.  They’ve been called psychopaths, sociopaths and ASPD’s and no one is sure which is which, except the psychiatrists.

The other confusing thing about Personality Disorders arises because they deal with personalities (and we all have one). ALL of the symptoms in this group are found in the general population. It is a matter of degree, duration, and debilitation.  Ironically, this is complicated because there are many definitions of personality, many acceptable degrees and ranges of behaviour and little agreement on a working definition of a healthy person.

According to

http://thecriticalthinker.wordpress.com/2008/10/10/list-of-personality-disorders/

the DSM-III included 3 clusters of Personality Disorders:

Eccentric Personality Disorders: behavior may appear strange or peculiar to others.

  1. Paranoid Personality Disorder –generally tends to interpret the actions of others as threatening.
  2. Schizoid Personality Disorder – generally detached from social relationships, and shows a narrow range of emotional expression.
  3. Schizotypal Personality Disorder – uncomfortable in close relationships, has thought or perceptual distortions, and peculiarities of behavior.

Dramatic Personality Disorders: intense emotional mood swings and distorted perceptions of themselves along with impulsive behaviors.

  1. Antisocial Personality Disorder – a pervasive disregard for, and violation of, the rights of others.
  2. Borderline Personality Disorder –a generalized pattern of instability in interpersonal relationships, self-image, and observable emotions, and significant impulsiveness.
  3. Histrionic Personality Disorder – displays excessive emotionality and attention seeking in various contexts. They tend to overreact to other people, and are often perceived as shallow and self-centered.
  4. Narcissistic Personality Disorder –a grandiose view of themselves, a need for admiration, and a lack of empathy that begins by early adulthood and is present in various situations. These individuals are very demanding in their relationships.

Anxious Personality Disorders: fearful and anxious.

  1. Avoidant Personality Disorder – socially inhibited, feels inadequate, and is oversensitive to criticism
  2. Dependent Personality Disorder –extreme need to be taken care of that leads to fears of separation, and passive and clinging behavior.
  3. Obsessive-Compulsive Personality Disorder –preoccupied with orderliness, perfectionism, and control at the expense of flexibility, openness, and efficiency.

Others Not Specified: In layman’s terms this was the category for everybody else that we knew had a disorder but there were no psychological criteria to diagnose and label the behaviors.

In the soon-to-be-released DSM-V the categories are:

  • Borderline Personality Disorder
  • Obsessive-Compulsive Personality Disorder
  • Avoidant Personality Disorder
  • Schizotypal Personality Disorder
  • Antisocial Personality Disorder
  • Narcissistic Personality Disorder
  • Personality disorder Trait Specified

You’ll hear all of these terms in day to day use. They are not incorrect, but their meaning has changed in the halls of medicine and education. But for the general public, not so much.You can see over two revisions of the manual that we’ve gone from 10 to 7 categories. Some are combinations, some are refinements but they are the latest and greatest terms in use in the journals and ‘formal’ world of psychiatry and psychology. And the ones that don’t appear in this version of psychiatry’s bible are likely being held for ‘additional study’ and clearer definitions.  It isn’t that they don’t exist, but rather, how they are assessed is being fine-tuned.

At this time, to the best of my knowledge, there is no cure for any of these; rather there is therapy and medication and meditation.

We’re going to take a look at these personality disorders, in no particular order, over the next few weeks.  If there’s one or two in particular you’d like to discuss sooner rather than later, leave me a note in the comments and I’ll work on it for you.

So what do you think? Do you feel like some of these quick descriptions mark you friend/ex/MIL/ or …? Remember we aren’t going to diagnose anyone but we can talk freely about signs and symptoms and behaviors.  Too often we’re afraid to trust our instincts and we keep trying to play nice with people who don’t understand the concept.  I’m hoping this series will help you understand some key points to look for and keep yourself out of the hands of an emotional vampire. If you know, or have a sense of what to be aware of, you can make good decisions about the people you let into your life.

