Showing posts with label treatment. Show all posts
Showing posts with label treatment. Show all posts

Tuesday, February 26, 2013

Guest post: Violent children


Treatment Or Help For Children Who Have Threatened Or Showed Violence

Violence and Children

We live in a culture that seems to becoming increasingly violent. Not only are adults violent, but children can also exhibit violent behavior. More often than not, violent behavior in children is not taken seriously. Parents, teachers and other adults are very quick to say that this type of behavior is a phase that the child is growing through and end it will end soon. However, violent behavior in children is something that should always be taken seriously.

What Causes Violent Behavior in Children?

There are a variety of things that can cause a child to become violent. Children who grow up in a home where violence is common are more likely to become violent. Other problems in the home, such as poverty and divorce, can trigger violent behavior in children. Furthermore, children who spend a lot of time watching violent television shows and playing violent video games are more likely to become violent.

What Are Some of the Warning Signs?

A child who is prone to violent behavior will usually exhibit warning signs. Some of those signs include irritability, intense anger and frequent loss of temper. Children who are prone to violent behavior may also get frustrated easily.

How Can Violent Behavior In Children Be Treated?

Again, violent behavior is something that needs to be stopped early. This behavior will only continue to get worse as a child gets older. Children who have had a history of violence should be seen by a mental health professional. The goal of professional treatment is to get child to control his or her anger and to teach him or her how to express it in a healthy way. Treatment will also teach a child how to accept responsibility for his or her own actions.

How Can Violent Behavior In Children Be Prevented?

One of the best things that can be done to prevent violent behavior in children is to reduce the child's exposure to violence. Children should not spend a lot of time watching violent movies and television shows. Parents also need to make sure that they avoid harshly punishing their children because that can also cause violent behavior. It is quite obvious that exposure to violence can cause a person to become violent.

*This is an informational article about violent behavior in children. If you want to get help for troubled teens, then you should read more articles on this website.*

Friday, February 8, 2013

Winning streaks and outsourcing

I taught myself to feel anxiety about certain tasks for my continued health and welfare. I taught myself to be sensitive and careful about certain select things. And now it is sometimes hard to turn it off.

This is not a design flaw. If I had made anxiety easy to turn off, I would turn it off whenever it was inconvenient to me to feel that way.

I'll give you an example of why it might be good or necessary to not have control. I have never been a gearhead. So I have a friend who makes all of my choices of what to buy in those particular areas. Sometimes I question his judgment, think maybe I might like something else. I was telling another friend about this and he said, "so why don't you just buy what you want then?" But that's the thing. I have outsourced the decisionmaking to my gearhead friend. If I second guessed all of his recommendations, then really I have not outsourced anything to him. I have just decided to get his opinion about things. But that's not what I want. I want to not have to decide.

Similar with the anxiety. I used to not care at all. I used to do the craziest things. Then I didn't like the consequences, so at least in certain areas of my life I set my brain to thinking more about particular important tasks. At first I made it a game. Can I do this simple but important task better than anyone else? Then the game became about consistency -- can I achieve this level of superior skill for the longest streak ever seen?

It was such a successful tactic that I kept adding tasks to care about. It's funny, in my mind and in my life I must have hundreds if not thousands of these little games going on by now. All simultaneous. All keeping my life together. And they are sort of important, that's why I singled them out once upon a time to care about. But now when something goes wrong, the feeling of loss or letdown I feel is out of all proportion to the relative significance of the small skirmish lost. Because it's not just the one mistake, it's the end of a winning streak.

It's sort of laughable, that I have made myself like this -- chosen the choices I have led which have, when compounded with hundreds of similar choices, made me care a lot about certain little things. I should maybe rethink the plan. But I also now better understand why most people are the way they are -- why nature or God has chosen to reinforce our important decisions like mating with emotions like love. We have to give ourselves some sort of system to rely on when our minds might be distracted -- some way to make sure that important things don't slip your mind or through the cracks. And my system does that too, and probably just as well or better than emotional reinforcement. But my system takes an incredible mental toll. And when my mind gets taxed just slightly above what I have expected it, I can push myself into mind sickness. So that's why I might have to reconsider my system. Or maybe I should just to outsource more.

Friday, February 1, 2013

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.

Thursday, January 31, 2013

Gold star sociopath?

When people ask me for recommendations of what to read/watch to understand sociopaths better, I tell them, among other things, the film The Woodsman with Kevin Bacon. In it he plays a "recovering" pedophile who struggles with his urges as he tries to form a "normal" romantic attachment with a woman and stumbles upon another predator like himself. Un-acted upon pedaphilia was recently addressed in a Dan Savage column. when I read it, for "pedophile," I substituted "sociopath," for "sexual attraction to children," I substituted ...
Let's say, theoretically, I'm a pedophile.

I'm not stupid or evil, so I'm not gonna DO anything. I'm not even gonna look at porn, because the production of it involves child exploitation. I don't even look at kids in public places.

So what the fuck should I do? Chemical castration? But I haven't DONE anything and I don't plan to. Am I obliged to tell anyone? Good way to lose friends. Can I keep babysitting my friends' kids when they need a hand? After all, if I were into adult women, people wouldn't see anything wrong with leaving me alone with a couple of those.

What the fuck do I do? Live alone and hope Japan starts producing affordable sexbots before I'm too old to care?

You know, theoretically. If I were a pedophile.

