Intermittent Explosive Disorder: The ‘Illness’ That Goes On Growing

According to the APA, intermittent explosive disorder is characterized by angry aggressive outbursts that occur in response to relatively minor provocation.

This particular label has an interesting history in successive editions of the DSM.

DSM I  (1952) 

Intermittent explosive disorder does not appear as such in the first edition of DSM, but the general concept is clearly discernible in “passive-aggressive personality, aggressive type”:

“A persistent reaction to frustration with irritability, temper tantrums, and destructive behavior is the dominant manifestation.” (p 37)

Note the term “reaction” in the definition, implying that the temper tantrums are being conceptualized as a reaction to a frustrating experience, rather than an illness, as such.

DSM-II (1968)

By DSM-II, the diagnosis had acquired free-standing status as a “personality disorder”, and was called “explosive personality (Epileptoid personality disorder)”.  Here’s the definition:

“This behavior pattern is characterized by gross outbursts of rage or of verbal or physical aggressiveness. These outbursts are strikingly different from the patient’s usual behavior, and he may be regretful and repentant for them. These patients are generally considered excitable, aggressive and over-responsive to environmental pressures.  It is the intensity of the outbursts and the individual’s inability to control them which distinguishes this group. Cases diagnosed as ‘aggressive personality’ are classified here. If the patient is amnesic for the outbursts, the diagnosis of Hysterical neurosis, Non-psychotic OBS [Organic Brain Syndrome] with epilepsy or Psychosis with epilepsy should be considered.” (p 42-43)

There are three notable features of this definition.

Firstly, the term “reaction” has been eliminated.  With the benefit of hindsight, it is clear that the term “reaction” which was used extensively in DSM-I became an embarrassment for psychiatry.  In 1952, I believe that many psychiatrists would have acknowledged that the problems they encountered in their work were not illnesses in any biological sense of the term.  By 1960, however, the drugs were beginning to come on stream, and the promise was emerging that psychiatrists, if they made some conceptual adjustments, could ride pharma’s bandwagon and become “real” doctors.  And one of the conceptual adjustments that had to be made was the elimination of the word “reaction” and all that it entailed.  So, eliminate it, they did.  They offered no explanation, but there is this charmingly candid little quote on page ix of DSM-II:

“Consider, for example, the mental disorder labeled in this Manual as ‘schizophrenia,’ which, in the first edition, was labeled ‘schizophrenic reaction.’ The change of label has not changed the nature of the disorder, nor will it discourage continuing debate about its nature or causes. Even if it had tried, the Committee could not establish agreement about what this disorder is; it could only agree on what to call it.”

Secondly, the notion that the person is unable to control the aggressive impulses is introduced as a distinguishing feature of the “diagnosis”.  This is a particularly interesting development, in that it is impossible to determine whether a person is, or is not, unable to control his aggression.  All that can be determined is whether a person did or did not control aggressive impulses on any given occasion.

Thirdly, the definition clearly allows the “diagnosis” to be made on the basis of verbal aggressiveness.

Side note on “epileptoid Personality disorder”:  During the first half of the 1900’s, and even as late as the 70’s, there were frequent references in psychiatric writings to epileptic (or sometimes epileptoid) personality disorder.  It was widely believed that people with epilepsy tended to be generally impulsive, explosive, and egocentric.  The notion was given a good deal of credence and attention.  Psychiatric research purported to identify the traits involved, and causative theories were developed and promoted.  Most epilepsy specialists today consider the research to have been questionable, and the supporting observations to have been cases of people “seeing” what they had been taught to expect:   a lesson that psychiatry generally seems unable to assimilate. 

DSM-III (1980) 

In DSM-III, “intermittent explosive disorder” appears as an entry in the category “Disorders of Impulse Control Not Elsewhere Classified.”  Here are the criteria:

“A. Several discrete episodes of loss of control of aggressive impulses resulting in serious assault or destruction of property.

B.  Behavior that is grossly out of proportion to any precipitating psychosocial stressor.

C.  Absence of Signs of generalized impulsivity or aggressiveness between episodes,

D.  Not due to Schizophrenia, Antisocial Personality Disorder, or Conduct Disorder,” (p 297)

Notice that the criteria are fairly simple, and that, even allowing for the vagueness of language, what’s being described is relatively severe and serious:  “…serious assault or destruction of property.”  In other words, DSM-II’s acceptance of verbal aggressiveness as a criterion item has been eliminated: a rare instance of the APA actually tightening their criteria.  The effect of this, however, was probably minimal, as the “diagnosis” was still described under Prevalence as “very rare”.

