Which came first, the chicken or the egg? It’s an age old brain teaser, as is trying to splice character flaws from mental illness. What about the sociopath who slaughters a person in cold blood and then sits in the midst of the horror to eat a slice of pizza? Is it pure evil or did the mental illness make the person evil? Does mental illness magnify character flaws or does it create them?
Our penal system certainly treats the sociopath as a dangerous criminal, which is why when prosecutors can prove that a perpetrator of a heinous crime knew what they were doing was wrong and did it anyway, they are found guilty.
But it turns out that knowing you are doing something wrong and being unable to stop yourself isn’t that black and white. If an individual is unable to stop himself from committing atrocious behaviors, is it because he lacks character traits such as self-regulation and impulse control? Is there a flaw in his moral character or is it something in the wiring of the brain or in the deep recesses of the body’s cells that cause a person to be unable to exercise their own will over the body?
These are all serious questions for those who suffer from mental illness and for those of us who grapple with understanding them. If you have ever been involved with a loved one who suffers from a personality disorder, such as bi-polar or borderline personality, or even Aspergers, there are times when the behavior they exhibit is chilling. You know that this person knows right from wrong and otherwise conducts themselves in a manner that befits walking and talking among the masses, but when the rage, abuse or chillingly cold-heartedness strikes, how are you to think about them as the good person you love?
The silence and shame of those who suffer from mental illness is enormous. If their illness is untreated, they must often deal with the serious damage they may have wrought in their relationships, the law, or their reputations. There is also a great deal of shame and pain for those who are close to someone with a mental illness. What did we do wrong? How do we best sort out and deal with manipulative behaviors, explosive outbursts or physical and mental abuse without blaming the person for their behavior?
Most people suffering from serious mental illnesses won’t seek treatment on their own or won’t stay in treatment for any length of time, which means they scorch relationships and often can’t function long-term in jobs, making them economically dependent on others or leading to serious drug or alcohol abuse to numb their pain. They often harm themselves or threaten to kill themselves. This does not leave those who love them with much wiggle room on how to read a situation and respond in a way that is both loving and self-protective.
People who suffer with personality disorders do not see their own behavior accurately. They lack what those of us who do not suffer from these disorders take for granted. The ability to calm ourselves and think rationally. Those who suffer with chemical imbalances and personality disorders have seriously impaired thinking. They often laser focus on thought patterns or meditate over something that has emotionally pricked them, becoming obsessive and exhibiting irrational thinking and drawing incorrect conclusions. When in the grip of building and blinding emotional pain, they behave in self-destructive patterns creating cycles of highs and lows. It is exhausting for them and for those of us who love them.
Adults in the low Autism spectrum also can become unreasonable when a disagreement arises. They see everything in very black and white terms and can appear to be unempathetic and cold. They obsess over something for so long that they become their own expert in whatever is rankling them and they are overly confident that their position on an issue is right. The problem is they forget that we are all complex human beings, with both goodness and flaws. Not able to see the nuances in human problems, they can be too quick to cut off a blooming relationship or put in the work to build on a rocky one.
The reality is that if you are dealing with a loved one who is suffering from an untreated mental illness is that there will be times when you must establish boundaries of what behavior you will tolerate and either remove yourself from the situation or demand that the person seek treatment. All of which causes more mistrust and anxiousness from the person suffering from the mental illness, particularly if they suffer with abandonment issues. But even boundaries cannot be black and white. They must be flexible enough to ensure the safety of perhaps children or a partner but not so rigid that they lock out the individual who is suffering the most and is self-harming.
So back to my initial question, is mental illness a character flaw or is it both a mental and physical biological problem? The human body is an amazing machine of neurons, cells and sensors, but we are not just our bodies. We are inhabited by a mind, or a soul, and we are spirit. We cannot treat the body without at least addressing this issue of character, which involves both the biology of the brain and issues of soul and spirit.
Think of the life-long, church-attending man who never harmed a fly in his life who now routinely hurls insults and vulgar curse words at loved ones while in the iron grip of dementia. Why do those with Turrets often blurt out hateful and nasty things rather than something lovely? The simple answer is that each and every human being has the capacity for both evil and good. It is built into our very genes. For Christians, this phenomena is identified as our sin nature. Even if you are not a Christian, any parent knows that we must teach our toddlers to do good, to not bite or hit others, to share, etc.