Knows It's Wrong

"My heart goes out to people to whom nature has given something as powerful and as distracting as a sex drive and no healthy way to express it," says Dr. James Cantor, a psychologist and the editor in chief of the research journal Sexual Abuse. "Pedophiles are not the only folks in this position, but they are by far the most demonized, regardless of whether they have ever actually caused anyone any kind of harm."

My heart is going out to you, too. As I've written before, we should acknowledge the existence of "good pedophiles," people like you, KIW, who are burdened with a sexual interest in children but who possess the moral sense to resist acting on that interest. It's a lifelong struggle for "good pedophiles," and most manage to succeed without any emotional support—to say nothing of credit—whatsoever.

Unfortunately, science doesn't know much about pedophiles like you, pedophiles who haven't done anything, because the social stigma is so great that most nonoffending pedophiles never seek treatment. And what research has been done, says Cantor, isn't very encouraging if you're looking to free yourself from your attraction to children.

"There is no known way of turning a pedophile into a nonpedophile," says Cantor. "The best we can do is help a person maximize their self-control and to help them build an otherwise happy and productive life."

"It is true that a regular heterosexual man is not going to commit an offense against every woman he finds attractive. However, most women are capable of recognizing when an interaction is just starting to go south and of getting out of the situation. Most children are not. So although there is every reason to believe that there exist cats that can successfully be in charge of the canary, it's not a very good idea for the cat to be the one making that call."

"I wish I had better news," concludes Cantor. "I also wish that more people did good research on this so that one day I could have better news to give."
The money quote for me: "Unfortunately, science doesn't know much about pedophiles like you, pedophiles who haven't done anything, because the social stigma is so great that most nonoffending pedophiles never seek treatment."

Monday, January 28, 2013

Successful and sociopathic

I thought this NY Times op ed, "Successful and Schizophrenic," had some interesting parallels. It tells the story of a law professor who was diagnosed as schizophrenic (I hope I'm doing the math right) in her early 20s. She was basically told that she would be living in a group home for the rest of her life. And she was actually hospitalized multiple times (apparently), but after her last stint at age 28 she was told that maybe she could get a job as a cashier making change part time. Instead she became a law professor and recipient of a MacArthur Foundation genius grant. Is she still schizophrenic?


Although I fought my diagnosis for many years, I came to accept that I have schizophrenia and will be in treatment the rest of my life. Indeed, excellent psychoanalytic treatment and medication have been critical to my success. What I refused to accept was my prognosis.

Conventional psychiatric thinking and its diagnostic categories say that people like me don’t exist. Either I don’t have schizophrenia (please tell that to the delusions crowding my mind), or I couldn’t have accomplished what I have (please tell that to [University of Southern California]’s committee on faculty affairs). But I do, and I have. And I have undertaken research with colleagues at U.S.C. and U.C.L.A. to show that I am not alone. There are others with schizophrenia and such active symptoms as delusions and hallucinations who have significant academic and professional achievements.


There were also really helpful suggestions about how each person came up with coping mechanisms specific to their individual issues:


How had these people with schizophrenia managed to succeed in their studies and at such high-level jobs? We learned that, in addition to medication and therapy, all the participants had developed techniques to keep their schizophrenia at bay. For some, these techniques were cognitive. An educator with a master’s degree said he had learned to face his hallucinations and ask, “What’s the evidence for that? Or is it just a perception problem?” Another participant said, “I hear derogatory voices all the time. ... You just gotta blow them off.”

Part of vigilance about symptoms was “identifying triggers” to “prevent a fuller blown experience of symptoms,” said a participant who works as a coordinator at a nonprofit group. For instance, if being with people in close quarters for too long can set off symptoms, build in some alone time when you travel with friends.

Other techniques that our participants cited included controlling sensory inputs. For some, this meant keeping their living space simple (bare walls, no TV, only quiet music), while for others, it meant distracting music. “I’ll listen to loud music if I don’t want to hear things,” said a participant who is a certified nurse’s assistant. Still others mentioned exercise, a healthy diet, avoiding alcohol and getting enough sleep. A belief in God and prayer also played a role for some.

Sound familiar to anyone? The advice to identify and avoid triggers by explicitly structuring your life to avoid or minimize them? Exercise and diet? Sleep and sensory inputs? Religion (which always what I fall back on when my brain is sick)?

She goes on to talk about how some people pour themselves into a rewarding career. She warns about the conflation of symptoms and diagnosis:


Far too often, the conventional psychiatric approach to mental illness is to see clusters of symptoms that characterize people. Accordingly, many psychiatrists hold the view that treating symptoms with medication is treating mental illness. But this fails to take into account individuals’ strengths and capabilities, leading mental health professionals to underestimate what their patients can hope to achieve in the world.


She mentions that some people with autism managed their symptoms, sometimes to the point of eliminating them. She then closes with these thoughts that could apply equally well to sociopathy:

I don’t want to sound like a Pollyanna about schizophrenia; mental illness imposes real limitations, and it’s important not to romanticize it. We can’t all be Nobel laureates like John Nash of the movie “A Beautiful Mind.” But the seeds of creative thinking may sometimes be found in mental illness, and people underestimate the power of the human brain to adapt and to create. 

An approach that looks for individual strengths, in addition to considering symptoms, could help dispel the pessimism surrounding mental illness. Finding “the wellness within the illness,” as one person with schizophrenia said, should be a therapeutic goal. . . . They should encourage patients to find their own repertory of techniques to manage their symptoms and aim for a quality of life as they define it. 

