CDR: The Passive-Aggressive (Negativistic) Personality Disorder

(PAPD) Case Study: Jim Choate
From: aluger at hushmail.com
Date: Mon, 12 Mar 2001 14:55:47 -0800 (PST)
Cc: cypherpunks at einstein.ssz.com, cypherpunks at lne.com
Old-Subject: The Passive-Aggressive (Negativistic) Personality Disorder
(PAPD) Case Study: Jim Choate
Reply-To: cypherpunks at ssz.com
Sender: owner-cypherpunks at ssz.com

>On Mon, 12 Mar 2001, Sunder wrote (referring to Jim Choate):
>
>> I'd wish that:
>>
>> 1. he'd stick to on-topic articles and not give us any random shit
>he likes

Choate replies:

>Every post I send is 'on topic' to crypto, civil liberties, or economics.

Sunder continues, along with Choate's replies:

>> 2. he'd post a one or two paragraph quote from the article describing
>> it under the urls.
>
>Keep wanting.
>
>> 3. put all the news stories from one site (slashdot for example) in
>> one email as if it were a digest.
>
>Keep wanting.
>
>> The way he "helps" us is annoying at best and only one or two notches
>> removed from spam.
>
>What makes you think I'm wanting to 'help' you or whatever 'us' you're
>refering to.
>
>> What pisses me off is that I actually do read slashdot regularly,
>>and don't
>
>You just want to be pissed off, and if you can make me the target so
>much the better.

Discussion:

Essential Feature-

The passive-aggressive (negativistic) personality disorder is located in
Appendix B: "Criteria Sets and Axes Provided for Further Study" of the DSM-
IV.  Millon (1996, p. 198) proposes a comprehensive concept of a
negativistic
personality.  He asserts that the negativistic personality reflects both
this general contrariness and disinclination to do as others wish but also
presents with a capricious impulsiveness, an irritable moodiness, and an
unaccommodating, fault-finding pessimism.

The DSM-IV (1994, p. 733) describes the PAPD essential feature as a
pervasive
pattern of negativistic attitudes and passive resistance to demands for
adequate performance in social and occupational settings.

The subject, Choate, demonstrates these traits clearly, particularly in
the context of responses to otherwise reasonable requests from the
electronic
social group "cypherpunks" from which the above samples are taken.

The general criteria of a personality disorder coupled with at least five
of the following is sufficient to warrant a diagnosis of Passive-Aggressive
Personality Disorder: procrastination and delay in completing essential
tasks -- particularly those that others seek to have completed; unjustified
protests that others make unreasonable demands; sulkiness, irritability
or argumentativeness when asked to do something that the individual does
not want to do; unreasonable criticism or scorn for authority figures;
deliberately
slow or poor work on unwanted tasks; obstruction of the efforts of others
even as these individuals fail to do their share of the work; and avoidance
of obligations by claiming to have forgotten them.

Examining the small sample above it is clear that Choate meets at least
four
of these subset criteria.  (This author has little doubt that a fifth will
quickly emerge with further study).   Procrastination and delay in
completing
any of the tasks requested of him (the addition of more substantive
summaries
which accompany his rote contributions to the mailing list), unjustified
protests that others make unreasonable demands (in the case of Sunder
above,
Choate's responses to Sunder's request for a more digest format illustrates
this), irritability or argumentativeness when asked to do something that
the individual does not want to do (while Choate could easily have ignored
the request, he chose instead to reply in an increasingly inflammatory and
argumentative tone), unreasonable criticism or scorn for authority figures
(as evidenced by material in his signature - "Legislators and Judges are
the pimps of modern American society.")

The passive-aggressive personality disorder was first introduced in a U.S.
War Department technical bulletin in 1945. The term was coined by wartime
psychiatrists who found themselves dealing with reluctant and uncooperative
soldiers who followed orders with chronic, veiled hostility and smoldering
resentment. Their style was a mixture of passive resistance and grumbling
compliance (Stone, 1993, p. 361).

Choate's response seems to mirror this type of response quite closely and
further study under the reference of Stone's work should be pursued.

The current criteria for the passive-aggressive personality disorder as
proposed by the Personality Disorders Work Group for the DSM-IV includes:

1. passive resistance to fulfilling social and occupational tasks through
procrastination and inefficiency;
2. complaints of being misunderstood, unappreciated, and victimized by
others;
3. sullenness, irritability, and argumentativeness in response to
expectations;
4. angry and pessimistic attitudes toward a variety of events;
5. unreasonable criticism and scorn toward those in authority;
6. envy and resentment toward those who are more fortunate;
7. self-definition as luckless in life and an inclination to whine and
grumble
about being jinxed;
8. alternating behavior between hostile assertion of personal autonomy and
dependent contrition (Millon & Radovanov, Livesley, ed., 1995, p. 321).