Posted in Louise Behiel, personality disorders, Psychology | Tagged , , | 50 Comments

Don’t You Hate it When Someone Says They’ll Do Something, but Don’t. Ever

I so enjoyed writing about psychopaths last week that I decided to take a look at some other personality disorders. They’re a fascinating bunch of behaviors that drive the rest of us ‘normies’ totally crazy.  The problem is, as we noted with Psychopaths, often people with these disorders live very ordinary lives although the people around them usually are frustrated, confused and angry.

Passive Aggressive Personality Disorder is no longer included in the American Psychiatric Association’s Diagnostic Manual.  I’m not sure why it was dropped, (I think it’s up for more study) but que sera.  People with this cluster of traits are still hard to live or work with.

By the name, you can probably tell some of the symptoms of this disorder. On the one hand, these people are very easy to get along with.  They’ll agree to almost anything.  But, try to get them to finish anything.  Good luck.

Their behavior is contradictory and inconsistent. On the one hand, they’re extraordinarily agreeable but on the other, their performance is sadly lacking and can sometimes be damaging.  It’s all about looking good but remaining in control.

People with this cluster of symptoms usually avoid as much responsibility as they can. They may be master procrastinators, never finishing anything. Or they may claim chronic forgetfulness. And lastly they usually perform your requests in a totally incompetent manner.  They’re very good at completing things on their list, but you’ll rarely get anything out of them.

The simplest way to tell if you’re dealing with a Passive Aggressive person is to listen carefully to them.  If you hear “I’m sorry” regularly, odds are you’ve been caught in their smiling web of inefficiency.

A common symptom is chronic lateness (don’t go ballistic because you’re always late – there may be other reasons for your behavior).  And of course this is always accompanied by a sincere and meaningful apology. Until next time when they’re late again. One of the clues that you’re dealing with someone who has this disorder is when you start telling them events start earlier than fact – so that you have a chance of them arriving on time.

Another cluster of symptoms is blaming, complaining and making excuses. Passive Aggressive people always have a reason for their failure. It’s always somebody else’s fault.  At a minimum, their failure is because of their poor memory.  I once had a client whose husband ‘forgot’ to tell her her brother was in the hospital.  Not his fault, he forgot.  And he was so sorry.

Some people with this disorder go through life with a perpetual smile on their faces.  You would never know to look at them, that they’re angry and resentful at you and will do anything to make you look silly, foolish or incompetent by their failure to follow through. And it is hard to see their stubbornness for what it is – a desire to do anything that will make you look bad.

Other are openly angry and resentful – of the power they give you, of your supervisory role in the company or your bigger house.  Whatever. The cause of the anger and resentment is irrelevant.

Another common statement from these folks is “I can’t”. What they should add is “I won’t, because I fear I might fail”. Since everything is a competition to these folks and the risk of failure is the most important aspect of every decision they make, they rarely try anything new.  Rather there’s always an excuse for why they won’t do something new (this can even extend to trying new foods), whether those reasons make sense or not.

So think of a smiling, cheerful woman, who is always helpful.  She is around all the time, volunteers regularly and enjoys the prominence of being part of the team.  BUT she over promises and under-delivers every time. Maybe she says she got sick. Or misunderstood. Or her cat/dog/son/niece got sick. There’s always a reason why she doesn’t follow through on her commitment and inevitably, her failure makes you look bad.  Worse, if you bring her pattern of behavior to her attention, she’ll be hurt and angry. And tell the world.

Nice, isn’t it?

Now remember, no diagnosing your siblings or in-laws.  That’s not fair. I’d love to hear if you’ve met or dealt with people like this. Is there a way to make this type of person a minor character in a book?  Would you want to?

Posted in Louise Behiel, Psychology | Tagged , , | 54 Comments

Weekend Writer: Are you a Veggie, an Egg or a Coffee Bean?

Welcome to another edition of the Weekend Writer, where we focus a little more on fiction writing.  Thank you for your response to the two blogs Diane Capri and I published about psychopaths.  You can read Part 1 here and Part 2 here.  She is an amazing writer and a good friend and I hope you’ll enjoy her book, Fatal Distraction.

