Just what are "psychological problems"? What’s a symptom?

I’ve said that symptoms are the expression of one’s being lost or stuck (see "Why go?"). Now why should that be? How do panic, obsession, phobia, depression, etc. express our having lost track of what we feel, believe, perceive, want, need? The answer lies in understanding symptoms and defenses.

We all have at least an intuitive sense of what a defense is. When we tell little Suzie to pick up a strayed toy and she erupts with "I didn’t put it there!", when our school chum, Harry, treats Linda with extra coldness and disinterest while we all know he’s sweet on her, we speak of these behaviors as "defensive". What we mean is that the person is trying, in an especially obvious and graceless manner, to avoid the pain of, and at the same time maximize their control over, their uncomfortable spot. Suzie is feeling accused, put down, even humiliated; Harry fears rejection, humiliation, and a blow to his perhaps already tenuous self-esteem. Rather than acknowledge these unpleasant experiences, the two devote their energy to defense -- to protecting the self and self-esteem.

Now imagine Harry is extra sensitive in this area, maybe because of his past history, maybe because of his inborn temperament, who knows. For whatever reason, he grows up always on the alert for this kind of humiliation. In response, he redoubles his bravado, behaving towards others with ever more disinterest, independence, "cool". The more uncomfortable he is the more aloof he acts. This sets up a vicious cycle, because those uncomfortable moments are precisely when he most needs reassurance -- and that’s just when he’s the least open and approachable. As his discomfort rises, then, he treats more and more people with indifference, even disdain. Perhaps he loses his job and must interview for a new one. With the added pressure and humiliation of needing approval from the people interviewing him, he becomes even more irritable and off-putting. Needless to say, no-one will hire him. He begins to rage inside at all the people who don’t appreciate or help him, ruminating on his anger to the point of losing sleep. To relieve the tension, he retreats nightly to marijuana, alcohol, and watching too much television late into the night. The rest of the time, he begins to suffer back pain and a nasty skin rash. Eventually whoever he lives with, can’t stand it any longer and leaves.

A personality that began as "defensive" has bloomed into one full of symptoms -- depression, drug abuse, various anxieties, insomnia, "personality problems", even paranoia. Under "DSM Diagnosis", his health insurance claim might list Depressive Disorder, Obsessive Compulsive Personality Disorder, Conversion Disorder, Paranoid Personality Disorder (it’s really called that), or several other possibilities.

So a symptom is an outgrowth of a defense. Defenses protect us from unpleasant experiences, such as rejection, humiliation, and other assaults to our self-esteem. When these defenses fail we tend to escalate our efforts. We develop new behaviors (Harry’s drug use), intensify old ones (initially just aloof or "cool", Harry becomes withdrawn and almost paranoid), or fall prey to irrational beliefs and feelings (such as phobias, panic attacks, Harry’s skin rash and back pain). At some point all this becomes sufficiently perplexing or distressing that they are perceived as "symptoms". We might usefully think of symptoms as defenses run amok.

The example of Harry is rather simplistic, to make the basic point. The next section, on personality, will give you a more realistic picture of how symptoms develop. You can also look at the case examples of Ron and Bully.

What’s a personality? What makes me me?