Millon suggests that the most essential features of PAPD are irritable
affect;
behavioral contrariness, obstructiveness, and sulking; discontented self-
image, e.g. feels unappreciated and misunderstood; deficient regulatory
control, i.e. poorly modulated emotional expression; and interpersonal
ambivalence.
They are noted for their interpersonal conflict, verbal aggressiveness,
and manipulative behavior. Suicidal gestures and a lack of attention to
everyday responsibilities are common (Millon, 1996, p. 198).

Little study is needed to recognize the diagnosis as a strong one for the
subject Choate.

PAPD resistance to external demands is manifested in oppositional and
obstructive
behaviors. These individuals resent having to conform to the standards set
by others. On the other hand, they fear direct confrontation. The
combination
of resentment and fear leads to passive, provocative behavior (as in the
case of the subject Choate and Sunder exchange- wherein subject Choate
incites
Sunder and seeks to create a situation in which Sunder will escalate the
rhetoric).

Individuals with PAPD view themselves as self-sufficient but feel
vulnerable
to control and interference from others (Pretzer & Beck, Clarkin &
Lenzenweger,
eds., 1996, p. 60). They believe that they are misunderstood and
unappreciated,
a view that is exacerbated by the negative responses they receive from
others for their consistent defeatist stance. They expect the worst in
everything,
even situations that are going well, and are inclined toward anger and
irritability (Beck & Freeman, 1990, p. 339) (DSM-IV, 1994, p. 734).
Subject
Choate demonstrates this classically, particularly in the context of his
often sardonically defeatist and pessimistic inclusions in the titles of
his
contributions).

Individuals with PAPD are often disgruntled and declare that they are not
treated as they should be. On the other hand, they are just as likely to
express feeling unworthy of good fortune. They have a basic conflict
concerning
their self-worth; they oscillate between self-loathing and entitlement or
moral superiority. Either side of this oscillation can be projected onto
the environment. The chaotic nature of this experience of self and others
often leads to people beginning to avoid or minimize contact with people
with PAPD out of self-protection (Richards, 1993, p. 259).

Individuals with PAPD see others as intrusive, demanding, interfering,
controlling,
and dominating. They believe that other people interfere with their
freedom.
They experience control by others as intolerable; they have to do things
their own way (Pretzer & Beck, Clarkin & Lenzenweger, eds., 1996, p. 60).
These individuals are determined that they will not be subject to the rules
of others (Beck & Freeman, 1990, p. 227). They resent, oppose, and resist
demands to meet expectations from others in a behavioral pattern seen in
both work and social settings (DSM-IV, 1994, p. 733). Their main coping
strategies are passive resistance, surface submissiveness, evasion, and
circumventing of rules (Pretzer & Beck, Clarkin & Lenzenweger, eds., 1996,
p. 60).

Individuals with passive-aggressive (negativistic) personality disorder
are ambivalent within their relationships and conflicted between their
dependency
needs and their desire for self-assertion. They waver between expressing
hostile defiance toward people they see as causing their problems and
attempting
to mollify these people by asking forgiveness or promising to do better
in the future (DSM-IV, 1994, p. 734).

These individuals are noted for the stormy nature of their interpersonal
relationships. They engage in a combination of quarrelsomeness and
submissiveness.
Their affect is sullen and they engage in deliberate rudeness. They are
resentfully quarrelsome and irritable. They often feel like a victim.
Central
to the disorder is a pervasive pattern of argumentativeness and
oppositional
behavior with defeatist and negative attitudes (Millon & Radovanov,
Livesley,
ed., 1995, p. 317). Richards (1993, p. 260) believes that PAPD may be the
most miserable personality disorder. These individuals inflict a great deal
of discomfort on others through the use of their anxiety and emotional
symptoms.
They can become so destructive in their attitudes and so unable to provide
rewards to others that they become socially isolated.

For individuals with PAPD, authority figures can become the focus of their
discontentment. They often criticize and voice hostility toward authority
figures with minimal provocation. Their resistance toward authority is
expressed
by procrastination, forgetfulness, stubbornness, and intentional
inefficiency.
These individuals are also envious of and resentful toward peers who
succeed
or are viewed positively by authority figures (DSM-IV, 1994, pp. 733-734).