What is your reactions to stress, change and pressure?  We work in a volatile industry. Publishing is under huge pressure right now and no one can foresee the final outcome.  Some of us are under contract to traditional publishing houses, are delighted to be there and have no desire for anything different. Some traditionally published authors are also putting out e-books.  Other people could not get a deal, or didn’t try, or walked away from those same houses and are independently publishing on the internet, via Amazon, Smashwords and many others.  Some of us are sitting on the fence, uncertain of what to do.

Stress and pressure are facts of life.  They always have been.  Whether we were running from the saber-toothed tiger or trying to get across town for a meeting, life is full of challenges.  And we all know that what we do with that stress and how we handle it has a great impact on our longevity and health.

Purposefully, writers put themselves into a milieu where stress is always present.  Deadlines (mine or my editors), reviews (good or bad), sales (high or low), and industry evolution (to hell or to heaven) are all part of the life of today’s writers.  How do you handle this stress?

Here are three examples of response to the stressors of writing:

Wikipedia Commons

Wikipedia Commons

1. Every root vegetable, when cooked, can be firm and crunchy or soft and mushy.  Itsimply depends on the time they spent in the boiling water.  As a new bride, I can attest that potatoes, when cooked too long, turn to soup.  So do carrots.

2.  Eggs, on the other hand, when boiled, become hard.  If you leave them in the hot water too long, they turn black and ugly.

3. Coffee beans, however, become aromatic and enticing when boiled.  They pump up your heart rate and open your eyes.

When we are stressed, some of us curl in on ourselves and collapse emotionally.  We can’t go on.  Writing for publication is not a good business for you if this is your response, simply because the industry is in such a state of flux, there is no predictability.  What worked yesterday, won’t work today, or tomorrow.

CR: Wikipedia Commons

If you respond like an egg, this might not be a good time for you to shoot for publication either.  Those black tinged, rubbery eggs are not appealing and they are most definitely not healthy.  If your voice is getting strained, you’re having back trouble or muscle problems or headaches, this might be you – even if you aren’t aware of the stress you’re experiencing.

CR: Wikipedia Commons

But if each change brings with it anticipation and excitement, a sense of a new day dawning, then welcome to the industry.  You will succeed because you will be able to take all that stress and turn it into productive, energetic, exciting output that the world wants.

Which type are you?  Can you think of a way to move from the veggie or egg stage to that of coffee?  How can you make that change? Who can help you if it’s necessary?  If your responses are more like the coffee bean, how did you learn that?  And more importantly, how do you maintain it in these crazy times?

My thanks to Olivia McIvor for the originating idea for this post.

Posted in Louise Behiel, writing | Tagged , , , , | 41 Comments

Psychopaths Among Us Part 2

Today, I’m happy to present part 2 of my interview/conversation with the fabulous Diane Capri.  If you’re just joining us, I recommend you read part one of our conversation here.

Louise Behiel: Before we start, Diane, I wanted to congratulate you on Fatal Distraction being a huge Amazon Bestseller. Readers are really resonating with this book and I’m not at all surprised. As you know, I loved it!

Diane Capri:  *blushing* Thank you, Louise. Fatal Distraction opened at #3 on the Hot New Releases in Legal Thrillers. Since John Grisham was holding on tight to the #1 and #2 spots, we were pretty happy with that showing. *laughs*

Louise Behiel:  *laughs* I knew you were well adjusted! I’m a therapist. I can tell. *laughs*

Diane Capri:  *laughs* So we were talking about the psychopaths we encounter in our daily lives. Not necessarily killers. But those who cheat and lie and hurt us in less immediately lethal ways. It would be helpful if we recognized these psychopaths right away. But too often, we don’t until the harm is already done.

Louise Behiel: Many times, I’ve seen patients involved with psychopaths who don’t realize their nature. Based on how well you’ve written your villain, you’ve had that experience yourself, haven’t you?

Diane Capri: *laughs* I’m not here for therapy, Louise!

Louise Behiel:  Don’t worry. I won’t send you a bill when we’re done here. Tell me about the psychopaths you’ve known.

