Later in a session, when talking with one patient about how distracted he gets and the ways he procrastinates, I made the parallel: his urge to “move on” from guilt or remorse, putting those feelings out of his mind, resembles the way he “moves on” when he comes up against boredom or frustration.
When I thought about how upset he looked at the beginning of our session — and how rarely he brings much emotion into our work — I realized there’s a lot more pain than I had thought, but that he distracts himself from it so effectively that the pain doesn’t seem to exist.
My session with Naomi focused on a similar issue. She was describing a “white lie” she had told her boyfriend for no reason she could understand: instead of admitting that she’d completely forgotten to pick up something for dinner on the way home from work, she told him she’d changed her mind and wanted to go out to eat instead.
Eventually, I was able to show her that she had lied because she felt ashamed to admit she’d forgotten, as she so often does; it made her feel as if she were somehow “defective” and that there’s nothing to be done about it. She grew visibly upset and then moved on to a different topic.
Last week, I had pointed out to her how, as soon as I’m finished saying something about what she has been telling me, she quickly moves on to another subject; it feels as if she’s moving so fast that she doesn’t really take in and digest what I’ve said. During this week’s session, it felt to me as if Naomi was “moving on” in order to escape the shame she feels about these life-long difficulties with forgetfulness, procrastination, lack of focus and self-discipline, as well as her tendency to lie about them to cover up.
I was able to show her how she moves on because she feels so “screwed up” that there’s no hope; her ongoing difficulties mean that she’s a “bad person” and won’t ever be otherwise. This feeling is so excruciatingly painful that she “distracts” herself from it by quickly moving away, mentally “changing the subject” so to speak.
Both Adam and Naomi use distraction from pain that is felt to be unbearable (guilt, pain, etc.) as a habitual defensive strategy, and it then permeates all of their mental processes. I’m convinced that it lies at the root of their so-called “ADD symptoms.”
Distracted woman photo available from Shutterstock.
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From Psych Central's website:
Anti-Social Personality Disorder and its Roots in Hopelessness | Therapy Case Notes (May 12, 2012)
Last reviewed: 28 Apr 2012