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Externalization

Question:

I have a 20 year old son who has problems with lying, stealing, taking responsibility for his actions, can’t hold a job, and just generally blaming everyone else for his lousy life. He has been on meds for ADD but has always refused to take them. He even went to jail and blamed us, his family, for it! What is wrong and what can we do to help him?

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Answer:

It doesn’t take a psychologist to see that there is something disturbing and wrong with your son’s behavior. What you describe goes beyond mere selfishness. An empathy deficit seems to be present (a fundamental difficulty he may have understanding and/or caring that other people have the same feelings and needs as himself), and then, of course, there is the externalization, lying and massive rationalization. His criminal record suggests that this bad behavior is not merely reserved for members of the family, but rather is part of a larger pervasive personality pattern. Chances are reasonable that we’re looking at someone with Antisocial or Narcissistic Personality Disorder. If this is the case, you should know that these conditions are quite difficult to treat.

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p> To the extent that your son comes to you for resources, you may have some leverage over him, and that leverage may help you to push him in positive directions. For example, if he still lives with you, you can make his continued housing privileges contingent on his behavior in a ‘tough love’ sort of manner. If he is involved with drugs, it would be a good idea for him to become sober, for instance, and you might motivate him in that direction. If he is associating with friends who are themselves antisocial, it would be better for him to find new friends, etc. I don’t have a lot of hope that you will accomplish much, I’m sorry to say. Even regular 20 year olds are hard to reach, and when you add in the possibility of a significant personality disorder, the odds only go down.

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p> It must be very stressful for you to watch your son do the things he does. I can imagine that you might feel a range of difficult emotions including shame, guilt, embarrassment and helplessness. I recommend that your family participate in some counseling to discuss how this affects family members, and how family members can protect themselves. Helping the family come together assertively with regard to the problem in a manner that doesn’t exclude or reject your son, but at the same time refuses to be abused by him may help everyone involved.

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