Thursday, December 25, 2014


Dogs on average.

Though I’ve been trying to think about Obstinate Defiance Disorder, a bit of cruising around in the Diagnostic and Statistical Manual of the psych community keeps making me more suspicious of the category altogether.  Years ago when I was thinking of being a clinical psychologist I had to take statistics, which put me right out of the notion.  The main thing I got out of the course (which I had to take three times in order to pass and even then only passed the first half) was the definition of a “standard deviation” though there’s a nice oxymoron for you.  I’m incorrigibly innumerate in the first place and in the second place more attracted to the idea of deviance than standardization.  

"You'll have to break this one early," said Old Lady Otto.
(I couldn't sit up alone yet.  She must have been waving a fetish at me.)

My encounters with female PA’s and some female MD's have given my innate ODD a lot of energy.  These women have learned to be straight A students by passing multiple choice tests, learning vocabulary, and following the pharm folks’ “likelihood” numbers.  They do not look at the person and ask them about their story.  They are not part of the traditional physician culture.  They want blood measurement scores and little charts that they follow across the dotted lines to the “right” prescription.  For instance, they demand to know when I wheeze.  But I DON’T wheeze.  They have seen that in the past I was prescribed a steroid inhaler which is often for wheezing, but this time was because of a summer pollen allergy.  When I tell them that, they flatly don’t believe me.  As far as they’re concerned, correlation is causal.  Real docs are scientific.

This makes me defiant and obstinate.

Now that further research is breaking up many of the assumed statistical correlations about fats, sugars, tobacco, alcohol, caffeine, high BP, and so on, the importance of looking at individuals and finding actual causal links -- esp. since many of the correlations were established only for white men of a certain age and economic level, all of which I am not -- those nice obedient ladies always try to do the right thing get more and more frustrated with me.  It’s a reciprocity, which is always reinforcing.  I mean, the more I fluster them, the better I like it.

But it’s one of my deep patterns anyway.  I ran across another “aggressive” syndrome based on children.  This one is called Reactive Attachment Disorder and is beginning to be connected to adults, now, rather like ODD.  There’s a description which is too long to copy and paste here.   My fav symptom in this long hodge-podge is “darkness behind the eyes when angered.”  Is that the same thing as “seeing red”?  Is it from the point of view of the person with the eyes or the person looking at someone who is angered?  

A stormy petrel

Clearly this is a list meant to bring in clients and basically means “people whom you consider troubled and therefore troublesome.”  My supervising minister when I interned called such people “stormy petrels,” which is a high and far-flying sea bird thought to show up when there’s trouble due to storms -- some feel they are “causal,” that the birds actually bring the storm.  Think Heathcliffe out there on the Wuthering Heights.  It’s actually an attractive personality to a lot of people.  At least not boring.  (Notice that “compulsive caregiving” is on the list.  I could suggest that to a few female medical practitioners.  Resistance will get you labeled ODD.)  But birds don't control storms.

RAD as originally proposed was about a baby who fails to attach to the mother.  “Attachment” is a physiological reaction built into vertebrates that keeps the baby with the mother in the absence of a nest to protect infants too helpless to go anywhere.  It causes the babies to welcome the parent back to the nest, esp. if they’re bringing food.  But Harlow’s experiments with baby monkeys, publicized with heart-breaking photos in Life magazine that went right into the black space behind my eyes, taught us all that cuddling means more than milk, though having to make that terrible survival choice is soul-destroying.  Bowlby’s studies about attachment were a little less traumatic and Winnicott was the warmest interpreter of all.

You must survive however you can.

I attached, though my mother was having a bit of a struggle.  She was thirty, a career-woman, alone in a city because my father’s job was traveling -- my advent meant that she could no longer travel with him.  Her mother was dying and the family blamed her defiant marriage for causing cancer.  She'd just had all her teeth pulled.  She must have been depressed, but even if she’d had those life-endangering postnatal hormonal swings, she was also conscientious and we bonded, which I understand as mutual attachment, not just one-way like ducklings following their mother.

My mother and I in fusion.

Then came two brothers.  She unbounded -- or at least distanced -- just as I hit the Terrible Twos but it was the second brother who tipped the scales -- by then I was near kindergarten age and my mother got the idea that the solution to being overwhelmed was to enroll me in kindergarten.  She often told about how she took me into the principal’s office, set me on his knee, and told him the story of an ODD girl disrupting the necessary routine of baby boys.  It was only half-a-day but I was starting late and the class did not accept me.  I was now an isolate in a room of hostiles.  It has never changed since then.  Not down deep.

The interplay of ODD and RAD is not discussed any place I’ve found so far, so I can interpret it my own way.  There is a well-described dynamic about little kids whose dearly beloved parent is gone for some reason -- illness, travel, whatever -- and at first  the little one mourns and grieves, but then becomes resolute and when the parent returns will not respond.  They turn their face away.  “The hell with you.  I don’t know you.”  I can understand that in a family where parents quarrel and one disappears for days or weeks -- even years -- RAD is the only sensible response.  There’s no use being stubborn and defiant if the other is not even present.

Poor Soames as depicted by Damian Lewis

Bob Scriver, when he wanted to get rid of someone (employee, lover, wife or even child), never straightforwardly asked them to leave.  Instead, he escalated his demands.  I would master some impossible task, but he would just make the next one more difficult until I went ODD and finally RAD.  The truth was that he couldn’t stand taking blame -- he thought it would result in catastrophe -- so he managed to convert the situation into being all the other guy’s fault.  To him it was survival.  I think this is a very common pattern, which is why it’s worth reflection, and possibly a close literary account.  (I just watched “The Forsythe Saga,” which is a similar sequence, a rigid upper-class Brit set of standards so internalized that it destroys a man named Soames.  He becomes more and more demanding and it becomes more and more impossible.)

Many “syndromes” that people might try to address with therapy -- hoping to make the person stop being a pain in the butt -- can be a good fit and even a force for good.  My RAD makes it easy for me to sit here day after day.  I even interpret my obstinate defiance tendencies as helpful in resisting medical Prairie Princesses intent on making me conform to the bell curve they learned instead of the “long tail” that is where I live.  

The key to survival for both individual and group is NOT conformity but “fittingness.”  But people in the long tail must watch out for rocking chairs.

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