True “acting-out” is an outward manifestation of an emotional conflict that can’t be consciously recognized by an individual. Acting-up is NOT acting-out.
In the ‘jargon’ of mental health professionals one frequently hears the term acting-out. It is amazing how frequently this term is misused. As is the case with denial, which I posted about earlier (see “Understanding Denial as a Defense Mechanism”), true acting-out is an unconscious ego defense mechanism. Without knowing it, persons who act-out engage in some kind of behavior (as opposed to a psycho-physiological or other kind of “symptom”) that serves to ease the emotional pain and anxiety associated with an unconscious conflict between their primal instincts and their conscience. A good example would be an overworked and underpaid worker who slaved all night to finish a project and when he placed it on his boss’s desk, the only thing his taskmaster had to say was “Well, it’s about time!” On his way back to his desk, the worker mutters under his breath “That SOB!.” He then enters the washroom and begins to wash his hands. He washes, and washes…and washes. He washes until his hands turn red and blister, but he continues to wash. He’s not aware of it, but he seems to engage in this compulsion whenever he feels bad inside for thinking ill about another. That’s not right, after all. On the one hand, he wants to tell his boss where to go. On the other hand, he’s grateful to have a job and he’s been taught well that bearing ill feelings toward another is the work of the Devil. He feels so unclean when he “slips” and says those hateful things under his breath. His compulsion is an instance of displaying through an action the conflict that rages within him. It helps relieve the anxiety he feels to some degree, but it doesn’t really solve the problem. Yet it gives him enough relief that he does this over and over again in similar situations, with no insight into the “dynamics” of the situation. In the end, we have a behavior (handwashing) that is a “symptom” (called a compulsion) that represents an unconscious way to mediate underlying emotional pain. This is what the term acting-out has historically been meant to describe. In such a scenario, a person is acting out a dynamic with which they cannot otherwise emotionally or consciously connect.
Acting-up, (i.e., conscious, deliberate misbehaving) is NOT acting-out. It is truly appalling how often people use the term acting out to refer to someone who’s simply exhibiting undesirable or problematic behavior. I hear TV commercials by behavioral therapists offering remedies that will “fix your child’s ‘acting-out’ behaviors at home and at school,” and see rules in psychiatric hospitals and residential centers forbidding “sexual acting-out” or other inappropriate conduct. One online psychiatric glossary even gave two definitions for acting-out — one correct, the other being the mistaken notion that has so deeply crept into the popular lexicon that it’s made a correct understanding of the concept almost impossible.
The real danger in misusing this term is that one can make a disastrous presumption that every time someone acts in an inappropriate manner, they’re necessarily playing out some kind of unconscious inner conflict (i.e., unresolved “issues”), when in fact they may be simply engaging in immature, irresponsible behavior about which they’re fully aware and which is completely within their ability to control. Misperceiving the nature of circumstances is a major way people end up being abused by irresponsible characters. It’s also how clinicians inadvertently enable irresponsible behavior instead of fostering real change. Words mean things. As behavioral scientists, professionals can’t communicate effectively with one another or even frame problems correctly unless they use terms appropriately. To do that, we have to know what the words actually mean and then use them to label a situation accurately.
Although acting-out definitely tops the list, it is not the only misused psychological term, and professionals aren’t the only ones who misuse it. Denial, which I posted about earlier, is another of the more frequently misused terms. A good example of why it’s so important to use terms correctly is illustrated by research recently done on “denial” and its possible role in predicting the effectiveness of therapy. Some studies have shown that addressing issues of denial doesn’t appear to be crucial to effecting a positive therapeutic outcome. These results are counterintuitive. It’s been long assumed that a person can’t really begin to address and resolve a problem unless they are willing to admit they have it. It would be a big deal to have this assumption disproved experimentally. The problem with the research on “denial,” however, is that it didn’t bother to differentiate what really is or isn’t true denial. Rather, it lumped together all of the various types of behaviors often mislabeled as denial, and then got ambiguous results. A saying used in computer science — “Garbage in, Garbage out!” — attests to the fact that regardless of the elaborateness of the methodology or the sophistication of the statistical analyses, if you put ambiguous data into a study, you’ll get unreliable findings. We can never be clear about our scientific data unless we define our terms correctly and succinctly. As a psychologist, I’ve literally read thousands of studies over the years. The psychological abstracts alone are among the most hefty compilations you’ll ever find in libraries. Yet, the number of principles we know with certainty about human behavior would fill only a small book. Why? It is in large measure because even though our statistical and other data analysis methods are among the most sophisticated there are, the logic is flawed in the construction of our research, and the logic of our interpretations of the results is equally flawed much of the time. It’s really frustrating sometimes. But it should serve as a caution for all professionals to be much more careful about how accurate we are when we use terms or interpret data.
There are ten terms commonly used in mental health that are all too frequently misused. This post, and the next several to follow, will deal with the top 5 of these misused terms.