Psychological labeling can do more harm than good

Last week, a friend told me about an experience she had at a local fast-food eatery. While standing in line, she was engaged in conversation with an elderly friend who was seated. Their voices were somewhat raised due to the noise in the busy restaurant. The elderly lady was in the process of telling my friend how happy she was to be living here at the beach.

All of a sudden, another patron, seated all the way across the room, began to yell—accusing them of talking too loudly. The level of his voice was far higher than their conversation had been. They immediately lowered their voices, and you might have expected the incident to end right there. But it did not.

The man (who was with his wife and kids) continued to yell at them, screaming louder and louder, until the elderly lady finally got up and left. The man’s reaction—and escalation of his anger—was far in excess of whatever might have been even minimally appropriate.

Obviously there was more going on here than just a complaint over raised voices. We hear all the time about incidents of road-rage that escalate into violence, or verbal and physical attacks from strangers over things that seem so insignificant. Why are some people on a hair-trigger to yell, abuse and even do physical harm? What is going on in their minds that makes them so angry that the slightest thing sets them off?

Well (surprise, surprise), some members of my profession (no doubt to the satisfaction of some clever criminal lawyers) have turned this irresponsible lack of self-control into a ‘disease.’ (So apparently our screaming aggressor needed nothing more than a good pharmacist!) Behavioral sciences writer Bruce Bower states in Science News Online ( that ”Intermittent Explosive Disorder’ features tirades, grossly disproportionate to the triggering circumstances, during which a person destroys property, tries to hurt or actually hurts someone, or threatens to do so. The expression of rage elicits a sense of relief, followed by remorse for the incident.’

Well, OK—pretty obvious, in spite of the high-falutin’ language. Today’s trendy psychological labels are anything if not descriptive! If I had a nickel for every person who has proclaimed to me, ‘I have ADD (Attention Deficit Disorder),’ I would be a rich man (or at least have a big room full of nickels). Whenever I hear that, I immediately think, ‘So you don’t always pay attention. How is that a disease? It sounds to me more like a bad habit.’ This out-of-control ‘diseasing’ of every unusual behavior—from distracted teenagers who squirm in their seats, to spoiled adults who can’t control their tempers—is a disservice to the occasional person who might actually have a true physiological problem.

These labels do nothing more than describe (and, maybe, impress), but they don’t tell you anything about the deeper nature of the problem. Though it’s impossible to know the specifics about our angry restaurant patron’s life, we can be sure of three facts: First, he’s really angry about other things, and that day’s subjective trigger event happened to be a perfectly benign conversation. Two, he’s profoundly unhappy—not merely stressed, but unhappy. Even moderately happy people don’t take their troubles out on total strangers. Third, he’s in the habit of indulging his emotions. He’s in the habit of operating on the false belief that, ‘If I feel it, then it’s true.’

The early days of psychiatry brought about the unfair and outdated stereotype that an adult’s problems were the fault of his or her mother. I won’t do that, but I’m willing to bet that this man, over the course of his life, has been enabled in his behavior by at least one significant person—mother, father, spouse, whomever. This enabler, though not responsible for this man’s actions and emotions (he, alone, is), has helped perpetuate the illusion that he’s entitled to treat his feelings as valid—no matter how obnoxiously he chooses to express them.

I think we need to replace these technical-sounding labels with plain, objective language. How about: ‘That man is really angry about a lot of things, and he reacted in a profoundly irrational and inappropriate way.’ He does NOT deserve a free pass for having a ‘disorder.’ He should be held responsible, and ganged-up on by everyone in his life for being an insensitive idiot.

No, I’m not encouraging hostility here. That would just lead to more escalation (and possibly violence). The best course of action is to say nothing. Why get involved in his little, angry world? If HE tries to escalate, let the store manager do his or her job and throw him out.

There’s one thing I do NOT advise in situations like this, and that’s appeasing him. Don’t give him what he wants. Notice how when my friend hushed her conversation, he got even angrier. When you appease unreasonable and angry people, it ’emboldens’ them to go even further. Ignore them. Don’t grant them power they don’t deserve. By giving them what they want, you imply to them that their feelings ARE valid, which is exactly the wrong thing to communicate.

Logically, you might think that giving the man what he wanted—quieter conversation—would have made him calm down, yet just the opposite happened. Why? The answer is obvious: It’s not quiet he wanted; it was control over other people. If you respond and give him the power he wants, he’ll only demand more.

In such situations, neither escalate nor enable. It’s his responsibility to ‘cure’ his ‘intermittent explosive disorder’ on his own time, not yours—and not his pharmacist’s.