Diane Capri:  Once I learned that psychopaths are fairly common in the general population, I started arm-chair diagnosing several people I’ve come across over the years. As a student of human nature and a devotee of psychology, why people do what they do has always been intensely interesting to me. As a practicing lawyer, very often if I knewwhy someone took certain actions, I could resolve conflicts that were otherwise unresolvable or devise winning strategies for clients. Along the way, of course, I encountered people who were in it to win it, regardless of the rules or the morality of their actions. Many of these people are psychopaths, aren’t they?

Louise Behiel:  Absolutely. You’ve nailed the disorder perfectly. Psychopaths only care about what they want. Your wants, wishes or needs are irrelevant to them.  They give you as little thought as the mosquito they slap.  In the mind of a psychopath, your needs and that of the mosquito carry the same weight.

Diane Capri:  That is so hard to accept because we always want to believe the best of people.  But I know you’re right.

Louise Behiel:  It must be a challenge to work with a psychopath in a legal setting, since they’re not accustomed to telling the truth.  And the oath they take as witnesses is irrelevant to them.  Have you dealt with this type of person?

Diane Capri:  I’m sort of a Pollyanna and I generally give everyone too many chances to show their true colors. Often, to my detriment. I remember the first time I encountered a witness who lied after swearing not to do so. Lawyers are not ethically allowed to permit our own clients to lie and we can lose our license for that. But I won’t tell you it never happens. Unfortunately, it does.

Louise Behiel: How can the legal system function reliably when dealing with psychopaths?

Diane Capri: The system is reliable, but the operators within the system are fallible human beings, with all the flaws and faults other humans have. And this is one of the themes in Fatal Distraction, as you know. When humans subvert the system, some with understandable motives, has the system failed us? Or have we failed the system?

Louise Behiel:  In my experience, psychopaths come across as normal, nice even. Combined with the complete absence of a conscience, there is nothing they won’t do. I deal with the people they step on, because psychopaths don’t see anything wrong with what they’re doing or have done. You must meet more of them than I do.

Diane Capri:  Probably not. The psychopaths among us hide in plain sight. Often, they’re the most successful people in our society.

Louise Behiel: Why is that?

Diane Capri:  Because “success” is a lot easier when the psychopath completely ignores the rules that bind the rest of us. I knew a lawyer who told me he could “cry at will.” He used this, er, skill to manipulate people to his advantage. What normal person wouldn’t be moved by a man who cries in sympathy? People who scam others are often psychopaths. They justify their actions by saying, “Oh, he can afford to pay.” High profile psychopaths like Bernie Madoff, the man behind the largest ponzi scheme in history, didn’t care about people who lost their entire life savings so he could live large. The guy who cheats at cards; the woman who embezzles and then gambles the money away; the dude who attracts  women by praying on their insecurities and then exploits them; the man with two or three families. On and on and on.

Louise Behiel: You gave me a great fictional example a couple of hours ago. What was that again?

Diane Capri:  Right. A woman meets her soul mate at her mother’s funeral, but fails to get his phone number. After the funeral, she tries to find him, but can’t. But she really wants to reconnect with this guy. So she kills her father. Her reasoning is that if her soul mate attended her mother’s funeral, perhaps he’d attend her father’s funeral, too. The woman is a true psychopath: without a conscience.

Louise Behiel: I’ll say!

Diane Capri:  What can people do when they find themselves involved with a psychopath?

Louise Behiel:  I always tell people to watch behavior – and not pay so much attention to words.  Psychopaths will say or do anything to ‘win’, so a person in relationship with a psychopath will constantly be buffeted between what is said and what is done.  For the partner it’s crazy-making because the psychopath will always find a way to make the conflict their partner’s responsibility.

So pay attention.  If you’re frequently told that you’re wrong, you misunderstood, or you’re crazy, start making notes.  Keep them private and secret.  But keep them.  Note dates, times and behaviors. And of course outcomes. It never takes long to see a pattern of lies.  The problem for most of us is that we try to talk to the psychopath, to communicate so that they’ll understand that their behavior is incongruent with their promises.  This conversation is predicated on a belief that the psychopath cares.  But they don’t.

