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in order to accommodate the abnormal
patterns of thought and behavior. Most current therapies do not aim at reconstruction of the
personality, but perhaps they should be more mindful of the possibility that you cannot excise an
abnormality without affecting the personality structure from which it is removed.
Consider the example of a hypochondriac who has spent a good part of his life monitoring his
body and looking for pathology to explain every irregularity of function or unfamiliar twitch. His
illnesses have brought him sympathy and attention, and he has used his poor health to explain to
himself and others why he has not “climbed the ladder of success.” After his life is endangered
by an unnecessary surgery, he goes to a psychotherapist for help. The issue is, will he be able to
give up his hypochondria and its benefits? Can he change his perception to see himself as a
normal, healthy person living in a world in which illnesses and the danger of infection can play a
relatively minor role?
It is not easy for people to give up their maladaptive behavior, just as it is not easy for any of us
to break bad habits or improve aspects of our personalities. The therapist is in the position of
trying to teach old dogs new-or better-tricks.
Prefrontal Lobotomies
The doctor who developed the prefrontal lobotomy was given the Nobel Prize in Medicine. Ask
students if they have seen movies such as “One Flew Over the Cucko
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