Interpersonal Relationships

Medical Cases
of
Abnormal Interpersonal Relationship




THE DYSFUNCTIONAL BEHAVIOR



A dysfunctional behavior is a behavior that precludes an effective intepersonal communication and, thus, a productive relationship between an individual and his social environment, The dysfunctional behaviors have been classified as organic or as anorganic, with the first ones causing more social invalidity.

Causes of the Organic Dysfunctional Behavior

Among the many causes of organic dysfunctional behavior are:
  1. the deliriums that might be caused by drug or alcohol abuse(the withdrawal syndrome), an inflammation (acute encephalitis) or an infarct (atherosclerosis) of the brain or/and by epilepsy (a convulsive disorder),
  2. the dementiae that might be idiopathic, (i.e., of less known causes) like the Alzheirner's disease (senile or presenile)and the Pick's syndrome or that might be consecutive to a well known cause, like a head injury (chronic and postraumatic progressive encephalopathy) or a congenital or an acquired brain defect (as it happens in the chronic communicatory hydrocephalus)

 

Causes of the Non Organic Dysfunctional Behavior

There are many features of this ill-social relationship. Some are very bad like the major or "crazy" behavioral disorders, others are less crippling such as the personality's, the sexuality's, the gender-identity's and the anxiety's forms



      In a MAJOR dysfunctional behavior
the person behaves, mostly or always, improperly , being either:
  1. too outgoing like in mania or in hypomania,
  2. too depressive-- unduly over-anxious, childish, abusing of psychostimulating or of relaxing drugs always or from times to times (like in the cyclothymic or the bipolar form of mania) and/or suicidal,
  3. too retired or alienated from society -the many features of schizpohreny - having, for example, a disorganized and pigging or a catatonic behavior (staying still)
  4. too suspicious or paranoid, dangerous and jealous (the Othello syndrome,)-- thinking he is overun by others (sometimes called "Folie Deux" when it is sharing it with others)
This kind of improper behavior precludes any effective communication with the affected person and he/she is almost out of the society or absent from his/her community, at least mentally.

 

The Minor Dysfunctional Behaviors


    In a BEHAVIOR DRIVE dysfunctional behavior the person behaves either compulsively like in Don Juanism or messalinism and being prone to injury or illness; on the other hand he behaves with too much reserve, being afraid to commit himself (herself) and being prone to minor depressive state.

     In a PERSONALITY'S dysfunctional behavior the person may behave a litle bit improperly and have some bad ideas running in his head, and he might be either paranoid (folie de grandeur- thinking he is either a very intelligent or a powerful person), schizoid (being not enough communicative), avoidant (avoiding social contacts), obsessive-compulsive (behaving unreasonably and stubbornly), narcissistic (self-centered), antisocial (dressing improperly and being greedy), cyclothymic (too changing in mind or being ill tampered), or histrionic (overcoquettish and "playing game"). These kinds of behavior preclude good communication with others or make them last less longer if there was any.

     In a SEXUALITY's dysfunctional behavior, the sexual desire of the person is clouded The individual in this case may be incompetent sexually--not being able to enjoy itself sexually or to gratify his sexual partner, having no or not enough sexual drive. He might also have some improper sexual behavior such as fetichism (looking for sex with dolls or with inanimate objects), sadism (looking for anal or coercive sex), voyeurism (spying on people when they are nude), masochism (looking for sexual pain). People in this catgeory might have other improper sexual behavior that make them prone to contract venereal diseases, to have illegitimate or unwanted children and vulnerable to "teen pregnancies" when they are young--being sexually impulsive or uncautious.
     Those kinds of behavior preclude good intimate and sexual relationship with others while superficial and nonsexual relationship prevails. They are compensatory methods in the face of an improper sexual drive that might be either insufficient either impulsive. The individual behaves correctly at social gatherings or at work, but he does it improperly in intimacy or with his/her sexual partner.

     In a GENDER IDENTITY's dysfunctional behavior the sexual orientation of the person is perverted, but his sexual drive is normal. There are many features of this ill behavior, and among them one which is sujected to contentious and heated social debates--HOMO-SEXUALITY. Is homosexuality normal?
     There is no easy answer. Mine will be mixed and weighed, and I will use my knowledge both in Biology and in Psychology. Homosexuality is the exception in the animal kingdom and might be considered a fall, the Fall" (to quote the Christian Bible) for not being a reproductive force and thus leading to no biodiversity or to no where. However, Evolution which is a creative or reproductive force in the world may proceed without "genitality" or withouth genes' exchange. What is the answer then? Man and the higher mammals, in general, cannot live without affection or withouth sex, and whenever a partner of the opposite sex cannot be reached for reasons other than voluntary chastity, homosexuality might be a normal solution to a normal sexual drive.
     Other dysfunctional behaviors in this category are: transsexualism (wanting to be of the opposite sex, dressing like the opposite gender or mutilating his sexual part - legally or illegally - to change it), transvestism (a benign form of transsexualism), zoophilism (having sex with animals), fetichism (having sex with or loving inanimate Object), masochism and/or sadism (ignoring his sex or wanting to hurt it). Intimate relationships with others are difficult and that might explain the huge percentage of sexually oriented crimes in this group