Friday, January 25, 2013

You will always be my son

From a reader:


So tired of explaining my son and trying to figure out the dark mystery he is but your experience reflects a part of who my son is. At three diagnosed with Asperger's. Had some classic traits but still didn't quite fit the mold. Socially inept, uncoordinated, wanted friends but was awkward and inappropriate. The boy's IQ is 150. Thought that coping with all the Asperger's problems as a single parent with no support would be as bad as it would get. Then at 15 he had a "psychotic break" in which I came home from work as a case manager for mostly psychotic schizophrenics to find my own son crying hysterically begging me to stay away from him because he was having possible instrusive thoughts, not sure, and the urge to kill me. I stayed in clinical mode as I tried to calmly take his hysteria down and brought him to crisis. The clinician, who I knew and didn't really like me, told me to take him home and he would be okay. Oh yeah, he also told the clinician that he wanted to rape me. No big deal. I could handle it. And I did. Horrifying and heartbreaking.

At 16 he said he had begun hearing voices but I knew many clients who heard voices and my son did not present as they did. He never responded to the voices which is something people are compelled to do. Didn't make sense. Two weeks later he vividly described a visual hallucination saying that cops were at the door with guns drawn. He seemed fascinated by it. I had heard 100's of accounts of visual hallucinations and they weren't as clear as his.  About four months ago after complaining to me daily that he was having suicidal thoughts and the urge to strangle me I saw the intent in his eyes one day. Did not know this child. He was not my son. Back to crisis where he was clear and said he felt "good" in waiting area but presented as the perfect psychotic, demeanor, body language, voice when being evaluated by the clinician. This time he was taken to an adolescent psych hospital 90 miles away. I almost collapsed a few times that day during the process. I was so drained from weeks of waiting to be strangled. My denial enable me to cope but every time he would surprise me I involuntarily jumped and let out a small animal-like yelp. My subconscious knew to be scared.

While he was in the hospital everything changed as far as my perception of this innocent victim of mental illness. He would call several times a day crying and begging me to get him out. Then his voice changed and he was quite in control stating with hostility and threat that I'd better get him out AMA. One particular visit turned the switch in me. As he sat across the table crying and begging again making outragious complaints about staff and other patients I shut down and did not react. This accelerated his determination and manipulative tactics. He couldn't believe that I was calmly countering all he said. 

Then he began yelling and tried to leap across the table to get to me. I told him now I could really see the hatred and how much he really did want to hurt me. Not done, he put his hands around his neck in an effort to show he would strangle himself. His acting abilities did not impress me. I had been through so much in an effort to help him to this point, now I felt taken advantage of and betrayed. He had shown signs before of switching in seconds from the tortured victim to an arrogant kid just screwing around. He didn't know I had witnessed these incidents. And the lies were always there. He is home and still has the thoughts and urges. I don't know him anymore. Now that he knows I have caught on no more coming to me for sympathy just an uncomfortable distance. Need help. There is a Forensic Psychiatrist in San Jose, Ca not for from us, Dr. Arturo Silva, who has a theory that Asperger's can turn into psycopathic traits as a teenager. Been trying to get in touch with him but not successful. I feel in my gut he might have answers that I need. Can you help?


M.E.:

I don't know if there is anything I can do to help. If he is a sociopath, you should appeal to his self-interest. It does not help him to harm you because you are willing to financially support him through college, or whatever else it is. It sounds like he is around 17. You might want to talk to him about how when he turns 18, you will still be his mother and will support him in anyway you can, but he will be considered an adult by society. Anything he does after that could have very long lasting effects for him. Give him some facts about the average life expectancy of someone his age. Perhaps you two could "volunteer" at a prison? He should be rational enough to be educated in these ways. And if you acknowledge how he is different without judging him, things should be able to get better between the two of you. Say things like, "you will always be my son." Give him a sense of permanence. Explain to him the meaning of the phrase "don't defecate where you eat." Have him read the book "Lord of the Flies" and see how he feels about it. If he's not a sociopath, I don't think these things will work.

Friday, January 18, 2013

You are what you eat

I am very impressionable. I am so impressionable that the self that I call mine seems to be no more than a hodgepodge collection of everything I have thought, everything i have experienced, everyone I have been around. I used to be very reckless in my youth with what I did, what I chose, what I thought. I wanted to try everything and everyone, wanted to know what else was out there in the world. Everything I did changed me, though, for better or for worse. I didn't realize it at the time, and didn't really realize the extent of it until relatively recently. That thought has made me more circumspect.

I feel like this must be true of non sociopaths as well, but maybe to a lesser extent. Maybe they just don't acknowledge the inherent fluidity of the self? It's interesting to me to think that my body is made up of everything that I have eaten. There is literally nothing about my body that I haven't ingested at one time or another -- not my brain, not my heart, not my lungs, not my eyes or teeth... it's weird thinking that I am made up of cheeseburgers.

People want to know why sociopaths have a hard time letting go sometimes. Some of it may be the thrill of the hunt, the sting of defeat, or vindictiveness. I think for me it is mainly because everyone that has ever been close to me has become a part of me. Like that Paul Young song, every time they go away, they literally take a piece of me with them.

