Monday, April 29, 2013

"OPPOSITIONAL DEFIANCE DISORDER" pt. 3


Oppositional defiance disorder” gets more hits than anything else I write about, even religion or sex.  We clearly need more thinking about it.  This time I’m starting from the idea that defiance is not a “disorder” but rather an addiction.  It is at its core an arousal addiction, which means the substance doesn’t come from street drugs nor from prescribed pharmaceuticals, but rather from the person’s own body’s ability to create drugs.  Some of these are:

dopamine (pleasure)
adrenaline (anxiety, energy) 
oxytocin (love, jealousy, maternity) 
serotonin (mood stability)
endorphins (mild euphoria)

They can be triggered by thoughts, by events, by personal interactions, by art, by music and by risk.  They can also be triggered by violence, sex, thoughts of suicide, pain, cruelty, and urban roof-top parcours.   And defiance, which is courting danger.  I know the feeling.  The more powerful the person or force one is defying, the greater the high.  Remember when kids were daring each other to lie down on the yellow line on a busy street?  You know how many play chicken on the railroad?  Gambling, of course, is notoriously addictive.  Oh, the risk!  The rush!

Defiance is an addiction.  (The “oppositional” adjective is not needed.)  On the series “Homeland” the main spies, Carrie and Saul, both express addiction.  Carrie says she used to play chicken on the railroad and always won.  Neither will follow orders.  Neither will ever give up.

The basic process seems to be arousal, defined as heightened internal chemical states, which we generally interpret as emotions, that somehow crave repetition -- more, more, more.  I do not understand “cold blooded” emotionless risk, unless it is entirely driven by rational drive towards some advantage: money, status, control.  This discussion won’t touch that context.

The “problem” is that “this ‘addictive’ response is the underlying biological component that drives the dysfunctional behavior patterns of compulsive gamblers, shopaholics, sex addicts, and others who seek intensity as a means of self-soothing distraction.”  Like combat soldiers, surgeons, ballet dancers, artists, mountain climbers, etc.   That is, I’m saying that addiction in the sense of focused and constant preoccupation with a practice is what creates skill and mastery and is not a problem.  A person with a gambling addiction could become a helluva poker player and who would object?  It’s the dysfunctional behavior that either interferes with relationships or is illegal that creates the problem.  It may be that as we all live closer and closer together with more and more legal and regulation requirements, we are simply moving more behavior into the category of “dysfunctional.”

But if a person wants to change or is forced into counseling by the law, social workers and counselors likely use several strategies.  One is to form a group of peers who can support each other and discuss how to reach better control and why.  Another is to write out “boundary” contracts, voluntary agreement not to do whatever it is after negotiating with the counselor: basically operating off the morality of the counselor.  Maybe the least appealing treatment is prescribing drugs to counteract the “kick” from defiance.  The job of the social worker is to get compliance, to establish control, to be the one who knows.

“Oppositional Defiance Anonymous” programs do not exist as far as I know.  Defiance might be a conditioned reflex, might be self-protective, might be the product of fear, or might give the same chemical surges as other forbidden behavior.  The person who is defiant may not be doing it consciously at all.  Can one be addicted to defiance?  Why not?  But a written boundary contract as a remediation could not work because it would only present another opportunity to be defiant! 

There’s an old joke about a lecturer giving a talk at a women’s college.  He looked out and saw that some of the women were knitting.  He didn’t like that and quipped that knitting was a displacement of masturbation.  A woman looked up from her yarn and needles to say, “When I knit, I knit.  When I masturbate, I masturbate.”  In other words, she was not unconscious and knew the reasons for what she did.  In this case perhaps not wasting time while waiting for the lecturer to say something useful.  She was not susceptible to being shamed and knew what was appropriate, which the lecturer did not.  So which one was defiant?  Which one got the emotional surge?   

Can masturbation be displaced to knitting?  Can addictions be displaced?  To what would defiance be displaced?  Can a therapist join a client in a larger defiance, say against society’s misunderstanding?  What if the defiance were justified either in relationships where someone stood up against abuse -- the child refusing parental rape, the wife refusing to tolerate neglect, the colony refusing to accept imperial domination, the Chinese man standing in front of the invading tank?

Isn’t terrorism an oppositional defiance?

The most obvious first consideration when dealing with a defiant individual has got to address the reason for the defiance.  Otherwise we are only blaming the victim.  The point of the man who has turned informant in “Homeland” is that he sees good reasons to oppose his own country, like the use of bombs on schoolchildren.  The story turns the focus from his inner life -- which has been manipulated -- to larger patterns, in search of solidarity from the audience.  (Plot lines are always manipulations of the audience to generate emotional surges in them.)  

Justified defiance, allying with others in sympathy and solidarity, is an engine of historical evolution, like rebellion against empires.  Unjustified defiance with no outlet, no goal, no community, verges on evil, is certainly corrosive, and will probably cause the destruction of the defiant one.  Maybe a lot of people.

Must addictions escalate?  If the basic process is arousal, then it may find expression in  
intense fantasy, including conspiracy theories
urges, like rape or violence 
rituals, maybe shaped by religion like burning crosses 
and other behaviors 
as means of dissociating from or otherwise coping with internal and external life stressors, emotional pain, and uncomfortable feelings.  The nature of the behaviors defines the level of criminality and destruction. 

I’m reacting in part to a blog:  http://blogs.psychcentral.com/sex/2012/11/neurochemistry-escalation-and-the-process-addictions/  I don’t agree with everything Weiss says.  The issue I was looking for was escalation Is it inevitable?  Clearly it is common.  Often it is stopped only by repentance after doing grievous damage to someone valued.  One clear escalation would be moving from the internally triggered emotional substances to street drugs.  There is also a phenomenon of expansion and elaboration:  planning, anticipating, considering strategy, preparing materials, teasing and afterwards boasting, hinting.  Weiss calls this -- he says as the addicted do -- “being in the bubble.”  Clearly Tamerlane the Terrorist was “in the bubble” for quite a while.

Shame and guilt are also powerful generators of internal chemicals.  The problem is the same as that for trying to control someone defiant -- the attempt to cure through these emotions simply feeds the addiction.    Can appeal to reason make a difference?   Or can one begin to supply a new set of prompts to the defiant one, evoking a different set of chemicals?  The feelings of safety, being loved, being successful, accomplishing goals set by oneself, achieving “flow” -- all these things can be provided instead of punishment, confinement, stigmatizing, criminalizing.  When the person learns to find them for himself, there can be rejoicing, a classic high.

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