     In an ANXIETY's dysfunctional behavior, the sexual orientation and the sexual drive of the person are normal, but they both create unconsciously (withouth his knowledge) huge amount of anxiety and fear in him. The many and ill defined features of this group are:

  1. the phobias such as agoraphobia, claustrophobia (its opposite) , sociophobia (fear of human groups), zoophobia (tear of animals)
  2. the anxiety sickness, such as any unjustified anxiety (anxious state, an atypical or unordinary anxiety) , an anxiety following a stressful or traumatic situation, and any anxiety that leads to an obsessive/compulsive behavior (like spending too much money at buying too many gifts for others, fearing to loose their love)
  3. the conversion's disorders that translate the anxiety of those people into an unintelligible or non understandable behavior for their neighbours such as:
    • the many forms of hysteria (a temporary postural and bodily dysfunction, in sensing and/or in moving)
    • the amnesia (mostly mental),the fugue (both a mental and bodily dysfunction) somnambulism (sleep walking), and the multiple personality in which the person has two lives or two states of minds, one ignoring or forgetting completely what it is done by the other
    • the somatisation or psychosomatic dysfunction in which the person converts unconsciously its anxiety into a real illness and become sick in his body; he may also adopt an improper behavior that makes him sick as in the case of "accident prone" people
    • the hypochondrial feature in which the person is not really sick but behaves unconsciously as he was sick.


    

 Most of the non organic dysfunctional behaviors and some of the organic dysfunctional behaviors are developmentally related, i.e.. they are linked to the development of the personality that can go weird in many circumstances or to some growing neurological impairment of many causes (ethiologies) and therefore can be seen among the children. Here, like precedently, there is much overlapping.

     In the first group are those that ALTER SPECIFICALY THE ABILITY OF THE CHILD TO LEARN at school and in any other environment, such as the phobic or fearful child, the overeactive child, the constantly moving (hypekinetic) child ( a progression over the later, also called attention deficit disorder), the autistic and uncooperative child (progressing to adult schizophreny), the dyslexic child, the enuretic or incontinent child, the stuntering child (those last two being minor learning disabilities) and the child who performed badly at school for non external reason.

     Those dysfunctional behaviors are strongly related to a poor parent-child relationship that could have begun very early in the life of the child.

     Other dysfunctional behaviors are those RELATED TO THE AUTONOMY OF THE CHILD, particularly when he will become an adult. These are the temper-tantric child--with a poor socialisation because of his bad temper, the stubborn child (who wants always to behave like he thinks and who does not trust the adults) , the back-talking child and the dependent child--who can become a dependent adult, living on social welfare or of his/her parents. Still other developmental, dysfunctional behaviors are related to more specific problems such as these:

  • eating problems giving way to anorexia nervosa, vomiting and the like following forceful feeding by he parents
  • sleeping problems such as nightmares, somnambulism, night terrors. night awakening, resistance at going to bed and separation anxiety when going to bed; these are related to some misbehavior of the parents, like excessive spankling, excessive scolding and allowing the child to sleep with them problems related to the toilet trainig like enuresis (urinating in bed, at nighttime) , encopresis (defecating in clothes), voluntary fecal retention that may lead to chronic constipation and acquired megacolon
  • school phobias that may lead the child to fall behind school work and that may be related somewhat to another problem, the separation anxiety and to the fact that the parents are overprotective.

     In the second group are some minor impairments and again the dyslexic and the stuntering child, but also a large group of major impairments of the social behavior that are LINKED TO SOME NEUROLOGIC DEFECT which causes can be:
  • genetic or chromosomal, like the trisomies (18, 13 and the most common 21, or mongolism, due to the old age of the mother (>35 ans), the deletion syndromes like the one affecting chromosome 5 (cri du chat, cat's cry syndrome), the anomalies affecting the sexual chromosomes (Klinefelter--XXY and Turner--XO, fragile X syndrome) and the mosaicism affecting many chromosomes
  • specifically metabolic where all the syndrome (the signs of the illness) can be linked to an enzymatic trouble in a specific metabolic pathway that is also related to the genes but of unclear causes; they have bizarre names (they have also been named after the first patient in whom they have been diagnosed) suggesting the deranged metabolic pathway, like the occulo-cerebral (Lowe's), the hyperuricemia (Lesch-Nyhan's), the mucoppolysaccharidoses (Hunter's, Hurler's,.. ) , the lipidoses (Gaucher's, Tay-Sach's, Nieman-pick's . .) the aminoaci-durias (phenylketonuria leading sometimes to idiocy, galactosemia or mapple syrup)
  • non genetic but all related to some prenatal trauma or in utero suffering, like the cerebral palsy group and some cases of epilepsy; in this group can also be included those illnesses related to the exposure of the pregnant mother to drugs and radiation for medical pur pose, congenitally infectious like in congenital syphylis, congenital rubella, congenital toxoplasmois and congenital cytomegalus virus infection.
  • finally of unknown developmental causes.
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