In the world today, there are a lot of

people who make their suffering, their

problems a part of their personality.

And the title of today's stream or this

lecture is your problems aren't your

personality. I think this is a really

great example of how like there's a

disconnect between, you know, some of

our content team and what I'm about to

say because what we're going to talk

about today is how some people's

problems become their personality. So I

know the title is like your problems

aren't a personality but actually the

really crazy thing so if you look at the

science of the tendency for

interpersonal victimhood what you

discover is there is like a personality

construct that is the tendency for

interpersonal victimhood. So actually

the really crazy thing is that it is a

normal human mechanism to turn your

problems into your personality. And I I

think this tweet is really great because

it says, you know, we become too

articulate about our suffering and too

inarticulate about our strength. The

more elegantly we describe our wounds,

the harder it becomes to leave them

behind. When a struggle becomes part of

your identity, overcoming it feels like

a betrayal of who you are. And I would

wholeheartedly agree with this tweet.

And not only do I wholeheartedly agree

with it, we're going to show you all

some fascinating research about how and

why this happens. Okay, so the first bit

of research that I'm going to talk to

you all about is not something I'm going

to show you all a paper about because

sometimes in med school you just like

learn these things and they get banked

away. So I remember learning about a

really interesting study where they

measured pain scores like in the ICU. So

basically a nurse comes in every hour

and asks you how's your pain and the

more times that someone asks you how

your pain is, the more pain you actually

feel. Right? So, I remember walking away

from this study sort of thinking or

learning this in med school and sort of

thinking like realizing, okay, when you

continually ask someone like, "How's

your nausea? How's your nausea? How's

your nausea? How's your nausea?" The

more time that a patient's mind spends

on an issue, the worse that issue gets.

So, there are multiple studies that show

that ruminating about your the negative

things in your life actually exacerbate

whatever you're ruminating about. Right?

So the more time that I spend thinking

about something, the worse that thing

becomes. And the most counterintuitive

example of this is why people who go

through traumatic experiences are not

traumatized. One of the hardest things

that I learned as a psychiatrist is that

many people who go through a traumatic

experience like just kind of leave it

behind them and like don't need to

process it much. I know it sounds really

insane, but the most confusing thing for

many people, for example, who are sexual

assault survivors is how little it

bothers them. I'm not saying that it's

okay to do or things like that. I'm

saying that there's actually a bunch of

research that shows that, you know, 50%

or more of people, I'm a bit rusty on

the numbers, when they go through a

negative experience will sort of like

have some period of like negativity

around it and then they'll actually be

okay. But if we sort of look at it right

like bad stuff happens to people all the

time but as we become more focused on it

as we become ruminating on it as it

becomes a part of as we spend more time

on it does actually become a part of our

identity and once it becomes a part of

identity then something really scary

happens because now that this suffering

becomes a part of my identity this is

who I am so I can't let go of that

suffering. And this is actually exactly

what happens. The really weird thing is

that suffering turning into my identity

is actually like a completely normal and

arguably even healthy thing. Okay, so

this is an article on the journey of

sensemaking and identity construction in

the aftermath of trauma. So peer support

as a vehicle of co-construction. So this

this paper is specifically looking at a

study of like you know peer support and

people sort of getting together and

talking about the experience of their

trauma and when they talk about it

together they develop a sense of

identity and this is a key thing you

know we talk about this a lot in in uh

Dr. K's guide to trauma about how like

if you look at trauma, what trauma does

is it shakes your sense of identity,

right? I used to be this kind of person

and then I get traumatized and now I

don't know who I am. So there is a

systematic process of reconstructing

your identity in a healthy way that we

lay out in Dr. K's guide to trauma.

Okay. So this is can be a healthy part

of trauma recovery. The problem is that

sometimes when we experience a traumatic

event, if we don't steer that narrative

identity construction in the right way,

the identity that we are left with as is

as someone who has been traumatized.

I've been screwed in life. I haven't

dated anyone in high school or college.

Therefore, I am destined to be alone.

Right? I'm someone who is lazy. I'm

fundamentally lazy and undisiplined. I

had this failure. I had this failure. I

had this failure. And now I am a loser.

These negative experiences solidify

into a negative sense of identity. Hey

y'all, if you're interested in applying

some of the principles that we share to

actually create change in your life,

check out Dr. K's guide to mental

health. So, this is a guide that

explores this process. How does

experience shape us as human beings?

