What things, psychologically, can and cannot a person change about themselves?

Great Debates
1

I happen to inhabit a social circle which leans towards heavily towards the “you just need to change yourself/change your heart/change your thinking” spectrum, which has led to the following question - what is, or is not, within a person’s power to change about themselves?

We generally recognize, as a society, that some things, such as sexual orientation or right/left-handedness, are baked-in at birth and extraordinarily difficult, if even possible, to change. We also recognize that certain things are easy to change (such as, “don’t leave your socks all over the floor,” “you need to say please and thank you,”) and no big deal. We generally don’t tell depressed, OCD or bipolar people to “just snap out of it” anymore; there’s a recognition that mental illness is a real thing. As for phobias such as arachnophobia, acrophobia, etc. - we don’t generally tell people to stop being scaredy cats either (hopefully not, not anymore.) But is there a boundary as to what a person can or cannot change about themselves, and where does it lie?

Could Trump, for instance, stop being narcissistic, or is that just too baked-into his brain for him to alter? Can someone make themselves convert to another religion, or from atheism to religion or vice versa?

2

I am of the (unhappy) opinion that by the time you’re twenty, your personality is “baked and fired,” like clay. It can be shattered, but not re-molded.

Your beliefs are more open to change (although not a heck of a lot.) But your basic core attitudes – happy/depressed, optimist/pessimist, angry/calm, outgoing/introverted, caring/selfish – are all but set in stone.

Extreme life changes – the death of a loved one, a debilitating injury or illness, loss of a home in a fire or flood – can be the kind of shattering experience that might enable significant personality change.

I (unhappily) do not believe that professional counseling can do the trick. Psychiatry is like a bandage and antiseptic: it can help a little, and keep things from getting worse, but it doesn’t really “cure” anything.

3

Personality disorders, such as borderline, narcissistic, paranoid, antisocial, etc., tend to be very difficult to treat because the people who have them tend to not see that they have a problem, it’s everyone else that’s wrong and causing problems. In order for them to change they have to get to the point where they see there IS an issue, that the issue is with them and their maladaptive methods of dealing with the world and that it’s possible for them to change their patterns and habits. Then the fun part starts. That second step is a real doozy.

4

I believe strongly that people can change. Personality may be more or less set in stone barring the onset of psychosis or a severe traumatic event, but as far as many psychological disorders go, great progress can be made. I am living proof of that. It requires an insane amount of effort, but it’s doable.

Trump has probably the worst case of narcissistic personality disorder I have ever heard of. Changing that would require everyone around him to change the way they relate to him. But he is surrounded by enablers. I think he is without hope.

I don’t think belief (or not belief) is a choice. However, I do believe one can change their spiritual orientation by immersing themselves in the culture they want to transition into. When every relationship you have hinges on a shared belief, you start to believe. See: cults.

This could be very hard to change if you have ADHD.

counts number of socks on floor

Um, so I’m told.

5

You actually CAN retrain someone’s right/left handedness - that’s an essential part of rehab for losing a dominant hand/arm, or post-stroke if your dominant side is paralyzed. On the other hand, that sort of injury is (thankfully) not common and way, way more incentive than most of us will ever experience. Which might make right/left handedness more open to change than sexual orientation.

I disagree somewhat - you CAN make changes after that (and I would say 25, when the brain is fully mature) but it is very hard, it takes years, and it takes a level of motivation most people don’t have. Professional counseling can help if you’re determined to change, but no one can force you, you have to want to change yourself.

Yeah. I have a friend (we were roommates for several years, so I know her pretty well) who is diagnosed as borderline personality with some additional complications. In her late 20’s/early 30’s she came to the conclusion that a lot of her problems came from inside herself (a revelation most people with that disorder never have) and decided to change her life. YEARS of therapy ensued. Psychologically, she’s still not exactly normal but she’s actually a pretty decent person these days, pursued higher education, had had a long successful career, was the caretaker of her mother in her last years and is watching out for a sibling with some severe issues. So it is possible to change even something that extreme BUT as I noted SHE was the one who motivated to change.

I’ve been pretty worried about her during this year - while she doesn’t require constant human contact she does need to keep busy and have a schedule. Fortunately, she has worked out a schedule for herself in the current context and is hanging in there.

6

I think you are correct in your assessment of PDs, and I also think it’s a built in feature of some of them not to care when they cause other people distress.

However, I have seen people with PD diagnoses change. Borderline seems to be the most amenable to change-- maybe it’s because they crave so much attention, that they’ll go along with the idea of a diagnosis, just because it gets them attention, and they’ll take medication, submit to CBT, at it’ll have an effect, whether they were seeking one or not. Once they get a little way down the path, they suddenly get some perspective on themselves.

Interestingly, I’ve seen a narcissist, and a obsessive-compulsive PD change, and both for the same reason-- they were the worst of the worst. Because that was the case, they ended up doing things that actually got them in real trouble (one with the law, and one with CPS). Trying to straighten out their problems with the system got them on paths where they had to submit to some counseling, and ended up getting a little insight. In one case, IIRC, there was medication as a contingency of returning to previous circumstances (yes, I’m being vague on purpose, because I have confidentiality issues).

