Obsessive Compulsive Disorder

The older I get, the more my obsession with efficiency and decisionmaking provokes me to behave in quirky ways, giving me every appearance of suffering from obsessive compulsive disorder (emphasis on compulsion).

Every month or two I make a small trek to a warehouse store. At the store I buy the same approximately 20 items in various quantities (small amounts of hummus, large amounts of palm hearts). I eat these items in a particular order, prioritizing the fresh fruits and vegetables in order of their spoilage, shifting then to baked goods that have a slightly longer shelf life, and finally to canned and frozen foods until I am able to make another trip to start the cycle over again.

My approach to shopping at the warehouse store is a ritualistic self-indulgence of the extremes of my desire to control. Because I am never sure what fresh fruits and vegetables will be available, I start there (what I am able to acquire in fresh fruits may alter slightly my choices in the frozen foods section, and finally in the dry and canned goods section). Even though I have a list and even though I buy nearly identical items at each trip, I still spend approximately 2-3 minutes with each item, even more for produce. I look at the quality, looking for flaws, looking at spoilage dates, comparing the item I selected with other identical items to determine slight variations. I do this carefully and methodically, trying to remain focused as my body suffers through the artificial chill of the produce section’s walk-in refrigerator. I then do the same for each other type of food, frozen foods, dry and canned goods, as well as any paper goods. I walk fastidiously through each aisle, paranoid that I will neglect some forgotten need and have to go without for another month or two.

As I stand in line to pay for my purchases, I sometimes smile at the odd picture the bizarre array of foods makes, each one of them a carefully chosen trade-off between convenience and nutrition, taste and perishability, versatility and diversity. Are people more likely to believe that I am throwing a theme party (assorted beverages and ethnic foods) or that I have Asperger’s (16 jars of palm hearts)?

But after years of this self-indulgence I can’t go to a normal grocer’s anymore; at least I can’t go and feel satisfied about the experience. My datamining mind chokes on the sheer amount of data involved for choosing each item: the unknowns (taste, quality, perishability, nutrition, price, etc.) multiplied by the number of options. People say “a whole aisle of bread,” like it is a good thing, but to me it is horror.

The last time I went to a grocery store was a whim—I needed to kill time waiting for an appointment so I thought I would buy rye bread because I love it and my warehouse store does not stock it. When I walked into the bread aisle, I was aghast. There were 8 different types of rye bread. I looked at each one, comparing the descriptions of taste, comparing the color and feel, comparing the nutritional information and the ingredients list. After 20 minutes and about to become paralyzed with indecision, I picked one loaf of each—all 8 different types of rye bread. (I am still eating rye bread from that trip, the loaves suffering serious freezer burn.)

And that is why I like to shop at the warehouse store. There are not 100 different types of bread, there are 5. There are not 20 different types of yogurt, there are three. There are only two types of bacon, regular and turkey, and only one type of egg whites in tetrapak. Going to the warehouse store is a satisfying experience in which I am quite certain that I can make the best possible choices given my options. Given my love/hate relationship with food and my particular dietary needs, I avoid going to a large grocery store for the same reasons I avoid going to a used car lot .

UPDATE: Interestingly, James Fallon said that he was at one point diagnosed with both an anxiety disorder and OCD. 

Temptation and opportunity costs

I'm currently a point that a lot of my socio readers are when they write in to me. I am tired, bored, my life seems meaningless. For the past couple weeks I have only been going through the motions, using all of my will power to do the smallest things to sustain my career, my reputation, my relationships, my wealth, but I feel like it is all pointless, like trying to bail out the Titanic. Nothing seems sustainable to me right now. Everything seems like a potential liability or accident waiting to happen.

It's disturbing to me how demanding my id is right now. I have no desire to maintain anything I've built, to continue living this particular role. But I know that at my age and station, I don't have many more do overs, if any at all. And I wonder this current situation warrants one. I think if I could just start playing a game or otherwise indulging some of my more basic needs, it will distract me from my ennui and disgust with life and I'll be able to keep things together.

