Thursday, January 30, 2014

Blaming yourself when bad things happen

I've talked before about the role of self-blame in maintaining depression.  As I've read more on this topic I discvoered that self-blame is not always associated with depression.  (I guess I don't really see those people who blame themselves but aren't depressed.  They don't tend to need therapy).  Based on personal experience, it seems like self-blame often provides people with a greater sense of control.  If I did something wrong that caused something bad to happen then all I have to do to keep it from happening again in the future is to change my own behavior.  For many of my patients, gaining this sense of control decreases anxiety but also causes a lot of guilt which, over time, leads to depression. 

According to the research literature, however, this type of self-blame should not lead to depression.  Peterson, Schwartz, and Seligman explain that attributing a negative event to one's own behavior increases perceived controllability (as I said before) and creates the sense that one's bad behavior was situation specific.  (In other words, a person sees his behavior in a given situation as a one time thing.  He doesn't see it as representative of a broader pattern of bad behavior or as a reflection of who he is as a person).  Peterson et al. call this phenomenon "behavioral self blame" and describe it as an "attributional defense mechanism...[that is] inconsistent with depression."

So what gives? Why do I see so many depressed patients who blame their bad behavior for causing significant negative events?  According to research, this sort of self-blame is a defense mechanism and should protect them from depression.  Why does this not seem to be happening?

I don't have a definitive answer but I do have some ideas...

One thing that stands out to me is how many of my self-blaming patients seem unable to forgive themselves for making mistakes.  Theoretically, attributing a negative event to their own behavior should boost their sense of control, leading to increased hopefulness about their ability to prevent similar events from taking place in the future.  And yet, I don't often see hopefulness.  Instead I see a tendency to dwell on perceived mistakes, which creates an overwhelming sense of guilt and self-doubt.  It's difficult to feel hopeful about the future when you're busy condemning yourself for mistakes you made in the past.  Part of "behavioral self blame" is "admitting I did something wrong."  For some, making a mistake is simply unacceptable.  In such cases, "behavioral self-blame" equates to perpertual self-condemnation; this inevitably leads to depression.

Or perhaps certain kinds of negative events are simply so terrible that normal rules don't apply.  The negative events experienced by the majority of my patients fall into one of two categories: 1. Combat-related incidents in which one or more people were seriously injured and/or killed and 2. Sexual assault.  Rape and violent death are more extreme than most other negative life events.  Perhaps the reactions people have to these experiences are therefore more complex. 

Another possiblity for some is their inability to identify what exactly they did wrong.  That is, they have the general sense that they did something to cause a negative event but despite replaying the event in their minds again and again they are unable to identify a specific behavior that would explain what happened.  They feel compelled to continue replaying the event in their minds in an effort to figure out exactly what they did wrong.  I imagine the people who do this are people who have a pre-existing tendency to blame themselves when things go wrong; the drive to blame oneself in the absence of any evidence seems to suggest this.

These are just theories...

2 comments:

  1. If things happen because either you are the cause or someone else is the cause it quickly becomes a moot point...because it is in the past. Why not put aside any cause and instead learn some self-compassion in the face of adversity. Or start with humor to ease into it. That alone will continue to work when things "go south" as they often do unexpectedly.

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  2. So many of my patients have no self-compassion! I need to talk about this more often.

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