The diagnostic criteria in DSM-III-R (1987) were essentially similar to those in DSM-III, though the list of exclusions was expanded to:  “…a psychotic disorder, Organic Personality Syndrome, Antisocial or Borderline Personality Disorder, Conduct Disorder, or intoxication with a psychoactive substance.” (p 322)

Prevalence is still shown as “apparently very rare”.

DSM-IV (1994)

DSM-IV made two changes to the criteria.

1.  Item C from DSM-III-R, which had read: “There are no signs of generalized impulsiveness or aggressiveness between the episodes”, was eliminated. Up till DSM-III-R, the “diagnosis of intermittent explosive disorder” was given only to individuals who were generally even-keeled, but who exhibited episodes of explosive anger that were apparently out of character.  DSM-IV offered no explanation for the removal of this item, stating only:  “The DSM-III-R criterion excluding this diagnosis in the presence of generalized impulsiveness or aggressiveness has been deleted.”  Obviously this deletion widens the scope of the “diagnosis”, and allows a great many more people to be given this label than was formerly the case.

2.  As in DSM-III-R, the “diagnosis” is not to be given if the episodes  “…occur during the course of…intoxication with a psychoactive substance”. DSM-IV added the clarification that this included the effects of “medication” – an implied acknowledgement that psychiatric drugs can precipitate outbursts of violence and destructiveness.

DSM-IV also amended the prevalence from “very rare” to “rare”, though in fact, Kessler et al (2006), using DSM-IV’s criteria, reported a lifetime prevalence rate of 7.3%, and a previous 12-month-rate of 3.9%.  A lifetime prevalence rate of 7.3% is approximately one person in fourteen.  This is hardly rare!

DSM-5 (2013)

In DSM-III and IV, a diagnosis of intermittent explosive disorder required several episodes of serious assaults or serious destruction of property.

But DSM-5 changed all that.  Here’s criterion A:

“A.  Recurrent behavioral outbursts representing a failure to control aggressive impulses as manifested by either of the following:

  1. Verbal aggression (e.g., temper tantrums, tirades, verbal arguments or fights) or physical aggression toward property, animals, or other individuals, occurring twice weekly, on average, for a period of 3 months. The physical aggression does not result in damage or destruction of property and does not result in physical injury to animals or other individuals.
  1. Three behavioral outbursts involving damage or destruction of property and/or physical assault involving physical injury against animals or other individuals occurring within a 12-month period.” (p 466)

Note the word “either” in the lead in, and the proliferation of “ors” in 1 and 2.  This makes for labored reading, but one thing is crystal clear:  under DSM-5 rules, a person can be assigned this psychiatric label on the grounds of “verbal aggression” occurring twice weekly, on average, for a period of three months.  A person can also be so labeled on the grounds of physical aggression that does not result in property damage or physical injury.

Essentially what this means is that a person who, say, habitually rants aggressively and obnoxiously at other motorists while driving is actually mentally ill.  Prior to DSM-5, he wasn’t mentally ill; he was just rude and vituperative.  But now, thanks to the endlessly inspired creativity of psychiatry, he is mentally ill, and can be cured of this malady by ingesting a few pills every day for the rest of his (probably shortened) life.

The authors of DSM-5 offer no explanation for this change.

“The primary change in Intermittent explosive disorder is in the type of aggressive outbursts that should be considered:  DSM-IV required physical aggression, whereas in DSM-5 verbal aggression and nondestructive/noninjurious physical aggression also meet criteria.” (p 815) [Emphasis added]

Note also the specification:  “twice weekly, on average, for a period of three months.”  These kinds of frequency statements occur occasionally in DSM-5, and were included, presumably in an attempt to rescue the “diagnosis” in question from the charge of vagueness and unreliability.  What’s not usually recognized, however, is that the frequency criteria are entirely arbitrary.  Why not three times weekly for a period of two months?  Or four times weekly for four months? The answer, of course, is because the APA says so.  There is no evidence, nor can there ever be any evidence, supporting one over the other.

