Treatment resistant individuals

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A conundrum I sometimes encounter is a person who is unable to manage their lives - including essential survival functions such as food, shelter, and medications if needed - but when put into or offered an avenue for better care, walks away from it. I'm thinking of someone in my family and also someone in the WP forums. You could broaden the emphasis to people who won't adequately address their medical problems, saying things like "I don't trust doctors" or "there's nothing wrong with me."

I think it's a trap to get too involved trying to help people who are going to reject the improvement in any case. Maybe I feel this way because I have chronic fatigue, and I simply don't have it in me any more to work on anyone else's behalf other than immediate family.

It seems to me that there is a defect in personality development in many people, that results in disintegration when under severe stress. Sometimes these individuals had very troubled childhoods with narcissistic parents and/or child abuse (physical, emotional, sexual, etc.). This is overlaid upon any neurological status they have, such as autism or ADHD. They seem to have inadequate personal resources to manage their affairs when in a crisis.

Does this fit anyone you know? Or fit yourself?

I've known a few people like that.....it's from an over-arching desire for "independence."

I think I know who you are referring to on WP. Actually, there are at least two more whom I could name. Then there are the numerous relatives and acquaintances who fit your description, including those who weep and cry about how a tornado or flood destroyed their homes and how they are going to rebuild in exactly the same place. It's almost like they want trouble.

Like you, I believe it's a trap to get involved in trying to help or advise such people. They seem to have little or no actual interest in resolving their issues, and their interests seem to lie mostly in the directions of attention-seeking, affirmation of victimhood, and manipulating others for personal gain.

Helping relatives rebuild on a flood-plain or along "Tornado Alley" was a big mistake. They did not build any better (i.e., higher ground or sheltered between two or more hills, et cetera), but simply re-built what they lost on the same patch of land. Then they lost it all again, and came back to me for more help. "You shoulda learned the first time" was all I told them. Now I'm the Bad Guy (i.e., stingy, mean, miserly, et cetera) for not supporting their stupidity.

Yes, it's easy to get trapped into helping people, or just advising them. After years of complaining about their problems you'd think they would have learned how to solve those problems themselves, but they don't seem to want to learn.

I guess some people will never be happy until they drag everyone else down into their misery.

I'm not comfortable ascribing this set of behaviors to a motivation to be victimized. It seems to me more a failure of general intelligence and planning. I think there can be specific mental defects that cause a person to make the same mistake repeatedly, appearing not to learn from experience; it's as though they only know one place to build their house and the mental task of choosing other sites is too complex. Also the ability to foresee problems is too complex. These seem like executive function issues, but they might also involve failure to learn which could involve hippocampus function.

If childhood abuse is involved, they may actually have a resulting reduction in ability to learn (a new, as yet incomplete area of neuropsych research). An example is routinely picking exploitive and even dangerous people as friends and relationship partners. It's as though there is a blind spot to traits that everyone else can see are troubling.

Anyway.... I'm sure it's trying to health and mental health providers. Tragic to the individual and their family. But a bigger challenge than I can take on.

Edit: I meant to also say something about anxiety. Some people do not learn safe and effective ways of handling anxiety, and rely excessively on something such as drugs and alcohol, or jumping into any relationship without investigating the character of the partner, just to avoid being alone.

While I think the topic title is valid, I'm not comfortable with the use of it as an opportunity to covertly shame and demean un-named members whose identities will be manifest to most of us. I know some members will read that sentence and instantly think "well they deserve it, so what". I know how tempting it is to default to that setting, we all have at some time about someone, not being saints. But.

Remember that first and foremost, WP is a support forum; even the most hidebound of victim personalities will not change their challenging mindset due to shaming and blaming. Instead they are even more likely to default to greater self-justification of their mindset, a mindset where they are unable to shift from fear to one of personal agency.

How exasperating that mindset can be; I too can and do become exasperated at times. However, everyday lately when I read posts on Wrong Planet I find myself drawn into an inner contemplation of blame and blaming (especially when reading the characteristically superficial, mud slinging, reason-free type of political threads which started back when...)

Some members perpetually complain, yes. They are not many, though their impact is perhaps greater than their tiny number. Even they may shift to a sense of personal agency given time. Shaming them is, IMO, more likely to keep them stuck and increase their typical point of view.

I am not saying that I have always posted as kindly as I would hope, that I haven't fallen short of my own personal standards at times, and am lately very mindful of this wise proverb:

“He who blames others has a long way to go on his journey. He who blames himself is halfway there. He who blames no one has arrived.”

– Chinese proverb.




(Still on moderation break)

B19, was that a reprimand? It felt like a reprimand.

Each of us may have someone in mind that this thread refers to, and I'll bet you that we don't all think of the same person.

It was never my aim to blame and shame anyone. I am trying to understand the psychology of such individuals. I hope others will still contribute to this conversation.

I think we all know socially dysfunctional individuals who could have a clear path out of their affliction, if they chose it. Some obvious examples include "hoarders," as they are depicted on shows such as the A&E series. If you know anyone with that problem, I think you'll agree that it shares some features of addiction or addictive behavior. It is more than obsessive-compulsive disorder.

Some Aspies may appear to have a clear path away from their social problems, but the expert consensus is clear that social training usually succeeds only by rote memorization and almost never intuition.

