By Richard A. Friedman, M.D.
“You could say I’ve been unlucky in love,” a young man told me during a recent consultation. He went on to describe a series of failed romantic relationships, all united by a single theme: he had been mistreated by unsympathetic women who cheated on him. This was not his only area of disappointment, though. At work, he had just been passed over for a promotion; it went to a colleague whom he viewed as inferior. I asked him about his work as a computer scientist and discovered that he worked long hours and relished challenging problems. But he also did some curious things to undermine himself. Once, for example, he “forgot” about an important presentation and arrived 30 minutes late, apologizing profusely.
What was striking about this intelligent and articulate young man was his view that he was a hapless victim of bad luck, in the guise of unfaithful women and a capricious boss; there was no sense that he might have had a hand in his own misfortune. I decided to push him. “Do you ever wonder why so many disappointing things happen to you?” I asked. “Is it just chance, or might you have something to do with it?” His reply was a resentful question: “You think it’s all my fault, don’t you?” Now I got it. He was about to turn our first meeting into yet another encounter in which he was mistreated. It seemed he rarely missed an opportunity to feel wronged.
Of all human psychology, self-defeating behavior is among the most puzzling and hard to change. After all, everyone assumes that people hanker after happiness and pleasure. Have you ever heard of a self-help book on being miserable? So what explains those men and women who repeatedly pursue a path that leads to pain and disappointment? Perhaps there is a hidden psychological reward.
I got a glimpse of it once from another patient, a woman in her early 60s who complained about her ungrateful children and neglectful friends. As she spoke, it was clear she felt that all the major figures in her life had done her wrong. In fact, her status as an injured party afforded her a psychological advantage: she felt morally superior to everyone she felt had mistreated her. This was a role she had no intention of giving up. As she left my office, she smiled and said, “I don’t expect that you’ll be able to help me.” She was already setting up her next failure: her treatment.
Masochism is not solely the province of psychotherapists; even sociobiologists have had a crack at it. Some see its origins in the self-sacrificial behavior of ants and bees, which, at their own expense, go in search of food for others in the colony, instead of competing with them. Is human self-defeating behavior, similarly, a remnant of altruism that might once have benefited one’s kin? Perhaps, but it has long since lost any adaptive value. Believe me, your family is a lot better off if you succeed in life. Yet telling people they are the architects of their own misery doesn’t go over very well. The usual response is some variation on “Is it my fault that life is unfair?”
The American Psychiatric Association found itself in this position when it included a category for self-defeating patients in an earlier version of its Diagnostic and Statistical Manual of Mental Disorders. Partly in response to social and political pressure, the notion of masochistic character has disappeared from the manual altogether, even though the behavior is a source of considerable suffering and a legitimate target for treatment.
Of course, terrible things happen randomly to people all the time, and no one is suggesting that isolated misfortunes are anything more than that. Moreover, a history of repeated failures, especially in one sphere of life, doesn’t mean someone is a masochist. Many people fall far short of their potential not because they secretly desire to fail but because they are anxious about what it means to succeed. But if someone has a pattern of disappointment in many areas of life, a therapist should consider that it could be self-engineered. Treatment can help, including psychodynamic and cognitive therapy, but there is still no effective medication for masochism. It can be an uphill battle, as patients often try to defeat their therapists’ best efforts. But at least there’s a chance these patients can experience in therapy what they so expertly undermine everywhere else: success."
Dr. Richard A. Friedman is a professor of psychiatry at Weill Cornell Medical College.