Pathologies and the Mask

NOTE: This post is neither directed at, nor refers to, any particular person. It presents possible speculation based on information from the discipline of psychology.

Various surveys report that from somewhere between 50 and 90% of the population wear a mask in public. Many folks continue to be surprised at the level of resistance to the mask. My blog entry on May 8, 2020 discussed this issue in the context of narcissism, but some people have asked about psychological pathologies in general. That is, while refusal to wear a mask can reflect the belief that, “It’s all about me,” can refusal also be due to other personality disorders or psychological conditions? The answer is yes.

Consider antisocial personality disorder, a pattern of behavior in which individuals consistently disregard and violate the rights of others around them. Features of antisocial personality disorder include irritability, irresponsibility, and aggression; impulsive and reckless behavior; and little remorse or guilt for causing discomfort in others. Obviously, victims of this disorder would be less likely to wear a mask.

The same could be said for psychopathy, which overlaps with antisocial disorder, but is considered more extreme and intense in its expression. Psychopathy is characterized by absence of empathy. Callousness, detachment, and a lack of empathy enable psychopaths to be highly manipulative as they glibly ignore social norms. Masks would not be their thing!

In our book Subtle Suicide: Our Silent Epidemic of Ambivalence about Living, Mike Church and I discuss the pattern of behavior called subtle suicide. Sufferers show repetitive actions that are self-defeating and self-destructive. Victims may not be overtly suicidal, but they have a lackadaisical attitude toward life – “If I’m careless crossing the street and get run over and killed, what’s the big deal?” Subtle suicide rarely involves a single self-defeating behavior such as smoking cigarettes, failure to see the doctor on a regular basis, drinking alcohol, gambling, etc.; rather, subtle suicide actions fit a larger pattern of slow and steady self-destruction, usually over many years. Anyone fitting this profile would certainly be likely to refuse wearing a mask, an action that would be part of a larger pattern of self-damage.

Although typically diagnosed in children, oppositional defiant disorder in adults would certainly influence mask wearing. ODD victims are temperamental, argumentative, and refuse to comply with rules. They deliberately annoy others and blame others for their own mistakes.

Their repeated pattern of negativity, hostility, and defiance encourages them to “spit in the face” of authority figures who urge them to follow guidelines for their own and others’ well-being. Suggestions from authority figures to wear a mask would certainly trigger such oppositional reactions.

Victims of avoidant personality disorder struggle with shyness and fear of rejection from others. They are easily hurt by criticism from others, and are unwilling to try new and potentially embarrassing things. Under the right conditions, they might appear to be good candidates for obeying mask policies; under different circumstances, however, the threat of rejection and disapproval from others could make could make wearing a mask threatening to them.

Obviously, refusing to wear a mask is not necessarily a sign that one has a personality disorder or some other psychological pathology. Reaching such a conclusion would require a diagnostic evaluation of the individual and evidence of a persistent pattern of behavior. That said, however, whether one masks-up or not could easily be indicative of larger personality tendencies. The mask can also trigger internal insecurities: the robust man who fears weakness or criticism; the teenager desperate to avoid ridicule by peers. Anyone tormented by insecurities at some level of their mind is vulnerable to view wearing a mask as psychologically threatening.

Thus, when you see someone without a mask in a situation where donning a mask is appropriate – such as a grocery store – you may be right on target if you ask yourself, “I wonder what inner turmoil they’re avoiding?”

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