Thursday, January 17, 2013

Socialized

A reader recently asked me if a sociopath could be socialized not to act like one. I responded:

Maybe this analogy will help you understand what he probably means by being socialized. He is like a wild animal that just happens to have been tamed. I have an aunt who loves having wild animals as pets. Currently it's wolves. She fancies herself a bit of an animal trainer and it's true that the wolf essentially acts just like a dog would. I don't know anything about wolves, but I do know that it is illegal to have a wolf as a pet where she lives, presumably because there is something different about the vis a vis dogs, e.g. they are less domesticated and more dangerous because although they're behavior in that moment is socialized, there's still a greater likelihood that they will act like the wild animal that they are. One of my friends said that being in any sort of relationship with a sociopath is like having a wild, exotic pet. If stories like the lady getting her face chewed off by a chimpanzee or the entertainer who was attacked by his own white lion disturb you or make you think--that person was an idiot to ever trust that animal--maybe being in a relationship with a sociopath is not for you.

Monday, January 7, 2013

What exactly is psychopathy?

A reader sent this interesting article from one of our favorite researchers, Jennifer Skeem, whose previous attack on the PCL-R caused Robert Hare to take her to court and delay the publication before it was eventually released. The article is sort of an interesting primer on psychopathy and summary of the most recent research. She has her own ideas about the correct delineation of psychopathy that seems reasonable. First she discusses why there are so many ideas about what exactly sociopathy is:

As we will discuss, many of the controversies surrounding psychopathy stem from fundamental disagreements about its basic definition, or operationalization. The scope of phenomena encompassed by the term psychopathy has varied dramatically over time, from virtually all forms of mental disorder (psychopathy as “diseased mind”) to a distinctive disorder characterized by lack of anxiety; guiltlessness; charm; superficial social adeptness; dishonesty; and reckless, uninhibited behavior (Blackburn, 1998). Even contemporary conceptualizations of psychopathy contain puzzling contradictions. Psychopaths are often described as hostile, aggressive, and at times revenge driven (N. S. Gray, MacCulloch, Smith, Morris, & Snowden, 2003), yet they are also characterized as experiencing only superficial emotions (Karpman, 1961; McCord & McCord, 1964). They are impulsive and reckless, yet apparently capable of elaborate scheming and masterful manipulation (Hare, 1993). They can rise to high levels of achievement or status in society, attaining success in business and public life, yet present as criminals whose behavior is so poorly thought out and lacking in regard even for self-interest that they occupy bottom rungs of the social ladder

Given these contrasting depictions, it is scant wonder that some experts have concluded that the concept of psychopathy, as commonly understood, is disturbingly problematic: a “mythical entity” and “a moral judgment masquerading as a clinical diagnosis” (Blackburn, 1988, p. 511), “almost synonymous with ‘bad’” (Gunn, 1998, p. 34), “used by the media [to convey] an impression of danger, and implacable evil” (Lykken, 2006, p. 11). In the words of William and Joan McCord (McCord & McCord, 1964), two influential figures in the historic literature on psychopathy, “the proliferation of definitions, the tendency to expand the concept to include all deviant behavior, the discrepancies in judgment between different observers——these pitfalls in the history of the concept—— are enough to make a systematic diagnostician weep” (p. 56).

She then (optimistically) asserts that all is not lost, that sociopathy is a thing and we can figure out what that thing is through careful parsing of the literature and empirical evidence. First she dispels some myths:

  • Psychopathy is synonymous with violence: "However, psychopathy can and does occur in the absence of official criminal convictions, and many psychopathic individuals have no histories of violence."
  • Psychopathy is synonymous with psychosis: "In contrast with psychotic patients, psychopathic individuals are generally rational, free of delusions, and well oriented to their surroundings"
  • Psychopathy is synonymous with antisocial personality disorder (ASPD): "The difference arises largely because measures of psychopathy include personality traits inferable from behavior, whereas measures of ASPD more exclusively emphasize antisocial, criminal, and (to a lesser extent) violent behavior."
  • Psychopathic individuals are born, not made: "Contemporary understanding of the pervasive interplay of genetic and environmental influences in determining behavioral outcomes of various kinds argues against the likelihood that any psychiatric condition, including psychopathy, is entirely 'born' or 'made.'"
  • Psychopathy is inalterable: "some recent empirical work has emerged to suggest that personality traits in general, and psychopathic traits more specifically, undergo change across major developmental transitions"

The article is quite long. I will probably keep going back to it over the next month or so and perhaps sharing things that I learn here.

Saturday, January 5, 2013

Different children

Selections from a NY Times book review about children with unique issues:

Andrew Solomon’s enormous new book, “Far From the Tree: Parents, Children, and the Search for Identity,” is about children who are born or who grow up in ways their parents never expected.

Mr. Solomon explained that “Far from the Tree” took 11 years. It stemmed from a 1994 article about deafness he wrote for The New York Times Magazine. In the course of reporting it, he said, he realized that many issues confronting the deaf are not unlike those he faced as someone who was gay. 

A few years later, watching a documentary about dwarfism, he saw the same pattern again. Eventually the book grew to also include chapters on Down syndrome, autism, schizophrenia, disability, prodigies, transgender identity, children who are conceived during a rape and those who become criminals.

