Upton: Changing dangerous behavior

So, I'm sitting in the doctor's office waiting ... not for my own appointment actually, but for anyone's appointment. Why? Because I'm late.

Since I've already lost my place in line, they've told me I'll need to reschedule, but I decide to wait for someone not to show up instead.

Why? Because this is my rescheduled appointment from last week when I was late, and I'm not sure I'll be on time for a third. My dentist's office knows me so well they simply lie to me, writing down appointment times at least 15 minutes ahead to throw me off. Of course, I'm OK with this, even grateful. When I call them breathlessly to tell them I'm five minutes away, they simply laugh as if to ask, "What else is new?"

Miraculously, I get called to the back of the doctor's office, probably due to the staff's desire to politely remove me from the waiting room than to an actual cancellation. I marveled, 20-plus years of being not-so-fashionably late, and I still struggle to modify my behavior. I do try.

I wonder, though: What if my behavior led to something truly serious, like jail time? While being late rarely leads to incarceration, what if it did? Would I be the type of person that could truly change then? I'm sure I'd learn quickly how to manage my mornings better if being behind bars was the outcome of not being on time.

But there are forms of behavior that do lead to jail, and there are many people who can't change the behaviors that keep landing them in locked cells; they can't seem to stop.

According to several recent studies, many prisoners tend to suffer from personality disorders at much higher rates than the general population. Borderline and antisocial personality disorders specifically can affect at least half the prison population, studies show, whereas only 1 to 2 percent of the general population tends to suffer from them.

Personality disorders are pronounced patterns of behavior that are disruptive and often destructive. The characteristics of those suffering from borderline personality disorders are:

• Affective instability: Intense and unmodulated emotions. Basically, this person is all over the place when it comes to expressing their feelings, and flying into a rage would be rather common.

• Identity problems: They struggle to maintain a solid sense of themselves or others. They often experience feelings of total love or total disdain for people, rarely able to maintain middle ground.

• Unstable interpersonal relationships: They fear abandonment, are often ambivalent, dependent and yet distrustful. Think, "I hate you -- don't leave me!" which is actually the title of a great book on the subject.

• Impulsive and self-harming: They engage in behaviors which carry negative consequences, but seem to find themselves engaging in them regardless of those consequences

People with antisocial tendencies show a disregard for rules and laws, often leading to criminal behavior. They lack normal empathy for others, are aggressive and generally defy social norms. They have usually operated this way since adolescence.

Experts say that some inmate behaviors may be the result of mental illness or personality disorders rather than simply a matter of free will. Understanding this and treating inmates accordingly may help with violence within prisons, repeat offenses, and greatly reduce expenditures.

One study found that treating those with mental problems in prison costs far more than treating them outside of prison. Intercepting individuals already struggling on the outside could do more for transforming the justice system than we may know.

Tabi Upton is a therapist, writer, and workshop presenter. Contact her at tabiupton@bellsouth.net.

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