AGE OF ONSET

Age of onset has been an interesting issue across the various editions.

DSM-I and II made no reference to age of onset.

DSM-III:  “The disorder may begin at any state of life, but more commonly begins in the second or third decade” (p 296) [Emphasis added]

DSM-III-R:  The same as DSM-III.

DSM-IV:  “Limited data are available on the age at onset of Intermittent Explosive Disorder, but it appears to be from late adolescence to the third decade of life.” (p 611) [Emphasis added]

DSM-5:  “The onset of recurrent, problematic, impulsive aggressive behavior is most common in late childhood or adolescence and rarely begins for the first time after age 40 years.” (p 467) [Emphasis added].  Also, Criterion E states:  “Chronological age is at least 6 years old.”  [Emphasis added]

So the usual age of onset has progressed from “second or third decade”, to “late adolescence”, to “late childhood”, and as young as 6 years old!

DISCUSSION

What’s particularly noteworthy in all of this is the progressive loosening of the criteria across time, especially the elimination in DSM-5 of the requirement for serious damage or serious assault.  The lowering of the age of onset is also telling, and DSM-5’s criterion that “chronological age is at least 6 years” is chillingly consistent with psychiatry’s present promotion of the need for “early intervention”.  Here’s a quote from Kessler et al 2006:

“Intermittent explosive disorder is a much more common condition than previously recognized.  The early age at onset, significant associations with comorbid mental disorders that have later ages at onset, and low proportion of cases in treatment all make IED a promising target for early detection, outreach, and treatment.” [Emphasis added]

Promising, one is tempted to ask, for whom?

At the risk of stating the obvious, what psychiatrists call “intermittent explosive disorder” is not an illness in any ordinary sense of the term.  There are rare instances where brain damage can precipitate episodes of extreme anger, and these should indeed be considered illnesses.  But in the vast majority of temper tantrums, there is no neural pathology, but rather the simple fact that the individual hasn’t acquired the habit of controlling his/her temper.

To previous generations, the need to train/school children in this regard was considered a self-evident part of normal child-rearing.

But psychiatry needs illnesses to legitimize medical intervention.  And where no illnesses exist, they have no hesitation in inventing them.  And since they invented them in the first place, they have no difficulty in altering them to suit their purposes.  Of course, almost all the alterations are in the direction of lowering the thresholds, and thereby increasing the prevalence.

The idea of medical professionals arbitrarily inventing, and changing, the criteria for the “illnesses” that they treat sounds so preposterous that most people find it hard to believe.  It is widely assumed that psychiatrists have valid, scientifically-based reasons for making these changes.  But in fact, intermittent explosive disorder is nothing more, and nothing less, than what the APA says it is.  And over the years, in successive revisions of the catalog, they have made these changes, culminating in the sea-change of DSM-5.

And remember, DSM-5 was also the birthplace of “disruptive mood dysregulation disorder” – a pathologizing label for children (aged 6 and over) who are persistently bad-tempered.  In intermittent explosive disorder, the psychiatrists also have an “illness” for children (aged 6 and over) who are intermittently bad-tempered.  In psychiatry, as in fishing:  the bigger the net, the bigger the catch.

The great “breakthrough” for psychiatry in this regard was DSM-III’s definition of a mental disorder:

“…a clinically significant behavioral or psychological syndrome or pattern that occurs in an individual and that is typically associated with either a painful symptom (distress) or impairment in one or more important areas of functioning (disability).”  (p 6)

DSM-III-R expanded this to:

“…a clinically significant behavioral or psychological syndrome or pattern that occurs in a person and that is associated with present distress (a painful symptom) or disability (impairment in one or more important areas of functioning) or with a significantly increased risk of suffering death, pain, disability, or an important loss of freedom.” (p xxii)

If you strip away the verbiage, and note the frequent use of the word “or”, what this actually means is:  any significant problem of thinking, feeling, and/or behaving.  This was Robert Spitzer’s “great” achievement:  defining mental disorder/illness in such a way that it could include virtually any and all problems.  It was this simple contrivance that made it possible to expand the psychiatric net more or less indefinitely.  And Dr. Spitzer’s definition has been dutifully retained, with only minor verbal changes, by both DSM-IV and DSM-5.  After all:  “if it ain’t broke, don’t fix it.”  Though it should be noted that DSM-5 did manage to relax Dr. Spitzer’s definition even further by the ingenious use of the word “usually”:  “…usually associated with significant distress…”  “Usually” means not necessarily.