An old truism is important to remember in our relationships: “Fool me once, shame on you; fool me twice, shame on me”. Because psychopaths are charming and loving, we disregard their behavior and assume we misunderstood or didn’t hear right.  Or ‘it’s no big deal’. In a normal relationship, that’s true but not with a psychopath who don’t have a conscience. They are free of all the stirrings of guilt, shame and remorse that affect and direct the rest of us.

Diane Capri:  Family Ties, your current release, doesn’t deal with psychopaths at all. What about future books?

Louise Behiel:  Family Lies will be out in June. The heroine discovers that her recently deceased husband had a secret life – one populated with private jets, jewels from Tiffany’s and bank accounts in the Cayman Islands, all while living a typical upper-middle class life with her.  I don’t want to give too much of the story away, but he was a psychopath – he wanted what he wanted when he wanted it and would do anything to get it, all the while looking like a loving husband and father.

Diane Capri: Hmmmm. Personal experience, Louise?

Louise Behiel:  *laughs* Not really. But I do think we often forgive and forget some atrocious behaviors in our friends and families – even when it isn’t warranted.

We’re going to wrap it up here. We hope you’ve enjoyed our conversation about thePsychopaths Among Us.  You can buy or download a sample of Diane’s Fatal Distraction by clicking HERE.  You can buy or download a sample of Louise’s Family Ties by clicking HERE.

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Psychopaths Among Us Part 1

I recently read and reviewed an advance copy of Diane Capri’s terrific new thriller (after Don’t Know Jack) featuring a chillingly accurate villain. Fatal Distraction was released on 5/24 and is already climbing to the top of the charts garnering more rave reviews.

Fatal Distraction introduces Jess Kimball, a relentless investigative columnist with a tragic past in the style of Dominick Dunne, on the trail of a cunning Florida killer who’s targeted Florida’s first woman governor, Helen Sullivan. Helen and Jess together face the determined killer in a pitched battle of wit and nerve. Who will survive? Here’s what I said in my review:

5.0 out of 5 stars Compelling, Scary Read, May 19, 2012

By Louise Behiel (Alberta, Canada) – See all my reviews

This review is from: Fatal Distraction (Kindle Edition)

Normally, I read romance, but Ms. Capri’s thrillers are slowly pulling me over to the dark side. <vbg>

Fatal Distraction was a thoroughly enjoyable book. I couldn’t put it down. Looking into the mind and heart of a psychopath is always frightening and Ms. Capri does a good job of keeping the reader on the edge of her seat. She clearly shows the logic and reasoning of a twisted mind. Pitting him against an intelligent and driven reporter and a smart female governor is putting a flame to tinder and it’s always fiery.

Tight plotting and Ms Capri’s typical well developed characters make this book a compelling read.

After I posted my review of the book, Diane and I began a fascinating conversation about psychopaths among us. The more we talked, the more we discovered. We’ve broken the conversation into two parts. This is part one and we’ll post part two next time. Come listen in:

Louise Behiel:  I loved your book, Diane. Your villain is one of the most realistically portrayed psychopaths I’ve seen in popular culture. What inspired you to write about a psychopath and how did you create him so realistically?

Diane Capri:   Ideas that grow into novels for me often begin with something I don’t even notice at first. But it comes up and later grabs my emotions in a way that makes me realize a good story lives there. That’s what happened with Fatal Distraction.

Louise Behiel:  What was that?

Diane Capri:  At a dinner party, someone mentioned that a retired homicide detective we knew had recently died. We began reminiscing about him and the most notorious unsolved case he’d investigated decades earlier involving a local killer with multiple victims. He was dubbed The Oakland County Child Killer. Although the investigation was the largest in U.S. history at the time, it ended abruptly when he simply stopped abducting and killing children.

Louise Behiel:  That’s very odd for a psychopath and multiple killer. Once they start, they rarely stop.

Diane Capri:  No one knew why he stopped. At the time, people speculated that he’d actually been killed himself, or sent to prison for another crime, or maybe just moved on to another state or country. The case haunted our friend until he passed away, though. He always believed they’d find the killer.

Louise Behiel: But they never did?

