Deceived and Betrayed

Introduction

In this presentation I shall describe a character type revolving around recurrent crises of deception and betrayal. Patients who fall within this category appear to be so paranoidlike in their outrages, so excessively demanding of perfection, and so puritanically moral in their expectations of others, that they are frequently regarded as totally insufferable. Among a few good friends, they may be humorously labeled “the local anarchist,” “the local malcontent,” or “the local narcissist.” At first view their behavior seems to alternate between two extremes: (1) a state of vigorous, competent, single-minded devotion to the goals of an institution, the high moral purpose of a cause, or the personal well-being of a friend, as if their entire selves were merged with such aims; (2) a reaction of indescribably intense, all-encompassing outrage and disappointment which extends far beyond mere verbal expression or ordinary discharge of affect. In this reaction they feel grievously wounded and grossly betrayed by the occurrence of an ostensibly trivial but unexpected event, an event unimportant in others' terms, but vital to them. For instance, a friend may say “no” to a request, a colleague may disagree with a feature of a plan, a fortuitous minor stress may interfere with a planned project, or a spouse may make a modest but unusual request. What is of critical importance is that the event is felt to be wholly unexpected, utterly incompatible with previous experience. Its