It might be asked:  how can they do this?  How can they just invent illnesses for themselves to treat?  And the answer is simple:  they did it gradually and imperceptibly; and nobody stopped them.  Protesters were marginalized and ridiculed as unscientific blamers and stigmatizers, while the psychiatric juggernaut inched forward year by year, decade by decade, increasing its territory, expanding its scope, selling ever more drugs for pharma and – in the process – destroying people’s brains, and undermining our cultural resilience.

In this regard, here are some interesting quotes:

Intermittent explosive disorder:  Treatment and drugs, at Mayo Clinic:

“Different types of drugs may help in the treatment of intermittent explosive disorder. These medications include:

  • Antidepressants, such as fluoxetine (Prozac) and others
  • Anticonvulsants, such as carbamazepine (Tegretol), oxcarbazepine (Trileptal), phenytoin (Dilantin), topiramate (Topamax) and lamotrigine (Lamictal)
  • Anti-anxiety agents in the benzodiazepine family, such as lorazepam (Ativan) and clonazepam (Klonopin)
  • Mood stabilizers, such as lithium (Lithobid)”

Treating intermittent explosive disorder, from Harvard Medical School:

“A number of medications are known to reduce aggression and prevent rage outbursts, including antidepressants (namely selective serotonin reuptake inhibitors, or SSRIs), mood stabilizers (lithium and anticonvulsants), and antipsychotic drugs.”

Intermittent Explosive Disorder, Child Mind Institute, under the subheading “Treatment”:

“…a variety of medications have been used to help people with IED, including antidepressants and anti-anxiety medications, as well as anticonvulsants and other mood regulators.  After a careful evaluation, a psychiatrist will prescribe the appropriate type of medication for an individual case.”

This is not the practice of medicine; this is drug-pushing in the guise of medicine.  Whatever effectiveness the drugs might have in reducing aggression, is far outweighed by the spurious message to the individual, that he is incapable of controlling his aggression without “meds”, and to parents, that their 6-year-old’s temper tantrums are symptoms of a serious lifelong illness that needs prompt psychiatric attention.

This is not the practice of medicine.  This is a hoax.

  • Phil, Thanks for this article.

    Here are DSM-6 criteria for Intermittent Spontaneous Combustion Disorder:

    – Verbal or physical aggression occurring at least once weekly for a period of two months, or at least twice weekly for a period of one month, or at least three times in one week.
    – Two behavioral outbursts involving damage of property and/or physical assault occurring within a 208 day period.
    – The combustions (aggression) are not due to any observable environmental stimuli.
    – Does not involve actual physical spontaneous combustion.

    Please note that the illness only springs to life during any 208 period during which at least two spontaneous combustions occur. At this point it is entirely appropriate to administer medications to combat the fires.

    I wonder what odds I could get in Vegas for the DSM 6 version being like this.

    As for my real opinion, what a bunch of horsecrap. I’d guess that even most psychiatrists don’t take this kind of diagnosis seriously. But maybe I’m wrong?

  • Warren Heggarty

    IED is one of the many ridiculous diagnoses I have collected over the years. Fortunately, I met a responsible psychiatrist who told me I was a childish, irresponsible fool and that I ought to grow up and learn how to deal with anger. He doesn’t know how close he came to a fight, but he was absolutely right. I have met other people who have similarly benefited from straight talking from professionals who were more interested in helping than drugging their patients.

  • Phil_Hickey

    Warren,

    An interesting approach!

  • Phil_Hickey

    Edward,

    I don’t know if they take it seriously or not. I suspect that in their hearts they all know that it’s nonsense, but economic advantage has a way of dulling the conscience.

    Best wishes.

  • all too easy

    You’ve never had a sibling freak out in furious, explosive, out-of-control, demonic-like seething, screaming, vicious, burning hatred on you or your loved ones. Remember The Exorcism? You know what demonic strength is? Snarling, volcanic eruptions of pornographic, murderous and vile threats of doom.

