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“There are some people in this world that you cannot reason with, no matter how hard nor how long you try ... They will play the victim, but they will not take responsibility for their part of the problem.”
I’ve known too many like this. Brain injury plunged me into a whirl of confusion, but people like this shamed me, blamed me, guilted me for being worse off than they, and held me in that whirlpool, decreasing my self-confidence, doubting my self-knowledge.
My health care providers universally told me that I must disengage. What they refused to tell me: how.
So you can imagine my excited internal scream of delight when I stumbled upon the how.
Joe Bunting runs The Write Practice. In episode 21 of his character-test podcast, he interviews Lynn Bunting, a licensed therapist, about people who have a “personality disorder.” I’ve always had difficulty with the DSM label “personality disorder” for it not only connotes defective but also bases it on symptoms, not neuroscience. And so I was impressed when Lynn Bunting used brain terms, not connotation-filled labels, to describe what’s going on:
They “don’t have self-reflective functioning, which is the ability to look at yourself and what you’re doing that’s causing pain and suffering in somebody else. So this part of the brain that is low functioning or maybe even non-existent for them — they don’t have the connections to do it. And because they’re not self-reflecting, they just can’t see what they’re doing to somebody else.”
She explained that self-reflective functioning is an aspect of empathy and part of the prefrontal cortex. Its absence in others disorients us because we expect people to self-reflect. For me, what’s also confusing is how compassionate they are, how much they feel for people and want to help, yet are unable to see my point in our conflict of the day.
Because of memory loss, inability to think in real-time, flat affect, and brain injury anger, you lose what little functioning you have when you are around them. Even now, with my thinking and memory vastly improved, my resting heart rate rises, my brainwaves enter beta spindling, and my energy flees when they suck me into their drama.
Bunting’s explanation is both more precise and more understandable than any DSM personality-disorder label. Let’s call it what it is: a brain issue in which self-reflective functioning is low or non-existent. That means people have trouble engaging their prefrontal cortex during conflicts; they remain reactive. They feel bad, they don’t know what they’re doing that feels bad, they cannot perceive when they’re wrong, they cannot see nor acknowledge your hurt, they cannot see that everyone is both right and wrong at the same time, and so they cannot work with you to resolve the conflict.
You end up in the Karpman drama triangle, in which they’re always the victim; you’re either their persecutor or rescuer. All of us do drama; most recognize it, feel bad, and want to resolve it. “But these people do drama and the next time you see them, it’s as if nothing happened.” Cue an "ooohhh" of understanding. She affirmed that “yes, I look at them as [mentally and emotionally] disabled.”
They are always the victim. Always.
In contrast, people judgmental of brain injury and the medical system truly victimize a person with brain injury. The unbelievability of it makes you look like a person inherently lacking self-reflective functioning. The difference is that you can see instances in which you're not a victim. Just like brain injury mimics depression but is not depression, an injured prefrontal cortex can mimic this, too. Treatment of the injury can heal both.
Loving Detachment
How to disengage, according to Bunting:
- Create boundaries while detaching from emotion. But brain injury removes emotion, which impairs thinking. What you really need is the clarity emotion brings to thinking and then the time to process into calmness. Conversation with a healthy person could sub in.
- Recognize you’re in the drama.
- Take a deep breath to shift yourself out of threat mode into your prefrontal cortex. What happens if your prefrontal is injured and you’re frozen or fighting back? Practice deep breathing until, when under stress, you automatically do it to calm a bit.
- Agree and nod. Nothing else.
- Remind yourself that it’ll take days to process; that’s when you’ll self-reflect. Use your own self-reflective functioning, however injured it may be, to remember everybody has a point, is right, is wrong.
- Compassionately see the lack of self-reflective functioning as a disability, which helps you simply agree and nod.
- Talk out the conflict with another. Strategize the common good solution. Role-play presenting it.
- Use Paradox of Intention to bring up the conflict with the person and emphasize your solution is in their best interest: “'I know it’s difficult for you to hear some things I’m going to say. But if you don’t want to hear it, that’s OK. I understand it’s hard for you. But if you do want to hear it, I’d like tell you something.’ Now you’re right either way, and they have to think about that. Won’t be long, but eventually these moments add up and you influence the situation.”
Brain injury instills a deep fear of confrontation and a huge desire to avoid conflict. But if you have someone like this in your life, you’ll have unending conflict and added fatigue. Work with a therapist to process the conflict, follow Loving Detachment, write down what you want to say, and role-play it until fear has lessened enough. Then go forth, knowing you’re not crazy and less at risk of being victimized.
Copyright ©2020 Shireen Anne Jeejeebhoy. May not be reprinted or reposted without permission.
References
Shaw, Marvin C. (1988). The Paradox of Intention: Reaching the Goal by Giving Up the Attempt to Reach It. Oxford: Oxford University Press.
