Behavior Serves a Purpose

By Dr. Lloyd I. Sederer

Your son leaves his dirty football uniform on the floor of his bedroom - despite your almost countless pleas to put it in a hamper or the washing machine. Your impatience with the extra work he creates and his indifference to your pleas has you plotting for retribution.

But what if he left the clothes pile up where he did as a visual cue, a memory for him of the adrenaline pumped football game he had played that day with his friends?  His behavior has a purpose. 

He may still be feeling the limbic traces of the gridiron, a clear escape from an afternoon of grinding homework awaiting in his room. After all, cleaning up his clothes might wipe his brain of the lingering thrill of the game.

Or more seriously, when a son or daughter isolates themselves in their room and calls out as if someone was knocking? Or avoids dinners with family or friends? Or locks their door to protect against fears about a demon plotting against them or the family? Or won’t eat fearing that the food is poisoned? Their behaviors serve a purpose, but one we may not recognize or understand. 

These are the types of incomprehensible behaviors that psychotic mental disorders can produce. They are driven by internal voices, ideas, or visions that others don’t experience. But which can carry great force in the mind of the person suffering from a psychotic condition, but not to you or me. For the person with a psychosis, they serve a purpose, just one you or I can’t appreciate.

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People with a serious mental illness (like schizophrenia or bipolar disorder) may not hear, see, or understand a comment, question or other cue from you or me inviting a response, whatever that may be. Their concentration may be limited, or they may be attending to another matter, like an inner voice (a hallucination) or fixed, false idea (a delusion). Whatever the cause, to them the voice or fixed idea feels real and compelling. They are responding to their own inner orchestra of sounds, sights, or ideas - called psychosis. They are responding to a personal, private world of hallucinations and delusions. To which we are not privy.

Usually, a person with psychotic thoughts or voices will not reveal them. Perhaps out of fear of not being understood or of the consequences of revealing the inner world they have, and others do not.

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When a behavior seems odd or difficult to comprehend, it likely is serving a purpose. For them - not us, to whom it may seem incomprehensible. 

By our asking a question to ourselves about what was meant to be said or done - without judgment – helps to maintain a conversation – even a relationship.  

Too often we are prone to dismiss or judge what we do not understand. Which has the effect of pushing the other person away from us, sometimes deeper into their inner world of psychosis. We all want to be understood and communicated with – but in a manner that is respectful and kind. By asking ourselves what purpose might be served by a behavior that makes no sense to us, we create the conditions needed for an everyday exchange of information. The conditions needed to effectively maintain communication, and thus a relationship with another person.

When this other person is a family member or loved one, the importance of ongoing and understandable communication grows in importance. Its alternative is distance, or confusion, or the loss of patience – all knives in the heart of maintaining a kind and comprehensible relationship with a person vital to us. As well as important to them.

People with serious mental illnesses have challenges with the relationships close to them, with their loved ones, friends, and co-workers. Yet, people with these serious illnesses need close and trustworthy relationships, just like the rest of us. Mental illnesses alter in troubling ways what people effected experience in relationships. Which make for distance, confusion and distrust.

One way we can counter the problems in having the good and trustworthy relationship we may have with a person with an (active) mental illness is to think that their behavior serves a purpose. For them, it is their effort to live in a world confounded by the mental disturbances caused by their illness. When we appreciate that behavior serves a purpose, we can better help keep the lines of communication open and understandable.

When we recognize that behavior serves a purpose, we are doing our part to maintain a safe and trustworthy relationship, based on respecting – not judging – behaviors that otherwise might confuse us. That can have us draw conclusions that distance and negatively influence us. 

Yes, this takes another ounce (or more) of effort. When you have decided that effort will likely serve all those involved.

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Lloyd Sederer, MD, is a psychiatrist, public health doctor, and non-fiction writer.

You can reach him through his website: www.askdrlloyd.com