Diane Capri:  *shakes head* The conversation continued to nag at me. Why did he kill? How could he just stop after so many victims? What kind of killer does that? I began research into that question and the answer came soon enough: a true psychopath. Then, the real chill started. I can feel it again as we’re talking here.

Louise Behiel:  Why?

Diane Capri:  Because I realized I’d seen this behavior up close and personal several times. A true psychopath coldly kills or steals or lies or cheats in a way normal people don’t behave. Because a true psychopath simply has no conscience. None at all. He never feels guilt or shame or remorse. Ever. For anything.

Louise Behiel:  Now you’re giving me chills!

Diane Capri:  Sorry! One of the things I learned doing the research for Fatal Distraction was that not all killers are psychopaths and not all psychopaths are killers. In your therapy practice, have you treated psychopaths?

Louise Behiel:   I don’t come into contact with psychopaths who are killers (thank heavens).  But psychopaths are all around us.  My clients are often in relationship with them, either at work or at home.  Psychopaths constitute about 4% of the population, so no doubt we’ve all met one or two of them.

Diane Capri:  Can you give us some common examples?

Louise Behiel:  How often have you worked for a ‘jerk’ boss?  A person who didn’t care about anyone but him or herself? Ever been in a relationship with someone (male or female) who is arrogant, self-centered and lives with a sense of entitlement?  Whose entire life is directed toward self–gratification?  Lying, cheating, and stealing are common with psychopaths.  When this is combined with charm and ingratiation, psychopaths can fool even the wisest among us.  They just don’t care about the rights, property or safety of others and have no remorse or guilt over their actions.  Remember, they will step over you or on you to achieve their goals and they won’t give their behavior a moment’s thought, except to celebrate achieving their goals.

Diane Capri:  But what motivates them to engage in such behaviors?

Louise Behiel:  Psychopaths get incredible pleasure and satisfaction from humiliating, demeaning, dominating and/or hurting others. What is most confusing is that they pass for normal in our lives. So sometimes, when you think a person is taking advantage of you and playing games, they might well be.

That’s all we have time for in this post. But join us next time when we’ll cover much more about the Psychopaths Among Us in Part Two. In the meantime, tell us about psychopaths you’ve known? We’ll tell you about the ones we’ve met next time.

Posted in Louise Behiel, writing | Tagged , , , , | 50 Comments

PTSD as an Outcome of Childhood Abuse

Originally, Post Traumatic Stress Disorder was recognized and diagnosed in returning war veterans.  Now, it is recognized as an outcome from a traumatic situation. In fact, new research postulates that PTSD can result from events that may not seem too severe.

Diagnostic and Statistical Manual of the American Psychiatric Association V5, has refined the diagnostic criteria of PTSD, but it now lists two sets of criteria – one for anyone over six and another for children under 6. This confirms that PTSD can occur in very young children and results in symptoms strong enough to be observed and measured.  If you have time to spare, feel free to read about the new criteria here.

For all of us, a traumatic event has some natural repurcussions. When our sense of safety is shattered, it’s normal to feel numb, or disconnected, depressed or ‘out of control’. Bad dreams, obsessive thoughts about the experience and overwhelming fear are all normal reactions to events that are beyond our normal life.  For most people, these feelings are short-lived and gradually dissipate. With PTSD, the feelings don’t lift and get worse with time. And since you feel ‘crazy’ you are not likely to talk to anyone about the event or your emotional reactions.

Children who experience trauma may lack the vocabulary to express what happened, may not be believed if they speak out or may have been told it’s their fault.  Latest research shows that abuse and/or trauma affect brain development, causing structural abnormalities in the frontal lobe, home to our emotions. Over time, these changes in the brain may result in personality deficits if not recognized and treated. (See http://www.upliftprogram.com/article_ptsd.html)

To diagnose PTSD there must be the presence or threat of a traumatic event, experienced or observed. It can also occur from hearing about a friend’s experience or observation. It is common in those who are exposed to the details of such events (police officers, firemen and paramedics reading reports).

