by Jonathan Bauman, MD, Emeritus ASAP Member
It occurred to me that this would be a worthy subject to write about since
we recently elected Donald Trump, the Master of Blame, to the highest
office in the land. Blaming horrendous fires in California on Democrats, or
a tragic air crash in D.C. on DEI, may satisfy blood-lust but is ignorant,
destructive, and counterproductive. It concerns me that when our leaders
are poor role models, it affects how our young people (and many older
ones) conduct themselves. I fear that blame, and it’s cousin bullying, is a
pernicious poison spreading through our culture with help from corrosive
leadership and the internet. Targeting immigrants, DEI, or “libs” are only a
few examples of this process.
I consulted Google’s “Gemini” AI about why humans are so ready to cast
blame. Here, in summary, is what they had to say:
"Humans are prone to blaming others for a variety of reasons. Here are
some of the key factors:
• Ego Protection: As a defense mechanism protecting self-esteem by
avoiding feelings of guilt, shame, or culpability for negative outcomes
and avoiding consequences.
• Emotion Regulation: As a way to discharge anger, frustration, or
disappointment while avoiding one’s own possible responsibility.
• Cognitive Bias: Attribution error such as the tendency to over-
emphasize personal characteristics (judging) and underestimate
situational factors (context) when explaining others’ behaviors.
• Social/Cultural Factors: As a learned and reinforced behavior to
maintain dominance and avoid punishment.
• Evolution: As an innate survival mechanism to maintain membership
and status in a group.
While blaming others may provide temporary comfort or safety, it can
damage relationships, stunt emotional growth, and impede learning from
one’s own mistakes. Self-awareness, empathy for others, and owning
responsibility for one’s own actions are essential for having healthy
relationships".
I think these factors provide a useful starting point for thinking about how
we discuss blame with our patients. First, it’s imperative that we,
ourselves, cultivate a “non-judgmental” attitude and style. Certainly many
of us have participated in “root cause analyses” of untoward events to
discover factors in a system that contributed to a bad outcome. This is
hard work that requires curiosity and temperance, much harder than
scapegoating an individual, which is easy but unvaryingly hurtful and
unproductive. People are imperfect and inevitably make mistakes. We
can reduce the risk of human error by developing policies and procedures
in processes (systems), which are often more complex than we think. A
non-judgmental attitude lowers shame and defensiveness so that
adequate information may be obtained and a useful “action plan” can be
reached. This is true for groups of two or twenty.
Imagine a teenage boy who is referred to you because of misbehavior,
bullying, and cheating at a private academy where he has been sent by his
parents for incorrigibly impulsive, aggressive, and destructive behavior at
home and school, as well as poor academic performance. The family is
wealthy with high expectations for their children. Father is a harsh
disciplinarian and mother is passive and submissive. At home, praise is
mostly offered for stoicism, achievement, and interpersonal domination.
The boy has a therapist and has been referred for medication evaluation
because of failure to improve. History suggests that the patient has
undiagnosed ADHD, combined type, and also may have a written
language learning disorder. The boy, himself, is sullen, fidgety and
maintains that the academy staff are stupid and his fellow students are
losers. His parents criticize the staff for not providing enough discipline.
You realize this will be a challenging treatment case that will require close
collaboration with the therapist. You also realize that you may be the next
target of their blame.
In our work with individuals, couples, and families, whether we are just
prescribing medication or also providing therapy, it is essential that we
look at the various roles individuals play in a system. Discussing individual
behavior and responsibility is challenging because people often
experience this as criticism, especially if that person is a blamer or self-
blamer. My approach, gleaned from journalism and Family Systems
Therapy, has been to cultivate an attitude of curiosity and explore the
“who, what, where, when, and how” aspects of a given event. I avoid the
“why” question because it is often experienced as pejorative and will elicit
an excuse, rationalization or blame. Instead I might ask, “do you recall
what you were thinking or feeling when you”...did this-or-that; took such-
and-such an action. The “why” is usually complex and can only be
uncovered by gathering data through a sober, non-judgmental process.
The thesaurus informs us that the opposite of “blame” is “praise”. Undo
or excessive praise can often be harmful if it reinforces false
accomplishments or antisocial behavior. I think a functionally more useful
antonym for blame is “shame”. Blame is criticism that is delivered to
reinforce one’s sense of superiority and maintain one’s status in a group (at
least in the mind of the blamer). Shame is self-criticism and engenders
fear that one will be banished from a group. If a person has never
experienced shame, you can be pretty sure that they are a narcissist with a
grandiose sense of self. If they have experienced shame, there is hope
they may be able to grasp the context of failures and empathize with their
victims. Are we breeding a generation of narcissists in a culture rampant
with blame from our leaders, amplified by the bullhorn of social media?
Well, yes and no. On the one hand, there are those who cope with harsh
criticism and developmental trauma by “identifying with the aggressor.”
These are the ones who become mean, nasty bullies who deal with their
anger and hurt at the hands of abusive parents by displacing it onto those
they can victimize. Self-blamers, who generally have low self-esteem, may
often be among their victims. I think that this group makes up a significant
cohort of our increasingly depressed, anxious, and suicidal (or homicidal)
teens. Those lucky enough to have had “good enough parenting” manage
by doing the work of growing up - emotionally, socially and academically.
But how many of these teens become demoralized, anxious, and
depressed by the chaos around them? How many of them add to our
crisis in adolescent mental health?
Blame is easy; solutions are not. How we conduct ourselves as healers —
promoting insight, counseling families, suspending blame — can provide a
healthy role-model for our adolescent and young adult patients and their
parents.
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