Tuesday, September 28, 2010


A doctor believes that sociopaths might be discriminated against in a treatment setting.

The defiant or untrustworthy patient — the alleged sociopath — suffers a similar fate. Everyone “knows” that sociopaths are liars and manipulators, cannot be trusted and need to be treated with an iron fist. The fact that lying and manipulating exist on a continuum of severity and can at least have semiproductive uses (Congress, are you listening?) is obscured by moral outrage.
And so the doctor’s determination not to lose a contest of wills undermines the opportunity to have successful discussions about treatment. The patient instantly senses that the doctor distrusts and dislikes him, and this, coupled with the patient’s lack of respect toward authority figures, leads to a rapidly deteriorating situation, often ending in a discharge against medical advice — much to the team’s relief.

There was an interesting House, MD episode titled "Remorse" that highlighted this very issue, in which a doctor really does refuse to treat a patient properly after discovering the patient is a sociopath. The doctor on House instead becomes obsessed with outting the patient as a sociopath. Of course true sociopaths could hide that aspect of their personality from their doctors pretty convincingly in most situations. The tricky balance is being honest enough to get the right treatment for the right symptoms without revealing your identity or otherwise making people very angry at you.


  1. The only person a sociopath is fooling is themselves (and a few others). There are so many things the sociopath is incapable of knowing.

  2. There goes the Hippocratic Oath, I guess.

  3. Anonymous - You're an idiot. Sociopaths are masters at pretending to be "normal." How many sociopaths do you know? Statistically speaking, I'll bet it is a lot more than you realize. You've been watching too many horror movies. Not all sociopaths, not even most, go around murdering people. Compare the number of sociopaths out there with the number of serial killers. There is quite a discrepancy.

    M.E. - I love House and I really liked that episode, but I found it rather... simplistic. I don't think the sociopath did enough to hide her identity, likewise I find it hard to believe that a smart and successful sociopath would be so easily tricked. And I had to laugh at the end of the episode.

  4. Haven't seen a legit portrayal yet on tv. Enjoyed Tom cruise's attempt in collateral, though.

  5. I don't know what they teach medical doctors, but in a graduate class I took on DSM diagnostics, the students were strongly urged to never accept sociopaths, narcissists, borderlines, and psychotics as clients. We were told that they probably wouldn't benefit at all from therapy, and would likely burn-out the therapist -- or worse.

    However, they were assured that it wasn't likely that they'd have such clients, because "they don't ever think anything is wrong with them, so they don't seek therapy." We were told that we'd likely only run into them if we worked in mental hospitals or in forensic settings. It never seemed to dawn on them that such a hostile environment is reason enough for such clients to avoid therapy. Or perhaps they were all too aware of it, and did it on purpose, though they might be giving them too much credit.

    I occasionally thought it might be interesting to break a cardinal rule and out myself to them on the last day of class, just to see the shock on their faces when they realized that they might be in the presence of one such demonized individual and never even suspect it, even after sharing classes for two years.

    Even as generalists, they would have been better served to have been taught at least some basic skills on how to respectfully deal with such "difficult" clients, even if only to discuss referral to a more appropriate specialist.

  6. That's bullshit.
    The doctor does treat the S properly after discovering she is an S by cat scan (she fell for the old CT trick.. gl with that one).

    She simply broadened her horizons.

  7. As a person professionally diagnosed “highly anti-social” I get what this article is saying. Before being diagnosed, I had two stays inside a treatment place (not technically by choice, but not court ordered either) in which I can say that once “tagged” as a sociopathic person, when going for round three, my “watchers” exhibited a less...shall we say...caring variety of understanding in their patient/doctor duties. They flat out avoided me until my stay was up at which point they actually just buzzed me out from behind the nurse’s station.

  8. Continued:

    I didn’t even have to sign anything first, they couldn’t wait to have me leave.

    -- Sid --

  9. Jesus "the motherfucker" ChristOctober 1, 2010 at 3:14 PM

    Hey man, us psychopaths are just genetically better and deep deep down they know it. GET OVER IT

  10. why are you offended; just the fact that you are so emotional and constantly lamenting about how you feel removes all doubt your a sociopath. You are just defective, get over it. Go to aspiesforfreedom or some other autism forum and all of you self-diagnosied sociopaths will find an entire community just like you.

  11. Are you two talking to me?

    If so, I wasn't offended, nor am I now by it. I've got nothing to "get over" because it was nothing more then an observation I made after I was "tagged and released".


    1. After being thoroughly targeted and destroyed by a sociopath I realize they are superior. Their plans are not influenced by emotion or guilt. They make their next move based on strategy and winning with no regard to the real human they are hurting. What I find funny is the last victim of this psychopaths car is now parked in my driveway. I'm now not sure if she was a victim. She took his house last round. And she will take my house from him this time. He is a master at portraying he is the victim. I'm a professional who he states discarded him because he is disabled. So they feel sorry for him. I ran away because he was going to kill me like he did his third victim and their 6 month old baby. He got away with that too. But I know better. He did it and I was next.

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