  • Rob Bishop

    Many people can’t control their rage, but that’s due to ignorance and a lack of skills, and isn’t a mental illness. From 9/11 to the Rodney King riots, we don’t discuss the true root causes of seething hate filled rage.

  • Rob Bishop

    This explains child abuse, road rage, and school shootings…

  • all too easy

    Prove it.

  • Rob Bishop

    You believe the masses who went stark mad crazy during the Rodney King riots were mentally ill? And violence and killings during soccer games? You must think rage is like the common cold and spread via sneezing 🙂

  • all too easy

    Prove it.

    You have trouble with compliance. No friends. Socially inept. Loner, not by choice. Immature. Petty. Hypercritical. Childish. Must have last word. Unteachable. Cranky. Silly.

    I still amaze myself.

  • ALL TOO EASY WATCH

    The troll calling himself “all too easy” has been harassing the visitors to this blog for almost 6 months now. I’ve no idea why anybody would respond to it. It obviously has no deficit of attention to pay to this blog, it’s been coming here daily for months, just making itself look more pathetic by the day. I recommend totally ignoring it. The only reason it is still present, is because this blog’s owner prides himself on only banning people for extreme hate speech, and otherwise maintains a very liberal policy of non-censorship, which is a good thing. But sadly that comes at a cost, the cost is weeding out the worthwhile commenters from the “all too easy” troll’s worthless rubbish. This person is obviously a pathetic misfit.

  • all too easy

    Good one, Steve. Post some cartoon pictures next. You have been following me obsessively for about 6 months now. Please leave me alone. You are a pathetic jerk. Tell all your other selves, including Juan Diablo from Canadian Full of Gas Works, to get lost. Get your buddies Baughman or Breggin in here. They are too chicken. What fools.

  • ALL TOO EASY WATCH

    The troll, below, claimed my name was “Steve”. This is incorrect. The troll also claimed I’m someone called, “Juan Diablo from Canadian Gas Works”, I’ve never heard of this person if they exist. I haven’t “followed” the troll for 6 months, I’ve noticed it’s digital diarrhea smeared across this blog every time I visit this blog, and I’ve been disgusted by this troll’s pathetic behavior, that’s about it. 6 months in to his daily tirades, one hoped in the early stages the misfit troll would tire of haunting this place, but alas, it remains here, which is a shame but I reiterate my previous point, the presence of unpleasant misfits such as these, is the price of freedom of speech. I encourage all serious people to continue ignoring the troll.

  • all too easy

    What’s his name and address, Warren?

  • all too easy

    Surprise! No answer. How bout that! Thanks Warren. Didn’t fool me for a second. MY, MY, MY

  • The Right Hon. Cledwyn B’stard

    I couldn’t give a toss what people think about my outbursts of anger. Not recognizing in almost the entirety of humanity the authority to pass judgement on just about anyone but themselves, neither am I inclined to defer to them, no matter how many and varied are the stratagems they employ, with the full force of their cunning, by which men endeavor to conceal the often sinister or selfish motives they have for engaging in what are perhaps the two activities that exercise the minds of men the most; passing judgement upon others, and doling out advice, usually unsolicited.

    Now, of course, insofar as the motives are pure and disinterested, or it serves the survival or welfare interests of the individual, then the criticism of some evil in others, and the sitting in judgement thereupon, is necessary. Sometimes, men exercise the faculty of judgment judiciously, when it fixes upon some real evil, but even then the appetite for judging, and for the doling out of advice that usually attends it, from which men reap such a rich harvest of self-importance, is usually whetted by some offense against amour-propre (the deity to which all men proffer their most devout reverence, sacrilegious treatment whereof occasions grievances and rancors which amass and accumulate over time and find utterance in the negative judgements issued against the individual who fails to observe the requisite devotion, such is the extent of cunning to which men are driven by custom, their native cowardice, and the desire to conceal their wounds from others, not least those who inflict them) and anything that jeopardizes that towards which men orient the majority of their thoughts and actions, that is, their own interests, save the odd genius or saintly individual whom others, interested in the world only insofar as it concerns the aforementioned, view as mad and foolish.

    “Whatever discoveries have been made in the region of self-love, there remain many unexplored territories there.”