In my own life, I put a high priority on "self sufficiency" by which I mean earning a living to support myself, and being able to do many things for myself where I would not have to ask others for help, which had a rather spotty track record. That impulse has served me well, but I still am socially ret*d in many ways. I think the best thing age has brought me is to reduce the urge to "fix" myself or indulge in endless self-improvement projects. I make my choices, and if people don't like it I'm way more inclined at this age to think they can piss off.

Anyway, I think the principle you are getting at is called "learned helplessness" and it's the subject of a lot of psychological writing over the years. I guess that means it's a fine line, between incompetence and lack of motivation, but they are two different things and apply in varying circumstances.

Intended as a plea, to the membership as a whole, not a reprimand Bea. We have all seen threads in the past light flames that the OPs never intended. Most of us at some time have experienced it as OPs ourselves...

In the last analysis, we all do the best we can with what we have. Each person's path is different and we cannot see the limitations of other's sight.

OTOH, we are not obliged to go down with another's ship and I think this is what Bea is struggling with. Please feel to correct me if I am wrong. I have had the experience throughout my life of being torn between the desire to help others and my own preservation. That has led me into many hazardous situations which certainly had the potential to quite literally destroy my life. In general, I help when I can and disengage when I cannot. The process to distinguish one from another is discernment which is a Quaker practice, but I am sure can be adapted to other practices.

Sometimes withholding "help" (when I can't due to lack of resources, lack of energy, illness, etc) can create great sadness. Sadness is painful and I have to resist the temptation to move to a "he deserves that," or some version thereof to get out from under the sadness. Sometimes things just plain are sad, grievous and not fixable, at least by me.

Who can say what the purpose of life is? Personally, I'm highly resistant to pill pushers and any non-vegan dieticians. I went to the hospital for a broken thumb two years ago, and they turned it into a life-threatening situation by ignoring my sleep disorder. Many dysfunctional lifestyles that look like slow suicide may in fact be just that, a period of time sufficient for final contemplation of one of Ma Nature's unlucky combinations.

Speaking from my own experience, as someone who has always struggled immensely with change, asking for assistance, and taking even very good advice, I think that a big factor in these problems is feeling a lack of agency, and that in autism in particular, this can become ingrained during childhood development even in the absence of overt abuse.

As children, we have no sense of in what way we are different to other people, even if we have a vague sense that we are. What we do learn very early is that our innate intuition can rarely be trusted to tell us what behaviour will be appropriate. Hence, we can easily internalise the idea that mimicking other people's behaviour and conforming to their expectations should be our goal in life at the expense of exploring our own needs and desires. In a sense, we become someone who is always waiting for someone else to provide a model for how we should act, and so don't develop mental independence, any sense of trust in our own solutions to problems, or any sense that self-motivated actions can have positive outcomes - we've experienced too many situations where the world around us has convinced us that our conclusions are always "wrong" or "inappropriate", right from the first moments that, as infants, we became aware of the possibility of interacting with other people. Hence a lack of agency develops; we feel as if our course in life is like that of the ball in a pinball machine, barely affected by our own desires, merely reflecting off the unpredictable (to us) boundaries imposed by our social environment.

Executive function impairments, I believe, can exaggerate this immensely. When there is a disconnect between intent and action, due to innate problems with awareness, attention, and volition, it is easy to fall into the trap of feeling that there is little point in being motivated to act, as our wonky mind is likely to sabotage our efforts at any moment. Before my autism was diagnosed, this is certainly how I felt very often. My executive function impairments were often the most frightening aspect of my autism, causing me to profoundly question the idea of "free will" and whether I truly had very much control over my own actions. Again, this is counter to forming a sense of agency.

It's also the case that many of us have experienced "one size fits all" advice and supports, either informal or from professionals, which have been unsuccessful because they didn't take our autistic traits into account. This very easily leads to a lack of trust in the guidance of others, and difficulty distinguishing good advice from bad advice - the default becomes to assume that all advice will be as ineffective as in the past, and years of practice makes rationalising reasons why advice won't work all too easy.

[NB: The "we" that I notice I used a lot is purely rhetorical, my apologies if I've given the impression that I'm trying to speak on others' behalf.]

There was a time in my life when I felt helpless and at the mercy of a cold-hearted, indifferent world.

Then I finally grew up, got up, went out, and did for myself what I had always expected others to do for me.

No regrets.

It's best not to rely on other people.

It's always better to be able to rely upon one's self.

Trog, I think you're on to something here. Lack of agency leads to an adult who, though possessing many abilities, may still be unable to act as an independent adult. If we think in these terms, it may lead to more beneficial child-raising practices for autistic children. For instance, giving the child choices, asking the child to mentally project what would happen if..., and of course, developing abilities to solicit and appropriately rely on help.

There are many reasons why people are "resistant to treatment."

One of them is the fact that some people believe they have a "right" to whatever feelings they feel----and the right to not seek solutions or "treatments." The right, from their viewpoint, to "to be themselves."

My mother is like that. One day, she felt claustrophobic while riding in my car; I proposed a solution whereby she call one of her friends on a cell phone; this would distract her from her claustrophobia. She refused, saying, in essence. "I have the right to feel claustrophobic---and to experience that feeling."

This sort of thing drives me up the wall!! !

I believe people not seeking solutions frequently hamstrings progress. Yes, people have the "right" to be themselves. But I believe, if people are suffering, that they should seek to actively alleviate that suffering.

Some people believe that they can't be helped ...... while others are happy with just being miserable.