While everyone experiences PTSD differently (and the DSM – V has more detailed criteria), there are three main symptoms:

1.  Flashbacks (re-experiencing the traumatic event): The re-living of traumatic events in the moment.  They can be precipitated by an external event (the sound of footsteps in the hall) or a jogged memory.  They feel ‘crazy’ and disorienting because of ‘feeling’ back in that moment in time.  To work thru them, remind yourself that you are an adult and are safe now. Breathe slowly but naturally. Consciously slow down your alarm response. Sometimes wrapping yourself in a blanket or holding a pillow can help.  If you’re in public, grab hold of something, (a chair or a desk) plant your feet firmly on the ground and take a couple of deep breaths, and remind yourself that you are an adult, you are in a safe place and that all is well.

Bad memories can also occur as bad dreams.  If they occur regularly, remind yourself before you go to sleep, that should a bad dream occur, you will wake up immediately.  (This will take practice but can be learned.) Then follow the suggestions above to soothe and calm yourself.

 2.  Avoiding reminders of the trauma – At its simplest, PTSD is the ‘storing away’ of bad memories which are too difficult to assimilate, integrate and release.  Because we need to deal with them, they pop up, usually at inopportune times.  From the desire (Conscious or sub-conscious) to keep the memories at bay sufferers may try to avoid reminders of the trauma.  So they won’t go near a specific house, or will avoid certain types of people. Or will only sleep in locked rooms or high windows.  Making love in certain positions may cause panic attacks. Ditto for the shower hitting your face. 

 The list is endless and applies to the person’s need to feel safe and avoid the memories.  Ironically, often there is no knowledge of why I can only sleep in a room with a locked door, but that’s my truth and so I live that way. 

Most of us have seen TV programs where a car backfiring throws a veteran into a flashback.  But this is not necessarily the only type of trigger.  For abuse survivors, triggers are often more personal and less obvious.  I regularly hear from clients who can’t sleep in their parents’ home or at grandma’s house.  The smell of a barn or a new vehicle can be triggers.  As they try to avoid any stimulus that might trigger their memories, the risk is that their world becomes smaller and smaller.  And they get more and more stuck in the drive to keep the memories at bay. And worst of all, along with this symptom is the inability to remember the original trauma.

 3. Increased anxiety and emotional arousal: Over time, clients with PTSD often have trouble falling asleep, or once asleep, they can’t stay asleep.  Or if they do sleep, it is a light, shallow sleep that is not restorative. Sufferers are usually hyper vigilant – they know where everyone is around them, all the time.  I had a client who could empty a handful of change from his pocket, along with all the other paraphernalia men carry, and seemingly drop it on the nightstand.  He could always tell if any of it had been moved – even 24 hours later! This kind of vigilance consumes lots of energy and is exhausting.  It exacerbates the lack of sleep. 

Many people with PTSD have an exaggerated startle effect, so a slamming door will be much more jarring to them.  Usually they are more sensitive to noise (banging plates as the table is set) and loud voices.  And because of their heightened state of awareness, they may have trouble concentrating.  Often misdiagnosed as ADHD, PTSD clients do not find relief with the drugs or therapies for that syndrome because the cause is different.

If you consider a person who isn’t getting enough sleep, who is easily startled and who is always aware of what is going on around them (by the way, they often have amazing peripheral vision), what would be the expected outcome?  You got it!  Irritability and a bad temper are common in PTSD sufferers.  But when considered in the context of PTSD, anger and irritability are perfectly logical outcomes.

Not everyone who is sexually abused gets PTSD, but it is very common.  It begins from a need to put the originating trauma at a distance, but ironically creates many problems.  It is treatable with therapy and occasionally, medication.

Remember the rules of this blog: No diagnosis.  But if some of these symptoms match your experience, contact a mental health professional who can help you determine what’s going on and start you on the road to healing.

Additional information came from: http://www.upliftprogram.com/article_ptsd.html and

http://www.helpguide.org/mental/post_traumatic_stress_disorder_symptoms_treatment.htm

Questions? Comments?  Did this raise the hair on the back of your head?  Let me know and I’ll repond.

Posted in child abuse, Louise Behiel, Sexual Abuse | Tagged , , | 51 Comments