One of them ended up going very much extremely the other way, getting into meditation, yoga, alt-med for “spiritual healing,” etc., but she was a much easier person to deal with, who had learned to enjoy being genuinely kind to people. I suspect that her brain was still not working quite like most people’s, and she was getting the same sort of endorphin rush off her new paradigm that she used to get off the PD behaviors, but the new one was good for the people around her, and the old one was harmful, so it was a big improvement. So, basically, she had to have something, but she replaced the really dysfunctional behavior with something that was still a little, well, I guess “kooky,” but harmless. At least that was my observation.

7

Second step of what?

8

Of replacing the PD behaviors with ones that aren’t harmful to other people, and self-defeating in the long run.

If you’ve ever watched someone who was a fall-down drunk get sober, you know that the drying-out period can be tougher to live through with someone than the actual drinking was, and you get through it because you know it’s just a step along the route to eventually being way, way better.

Dysfunctional behaviors are deeply ingrained habits, and no, you don’t go into withdrawal when you try to give them up, but it’s a huge upheaval.

Ever had to recover from a pretty serious jet lag? You know that can be hard. This is logarithmically harder. People who have not had to recover from an 8-12 hour jet lag probably think I’m making light of the situation, but I’m not. Trying to change old behavior patterns of a personality disorder probably feels like getting fired, dumped by your spouse, and having your dog die on the same day. No matter how unworkable those behaviors might be, people rely on them.

Whatever new behaviors they’re trying to replace them with are strange, and the people aren’t very good at them yet, so they’re not producing good results.

So, yeah, really difficult.

9

I’m fine long as my truck don’t break down on the way to the bar in town.

10

This is a repeat of what I said in another thread, but I think some personality traits are a product of bad intellectual habits (simplest example: I don’t care about details of anything outside my life, and I’m uncomfortable having too much responsibility for knowing and deciding things, so I’d like to be governed by a trusted authority. Boom: authoritarianism).

If you could train someone out of that authoritarian mindset, and reset their locus of control to their own personal agency, then they no longer need to lean on authoritarian structures like religion and tend to abandon them. (not that every single religion is authoritarian, but plenty of huge ones are).

I’d also add that science is not immune from the authoritarian mindset. i.e. scientists are a great source of authoritative information, and this mistakenly treats people to engage with science in an authoritarian mode (i.e. you’re the expert, just give me the best info you have, and I’ll believe it). That’s bad, because people get upset with science when it changes and evolves exactly as it’s supposed to do.

11

We should probably talk a bit about neuroplasticity here. It was once believed that you were pretty much stuck with the brain you’ve got, but now we have a ton of evidence that certain activities can generate new brain cells, and that the brain is constantly adapting, changing and developing new pathways as our environments and behaviors change. The internet is a good example. There is evidence that the age of information has enhanced our ability to gather data but has weakened our ability to draw connections between the things we learn. (This is discussed in The Shallows: What the Internet is Doing to Our Brains by Nicholas G. Carr.) When we’re data-hunting, we’re not even reading in any meaningful sense, we’re just skimming for the thing we want to find. The impact is that deep work, like extended time reading for comprehension, has become a lot more difficult for the average person.

My point is, brains can change. They can be taught to do new things. Cognitive schemas can be rewritten. Neural pathways can be formed to beat down old habits. This is a scientific fact. The drawback here is that once you have habituated a particular neural pathway, it never goes away. That means if you fall back into the same environment or the same behaviors it will feel as cozy as slipping on an old bathrobe. You have to choose which neural pathway to activate - the destructive behavior, or the adaptive one. A lot of the success or failure of behavioral change is dependent on environmental triggers, so if you want to change a behavior, you must change your environment.

Now… some people have offered anecdotes, so I guess I’ll offer mine.

I used to be really messed up. At my worst, in my early twenties, I was unable to function due to numerous severe psychological problems. At the root of it was a traumatic childhood that had left me with the inability to manage extreme emotional states. But I had some strengths: a rare self-insight and a willingness to change how I was doing things. This required a lot of experimentation.

Over the next 17 years, I put tremendous effort into virtually every evidence-based treatment I could find. I’ve done the following:

-Cognitive Behavioral Therapy
-prolonged exposure therapy for anxiety
-prolonged exposure therapy for PTSD
-cognitive therapy for PTSD
-Acceptance and Commitment Therapy
-Meditation
-Dialectical Behavioral Therapy
-Behavioral Activation
-Transcranial Magnetic Stimulation for recurrent major depression
-Eye Movement Desensitization and Reprocessing (EMDR), three rounds - a freaking miracle, by the way
-Too many medications to list

My problems didn’t vanish forever, but at this point in my life, I have developed a certain flexibility in managing my own chronic mental illness. I have a wide array of skills at my disposal to apply to whatever situation I’m dealing with. My severe depressive episodes used to wipe me out for an entire year, now I can get back on track in a matter of days by intervening at the critical point right before bad becomes worse. I’m not saying it’s fun to be me, exactly, but the person I am now is nothing like the person I was in my twenties. I am much more resilient than I ever was before. My lows are just as low, but I bounce back faster.