Left to their own devices, the human propensity to do harm would make for a very dangerous and anti-social adult. As children grow, they are taught to exercise appropriate behaviors. They are building a rock solid firewall that is in standing order as they become adults. However, when a person is suffering in the throes of an illness that affects the way the brain functions, their firewalls are completely breached. The bricks in the wall have fallen into disrepair and there are gaps in their armor. The complex neuropathway that serves as a regulator, or governor, keeping our ugly bits in check, is weakened and no longer functions properly, particularly under stress.
If you have a partner or family member who suffers from a mental illness, the most important factor in helping you and your loved one to manage the illness is openly recognizing and accepting—first and foremost—that your loved one has a life-long illness. They are not likely to be “cured.” They cannot receive chemotherapy and radiation and “beat” their cancer. There will be no remission. Their disease is not visible to the naked eye, such as a paraplegic in a wheelchair is, but it is just as debilitating.
Although science doesn’t yet understand the biology and chemical makeup of how our brains and emotions function together, it does have a biological root. Focusing on the negative behavior of someone suffering from a damaged brain, isn’t helpful. The brain is damaged in some way that has breached the firewall of normal response and may also play into a damaged psyche. Whether it was the chicken or the egg first, it remains to be discovered and understood, but it must not and cannot be treated as a moral failing.
As a physical illness, mental irregularities must be treated through medications, therapy and counseling. It is not a character flaw to be mentally ill. As many of you know, when your loved one is receiving proper medication, behavior therapy and counseling, he or she can be one of the most kindest and selfless human beings you could ever hope to know and love, bringing joy and laughter to those around them.
Those individuals who have mild Aspergers or who score low on the Autism spectrum are also some of the most loyal and loving individuals you will ever have the pleasure to meet. They trust few people and let fewer people into the inner sanctum of their minds. With patience and love and because they trust you, you can get them to see things in less than black and white terms over time. You can encourage them to reach out for human connection when their inner loneliness threatens to spill over into depression and suicidal thoughts. They do know they are different and they do crave loving and trusting relationships.
Those who suffer with mild Aspergers are extremely bright people and they learn as they grow into young adults to say and exhibit appropriate behaviors because they know this is expected of them in a complex society, even when they may have no such feelings. However, in time they may begin to connect more with their emotions by routinely putting in play behaviors they might not yet feel. This too, is what we must teach people who suffer from personality disorders.
Any counseling for personality disorders must include real-world therapy methodologies that the individual can repetitively act out that will lead them to appropriate scenarios when their raging mind and emotions crest. The goal is to give them the tools to reach a tolerable equilibrium on their own by employing literal mind over matter exercises and teaching them how to step back and neutrally observe whether their own thinking is accurate.
Although mental illness will never be cured, it can be managed. We must provide the tools for those suffering with mental illnesses to cope. We must teach them the skills they need to help them overcome and minimize the lows of their illness so it mitigates damage in their relationships and careers and their quality of life improves.
Second, it is important that even when we must erect barriers of self-protection to preserve our own sanctity, our loved one who is in the grip of their mental illness understand that our actions do not mean we do not support or love them. They must know that, ultimately, it is their safety, quality of life and happiness that we care most about. Despite the lows people with mental illness experience, with help and encouragement they can come to understand that they can live lives more rich and with less pain (not the absence of it) if they exercise self-care over their illness and proactively commit to their own treatment.
Finally, the simple act of sharing with them that you understand their illness while still holding expectations for them to rise above it by exercising the tools they learn to cope with it is not unkindness, it is love. Being empathetic to their pain is important, but we cannot allow them to succumb to it and self-destruct any more than we would let someone we love go untreated for any other type of serious illness—otherwise we wouldn’t love them at all.
No, mental illness is not a character flaw. It is a serious physical illness that affects both the brain and the emotions. People are born everyday with missing or damaged limbs, congenital diseases and serious life-threatening illnesses. They also come into this world with miswired or damaged parts of the brain. Life has never been fair and your loved one didn’t win the lottery on this one, but you can encourage them to use their considerable strength and intellect to work for them, to fight as if their very life depends on it, because it does. Reign well.