Trauma is all about walling off or

suppressing things that are

overwhelming. They cannot control their

emotions, so their emotions control

them. So, check out the link in the bio

and start your journey today. Now,

here's what this kind of practically

looks like, okay? Or why this becomes a

real problem. Okay? I like this because

when we kind of go back to this when a

struggle becomes a part of who your

identity, overcoming it feels like a

betrayal of who you are, right? So I

wouldn't necessarily use the word

betrayal but I think that when I work

with patients who have developed an

identity of victimhood which if we sort

of look at this victimhood is an

identity. In the present research we

introduce a conceptualization of the

tendency for interpersonal victimhood

which we define as an enduring feeling

that the self is a victim across

different kinds of interpersonal

relationships. So the findings highlight

the importance of understanding,

conceptualizing, and empirically testing

TIV and suggest that victimhood is a

stable and meaningful personality

tendency. Okay, so here's what this

practically looks like. Some people

develop an identity based around their

suffering. Now, here's the big problem

with that. Once you develop an identity

as a victim, what this study shows and

other studies that sort of explore it

will show is that once I am a victim, no

matter where I go, that is who I am,

right? So like you may have encountered

some of these people in life, you could

be one of these people in life where

like they're a victim like at

Thanksgiving, they're a victim at their

job. And it's really fascinating because

once you tunnel down into the research

of this, there are particular things

that happen to these people. So they are

particularly like raw in terms of

interpersonal interactions. They see

themselves as the victim in

interpersonal interactions. And then the

bigger problem is that once this becomes

part of your identity, once you have a

traumatic formation of a maladaptive

identity, then it becomes really hard to

let go of. Okay. So I'll give you all an

example. I was working with uh someone

who was in their mid30s who had

something called double depression. So

when we look at depression this is

multiple clinical entities okay so one

is something called major depressive

disorder okay this is where there are

episodic periods so there are episodes

of persistently low mood anhidonia which

is the inability to experience pleasure

low energy low motivation sometimes

suicidal thinking impaired sleep all

this kind of stuff the key thing about

major depressive disorder is that it's

episodic comes and goes. So the longest

it tends to last is about 12 months. The

other interesting thing about MDD is

that it tends to resolve. So MDD is when

you have like a period of time maybe

like up to a year where you had like a

really crappy year that was hard for

you. It can be triggered by life

circumstances like losing your job or

losing a loved one or a breakup or

something like that. But then what the

way we know someone has MDD and this all

we explain in Dr. K's guide to

depression. Um the way that you know if

you have MDDD or the way that a clinical

uh clinician tells is that knows is that

let's say you have a breakup and we

would expect after a breakup you're sad

for a certain amount of time. Okay. But

if the sadness is persistent beyond the

breakup what we would expect for the

breakup period, right? So after you lose

after you uh get fired from a job,

you're really sad, you're bummed out,

you apply for other jobs, right? You

pull yourself out of it, you apply for

other jobs, you find another job. But

even when you go into work, you're

incredibly like unmotivated, very low

energy. Even though you have fixed the

problem, the symptoms persist. This is

how we separate out an appropriate

negative reaction. So in in in the guide

to depression, I talk these talk about

these as congruent depression from a

persistent clinical or sorry a clinical

episode which lasts beyond the the

stressor. Okay. But then there's another

kind of depression called dthimeia. So

this is a very like the clinical

construct behind this is like kind of

variable. It's an older concept from

psychiatry that we've sort of mod like

turned into something else. But I I like

this concept of dimeia. So dimeia is a

persistent depressive state that is

usually not as severe as major

depressive disorder. So you're kind of

sad for like 15 years at a stretch. And

some really unlucky people have both. So

I'm persistently sad for a very long

time and I have episodes of depression

layered on top. When I work with people

who are persistently sad, there's a

really really tricky element of

treatment which is that the dimeia

becomes the explanation for so many

things in their life. Right? If I am

persistently depressed, that explains

why I haven't had a successful career.

that explains why I don't have

successful relationships. That explains

my obesity, right? And and this is the

really tricky thing. I don't want to use

the word excuse because excuse implies

that it's not the real cause, right? So

when I say like, oh, this is an excuse,

that's not really the reason. So the

really tough thing about this is that

this is real. Your persistent depression

is a very real contributor to your lack

of professional success, your lack of

relationship success, your lack of, you

know, physical health and wellness,

whatever. It is a very real cause. There

are tons of studies that show that

depression leads to bad outcomes. But

the problem is once it becomes your

identity, once you have a reason why you

are a failure in life, that reason

becomes really hard to let go of.

Because if you get rid of that reason,

then why are you a failure in your life?

You can no longer blame the depression.

You have to accept responsibility

yourself. Okay? And I I see this like in

this patient other examples of um this

when I seen it in its mo most toxic

forms is actually with parents. So

parents who are like narcissistic and

things like that like you know once they

have this idea of being a victim and

like they have all of these challenges

and like I went through a lot of trauma.