Authority figures are seen by individuals with passive-aggressive
(negativistic)
personality disorder as arbitrary and unfair. When they are faced with the
consequences of not adequately meeting obligations, these individuals will
become angry at those in authority rather than seeing how their own
behavior
has contributed to the situation (Beck & Freeman, 1990, p. 339). Authority
figures are defined as intrusive, demanding, interfering, controlling, and
dominating. On the other hand, individuals with PAPD also see authority
figures as capable of being approving, accepting, and caring. A key issue
for individuals with PAPD is the desire to get benefits from authority
figures
while exerting their freedom and autonomy (Beck & Freeman, 1990, p. 45).

The conflict is intense. Individuals with PAPD have a tendency to see any
form of power as inconsiderate and neglectful. They are also likely to
believe
that authorities or caregivers are incompetent, unfair, and cruel.
Nevertheless,
these individuals are not inclined to rebel directly. They will agree to
comply with demands or suggestions but will often fail to perform (or they
will perform while experiencing increasing resentment). Then, when there
is trouble, these individuals will complain of unfair treatment. They envy
and resent others who manage authority situations and who are able to
relate
to authorities with less difficulty. These individuals believe that their
suffering indicts the negligent caregiver or authority figure. They fear
control in any form but long for nurturing restitution from those they
perceive
as having power (Benjamin, 1993, p. 272).

Origins of PAPD in the Subject Choate-

Stone (1993, p. 361) suggests that the contrary, sulking, and verbal
nitpicking
behaviors of PAPD appear to have their origin in unending power struggles
with parents. The comparative helplessness of youth made it impossible to
win in these struggles so the face-saving technique of passive resistance
was employed. Parental overcontrol, neglect, or favoring of a sibling can
all contribute to the development of the silent protest and grudging
obedience
associated with PAPD (Stone, 1993, p. 361).

It is reasonable to assume that Subject Choate experienced some level of
paternal angst and the description of unending power struggles seems apt
in this context.

Treatment-

There are two major ways for individuals with PAPD to enter treatment. The
first, and most common, is externally leveraged treatment for those
individuals
who do not see themselves as having a problem. Someone forced them into
treatment, e.g., family, employers, or the legal system. These clients with
PAPD have minimal insight; they fail to admit that they are a major factor
in the problems they have. The second method for individuals with PAPD to
enter treatment is via self-referral for vague complaints, e.g. "I'm just
not getting anywhere" (Turkat, 1990, pp. 87-88).

All of the personality disorders are composed mostly of abrasive traits
that are negative in nature. Maladaptive traits are usually favored over
adaptive traits (though there are adaptive traits within all personality
disorders) (Kantor, 1992, p. 10). PAPD is a particularly abrasive
personality
and interpersonal problems are readily identifiable. However, individuals
with PAPD do not frequently seek treatment for relationship issues as they
consistently blame others for the problems they have. Even if they do come
in for treatment for a marital or parent and child problem, they will
uniformly
demand that the treatment providers "fix" the other person or persons who
are at fault for the problems within the relationship.

Treatment for individuals with PAPD involves openly exploring the ways they
indirectly and unassertively express aggression and neediness toward others
by being contrary. Understanding this aggression can allow discovery of
the depressive and invalidating experiences underneath -- which lead to
a fear of loss of autonomy when others want to be close and a fear of loss
of connectedness when others want to be alone (Kubacki & Smith, Retzlaff,
 ed., 1995, p. 175).

This author believes that Subject Choate is unlikely to seek treatment
individually
and should be compelled to seek treatment in whatever fashion is most
likely
to produce results.

Study continues...

At Mon, 12 Mar 2001 17:56:49 -0600 (CST), Jim Choate
<ravage at EINSTEIN.ssz.com>
wrote:

>Cool, we've got two wanna be head-shrinkers. This is gonna be fun.

A common countertransference issue with these clients is outrage or
punitive
anger. They are manipulative individuals who are consistently stubborn,
demanding, help-rejecting, critical, and inclined to ridicule both the
treatment
process and the service providers.  Subject Choate has predictably
responded
in exactly this fashion to the onset of treatment.

Identify all avoidance and anxiety-arousing situations. Address these
issues
with anxiety-management behavioral intervention techniques (Turkat, 1990,
 pp. 88-89). Cognitive therapy can help these individuals understand that
they expect the worst from others and then proceed to behave in such a way
that brings out the worst from these same people (Stone, 1993, p. 363).

Group therapy provides individuals with PAPD with an opportunity to learn
how to manage their hostility. When their hostility emerges, group leaders
can comment on hostile behavior and encourage other group members to
respond.
The group leader can assist these individuals to process what it is they
want or need at that moment and to rehearse appropriate behavior within
the group context (Ries, TIP #9, 1994, p. 72).