Making things worse is that there is already a perfect target on the horizon, someone who could start falling into my hands today if I want. This person could ruin me. I don't remember the last time I felt so enticed by a person, but in all other respects this person could not be worse for me to target, not if I want to keep living roughly the same life that I have been living. So that is the issue. I need a game to amuse me, something to engage me in this life I have, but in order to maintain this life I can't target my most appealing opportunity.

Do you know who I now understand? I understand all those people who are married, maybe kids, some stable normal life and along comes some siren, some cad that they feel inexplicably drawn to. They're seduced. They fight the feelings for a while, they remind themselves of what it would mean to give into temptation, that it's not worth it. But while they are fighting so hard to keep their normal, stable life, they start to resent that life. They resent their spouse and their kids and everything that is keeping them from indulging in what they really want to do. So just at that moment when they need to be trying their hardest to keep what they have, they are valuing that life the lowest. This decreased opportunity cost makes taking the low road a fait accompli.

This is a horrible situation. I'm so disgusted right now. I feel like my "normal" life has made me too much of a eunuch, but also not enough of a eunuch that I am immune to destructive temptations. Socio readers with uncontrollable bloodlust, peadophiles, I feel your pain.

Creating boundaries, finding outlets

A few of my socio readers have asked how to get to be higher functioning, particularly about controlling some impulses and knowing when it's ok to indulge others. Here is what another reader said:

For me it is a little different. I have a natural talent for art and I use this as a way to explore my impulses and desires without acting on them. My boundaries, sadly, are not that current. As long as I don't get caught, nothing truly stops me. There is a voice in my head that constantly reminds me of what I should not be doing, due to my possible loss in freedom, but most of the time this voice goes ignored. I can say that having a hobby, something that satisfies even for a brief moment, can aide in a form of control. My need to kill and destroy is kept in tact by an obsession I have of collecting objects that have to do with death. I study criminals, watch violent educational programming, and read as (well as collect) reading material on past crimes, violent fiction, and the like. Instead of killing animals I collect the road kill, and macerate the parts to keep the bones. I buy taxidermied creatures, and have photos of x-rays. I keep my urges under wraps by indulging what I want through Internet, books, art, and programming, everything, and I mean everything, besides the actual murder. The criminal television is the most helpful because more than half of the time at the end of the program the criminal is caught. Shows like "Law and Order: SVU" touch nearly every form of sexual perversion you can think of, so seeing it gives me plenty of joy for that moment. In "reality based" programming I hear the thoughts of the detectives, and learn that they are pretty clever and instinctive when it comes to what to look for. Regardless of what they are personally, they still get the job of capture and punish complete, and I get the point, and a tinge of hesitation.

I won't lie and say this hasn't made my temptations worse at times. Other than entertainment, I watch this form of programming to figure out what they did wrong, and how I would have done things differently to get away with it. Once I come up with a list of what they did wrong, I replay the act in my mind, committing the crime myself. In a fantasy it is always easy to assume I can get away with it, but one never knows until they try. The key is to never let it get to that point, repeating the words told to me by some associates of mine. Their words made sense.

Another thing I do, if the decision to go through with any impulse is still rampant, is to go through a mental list of pros and cons. I only get through this if I catch the impulse, which is something I am currently working on. On the rare occasions where I do catch them, I get irritated and anxious if I don't act. I can either do what I need to to calm this feeling, or walk away from it, and calm myself down. My laziness usually causes me to go through with the more damaging approach.