So I've seen like you know parents with

borderline personality disorder who were

abused growing up and they were a victim

and once they become a victim right so

that then like if you have something

like borderline personality disorder or

bipolar disorder then what happens is

like you have a reason right why you

like you have a good reason to screw up

you have a good reason to yell at your

kids you have a good reason if you've

got BPD and you're ill and you've gone

through so much trauma and you have

difficulty regulating your affect you've

kind of got like a a very reasonable

like real reason why you are not a great

parent. And the problem is as we start

to treat this, the problem, the real

problem is that the BPD does not explain

all of you being mad at your kids. They

don't expl they don't explain every part

of the explosiveness. They don't explain

the persistent depressive disorder does

not explain every one of your failures,

right? It makes everything 50% harder.

But there is some degree of personal

responsibility somewhere in there and

that becomes really hard to let go of

right and and this is what's really

scary is our brain our mind you know

when we have a good reason for failure

it sort of shields us from our own

responsibility and so the hard work that

I often times have to do and this is not

easy to do right it's not as simple as

like because then it's like the the hard

work that I have to do is like okay how

much are you responsible right what

percentage of this is your fault and

what percentage of it isn't your fault?

That's a really hard thing to tunnel

down into. The other reason that this

becomes really hard to let go of is

constructing a a hero victim identity

through reminiscing, a phenomenological

study on rural Chinese elders. Okay, so

this is a super cool study that's

looking at older people from China who

went through some bad stuff. And the

really interesting thing about this is

these people were many times victims.

But what they sort of talk about is like

how the idea of being a victim actually

connects with the idea of being a hero.

Okay? And I I want to show you guys like

what this means. So here's the really

weird thing about being a victim. If we

look at psych basic psychology, being a

victim actually makes you a hero. It's

kind of weird, right? So think about it,

right? So there's like breast cancer. I

get diagnosed with breast breast cancer.

Now I'm a victim, right? This is not my

fault. So when we think when we define

victim and the the paper does a good job

of this, like a victim is someone who

something bad happens to you and it

isn't your fault. Now once I become once

I get diagnosed with breast cancer, that

also opens the door to being a hero.

That opens the door to being a breast

cancer survivor. Right? So being

traumatized is bad. I'm a trauma victim.

I'm a victim of trauma. But then I'm

also a trauma survivor. And this is like

healthy and adaptive. So part of that

process, part of that healthy process is

like reconstructing your identity in a

healthy way to view yourself not as a

victim but as someone who is triumphant.

This is where things get really tricky

psychologically, right? Because unless

you do this in the right way, your

heroism is rooted in your victimness. So

I don't know if y'all have seen people

like this, right? So we call this

colloquially a martyr complex. What is a

martyr complex? It is the tying of

heroism to being a victim. I am

persecuted. But what is a martyr? A

martyr is someone who suffers and is a

hero. It is the tying of a heroic

identity to being a victim. And now if

you do this now, you're in huge trouble

because the triumphant part of you, the

heroic part of you, imagine you have

persistent depressive disorder and every

day is sad. But you know what? You are

someone who's still here and your value

is not from your career, not from your

relationships, not from what you've

accomplished in your life, but your

heroism comes from your resilience in

this in the face of depression. That

becomes the most positive part of your

identity is that you're a hero because

you're a survivor. And if that becomes

the core part of your identity, if your

claim to self-esteem is that you are a

survivor, as you go into the workplace,

we end up with this, right? We end up

with everywhere I go, I become a victim

because every time I'm a victim, I'm a

hero. And when I go to work, I want to

be a hero. when I go to work, I need to

be a hero because instead of actually

doing the job and excelling in work

performance, what I'm going to do is

adopt this victim hero complex. And this

is the key thing that a lot of us miss,

right? Because we see the victim, they

cry the victim, they say they're the

victim, and sometimes they are the

victim. I'm not saying like don't

believe victims, but there is an

insidious part of this where like our

positive identity comes out of that,

which is why we can do a study that

demonstrates that there is a personality

construct of victimhood. So, how do we

get over this? It's hard, right? I I I

think a big part of this is encouraging

personal responsibility. A big part of

this is when I work with these kinds of

people, you you know what I try to do is

I don't know if this makes sense. An

idea of positive identity as a hero

victim construct is one of the worst

ways to feel good about yourself, right?

It becomes a really easy way to feel

good about yourself, but you don't feel

good about yourself because of your

actual accomplishments. That's so much

that feels so much better. And so a big

part of this is in asking yourself okay

where is my personal responsibility now

that question becomes really painful

because that means it's not somebody

else's fault that means that it's your

fault but then that also opens the door

if it is my fault then I can do

something about it then I can improve in

that dimension I actually have some

degree of control in that dimension and

then once I exercise that control once I

start making the right decisions once I

start doing things that I can actually

be proud of aside from being a victim

hero then my self-esteem is solved.

Right? And that's what we want to do

when we talk about positive narrative

identity construction. So in in the

trauma guide, we rewire your physiology,

change your brain, change your mind, and

then construct an identity. Construct a

healthy identity. And that healthy

identity is some of this isn't my fault.

Some of this stuff is. And the moment we

do that, we become empowered to change

our lives instead of being a victim.