    La Rochefoucauld

    As with negative judgements, so self-love’s tyranny extends to the positive. Man, narcissist that he is and such being the infinite demands that amour-propre makes, man, not content merely seeing his own image in the mirror, or on the surface of the water, looks for its reflection also in the tastes, opinions, passions and appearance of others, so that, for example, when a man praises another and his works, it is rarely because of their intrinsic worth (far from it), but because it affords the opportunity to indulge in the vice, to which virtue here pays homage, of self-praise, whilst seeming to be praising another, for which reason, given that all the finest attributes our always in the minority, it is usually that which is most deserving of praise that least gets it, whereas the less praiseworthy are a man and his fruits, the more numerous and resounding the chorus of praise, and the richer and more abundant is the harvest reaped thereof, for the latter can rely on the amour-propre of the many, whereas the former must contend with their envy, and the intolerance of human difference self-love nurtures. For which reason praise is a vice I rarely indulge.

    Self-love is like the grey-eminence wielding power surreptitiously over the hearts and minds of men.

    It is like some sort of criminal mastermind that has been driven underground in order to evade captivity, only to resurface in all manner of disguises, in which respect it invites comparison with so many other traits and propensities that either the march of civilization, or their simply undesirable or unpalatable character, has condemned to a fugitive existence, so that they must dissemble in order to escape detection and capture, and to flourish.

    Take lunacy for example. Outlawed in the age of Reason, the lunacy to which all human flesh is heir has taken up residence in the subterranean depths of human consciousness, from where it conduct its operations in peace, leading a mostly shadowy existence in the conscious life of society and resurfacing under the guise of its customs, laws, beliefs, conventions, and morals, wherewith it evades the psychiatric gaze.

    (The deceptive forms that madness incarnates are too many to enumerate. The bottomless abyss of intolerance and egotism men contain within the paltry proportions of their hearts, welling up from the depths of which comes the desire to dominate, persecute, torment and mock others (a veritable mother-lode of lunacy), has no doubt been one of the sources whence sumptuary laws originate regulating consumption of pharmacological agents. This intolerance brought forth by Reason’s sempiternal slumber might just be the finest flowering of lunacy, the ne plus ultra thereof. This fanatical, lunatic obsession with a man’s habits of consumption, or any of the other trivialities people lay stress on, whereupon they base so much of their intolerance, and whereto they attach so importance, such as a man’s hair, his weight, his sexuality, his looks etc. etc.; surely this obsession is a form of lunacy, albeit it one that disguises itself in numerous forms behind the morals, laws, beliefs and customs of society.)

    The same applies with envy. As with madness (and anger, which I will come to shortly), envy, whose acknowledgement in ourselves man’s egotism denies, banished to the subconscious mind, turns up unsupervised in the most unexpected places, often underpinning the noblest and most praiseworthy endeavors (No doubt, every time St. Francis performed one of the acts, commemorated in one of the books consecrated to his memory, he directed a withering, exultant glance in his mind’s eye towards all his rivals, whom out of envy and personal ambition he endeavored through his works to triumph over in terms of sheer saintliness).

    Of course, as with madness, envy, insight whereinto presupposing a measure of space within the human mind for humility and self-loathing that amour-propre is loth to grant, is, as a general rule, the exclusive property of other people.

    The costume envy adopts in the human comedy most readily is that of impartial aesthetic criticism, amongst lay people especially, a field in which mediocrity and self-love endeavor to exact vengeance on the aristocracy of the imagination.

    Just in case anyone think I have wandered completely off-point, coming back to the subject under discussion, anger, and its sibling, hatred, invites the same comparison as the foregoing, taking refuge in the most polite gestures, smouldering beneath the most placid surfaces.

    Those who are either too rash or (even worse) too sincere to resort to the stratagems custom and prudence demands, who ventilate their vexation, with touching naivety, too openly and without dissimulation, join the ranks of the endlessly proliferating scapegoats upon whose shoulders the responsibility for the rage that regularly convulses every human heart devolves.

    Not that people shouldn’t try to contain their rage within certain limits, or should discharge it on improper objects when the proper one is wanting, but the human propensity for scapegoating, as Girard has pointed out, is deep-rooted, and like other aspects of human nature that operate unconsciously and that men struggle to reconcile themselves to, it assumes many specious forms that make its detection difficult, yet is almost like the air we breathe; everywhere, but impossible to see.

