Most people who come to see a psychiatrist are suffering from what is called either neurosis or a character disorder. Put most simply, these two conditions are disorders of responsibility, and as such they are opposite styles of relating to the world and its problems. The neurotic assumes too much responsibility; the person with character disorder not enough. When neurotics are in conflict with the world they automatically assume that they are at fault. When those with character disorders are in conflict with the world they automatically assume that the world is at fault.
Even the speech patterns of neurotics and those with character disorders are different. The speech of the neurotic is notable for such expressions as “I ought to,” “I should,” and “I shouldn’t” indicating the individual’s self0image as an inferior man or woman always falling short of the mark, always making the wrong choices. The speech of a person with a character disorder, however, relies heavily on “I can’t,” “I couldn’t” “I have to,” and “I had to” demonstrating a self-image of a being who has no power of choice, whose behavior is completely directed by external forces total beyond his or her control.
As might be imagined, neurotics, compared with character disordered people are easy to work with in psychotherapy because the assume responsibility for their difficulties and there fore see themselves as having problems. Whose with character disorders are much more difficult , if not impossible, to work with because they don’t see themselves as the source of their problems; they see the world rather than themselves as being in need of change and there fore fail to recognize the necessity for self-examination.
M Scott Peck, The Road Less Traveled