Mr. Solomon said he included criminal children after deciding that society’s thinking on the subject hadn’t really advanced very much, even while it has on autism and schizophrenia. “We still think it’s the parents’ fault if a child becomes a criminal or that something creepy must have gone on in that household,” he said. He included the children of rape because he discovered that their mothers shared a lot with all the other mothers in the book. “They feel alienated, disaffected, angry — a lot of the things a mother feels about a child with a disability.”

This kind of commonality, he went on, was something he discovered only while writing. “Each of the conditions I describe is very isolating,” he said. “There aren’t that many dwarfs, there aren’t that many schizophrenics. There aren’t that many families dealing with a criminal kid — not so few but not so many. But if you recognize that there is a lot in common in all these experiences, they imply a world in which not only is your condition not so isolating but the fact of your difference unites you with other people.”

“Forewarned is forearmed,” he said. “Some things, on some scale, go wrong in everyone’s life. I think I have perfectionist tendencies, but I know you can’t go into parenthood thinking, ‘I’m going to love my child as long as he’s perfect.’ Rather, it should be, ‘I’m going to love my child whoever he is, and let’s see how he turns out.’ ”

I wonder how many parents can say that about criminal or sociopathic children -- that they appreciate the experience of raising a child with those unique difficulties and that they love their child no matter what. Still, it is a nice, aspirational thought.

Tuesday, December 18, 2012

"I am Adam Lanza’s mother'

From a reader:

There's a popular blog post circulating pretty fast around from a mom who has a son with a pretty dangerous mental illness, not properly diagnosed. The message of the post seemed fairly positive, but I found myself taken aback by how she handles her kid, and then goes on to say that he could be the next massacre shooter without proper help.

Is it just me, or does this kind of thing seem inherently wrong? I watched the Child of Rage documentary, and if anyone was going to become a killer, it was that kid, but after some proper therapy and rehabilitation, she ended up pretty damn well-adjusted.

I know you've talked about the issue with labels in the past, and in light of these massacres and a new-found interest in mental health being the root issues of them, it just seems that treating a kid like an unpredictable prisoner is just wrong. I mean, if a child can't even turn to their family for support and understanding, then you've essentially isolated them mentally and emotionally. If they're that unstable, they're not going to have even friends to turn to. When the kid turns 18, he's going to cut loose, because the only people who could have helped him didn't. Considering the behavior she described, if someone doesn't find a way for him to adjust, he's going to go to prison sooner or later.

And this is exactly how they're treating people like sociopaths. Giving them a supposedly incurable mental disease label, and then just settling for locking them and throwing away the key. What life is that?

Speaking of which, currently in the States, 56% of prisoners have a diagnosed mental disorder. So much for the asylum...

I don't know if I have much of an opinion about the macro problem of mental illness. When I first read the blog post linked above I was sort of turned off for a lot of reasons, including the one the reader mentions. I thought about it for a little while, though, and re read it and realized that the mother is not really advocating anything in particular, so much as just wanting to add to (or open up) the conversation on mental illness.

The truth is that I don't really think that this can be addressed effectively on the macro level, but rather any truly effective solution/treatment, at least for children, will be better parenting or people in substitute parenting roles. It reminds me of this selection from the NY Magazine article on autism mentioned yesterday: “A lot of kids are just delayed in development, slow to talk, or anxious, or hyperactive, and a lot of kids are just terribly parented. . . . We see a lot of diagnosis-of-childhood kids, whose parents have never set limits, plus kids who are temperamentally difficult to raise."

That is not to say that parents of severely disturbed children have necessarily done anything "wrong." But I do believe in the plasticity of the child's mind and that there are ways to improve any child's behavior if one thinks creatively enough about it. This is also not to say that every parent is capable of parenting a child with these particular special needs. To the extent a label helps the helpless parent, I can see that possibly being a positive in the child's life. But to the extent that applying labels limits their/our beliefs about whether a child is redeemable or not, then yes, I believe that "labels for life" are counterproductive.

On the micro level, I feel like the biggest opportunity for children, particularly for those who are damaged but not quite mentally ill, is for them to feel a paradigm shift in their own concept of self. Like the girl in Child of Rage who was taught to believe that "when I hurt other people I'm hurting my good self." Maybe I'll write more on that later.

Saturday, December 15, 2012

Promoting prosocial behavior

This was an interesting recent article in the NY Times, "Understanding How Children Develop Empathy," but I thought some of the parts about the source and development of prosocial behavior were just as interesting--particularly that it is not just about (or even primarily) about empathy:


By itself, intense empathy — really feeling someone else’s pain — can backfire, causing so much personal distress that the end result is a desire to avoid the source of the pain, researchers have found. The ingredients of prosocial behavior, from kindness to philanthropy, are more complex and varied.

They include the ability to perceive others’ distress, the sense of self that helps sort out your own identity and feelings, the regulatory skills that prevent distress so severe it turns to aversion, and the cognitive and emotional understanding of the value of helping.

And this part about how people can be taught to feel the rewards of prosocial acts:


Experimental studies have shown that the same brain region that is activated when people win money for themselves is active when they give to charity — that is, that there is a kind of neurologic “reward” built into the motivational system of the brain.

“Charitable giving can activate the same pleasure-reward centers, the dopaminergic centers, in the brain that are very closely tied to habit formation,” said Bill Harbaugh, an economist at the University of Oregon who studies altruism. “This suggests it might be possible to foster the same sorts of habits for charitable giving you see with other sorts of habits.”