Example. There is a girl at my school right now that I am more than close to taking out violently. She is obnoxious, mentally deficient, cowardly, and her constant rhetorical questioning, instead of shutting her trap and listening, leaves me more than livid. Her existence does not contribute anything worthy to this planet. Even her look boils my blood, and there will be a point where my smart ass remarks towards her will not suffice. She used to sit near me, but I know she senses my distaste for her, so she has moved, which has helped. I spend half of the class daydreaming on ways to take her out instead of listening to the teacher. At first my fantasies seem more than pleasant, heavenly in fact, and in moments like this I forcibly question myself.

What will I really get out of this? Will this joy I may experience last long enough? What if this only makes my urges worse? Will I keep having to kill in order to get this euphoric feeling? Will I become a slave to my impulses to destroy? How long until I get complacent? What if I get caught? Where is my future if I do this?

My answers: Pleasure, possibly joy, who knows, find out. Who knows, find out. Deal with it when it happens. Possibly, is this a bad thing? Yes. Not that long. I may get caught, I may not. Prison, but once at the end of the road, who cares what the future outcome is.

Sadly, even after a list of logical reasoning and questions, most go ignored, but the main thing that always sticks out with me is the slave issue. I do not want to be a slave to anything or anyone, and if I fail to control my urges, I will, ultimately, become a slave to my desires. I will be living a paranoid life of never ending dissatisfaction because I'm being controlled by my need to destroy. Not fun.

Sexually my intentions are cruel. I indulge in them for the most part, but I make sure the people involved are, to some extent, willing. I frequent S&M conventions where you have people who want to be humiliated and punished, and though a little more controlled, this has helped. The fact that there is an audience helps a lot too. Being a secretive person, having an audience ruins my chances of completely acting out. Prostitutes are too dangerous to even bother with, as they are nobodies that can easily go missing, if not already, and make the temptation worse. They allow anything to be done to them, and because I don't value much of human life as it is, they would only make it easier for me to disrespect them. The people I have hurt and humiliated through sex wanted it, and what kept me from crossing that line was to constantly remind myself that I don't want to become a slave to this.

The boredom? Something I will just have to suck up and deal with, like everyone else. I don't have any successful methods for this as of yet. I still use art, but lately the drive to fulfill a finished piece isn't happening. I have some assignments that are time consuming, but after a certain amount of time, usually two and a half hours, I need to do something else. I go on spontaneous shopping sprees buying things I don't need just to do something, but being around people acting so foolish only causes my mind to race all over again with violent thoughts. I have medication that I am not taking because it leaves me awake for days even though it is supposed to make me drowsy. Not much aide in this category, tee-hee, sorry.

Is this a reverse psychological way of teaching me how to control myself, by having me write down my methods?
You sly devil ;)

If you were, in fact, clueless as to what went on here, and this wasn't a positive manipulation of yours, then I take back the credit I gave you. Have a grand day, M.E.

Slip-ups

I thought this was an interesting recent comment about the ways that sociopaths can slip-up:

There are a few ways the sociopath can blow it. 

1) He doesn't anticipate the disgust. E.g. an American in Thailand might pat a kid on the head. Similarly, I might remark to a mother/daughter pair, "it is amazing to think that she came out of you," because I just don't have the same feelings about things. Observers think, "the sociopath is disgusting."

2) He acts charming to get something. Then he takes it, impulsively, when the opportunity appears. Feelings of betrayal and hatred arise in the victim and observers, because the victim thinks, "he could & should have kept doing what I liked. He shouldn't have betrayed me." If you asked the sociopath why he deceived, he might say, "I gave the person what he wanted. Later, I saw an opportunity to take what I wanted, and I did."

3) The sociopath gets irritated by a person. There's stimulus -> rage -> plotting/scheming. The sociopath mostly thinks. He doesn't experience his feelings much. His response is to "act" either by doing something or thinking about what to do; it isn't to experience the feelings, question the feelings, question the assessment of the situation that led to the feelings. The sociopath might build weapons (or the equivalent) and stash them, anticipating a conflict; that's a way to "let off steam" by taking action. 

