I've often tried to formulate this as neurotic as opposed to psychotic meaning choice and/or nurture which can be changed vs nature requiring medical intervention. Some people just have a bad set of behaviors and/or attitudes and can be trained out of them, others have a physical illness and some have both which really confuses things. The really unfortunate ones are so neurotic they fight any treatment for their psychosis. I see it especially in depressives who blame the world for their disease and hang on to their symptoms in an ongoing cycle of self pity. If they worked at treating their depression, they would have to give that up and some people are hooked on it.
Although I'm not sure how it relates to Bouncy Ball's post. But I have noticed the behavior that you are talking about in regards to depressives on more than one occasion. Three to be exact. I've confronted all of them about it. One got very defensive. One changed the subject and proceeded to get very drunk. The most honest one basically said that the depression is a part of who she is so I should accept her for who she is. Changing is probably the hardest thing to do.
destructive behaviors that can be changed (dysfunctional families) and destructive behaviors that are a result of skewed impressions brought on by disease. Society uses the term "crazy" to describe both, and there is some confusion and crossover at the edges. Some are "crazy" in both senses. Some cases are especially hard. How much in control was the Unibomber?
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