Understanding Abnormal Behavior - Cengage Learning

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The Case of Steven V. xv
Hello diary! Another do-nothing day! Parents won’t let me do anything. Maybe I should jack
off. . . . Got another good porno tape. This room’s like a prison. Hello walls. . . . hello desk . . .
hello fly . . . hello hell! Ha, that’s a good one . . .
Every day’s the same.
When you’re in the well!
Every day’s a game.
When you’re in hell.
This passage reveals another aspect of what is happening with Steve. He feels trapped, immobilized,
lonely, and unable to change his life. He has never recognized or accepted the responsibility of making
choices. He externalizes his problems and views himself as a passive victim. In this way Steve evades
responsibility for choosing and protects himself by staying in the safe, known environment of his room.
Steve needs to realize that he is responsible for his own actions, that he cannot find his identity in
others. He needs to get in touch with, and express directly, his feelings of anxiety, guilt, shame, and
anger. And he needs to be open to new experiences. All this can be accomplished through a free, open,
and unstructured client-therapist relationship.
A Behavioral View of Steven V.
Now suppose that Steve’s therapist is strongly oriented toward the behavioral models. He or she would
then discuss Steve’s problems in terms very much like the following.
Let me start by drawing an analogy between behavior and music. In music, all the songs a performer
has learned make up the performer’s repertoire. Quite similarly, all an individual’s behaviors—all the
responses the person has learned to make in each situation—constitute the person’s behavioral
repertoire.
The roots of Steve’s problems can be traced to his behavioral repertoire. Many of the behaviors he has
learned are inappropriate (much like songs that nobody wants to hear), and his repertoire lacks useful,
productive behaviors.
Many of Steve’s troubles stem from his deficiency in, or lack of, social skills. He has had little practice
in social relationships, and so has difficulty distinguishing between appropriate and inappropriate
behavior. You can see evidence of these problems in his withdrawn behavior when he is in the
company of relatives or his parents’ or Linda’s friends. Steve himself reports that he feels apprehensive
and anxious in the company of others (for example, Linda’s friends) and finds himself with no idea of
what to do or say. While others seem to have no difficulty making “small talk,” Steve remains silent.
When he does speak, his statements are usually perfunctory, brief, and inappropriate. I think this
deficiency stems from Steve’s early social isolation, which prevented him from developing
interpersonal skills, and from his lack of good role models. His parents seldom interacted with one
another or with Steve. Recall that Mr. V.’s manner of relating to his son was generally antagonistic; he
did not model effective and appropriate skills.
I am also interested in exploring Steve’s bouts of depression, but I need to know several things: first,
through what specific behaviors is Steve’s depression made manifest? Does he withdraw from social
contact? Lose his appetite? Weep? Make negative statements? If we are to help Steve change his
behavior, we must know what behavior we are talking about. Too often terms such as depression,
passivity, and anxiety are used without a common referent. For example, when a client calls himself
“shy,” we must be sure that both therapist and client understand the term in the same way.
Second, what situations tend to elicit his depression? If the events share common characteristics, then
we may be able to control or alter them to Steve’s advantage. Again, it appears that Steve experiences