Finally, in response to a trigger, the sociopath lashes out and executes a plan, perhaps using preplanned elements. Outside observers see the sociopath as being impulsive, vicious, premeditated and overreacting. 

Feelings of horror or fear arise in observers and they decide the sociopath is very frightening, extreme and beyond redemption. It doesn't help that when they interview the sociopath after the stuff, he'll probably sound quite unemotional; observers will translate that into, "he not human."

Sound familiar?

Why/how delayed gratification?

This NY Times article (You're so Self-Controlling) discusses (and unfortunately confuses?) the difference between failure to delay gratification based on (1) a lack of self-control versus (2) a perception that the future reward is too uncertain to wait.

For instance, recent research recreated the classic marshmallow experiment done with children (the children could eat one marshmallow right away or could wait to get another one). Researchers wondered whether the choice to eat or wait was really the result of a lack of self-control, or whether the children were just unsure whether the second marshmallow would come in a timely manner. Performing a similar experiment, they found that children who believed the experimenter to be unreliable would wait only 3 minutes for the second marshmallow before giving up and giving in, whereas children who believed the experimenter to be reliable would wait as long as 10 minutes before giving up. So is it all about ascertaining the uncertainty of the future rewards? Because in the original marshmallow experiment, the researchers followed the children into young adulthood and found that the children who could wait longer tended to be more successful, which suggests that their ability to delay gratification can't just be the uncertainty of future rewards.

It's an interesting question for sociopathy because sociopaths are notoriously impulsive? Which has led some to believe that sociopaths can never plan ahead or stick to any particular plan. Taken to the extreme, this would suggest that most sociopaths wouldn't even be able to graduate grammar school, and yet some manage to become CEOs of major companies, political leaders, or hit other high levels of skill or achievement. Personally speaking, I have managed to perform very well at certain long term tasks, including excelling in school, at work, and managing to fully fund my retirement. How? Maybe the answer lies in what we mean by "impulsive" and what relationship impulsivity has with how we view will-power. From the NY Times article:

[T]he ability to delay gratification has traditionally been seen in large part as an issue of willpower: Do you have what it takes to wait it out, to choose a later — and, presumably, better — reward over an immediate, though not quite as good one? Can you forgo a brownie in service of the larger reward of losing weight, give up ready cash in favor of a later investment payoff? The immediate option is hot; you can taste it, smell it, feel it. The long-term choice is far cooler; it’s hard to picture it with quite as much color or power.

In psychological terms, the difference is typically seen as a dual-system trade-off: On one hand, you have the deliberative, reflective, cool system; on the other, the intuitive, reflexive, hot system. The less self-control you have, the further off and cooler the future becomes and the hotter the immediate present grows. Brownie? Yum.

But if a sociopath's rage tends to be cold-hearted rather than hot-headed, could it be that sociopaths also respond to different stimuli for impulse control than normal people do? Perhaps that they both manifest an unusual degree of impulsivity in some aspects of their life and amazing self-control in others? Maybe sociopaths feel cooler about things that often seem hot to other people. Or maybe it's because we can take future events and make them seem hotter? I feel like that is at least sometimes true of me, that I can imagine my future self vividly enough that I feel some of the pleasure of the delayed gratification in that moment that I'm delaying it. 

Mellowing with age?

I've written a little about sociopaths mellowing with age. I was reminded of the concept again when I read this recent comment:


I've reached the point where I'd like to get some help for my impulsive traits. I'm' saying "impulsive" rather than "psychopathic" because I'd like to focus on what I see as the problem.

You could say that I'm a high-functioning psychopath. I'm Machiavellian, narcissistic and psychopathic. 

I've apparently got enough impulse control (and intelligence) to get me what I need. But I sense that there's a gap. I'm missing something.

In the past, I wouldn't have done this because I was too proud. I wasn't able to admit that I was behaving "badly" or had a problem. And I was young enough that I was substantially getting what I wanted. 