The other theory of prosocial behavior, Dr. Huettel said, is based on social cognition — the recognition that other people have needs and goals. The two theories aren’t mutually exclusive: Cognitive understanding accompanied by a motivational reward reinforces prosocial behavior.

But shaping prosocial behavior is a tricky business. For instance, certain financial incentives seem to deter prosocial impulses, a phenomenon called reward undermining, Dr. Huettel said.



I thought that made a lot of sense, that a lot of prosocial acts stem from a greater cognitive understanding that other people have needs and goals. I feel like the more aware I have been taught to be about the inner worlds of others, the more I am naturally inclined to defer to those needs and goals, especially when it is hardly any trouble to me and means so much to them.

Friday, December 7, 2012

Life hacking

I enjoy reading research from behavioral economists, to learn more about why I and those around me do the things that we do -- what are our natural tendencies, inclinations, etc. I've been casually  following the field for the past decade or so. Initially its findings were sort of met with uproar by some, particularly from those who believe in a stronger form of free will than the evidence would suggest. When confronted with how easy it was to fool the average person or get them to behave with cruelty, there was disbelief and offense. I loved reading about these studies because they confirmed some of my suspicions about human nature and gave me insight into other areas of human behavior that I had not previously considered.

Now I read these studies more as a how-to for "life hacking," improving the quality of my life and making it easier on myself to think and behave the way that I think is optimal given my circumstances. That's why I liked this passage from the introduction of Dan Ariely's latest book, via Brain Pickings:

In addition to exploring the forces that shape dishonesty, one of the main practical benefits of the behavioral economics approach is that it shows us the internal and environmental influences on our behavior. Once we more clearly understand the forces that really drive us, we discover that we are not helpless in the face of our human follies (dishonesty included), that we can restructure our environment, and that by doing so we can achieve better behaviors and outcomes.

I think this is important for everyone, but perhaps particularly the personality disordered. Writing the blog and doing the research that I have done in the area of sociopathy has been largely targeted to do just this -- undertand the internal and environmental influences on my behavior so that I can restructure what I can for better outcomes.

I've learned a lot about myself over the years and I continue to learn about myself. Even on this recent trip, one of my traveling companions accused me of objectifying her -- treating her as just another thing to be managed. I would manage her the same way I would manage transfers between hotels and airports even though she is professedly one of my favorite people. I realized I have defaulted into this mode with everyone for the past couple of months, had gradually slipped into it without realizing. Of course I wish that she hadn't told me through a tearful and sudden outburst while I was in the middle of troubleshooting some technical problem, but still I was glad that she was able to pinpoint what exactly about my behavior was upsetting her. It took a while to remember why and how to admire/love her, but I did so by trying to remember past happy times, smelling her clothes, sitting unnecessarily close to her, etc. Creepy? I think so too, but it worked. The more I learn about myself, the more empowered I feel.

Monday, October 15, 2012

Educating children sociopaths

This was an interesting article about the delicacy between not wanting to diagnose sociopathy in children because it can be such a damning prognosis, but also wanting to do it to possibly put at-risk children in some sort of early intervention program. As researcher put it:

To me it seems a no-brainer,” says Essi Viding, professor of psychology at University College London. “Nobody’s going to get psychopathy as a present when they turn 18. Of course you’re going to see some precursors."

What might early intervention look like?

“If you’re labelling someone a psychopath, it does seem to assume that there’s nothing we can do for them, that they’re going to grow up to be a criminal, and that you might as well just lock them up,” Frick says. “But you can teach a child to recognise the effects of their behaviour.”

The lack of success in educating children sociopaths to recognise the effects of their behaviour may have more to do with using the wrong methods than it does a sociopath child's inability or unwillingness to learn:


“What [people who use social shaming as a method of punishment] assume is that children have the motivation to shift their behaviour. That their primary social motivator is the relationship,” says Warren.

She interviewed more than 1,000 children with behavioural problems, aged eight to 18. “I was beginning to see children who weren’t responsive to these interventions, who weren’t interested in what adults, parents, educators, think,” she says.

“If a child or group of children isn’t interested in pleasing someone, doesn’t care about sanctions, what they’re driven by is pleasure or reward. They will take the pain of the consequences but won’t change their behaviour.”

What does work?


The programme, called Let’s Get Smart, replaces sanctions with rewards. Some teachers were uneasy. “Some teachers felt that punishment happens in the real world; if they misbehave in the real world they will still go to prison. Why are we setting them up for unrealistic expectations?” says Jones. “Our point is that it doesn’t work.”

By offering regular rewards, perhaps three times a day, controlled by the adult in authority, it aims to provide a rational, self-interested motivation for pleasing adults where that motive is emotionally absent. “The adult becomes the clear intermediary between the child and what the child wants,” Warren says. The rewards are tailored to each child’s interests.

These children often have a strong desire for control and teachers have to resist attempts to negotiate, because any concession just leads to more demands. “I teach parents and teachers to say, ‘It’s not open for discussion, go away.’ Adults don’t like to dismiss children,” Warren says.

All this is backed by role play and other exercises that are intended to build children’s capacity to pay attention to and respond appropriately to others’ emotions. Video playback helps the children to see their behaviour as others do, often to their surprise. (“I do swear a lot,” one girl told Warren.)

What sort of results can you expect?

“These kids are still having quite significant problems: they are not cured. But they are improving. Some have gone back to mainstream school, which is incredible,” she says.

