Externalization is a term used in psychoanalytic theory which describes the tendency to project one's internal states onto the outside world. It is generally regarded as an unconscious defense mechanism, thus the person is unaware they are doing it. Externalization takes on a different meaning in narrative therapy, where the client is encouraged to externalize a problem in order to gain a new perspective on it.
In Freudian psychology, externalization (or externalisation) is a defense mechanism by which an individual projects their own internal characteristics onto the outside world, particularly onto other people. [1] For example, a patient who is overly argumentative might instead perceive others as argumentative and themselves as blameless.
Like other defense mechanisms, externalization can be a protection against anxiety and is, therefore, part of a healthy, normally functioning mind. However, if taken to excess, it can lead to the development of a neurosis.
Michael White states that the problem of the client is externalized, to alter the client's point of view. [2]
Problems with self-regulation, including impulsivity, violence, sensation-seeking, and rule-breaking, are indicative of an externalizing risk pathway. [3] A discrepancy exists between bottom-up reward-related circuitry, such as the ventral striatum, and top-down inhibitory control circuitry, which is located in the prefrontal cortex, linking externalizing behaviors. [4] Externalization is often related to substance use disorders. In particular, alcohol use disorder is one of disorders that much externalization research has been dedicated to. Often, issues within the externalizing risk pathway, namely vulnerabilities in self-regulation, may impact the development of alcohol use disorder differently across stages of the addiction cycle. [5] Likewise, marijuana use has been linked to an externalizing pathway that highlights aggressive and delinquent behavior. [6] Another type of disorder that is linked to the externalizing pathway is Antisocial Personality Disorder due to its tendency to relate by lack of constraint. [7] Much research has examined the similarities of antisocial personality disorder and substance use disorder in relation to externalizing behaviors. [8] [9] [10]
In externalization, the problem is the problem. As such, it becomes objective and can be addressed in unique ways (White, 1991). Externalization separates the person from the problem and permits the problem to be viewed from a variety of perspectives and contexts.
Conduct disorder (CD) is a mental disorder diagnosed in childhood or adolescence that presents itself through a repetitive and persistent pattern of behavior that includes theft, lies, physical violence that may lead to destruction, and reckless breaking of rules, in which the basic rights of others or major age-appropriate norms are violated. These behaviors are often referred to as "antisocial behaviors", and is often seen as the precursor to antisocial personality disorder; however, the latter, by definition, cannot be diagnosed until the individual is 18 years old. Conduct disorder may result from parental rejection and neglect and can be treated with family therapy, as well as behavioral modifications and pharmacotherapy. Conduct disorder is estimated to affect 51.1 million people globally as of 2013.
Antisocial personality disorder, sometimes referred to as dissocial personality disorder, is a personality disorder characterized by a limited capacity for empathy and a long-term pattern of disregard for or violation of the rights of others, starting before one was 15 years old. Other notable symptoms include impulsivity, reckless behavior, a lack of remorse after hurting others, deceitfulness, irresponsibility, and aggressive behavior.
In psychology, trait theory is an approach to the study of human personality. Trait theorists are primarily interested in the measurement of traits, which can be defined as habitual patterns of behavior, thought, and emotion. According to this perspective, traits are aspects of personality that are relatively stable over time, differ across individuals, are relatively consistent over situations, and influence behaviour. Traits are in contrast to states, which are more transitory dispositions.
Disinhibition, also referred to as behavioral disinhibition, is medically recognized as an orientation towards immediate gratification, leading to impulsive behaviour driven by current thoughts, feelings, and external stimuli, without regard for past learning or consideration for future consequences. It is one of five pathological personality trait domains in certain psychiatric disorders. In psychology, it is defined as a lack of restraint manifested in disregard of social conventions, impulsivity, and poor risk assessment. Hypersexuality, hyperphagia, substance abuse, money mismanagement, frequent faux pas, and aggressive outbursts are indicative of disinhibited instinctual drives.
Oppositional defiant disorder (ODD) is listed in the DSM-5 under Disruptive, impulse-control, and conduct disorders and defined as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness". This behavior is usually targeted toward peers, parents, teachers, and other authority figures, including law enforcement officials. Unlike conduct disorder (CD), those with ODD do not generally show patterns of aggression towards random people, violence against animals, destruction of property, theft, or deceit. One-half of children with ODD also fulfill the diagnostic criteria for ADHD.
Emotional dysregulation is characterized by an inability to flexibly respond to and manage emotional states, resulting in intense and prolonged emotional reactions that deviate from social norms, given the nature of the environmental stimuli encountered. Such reactions not only deviate from accepted social norms but also surpass what is informally deemed appropriate or proportional to the encountered stimuli.
An addictive behavior is a behavior, or a stimulus related to a behavior, that is both rewarding and reinforcing, and is associated with the development of an addiction. There are two main forms of addiction: substance use disorders and behavioral addiction. The parallels and distinctions between behavioral addictions and other compulsive behavior disorders like bulimia nervosa and obsessive-compulsive disorder (OCD) are still being researched by behavioral scientists.
Psychopathy, or psychopathic personality, is a personality construct characterized by impaired empathy and remorse, in combination with traits of boldness, disinhibition, and egocentrism. These traits are often masked by superficial charm and immunity to stress, which create an outward appearance of apparent normalcy.
Emotional and behavioral disorders refer to a disability classification used in educational settings that allows educational institutions to provide special education and related services to students who have displayed poor social and/or academic progress.
A spectrum disorder is a disorder that includes a range of linked conditions, sometimes also extending to include singular symptoms and traits. The different elements of a spectrum either have a similar appearance or are thought to be caused by the same underlying mechanism. In either case, a spectrum approach is taken because there appears to be "not a unitary disorder but rather a syndrome composed of subgroups". The spectrum may represent a range of severity, comprising relatively "severe" mental disorders through to relatively "mild and nonclinical deficits".