Now that I'm middle aged, that isn't happening. Perhaps because I'm not getting what I want, I can see I've behaved anti-socially, and it has cost me. E.g. I'm heading into old age, and no matter how optimistic I'd like to be, it is clear that it is going to get harder and harder to have sex with women in their twenties. And eventually I will die, no matter how much I fight it.

Have any commenters, motivated by the same sense of "oh shit I'm screwed" sought help? How'd it go? 

I do have this general sense of trending towards being more actively aware of potential consequences of my actions to the point where I am able to assert more "self-control" than I could as a young person. And sometimes people say that I seem like I've gotten better -- either people in my life or even sometimes commenters on the blog in response to things I have written. But's also interesting to re read other posts like this one, where as recently as two years ago I wanted to burn it all to the ground. But I didn't. Maybe that's the difference that's come with age.

Kid sociopath

Quite a few people emailed me this NY Times article that has hit the most emailed: Can you Call a 9-Year-Old a Sociopath?"  Here are selections (the article is quite long, but an engaging read):

• “We’ve had so many people tell us so many different things,” Anne said. “Oh, it’s A.D.D. — oh, it’s not. It’s depression — or it’s not. You could open the DSM and point to a random thing, and chances are he has elements of it. He’s got characteristics of O.C.D. He’s got characteristics of sensory-integration disorder. Nobody knows what the predominant feature is, in terms of treating him. Which is the frustrating part.” . . . . Following a battery of evaluations, Anne and Miguel were presented with another possible diagnosis: their son Michael might be a psychopath.
• Currently, there is no standard test for psychopathy in children, but a growing number of psychologists believe that psychopathy, like autism, is a distinct neurological condition — one that can be identified in children as young as 5.
• “If they can get what they want without being cruel, that’s often easier,” Frick observes. “But at the end of the day, they’ll do whatever works best.”
• “This isn’t like autism, where the child and parents will find support,” Edens observes. “Even if accurate, it’s a ruinous diagnosis. No one is sympathetic to the mother of a psychopath.”
• “As the nuns used to say, ‘Get them young enough, and they can change,’ ” Dadds observes. “You have to hope that’s true. Otherwise, what are we stuck with? These monsters.”
• “They’re not like A.D.H.D. kids who just act impulsively. And they’re not like conduct-disorder kids, who are like: ‘Screw you and your game! Whatever you tell me, I’m going to do the opposite.’ The C.U. kids are capable of following the rules very carefully. They just use them to their advantage.”
• Their behavior — a mix of impulsivity, aggression, manipulativeness and defiance — often overlaps with other disorders. “A kid like Michael is different from minute to minute,” Waschbusch noted. “So do we say the impulsive stuff is A.D.H.D. and the rest is C.U.? Or do we say that he’s fluctuating up and down, and that’s bipolar disorder? If a kid isn’t paying attention, does that reflect oppositional behavior: you’re not paying attention because you don’t want to? Or are you depressed, and you’re not paying attention because you can’t get up the energy to do it?”
• Most researchers who study callous-unemotional children, however, remain optimistic that the right treatment could not only change behavior but also teach a kind of intellectual morality, one that isn’t merely a smokescreen. . . . “I try to tell him: You’re here with a lot of other people, and they all have their own ideas of what they want to be doing. Whether you like it or not, you just have to get along.”
• “I’ve always said that Michael will grow up to be either a Nobel Prize winner or a serial killer.”

Some of these selections are regarding a clinical study/camp for these youngsters.  That was probably the most entertaining part--seeing how they interact with each other.

• The study had a ratio of one counselor for every two children. But the kids, Waschbusch said, quickly figured out that it was possible to subvert order with episodes of mass misbehavior. One child came up with code words to be yelled out at key moments: the signal for all the kids to run away simultaneously.