    Concomitant with the march of civilization has been an increase in man’s capacity for dissimulation, it being endemic to civilized societies it would seem, the capacity for which has evolved to allow the pariahs of human nature to adapt to an environment wherein they must live a secretive existence, lest those in whom they reside are themselves ostracized in deference to the God of Reason for failure to circumscribe the passions and propensities( that stir in every human heart) within the limits set by the customs and proprieties of civilized society, and which under a civilized dispensation can only flourish in the shadows of social life, and find their way into the life of individuals and societies only through the subterranean highways and byways of human consciousness, the naked expression of which, bringing with it the forfeiture of any claim a person might make on the sympathies of others, consigns one either to the obscurity within which society’s lepers languish and suffer a slow social death, or to some corrective institution for mental and behavioral heretics.

    In civilized society, so great has become this capacity for dissimulation and cunning, and such is the gulf that separates the inner world of man from the outer, the reality from the appearance; so hypocritical the relationship between a man’s desires, feelings, passions, and appetites on the one hand, and his expressions, words, and gestures on the other, that it has become almost impossible to figure people out with any degree of consistency, to decode the ciphers that man’s behaviors and expressions convey.

    Those who, no matter how much they may err in the articulation of their enlightened fear and cynicism, have sounded the gulf separating what men, through the external stratagems they employ, purport to be, from the inner depths of their nature, and those to whom the latter imparts its many confidences through some failure of the former; such people, having penetrated through to the dark heart of man and stripped him of all his prelapsarian and Pelagian pretensions, after long experience of the betrayal, hypocrisy, and corruption which disabuses the finest of any sacred notions they may hold about the generality of men; such people are inevitably dismissed as paranoid, either because a man, seeing in the wicked world his own reflection, is blinded by amour-propre to reality, or because, such is man’s hubris and philosophical naivety, for him there really are no things beneath the moon and stars beyond that aren’t contained in his philosophy.

    Some may find my view of human cunning (be it the cunning which is innate, or that which is the sediment left in the wake of the sweeping tide of civilization, whereupon modern man is being swept to the eight the circle of Hell, Malebolge, wherein hypocrites face their eternal punishment) to be extreme or paranoid. Maybe, maybe not, yet is it any wonder? Look at the weapons men deploy, in the service of cunning, in their arguments with others!

    Leaving aside the logical fallacies people employ, which Schopenhauer comprehensively catalogued in Parerga and Paralipomena, to which I refer the reader, and which he rightly adduced as evidence of the base cunning of man; leaving aside this, look at how they try to bully, slander, and mock their way to victory!

    They laugh at you. They try to enlist the support of observers in order so that they can thereby gang up on you, so that by dint of numerical superiority they can intimidate and overpower you. They congratulate themselves before you even have a chance to reply, no matter how wrong they are, exulting in their illusory triumph, in order so that they can confuse the thoughts and ruffle the feathers of their opponent.
    For which reason there comes a time in the lives of many men when they resolve to forgo confrontation with others, knowing all too well to what depths of cunning and depravity people will plunge when conflict intrudes in their lives along with the diabolical concoction of malice, spite, and rancor it stirs up; conflict, which lays bare the depraved depths of man, summoning forth all the demons that lurk in the shadows and deepest recesses of the human psyche.

    Coming back to the subject of anger, notwithstanding the Christian notion that anger is sinful (god, it would seem, tyrant that he is, loves to punish his creations for his own mistakes), which prejudice against wrath has adapted to the great epistemological shift that ushered in the age of reason and science through the medicalization thereof, and also notwithstanding said notion’s corollary, that we should practice universal and unconditional love, there are many uses to which anger may be legitimately and justifiably put.

    Anyway the bible, in its preaching of a martyr morality, its inculcation in victims the world over of a passion for crucifixion, and its attempt to accommodate them to their victim status, set the precedent for all subsequent ideologies of oppression that, through progressively more sophisticated rhetoric, have tried, to borrow from Voltaire on a different topic, to instill in oppressed peoples the notion that they should caress the serpent that devours them, which in the Christian ethical system took the form of enjoining victims to turn the other cheek (and to spread their butt-cheeks wide), and to love others in proportion as they hate you.

