Self-Destructive Behavior

Many people give lip service to the idea that depressed people are self-destructive. After all, suicide is the extreme end of depression. Of milder forms, we often say things like, "He keeps shooting himself in the foot," or "She's her own worst enemy."

What exactly does it mean to be self-destructive? Freud originally theorized that depression was aggression, the destructive wish, turned against the self, an explanation which doesn't tell us much of anything including how recovery occurs. There are two more concrete meanings. One is to engage in behavior that is clearly dangerous or self-destructive, without appreciating the danger. The other is to engage in behavior that backfires on us. The behavior is not, in and of itself, dangerous or harmful, but it has unintended negative effects. Although this can happen to anyone, for the depressive it often becomes such a pattern that we assume there is an unconscious process at work.

This discussion leads us to two important defense mechanisms, acting out and passive aggression. Remember that defenses are ways of keeping unacceptable feelings, impulses, and wishes out of consciousness. They are as much a part of being human as having fingernails, and they help make life much more pleasurable for all of us. But some defenses are more adaptive than others.

Acting out is the direct expression of a wish or impulse without the feelings or thoughts that accompany it. This is the trademark defense of adolescence. Juvenile crime is often said to be "acting out"-the child expresses his rage at abusive parents and unreliable authority figures by such things as vandalism, drug abuse, or interpersonal violence. Experts often reason that acting out is different from antisocial aggression because the person wants to get caught.

Passive aggression is a difficult concept to explain, though we all experience it. It involves making others feel the destructive energy that we ourselves cannot express. In psychotherapy, the patient who threatens suicide when her therapist is about to go on vacation is seen as passive-aggressive. She does not feel her anger at the abandoning therapist, but she gets to be angry with the therapist. In everyday life, anyone in a position of little authority may resort to passive-aggressive behavior as a means of retaining some control. For example, adolescents who refuse to do chores despite repeated warnings, until the parent finally yells, get to feel a certain satisfaction out of being picked on. In the office, the person who insists on doing everything exactly according to the rules doesn't acknowledge his own desire to control everyone else, though they certainly feel it.

Procrastination is a form of passive aggression that the depressive uses very cleverly to make himself feel miserable. The resented authority is not the abandoning therapist or the bossy parent, but the part of the self that says to the depressive, "You really should (get a better job, wash the dishes, paint the living room…)." Instead of acknowledging the conflict between this part of the self that sets standards and moralizes and the part that feels entitles to have the biggest piece of the cake, the depressive will procrastinate. Instead of washing the dishes, he will go to the store to buy a new sponge and get distracted by something else while he's there. The next day, he'll have even more dirty dishes because in the middle of the project he'll get frustrated and sit down and watch Oprah. Daytime television was made to give procrastinators something to do. But his depression, his low opinion of himself, his idea that he can't meet his goals, has just been reinforced.

Finding more direct and healthy ways of expressing anger, of developing autonomy, of acknowledging a need for intimacy, are the obvious strategies to disrupt self-destructive behavior patterns. Many depressed people are completely unaware of their self-destructive behavior, and many patients who go to see a therapist because their behavior has gotten them into trouble, are completely unaware of their depression.

On the next page we will talk about Assertive Behavior.