Some individuals possess innate traits and have learning experiences that together more easily prepare them to lead a responsible life. But other individuals possess traits that make the socialization process inherently more challenging than usual. And, if on top of that such folks just happen to come from environments replete with various types of abuse, neglect, or inadequate guidance, they can enter adulthood with little motivation to bear the burden of responsible living.

Learning to be responsible is largely a matter of accepting burdens for the greater good, and folks lacking in empathy rarely have the motivation to bear such burdens. The willingness to do so can only arise out of love, which is why a person’s incapacity to genuinely love is always reflected in their shirking of responsibility.

Talk, as they say, is pretty “cheap.” And most of the time, fancy gestures are equally devoid of substance. When a person really intends to make amends, they not only willing to repair damage already done but also to take action to help ensure they won’t inflict the same damage again.

Disturbed characters will expend all kinds of energy in self-serving pursuits. But they simply detest work they perceive is primarily on someone else’s behalf, or working for something that’s not clearly and intentionally self-serving, despite the potential benefit they might derive in the long run. That’s why they tend to give assent or “lip service” to the natural demands of a relationship (Assenting is one of the responsibility-avoidance tactics I outline in In Sheep’s Clothing and Character Disturbance), while resisting the real work of making amends.

Making amends in a meaningful way can be a particularly arduous task. But in a loving relationship, repairing any damage done (whether inadvertently or intentionally inflicted) is not only a person’s duty but also essential for maintaining integrity of character.

There was a time in psychology when therapists were held in low esteem for passing any type of judgment on the beliefs or attitudes their patients held. But in the age of character disturbance, no self-respecting therapist can avoid not only recognizing but also confronting the dysfunctional beliefs that inevitably damage relationships.

It’s an unfortunate reality that when character disturbances either fail to be recognized or are improperly labeled as something else, the problems associated with those disturbances can be “enabled” to continue or even worsen.

If someone’s behavior and impulse control problems are truly a problem of chemistry, then appropriate medication (and supportive counseling) is what’s indicated. But if the problem is primarily one of character, then the person’s way of looking at the world – the various ways they think about things, the attitudes they hold, etc. – all need to be confronted and corrected in within a highly specialized treatment framework.