  • all too easy

    Thanks cloddie. Took the words right out of my mouth.

    Next time, try summarizing, like this, “Everything sucks except me!!!!”

  • Growing

    Warren, your post reflects the fact that good mental health in underpinned by self honesty and responsibility and I trust that you are enjoying improved mental health, improved relationships and an improved life as a result of your efforts. Self honesty and responsibility take courage to develop and I have only admiration for people who choose that path, most especially when they have not been led down it as children by sound role models. Good on you.

  • Rob Bishop

    A troll’s goal is to spread their misery. Don’t let it infect you.

  • Ana Maria De La Guardia

    Say no to stigma against people with mental illness

  • Rob Bishop

    Say “no” to the people who claim you’re defective and need drugs to reduce your suffering. They’re not on your side. I know it’s difficult, but consider the idea you’re not screwed up. The belief that something is wrong with you is based in self hatred, which we all struggle with…

  • Ana Maria De La Guardia

    Hahahahahah how naive u are, u know nothing about me. I love myself even when a im in my most crazy states of mind. the crazys rule!!!! Suck it to me

  • Rob Bishop

    You sound very angry. From what you describe, you hate parts of yourself and try to eliminate aspects of your reality. It’s common to become addicted to suffering – I’ve been there. We can become dependent on feeding the part of our psyche that thrives on negativity. You’ve demonstrated a lot of negativity, which is an expression of self hatred.

  • Ana Maria De La Guardia

    U r hallarious. i cant believe u really think all those things and the things that this websites says its mind blowing. It makes think that you are 12

  • Rob Bishop

    Anyone here familiar with the concepts of NVC (Nonviolent Communication)? And how it relates to anger, rage, and violence? I find it’s powerful in explaining why sometimes normal healthy people fly into a rage and murder.

  • all too easy

    “This is the drug pushing…” Let’s ask Dr. Saul, shall we? You are accusing him of criminal behavior. Drug pushing, speed, in this case, is a felony and is punishable by imprisonment. Let us inform him what you are saying about him. Let’s contact the DEA, the FBI and the state and Chicago police and explain that you are as a doctor reporting that you know for a fact that he is engaged in distributing meth, ok? Because that is exactly what you are doing.

  • all too easy

    Dr. Saul, are you guilty of dealing drugs? Phil Hickey says you are.

  • all too easy

    Funniest, most long-winded, rambling, bunch of self-absorbed and fanciful hogwash yet, among the plethora of foolish, easily-refuted, inane, narcissistic, high-faluting and ridiculous garbage promoted by Mr Ego himself, wouldn’t you agree, that is, if in fact, you have a brain as wonderfully endowed with horse manure, as the one and only, clodisvonidiot, the great.

  • all too easy

    Concomitant with the march of civilization has been an increase in man’s capacity for dissimulation, it being endemic to civilized societies it would seem, the capacity for which has evolved to allow the pariahs of human nature to adapt to an environment wherein they must live a secretive existence, lest those in whom they reside are themselves ostracized in deference to the God of Reason for failure to circumscribe the passions and propensities( that stir in every human heart) within the limits set by the customs and proprieties of civilized society, and which under a civilized dispensation can only flourish in the shadows of social life, and find their way into the life of individuals and societies only through the subterranean highways and byways of human consciousness, the naked expression of which, bringing with it the forfeiture of any claim a person might make on the sympathies of others, consigns one either to the obscurity within which society’s lepers languish and suffer a slow social death, or to some corrective institution for mental and behavioral heretics.

    Thanks Clodhopper. That is one dandy of a sentence, I believe, except of course given that the rational mind assumes contrary points of view for contemplation, reorganization, commingled with man’s vanity, only reduce to an approximate level consisting of primarily induced thinking patterns of pre-industrial poets expressing their disdain for religion inspired by the works of the Impressionists and Marco Polo, Napoleon and the Russian revolution, all of which gave credible expression to the theory of flawed or sinful nature cleansing which John Wesley preached and his brother, Charles, wrote hymns, to be sung without instruments in the Nave during submersion baptismal celebrations, weddings, and funerals of the sanctified wholly.

  • Rob Bishop

    Rage fueled murder is not a disease.