In psychology, impulsivity is a tendency to act on a whim, displaying behavior characterized by little or no forethought, reflection, or consideration of the consequences. Impulsive actions are typically "poorly conceived, prematurely expressed, unduly risky, or inappropriate to the situation that often result in undesirable consequences," which imperil long-term goals and strategies for success. Impulsivity can be classified as a multifactorial construct. A functional variety of impulsivity has also been suggested, which involves action without much forethought in appropriate situations that can and does result in desirable consequences. "When such actions have positive outcomes, they tend not to be seen as signs of impulsivity, but as indicators of boldness, quickness, spontaneity, courageousness, or unconventionality." Thus, the construct of impulsivity includes at least two independent components: first, acting without an appropriate amount of deliberation, which may or may not be functional; and second, choosing short-term gains over long-term ones.
In personality pathology, dimensional models of personality disorders conceptualize personality disorders as qualitatively rather than quantitatively different from normal personality. They consist of extreme, maladaptive levels of certain personality characteristics. Within the context of personality psychology, a "dimension" refers to a continuum on which an individual can have various levels of a characteristic, in contrast to the dichotomous categorical approach in which an individual does or does not possess a characteristic. According to dimensional models personality disorders are classified according to which characteristics are expressed at which levels. This stands in contrast to the traditional categorical models of classification, which are based on the boolean presence or absence of symptoms and do not take into account levels of expression of a characteristic or the presence of any underlying dimension.
Callous-unemotional traits (CU) are distinguished by a persistent pattern of behavior that reflects a disregard for others, and also a lack of empathy and generally deficient affect. The interplay between genetic and environmental risk factors may play a role in the expression of these traits as a conduct disorder (CD). While originally conceived as a means of measuring the affective features of psychopathy in children, measures of CU have been validated in university samples and adults.
Externalizing disorders are mental disorders characterized by externalizing behaviors, maladaptive behaviors directed toward an individual's environment, which cause impairment or interference in life functioning. In contrast to individuals with internalizing disorders who internalize their maladaptive emotions and cognitions, such feelings and thoughts are externalized in behavior in individuals with externalizing disorders. Externalizing disorders are often specifically referred to as disruptive behavior disorders or conduct problems which occur in childhood. Externalizing disorders, however, are also manifested in adulthood. For example, alcohol- and substance-related disorders and antisocial personality disorder are adult externalizing disorders. Externalizing psychopathology is associated with antisocial behavior, which is different from and often confused for asociality.
Robert Frank Krueger is Hathaway Distinguished Professor of Clinical Psychology and Distinguished McKnight University Professor in the Department of Psychology at the University of Minnesota. He is known for his research on personality psychology, clinical psychology, quantitative psychology, developmental psychology, personality disorders, behavioral genetics, and psychopathology. He is the co-editor-in-chief of the Journal of Personality Disorders.
Wendy Johnson is an American differential psychologist and professor of psychology at the University of Edinburgh. She holds the chair in Differential Development in the Department of Psychology and Centre for Cognitive Ageing and Cognitive Epidemiology at the University of Edinburgh.
Deborah M. Capaldi is a developmental psychologist known for her research on at-risk male youth and the intergenerational transmission of substance use, antisocial behavior, intimate partner violence, and child abuse. She is a senior scientist at the Oregon Social Learning Center. Her current projects focus on child exposure to family violence and parenting practices of at-risk parents.
Theodore P. Beauchaine is an American psychologist. His research focuses on neural bases of behavioral impulsivity, emotion dysregulation, and self-injurious behavior, and how these neural vulnerabilities interact with environmental risk factors across development for both boys and girls. He is among the first psychologists to specify how impulsivity, expressed early in life as ADHD, follows different developmental trajectories across the lifespan for boys vs. girls who are exposed to adversity. In contexts of maltreatment, deviant peer affiliations, and other environment risk factors, boys with ADHD are more likely to develop conduct problems, substance use disorders, and antisocial traits, whereas girls with ADHD are more likely to engage in self-injurious behavior and develop borderline traits. In protective environments, these outcomes are far less likely. Beauchaine has received two awards from the American Psychological Association: the Distinguished Scientific Award for an Early Career Contribution to Psychology and the Mid-Career Award for Outstanding Contributions to Benefit Children, Youth, and Families.
The Hierarchical Taxonomy Of Psychopathology (HiTOP) consortium was formed in 2015 as a grassroots effort to articulate a classification of mental health problems based on recent scientific findings on how the components of mental disorders fit together. The consortium is developing the HiTOP model, a classification system, or taxonomy, of mental disorders, or psychopathology, aiming to prioritize scientific results over convention and clinical opinion. The motives for proposing this classification were to aid clinical practice and mental health research. The consortium was organized by Drs. Roman Kotov, Robert Krueger, and David Watson. At inception it included 40 psychologists and psychiatrists, who had a record of scientific contributions to classification of psychopathology The HiTOP model aims to address limitations of traditional classification systems for mental illness, such as the DSM-5 and ICD-10, by organizing psychopathology according to evidence from research on observable patterns of mental health problems.
The influence of childhood trauma on the development of psychopathy in adulthood remains an active research question. According to Hervey M. Cleckley, a psychopathic person is someone who is able to imitate a normal functioning person, while masking or concealing their lack of internal personality structure. This results in an internal disorder with recurrent deliberate and detrimental conduct. Despite presenting themselves as serious, bright, and charming, psychopathic people are unable to experience true emotions. Robert Hare's two factor model and Christopher Patrick's triarchic model have both been developed to better understand psychopathy; however, whether the root cause is primarily environmental or primarily genetic is still in question.