Case vignette

In summary, the case of Mark, described below, demonstrates the way in which biological, psychological and social factors might interact to develop problematic personality characteristics.

Mark

Mark was one of four children. Neither of the two different fathers of the children resided in the family home, or maintained contact with their children. His mother was described by him as loving and concerned to maintain a good home for her children, but she had to work hard to make ends meet, and was often exhausted and depressed during his childhood. Her own childhood had been difficult. She had been cared for by critical and strict grandparents as her own mother was an alcoholic. Mark was described as the ‘black sheep’ of the family, a boisterous mischievous child who was always in trouble and prone to temper tantrums. His mother expected him to be obedient – as had been expected of her as a child – and responded to his unruly behaviour with harsh physical beatings.

At school, Mark was in trouble from an early age, with poor concentration, disruptive behaviour and fights with peers. He was suspended from school at the age of 12, but nothing much changed in his behaviour and he was often truanting with friends. He joined a gang when he was 14, often associating with older delinquent boys, smoking cannabis regularly; and acquired a number of convictions relating to street robberies, and taking and driving away cars.

Here, one can see how an infant with intense emotional states (temperament) and difficult to settle might have posed a particular challenge to a mother who herself had few inner resources as a result of her own experiences of deprivation (parental capacity). Temperamentally inattentive and overactive, Mark’s behaviour was exacerbated within a school environment (social) in which teachers were grappling with large classes of children with variable abilities and behaviours. With the absence of a strong adult male role model (parental), he was drawn to identify with a delinquent peer group in adolescence (social) in order to develop a sense of himself as strong, independent and respected.