It was a lot of work.

12

On phobias. I had two growing up. One was acrophobia which was and remains severe. At the Grand Canyon, I had to turn away because I could not watch people walking close to the edge. And I just cannot watch a mountain-climging movie. The other was bees. In retrospect, I doubtless learned it from my mother who screamed whenever a bee came anywhere near her. I didn’t scream but I avoided them just as she did. This lasted until the day in early 20s that I got stung. Yes, it hurt, about like getting a needle. From that day to this I ignore bees and they ignore me. I’ve been stung a few times, once by a wasp (ouch), but survived. No big deal.

I know someone who lost his right arm (up to the shoulder joint) to cancer. It took about 6 months for him to write easily with his left.

Could Trump change? Doubtful. First he would have to realize there was a problem. What problem? He’s always gotten away with it in the past, as Mary Trump showed. He always surrounds himself with enablers and always will.

13

The other problem with Trump changing is that his current behavior has been entrenched for over half a century. In general, the longer you have certain habits and behaviors the harder they are to change. It is possible even into old age, but less and less likely as time goes by.

In Trump’s case

  • decades of behavior/habits
  • lack of negative feedback/positive feedback for those behavior (he’s gotten away with it, basically
  • lack of self-reflection
  • lack of motivation to change

With all that… nope, I do not expect change in that particular case.

14

Behaviour, in terms of how you deal with stressors, is amendable to change, but the underlying personality, or how you actual feel inside, does not necessarily change that much.

A new paradigm assigns people into mild, moderate or severe (ICD-11) for any personality disorder. While the personality disorder can never truly be ‘cured’, the severity can be decreased, at least according to this conceptualization.

Of course, without therapy, it might be impossible to change, although I think studies suggest the severity of personality disorders presentations do lessen with age, it just takes a lot longer for people with maladaptive schemas compared to people with more adaptive ones, since the schema itself has to change at least a little.

15

I don’t fully agree with @Trinopus that you’re fully baked at age 20. I think the cutoff is more like age 50 for some people, especially if their problems involve self-deception. Their ego hardens around the lie as a series of unconscious habits, like an invisible hedge.

Having said that… what motivation would Trump have to ever change? If he stops being a narcissist, he’ll lose his base, which will be very unrewarding.

16

Thanks everyone for the responses thus far. Although mental illness was only meant to be part of the discussion.

What about preferences or innate phobias? If you are terrified of spiders, but someone commands you to love them, can you make yourself love them?

If someone has a religious experience and transforms into a totally different person, what exactly happened, psychologically?

17

Phobia is one of the easiest forms of anxiety to treat. Treatment often uses a graduated exposure approach. You start by making a list of types of exposures on a scale of 1-10. Say that just the mere mention of spiders rates about a 1 on the scale. On you go up the scale. Say seeing a plastic spider rates about a 4. A horror movie with spiders in it is a 7. A real life spider is a 9. A real life spider on your face is the most terrifying possible thing you can think of.

Start at 1. Learn to assess your anxiety response and learn how to tolerate the feeling of anxiety. Maybe do some cognitive restructuring (arm yourself with the facts : spiders are rarely dangerous.) Up we go on the scale, as high as it’s reasonable to go (someone who is afraid of fire cannot reasonably be immolated.) The more often you are exposed to the thing you fear, as long as there is enough time to habituate, the less you will fear that thing.

It only works if you stick with the anxious feelings long enough to habituate to them. Usually at a certain point anxiety will peak and come down. If you don’t wait for that peak and the tapering off, the anxiety will just be reinforced. That’s why it’s good to have professional guidance.

My husband is an expert on the treatment of phobias. He has said he will never expect an exposure from one of his clients that he is not willing to do himself. He’s had to do some pretty unsettling things to help his clients - like lick a toilet seat! I find it hilarious that some of his professional expenses cover things like plastic spiders, pens that look like syringes, and fake vomit.

I myself have done graduated exposure for fear of heights. There weren’t a ton of high places in my town so my highest exposure was looking down over the rail of a 4th floor parking structure. It didn’t take away my fear of heights but it did take away my fear of fear. It’s the reason I can fly in a plane. In fact the whole point of getting treatment was so that I could fly on an important trip.

18

I should add that anxiety is frequently measured on a SUDS (subjective units of distress) scale from 1 to 100, not 1 to 10 as I indicated. The client decides what is most distressing to them personally and ranks those exposures on the SUDS scale. There is then usually a target during the exposure of getting the client to at least, say, a 70 on the SUDS, and they must experience anxiety decreasing by at least half (35 on the SUDS) before exposure ends.

Prolonged exposure also works for PTSD, using imaginal and in vivo exposures. It’s even more intense, usually you haven’t “succeeded” until you’ve hit a 90 or 100 on the SUDS.

19

Are we discussing mental health, or writing a country song?

20

What’s the difference?