Whether children ever really learn greater empathy or just learn to manage their behaviour is not clear. “My personal gut feeling is that you can modify behaviour perhaps more readily than you can improve the empathy response,” Viding says.



There are a couple of other interesting tidbits, like this one about "circle time" type emotional sharing activities:

“(In circle time) children say what makes them scared and children who have callous-unemotional traits think, ‘This is a useful piece of information to have’,” she says.

Hilarious.

Monday, August 13, 2012

Moral codes, boundaries and food allergies

I think empaths' brains work differently than mine. There are certain things that they consider sacrosanct that I just think are normal, or even silly. Luckily I was brought up in a religious household, so I learned that some invisible things actually mean a lot to other people: love, patriotism, god, goodness, etc. I learned that the general rule to avoid unwanted conflict is to respect those beliefs in others, even though they do not mean anything to me. This is sort of a hallmark of a modern, civilized society. When we walk into holy buildings, we remove our shoes if that is the custom even though the god of that temple may not be our own.

That is what we are socialized to do, but there is some debate regarding how much respect we should give other people's beliefs. For instance, if you believe cows are sacred, I'm fine with your boycotting beef, but your beliefs won't stop me from eating a cheeseburger in front of you. If the average person is willing to take off his shoes in your temple but eat a cheeseburger in front of you, what will he do about your belief that abortion is murder or your beliefs that the female labia is dirty and needs to be cut off or the vagina stitched up to ensure the purity of the woman? What is legitimate?

To me it seems like random line drawing: sodomy between two consenting adults is legitimate, sodomy between an adult and a child not legitimate. Public nudity is wrong, but so is a woman covering up from head to foot. There are reasons, sure. I have heard reasons. But many empaths will criticize dolphin slaughter while eating animals raised in deplorable conditions. (By the way, stop eating octupus. They are very smart, precocious creatures.) How do they reconcile this? What makes them freak about one thing and be so permissive about another?

I am a very tolerant person. I attribute this to my sociopathy. Unlike empaths, who are so hard-wired to believe whatever their culture has programmed them to think, I can look at something from a blank slate point of view. I guess this is also why I'm a libertarian -- I don't believe that my ideas are so right that they should be imposed on others, even if those other people disagree. In other words, I am as skeptical about the beliefs I hold as I am about the beliefs of others. And I don't play favorites like empaths who say, "Imposing my beliefs on others is fine because mine are supported by (fill in the blank pet reasons: science, religion, logic, tradition, etc.), but you can't do the same because your beliefs are only supported by (fill in the blank hated reasons: science, religion, logic, tradition, etc.)." So I trend away from imposing my beliefs on others, and I don't necessarily think that one basis for beliefs is better than another. That doesn't mean I don't respect people's beliefs, though. To keep the peace and as a courtesy to others that I expect to be reciprocated, i will almost always take off my shoes when walking on someone's sacred ground.

Does that make me not a sociopath? Ha. Well, the process of how I do it sounds at least Aspergian. How do I know when to take off my shoes? It's like discovering a food allergy. Maybe you eat something at a restaurant and get sick. Other people from your party ate the same thing and did not get sick. Maybe you just caught a flu bug, you think. A few months later you eat something else and get similar symptoms. The symptoms seem the same, but you don't know what could be the common ingredient. You keep collecting info, eliminating this, eliminating that, keeping a mental log of what you could possibly be allergic to. It is clear to you by now that even though you cannot see what is making you sick, can't even identify it, there is certainly something wrong because you keep getting bad reactions. Maybe your boss periodically gets angry at you in the same way. Maybe your spouse can't stand to be around you when you are like _____. I am in those types of situations all the time -- people are mad at me and I have no idea why. chances are, though, I am encroaching on someone's moral code and/or sense of personal boundaries. I have learned that either I keep doing the same thing and getting the same adverse reaction, or I figure something else out. otherwise I'm in for a world of hurt, because it's like a moral/personal boundary minefield out there. Right aspies?

Monday, May 14, 2012

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.



Thursday, February 16, 2012

Like father, like daughter (part 3)

My response:


I'm actually amazed that you have intuited so well how best to deal with your daughter.  I always advise parents of sociopathic leaning children to stay extremely consistent, don't get emotional, don't be critical to the extent that they feel like you are rejecting them or will reject who they are, don't punish -- incentivize and make the child see what's in it for them.

I think that sociopaths (particularly young ones) actually feel happier and thrive better in a world of clearly defined boundaries and rules that are so consistently enforced, the child will just start to take them as a given.  I think having simple cause and effect rules/boundaries that have clear and predictable outcomes for acceptance/violation encourages the young sociopath to think of life as an interesting puzzle that can be gamed.  As long as the young sociopath believes that he or she can acquire some advantage through skillful planning and execution (and finds some measure of success, which I feel is almost a given), they will stay committed to the structure of the game you have set up.  It's why sociopaths can be ruthless businessmen fiercely defending the principles of capitalism.

The worst thing that parents can do is to be inconsistent.  It makes the child sociopath think that the game is rigged and it doesn't matter what he or she does, except to the extent that he or she can outcheat the cheater (the parent).  Other big mistakes are being emotional (it's insulting to the child and he or she will lose respect for you).  If you react emotionally and negatively to the child, the child will perceive it as a clear betrayal and one that will instantly dissipate any trust in the relationship.

