From Entitlement to Treatment


It is a common trait found among many of those undergoing treatment for addiction: A pronounced sense of entitlement. It may be viewed as a lack of gratitude, or even a form of narcissism, and while there is little doubt that it can substantially contribute to the development of dependent behavior, it may also be a symptom of personal trauma as well.

“I Deserve This”

It is easy to recognize how a sense of entitlement can contribute to dependency. Seen through the self-centered lens of entitlement, virtually any circumstance can be manifest into a rationale for self-destructive behaviors such as drinking or using drugs. When sad or stressful situations arise, the entitled person may feel they deserve relief, just as they may feel that happy occasions deserve “celebration.”

Because the entitled individual is making these choices consciously, it may interfere with their ability to recognize the physiological effects of addiction when they manifest themselves. Since the body’s need for a “fix” induces stress-like symptoms, entitled individuals may just attribute it to everyday irritations like bad traffic or an irritating coworker. This can both expedite addiction’s downward spiral and prolong the time before an individual is able to recognize that they need treatment.

It can also serve to complicate the treatment process itself by adding another layer of dysfunction between personal trauma and dependency, as well as by making the process more contentious.

Frozen Growth

As we have discussed previously, the roots of addiction can ultimately be traced back to unresolved personal trauma. Most often, this kind of trauma occurs in childhood, where it interrupts the normal course of emotional development, causing the individual to develop defensive coping methods at an early age.

Although these coping mechanisms may evolve as the child grows into adulthood (manifesting into addiction or dysfunctional behaviors), the need for them does not. Thus, it is not uncommon to see a fully-grown adult addict display childish behavior when emotionally triggered. In many ways, their traumatized individual’s emotional development is arrested, and they must use whatever coping mechanisms are available to them to both deal with and mask the psychological pain the trauma causes. Such is the case with entitlement and self-centered behavior, which is normally found in young pre-school-age children, and even to some degree in teenagers.

However, entitlement can be complicated. Dysfunctional self-centered behavior may stem from physical abuse, but it may just as easily stem from an overindulgent and overprotective parent, which can also cause a form of trauma. (Read our blog article on Enmeshment here )

King Baby Syndrome

It is natural for a parent to want the best for their child. However, it can be difficult for parents to recognize where to set limits or establish boundaries.

Even when a parent is aware that they may be “spoiling” their child, it may not be clear how indulgent behaviors can affect their child’s development. And certainly, no doting parent wants to recognize that they may be creating or facilitating trauma in their child.

In 1986, Tom Cunningham of Hazelden termed this the “King Baby Syndrome” in a pamphlet, giving a name to the personality disorder seen so often among the recovering addicts treated by Hazelden.

Narcissistic Wound

Further complicating the connection between entitlement, addiction, and trauma, is the fact that self-centeredness in adults can grow out of reinforcement of either a positive OR negative self-image. While the “King Baby” scenario suggests that overindulgent parents inadvertently teach their children the world revolves around them, the exact same kind of entitlement can be found in those who suffer from very low self-esteem.

This kind of poor or negative self-image often arises being unable to live up to unrealistic standards, or from traumatic events that inspire intense shame. Termed a “narcissistic wound,” individuals who suffer this kind of trauma often cope with it by overcompensating. In order to diminish the psychological pain of feeling inadequate, these individuals perpetuate their own self-importance and entitlement while constantly seeking the admiration of others.

A Piece of the Puzzle

Thus, it’s not surprising that entitlement also plays a significant role in depression. Clinically depressed individuals often exhibit selfish, entitled behavior that borders on self-obsession. Generally, this is a result of the depression itself, but like dependency, depression may also have roots in personal trauma.

Despite the fact that entitlement is not indicative of any single condition, it is still very valuable to clinicians in helping follow the diagnostic clues to the core causes of a psychological disorder. This is especially true when one considers that, all too often, individuals in treatment are struggling with a mixture of interrelated symptoms and conditions. For clinicians, symptoms such as entitlement are a strand that can be carefully traced and untangled, helping to more fully understand a complex psychological puzzle, and to prescribe a more effective course of treatment.

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