And this little vixen:

• Charming but volatile, L. quickly found ways to play different boys off one another. “Some manipulation by girls is typical,” Waschbusch said as the kids trooped inside. “The amount she does it, and the precision with which she does it — that’s unprecedented.” She had, for example, smuggled a number of small toys into camp, Waschbusch told me, then doled them out as prizes to kids who misbehaved at her command. That strategy seemed particularly effective with Michael, who would often go to detention screaming her name.

Silencing the devil

Sometimes I feel like I have a devil and angel on my shoulders trying to convince me how to behave. More devil than angel, of course. In the books on which the TV show Dexter is based, the fictional Dexter refers to his devil as "the Dark Passenger." (Apparently. I haven't read the books, but so says wikipedia.) It's an interesting idea -- how do sociopaths perceive their identity? Is it split? Is there a devil tempting them to do things they otherwise wouldn't? With Dexter, the Dark Passenger is the one that wants to do all the killing. When Dexter can no longer ignore it, he "lets the Dark Passenger do the driving." That sounds plausible enough, until the books get all voodoo:

In Dexter in the Dark, the third novel of the series, it is revealed through third person narrative of an entity referred to as "IT" that the Dark Passenger is an independent agent inhabiting Dexter, rather than a deviant psychological construction. "IT" is revealed to be Moloch, a god worshipped in Biblical times. The Dark Passenger is one of ITs many offspring: IT had many children (formed through human sacrifice), and IT learned to share ITs knowledge with them. Eventually, there were too many, and IT killed the majority, some of whom escaped into the world. In the novel, Dexter learns of the Dark Passenger's true nature when it briefly "leaves" him, frightening him into researching possible reasons for its existence.

The demon angle is ridiculous, but again, maybe that is just how Dexter deals with his impulses. Because that is what I think the Dark Passenger really represents, and for me the little devil on my shoulder equals impulses. Everyone has impulses, and sociopaths are notorious for having poor impulse control -- at least those in prison. I am a highly rational person, always weighing the costs and benefits of every action, but I can still succumb to ill-advised impulses some of the time. That's my devil, always trying to get me into trouble. As I grow older, the impulse-control has actually gotten worse instead of better. When I was a child, I was used to people looking over my shoulder all the time, so keeping my own behavior in check was a more immediate concern. Adults don't have the same external restraints. For instance, I am frequently tempted to "ruin people" or lash out in anger. Recently I've been looking for ways to not just ignore or suppress these impulses, but to tame them. I am getting too secure in my career and position in society to risk having a blowout over nothing. I have found that swimming laps helps a lot; the rhythm and the white noise are very soothing. I have also recently discovered tai chi. I'm almost ashamed to admit this, but it really works wonders for soothing the mind. You have to do something, otherwise you'll end up in prison or a social pariah or worse.

On a friend asking if I'm a sociopath

I sort of self-diagnosed myself five years ago. It seemed to fit. Not everything, of course. I believe that there is a spectrum of the emotionally impaired like there is a spectrum of the blind or the deaf. You are legally blind without your glasses, right? But that doesn't mean that you consider yourself in the same category as completely blind people. Similarly, I may be emotionally impaired without necessarily being handicapped. I think there is a big difference in terms of how people can function in the world depending on where they fall on the spectrum. But I do think that emotional language is like a second language to me. I have to go through several different deductions before I can "empathize" with people, and not just sometimes but most of the time. I do think that I use different strategies to navigate the world than most people--that I have different wiring.

I definitely have sociopathic impulses. I find myself ignoring urges to kill or do great bodily harm to ignoring a temptation to ruin somebody, to even just ignoring the invitation to view the world in a way that would push me to engage in excessively risky behavior. These urges cloud my judgment and take me away from the person I want to be, so I try not to indulge them. I treat them like hallucinations instead. They feel very real, everything feels so real, but I have experienced them frequently enough to know that they are wrong--that I will regret acting on them. So I try to ignore them, just like I would try to ignore the image of a monster breathing fire in my peripheral vision.