This is a very important topic you have raised.  Would you allow me to publish this exchange?  I can redact out any information that you believe is too personal.

Tuesday, December 27, 2011

A prosthetic moral compass?

Like many sociopaths, I have my own way of organizing the world and coming up with shortcuts for good decisions. I like to use economics and the principles of efficiency. Most of the time my method tracks what the majority think is the moral thing to do. Why don't we kill? Because if it were really more efficient to take another person's life, the murderer should be able to pay enough money to the victim that he would consent to the murder. Along the same reasoning, murder of animals is fine because animals don't have the access to capital markets or earning potential to be able to buy their life, right? Wrong. Because otherwise that would also apply to slaves. See? It's complicated. Hard to keep track of things. But it's only a prosthetic moral compass, so what do you expect?

Here's an oft-asked question: If there were a cure for sociopathy, would I take it? Or do I really believe that sociopathy is just another way of navigating the world, an acceptable variance in human behavior? Would it be a betrayal to "my people" to accept a "solution" to a "problem" that they don't think needs solving? A significant portion of the deaf community feels that cochlear implants are an affront to legitimate deaf culture. What if there there were a cochlear implant for the heart? Wikianswers seems to think there's one coming:
In cases where brain damage is too severe to permit [normal therapy], new developments in technology in the next decades will bring implantable devices that may be able to be used in the brain, along with other means including synthetic replacement neurotransmitters, to carry nerve impulses along paths formerly silent and unused in the sociopath's brain.
I'm not one to get my information from wikianswers, and I haven't been able to find out what new technology this person was referring to, but it still is an interesting idea. Particularly if it stopped being evolutionarily advantageous to be a sociopath, I think I would seriously consider getting a mechanical device to "fix" my "broken" brain.

At the very least, I think it would be interesting to experience what others experience, even for a limited duration or in a limited capacity.  I was just reading in the NY Times about how John Elder Robison (Aspie and author of the memoir "Look Me in the Eye") underwent some experimental treatment that "had given him a temporary insight into other people he had not had previously".  If something like that were possible for people like me, I would almost certainly choose to do it.  I feel like that sort of insight can only be a good thing.

Monday, November 28, 2011

Psychopath myths

From Scientific American, author of the book "50 Great Myths of Popular Psychology," Scott Lilienfeld, discusses some myths and misconceptions about psychopaths. Some of the highlights:
  • Few disorders are as misunderstood as is psychopathic personality.
  • Research also suggests that a sizable number of psychopaths may be walking among us in everyday life. Some investigators have even speculated that “successful psychopaths”—those who attain prominent positions in society—may be overrepresented in certain occupations, such as politics, business and entertainment. Yet the scientific evidence for this intriguing conjecture is preliminary.
  • Psychopathy seems to be present in both Western and non-Western cultures, including those that have had minimal exposure to media portrayals of the condition.
Here are the myths:
  1. All psychopaths are violent. Research by psychologists such as Randall T. Salekin, now at the University of Alabama, indicates that psychopathy is a risk factor for future physical and sexual violence. Moreover, at least some serial killers—for example, Ted Bundy, John Wayne Gacy and Dennis Rader, the infamous “BTK” (Bind, Torture, Kill) murderer—have manifested numerous psychopathic traits, including superficial charm and a profound absence of guilt and empathy. Nevertheless, most psychopaths are not violent, and most violent people are not psychopaths. . . . Regrettably, the current (fourth, revised) edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR), published in 2000, only reinforces the confusion between psychopathy and violence. It describes a condition termed antisocial personality disorder (ASPD), which is characterized by a longstanding history of criminal and often physically aggressive behavior, referring to it as synonymous with psychopathy. Yet research demonstrates that measures of psychopathy and ASPD overlap only moderately.
  2. All psychopaths are psychotic. In contrast to people with psychotic disorders, such as schizophrenia, who often lose contact with reality, psychopaths are almost always rational.
  3. Psychopathy is untreatable. . . . Although psychopaths are often unmotivated to seek treatment, research by psychologist Jennifer Skeem of the University of California, Irvine, and her colleagues suggests that psychopaths may benefit as much as nonpsychopaths from psychological treatment. Even if the core personality traits of psychopaths are exceedingly difficult to change, their criminal behaviors may prove more amenable to treatment.

Monday, October 24, 2011

Managing mental illness

This is an interesting NY Times article about managing Schizoaffective disorder that questions the typical advice of taking it easy. Particularly, it suggests that people with that particular disorder do better when they have a very busy, demanding job or otherwise keep busy with obligations:

She travels a lot to conferences, and when she is back in California she keeps her schedule as full as possible. Her mind runs on high, and without fuel — without work — it seems to want to feed on itself. Her elbows usually tingle when that is about to happen, she said, and she will often play number games in her head. If she needs to, she will make a quick phone call.
I remember being happiest in my childhood during the school year. Once the summer came around, it was very easy for me to get cripplingly bored and generally dissatisfied with life. When I was a teenager, I would actually have symptoms of depression in the summer--feelings of malaise and general mental unrest that would always quickly disappear once school started again. During the school years I had every hour of my life scheduled because I liked it that way. One time I got appendicitis and went for 10 days with it perforated without seeking medical attention--I just had so many things I was caught up with. Right now I am in a similar situation of possibly overdoing it. I'm sleep deprived and may be developing an ulcer, but at least my mind isn't eating itself.
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