Saturday, January 20, 2018

The Pathology of not knowing your own mind

I work as a psychotherapist. Over the years I have observed patterns of behaviour in my clients & their families and see the same patterns reflected among the 'non-clinical' population such as my own friends, families, relatives.
I am writing the current piece about one such behaviour. To me this behaviour is definitely 'not healthy'. I would like to label it pathological as I find it so disturbing.
 I have not tried to search for this behaviour in the  psychology journals or books. I am  noting my observations and my own theories about this behaviour.
For the time being, let me call this behaviour as 'not knowing your own mind'. Hopefully, I will think of a better term some time soon.
First let me give samples of behaviour, which come under this label.
1) A is a young lady, suffering from  psychosis & OCD. She is on medication. She has dropped out of university, staying with parents, has no fixed routine in her life. Her parents are upper-middleclass and finance is not an issue. 
'Not knowing her own mind' behaviour of A: A does not answer the simplest question in a straight-forward manner. When asked what she would like to eat, she does not make a choice. She will say, 'my dad wants me to eat this as it's healthy' or 'my mum wants me to eat this as she wants me to lose weight'. When asked what movie she would like to see or what she would like to buy, she simply cannot tell what she wants. She always prefaces her choices by stating what someone else wants her to do. I have tried to give her plenty of time and repeatedly told her, 'Don't choose what you think your mum wants; dont choose what your dad wants; choose what you want, Take your time'. Yet she simply does not say what she wants. After interacting with her for years, I now have this gut feeling that she has reached a stage where she really does not know what she wants. She has no idea what she likes to eat, to wear, to see, to read. It is such a tragedy to be in this state. Not getting what is you want is one sad state many of us face...lack of money or lack of time or lack of accessibility and so not getting what we want. But this poor lady's tragedy is worse...she doesn't even know what she wants.

2)I have seen a few parents of psychiatrically ill off-spring who are unable to make any independent decision. They seem to have forgotten or seem to not know the simplest things. They ask for directions for the most simple decisions. It's like they have lost their self-confidence completely and need to be guided by someone else. Some parents have simply stopped relying on their own common-sense; have stopped thinking and problem solving independently for the simplest decisions and ask for suggestions or guidance from others. It's like they were born without instincts when it comes to doing things by instinct. 

 The causes of 'not knowing your own mind' according to me:
In the case of the first lady, I have observed that her parents rush to give her instructions, suggestions, 'tell her what to do' despite her being of average to above average intelligence and despite her being an adult now. They do not give her even a second! For example, someone comes home. The very moment, they have stepped in, the parents tell her, "Say hello''. I can give multiple examples of such behaviours of the parents. I believe that this constant barrage is instructions and suggestions has rendered this young lady, completely passive. She must have sort of switched off her brain and her thinking and simply waits for the instructions and does what she's told. I have tried to explain this to the parents and tell them to back off from giving her instructions.But jumping in to instruct her seems to be so deeply ingrained in the parents' behaviour that they seem unable to refrain. 
Secondly, one of the parents is always second-guessing what she likes and doing those things she likes or buying those things. She never seems to ask her daughter directly, 'what do you want? What do you like?' Whether this is because her daughter does not give a direct answer when asked or because this mother has this annoyingly firm belief that she knows her daughter's mind very well and needn't ask her...I am not sure. It must be both these reasons and maybe other reasons too.
Thirdly, I believe the lady in question, for some reason, wants to do what she thinks her parents want her to do. She has a lot of anger against her parents for many reasons. Some of her anger is a part of her illness. But I also believe that anyone who lived with parents who behaved like her parents do, would be much angrier than her. Her parents are loving and caring. But their interaction skills with her are terrible. Whether their interaction with her deteriorated after the onset of her illness or whether their interaction with her was 'not good' from before her illness, I do not know.

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