Tuesday, September 28, 2010

Mistreated

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.

Monday, September 27, 2010

New season of Dexter!

No spoilers, but I just wanted to acknowledge that Showtime's "Dexter" has done more to educate the general public on sociopathy than any other one source. It is such an accurate depiction of the inner monologue of a sociopath that I think there must be a sociopath on staff as a consultant or a writer. Interestingly, one of the writers at Love Fraud criticizes the character of Dexter for the very reasons that I think there must be an "inside man" who is aware of how a real sociopath thinks:
Speaking of actor Michael C. Hall, I wonder what your take is on Dexter, the great Showtime Series in which Hall plays a sociopathic serial killer working, by day, as a Miami crime-scene forensics analyst?

I love this series, which is coming into its third season. But as disturbing a character as Dexter is, I would not characterize him as a sociopath. This is just a fun diagnostic quibble. Ostensibly, Dexter grows up a budding, violent sociopath. His father (or father-figure) recognizes the dark, evil side over which, as a boy and adolescent, Dexter seems to have little, and diminishing, control. The father sees that Dexter is compulsively, inexorably inclined to sadistic violence.

His solution is to somehow train Dexter to direct his sociopathic, homicidal proclivities towards cruel, menacing, destructive individuals. Best, if someone’s got to be snuffed-out by Dexter, it be someone the world will be better without!

And so Dexter becomes skilled, over time, at identifying individuals the world won’t miss; individuals as dangerous and creepy as he.

Why, then, is Dexter not really a sociopath—and indeed, diagnostically speaking, not even necessarily plausible? Because, despite his violent, murderous compulsions, Dexter is, first of all, a fundamentally sincere person. He is also loyal–for instance to his sister and a girlfriend. And while Dexter struggles to “feel” warm feelings, indeed anything—a struggle, incidentally, that he embraces—he knows how to have the backs of others, even where his self-interest may be at risk.

In a word, Dexter strives, against his darkest, most sordid inclinations, for growth. This is precisely what makes him and the series so fascinating, and precisely what rules him out as sociopath.
One of the commenters on that site quickly points out what should be obvious to readers of this site:
I think a sociopath can show what appears to be loyalty to a girlfriend or someone else, and they can also take action to have someone’s back, even though it appears to put them at risk. Why do I think this? I think if the girlfriend or someone else is someone they view as someone they “own” or have power over, and who will repay their act of loyalty in kind, if the person is someone who has utility to them, they will take action to protect the person. And if that girlfriend or other person is being mistreated or in some sort of trouble from someone OTHER than the psychopath himself, then I think it is also a game to them, to oneup that other person who is causing the trouble–to win over them. Even when it appears they are putting themselves at risk out of altruisim or concern to save someone else, it is really just to see how they can manipulate the situation to save the person, and it is thrilling to them to put their ownselves at risk, then get away with it and get themselves out of the situation and win the game. But if it actually came down to the wire of the girlfriend or person whose back they are saving or themselves, at that point, if they’ve exhausted all other options, then they’d throw the person under the bus.
But again, if anyone knows or wants to find out who Dexter's "inside man" is, I would pay money to know. I would credit the insider's level of insight to the author of the original books, which I haven't read, but I hear they are not quite as good as the television series.

Saturday, September 25, 2010

No longer a "victim" of a sociopath

A reader and the author of a sociopath survival book, Dark Souls gives this opinion about healing:
I had an email from a woman who said I am thinking about going back to my sociopath ex. He is thinking about being open and honest. What do you think ?

I said I think the chances are he has been caught with his pants down and wants to keep the relationshp going in the hope that he might be able to have you for supply in the future. I get a reply back to say he has raped, buggered, and battered her. Why does she want to go back. Because it feeds into her victim mentality and she is not ready to heal.

To heal you have to stop being a victim. Its basically that we have to understand the sociopath, narcissist or psychopath, know what they do to manipulate us us then STOP trying to figure them out. Then we stop being a victim and Then we can heal. Learn why we would have such low self esteem to want to be with these people in the first place. work on that and then we can leave.
A reader mentioned reading it, so I asked for her opinion on the book:
One thing that drove me nuts were all of the typos. For the amount that she's charging that book shouldn't have a bunch of typos. I am a technical writer so maybe I am too picky.
She also kept talking about this douche who she calls Oliver over and over and she's all over the place with time references. She kept saying that she didn't want to sound like she's a victim but that's exactly what she sounded like to me. I also had an issue for her not ever once taking responsibilty for her actions. Nothing was her fault. I asked her why she didn't acknowledge responsibility for fucking a married man for five years, and what about what she did to his wife? NOPE, her excuse was that he said he had cancer. Another thing I disliked about her book was how she went on with this whole spiritual crap.
I think I found her book on an "anti-sociopath" site. I mean I don't like getting fucked over but Jesus tap dancing Christ, take some responsibility for your actions. Empaths want you guys to take responsibility so why won't they/we?
I honestly cannot remember how I found your site but it has been more helpful than anything. However, I am not like most empaths so I guess I'm in between. I think the book, "He's Just Not That into You" was more helpful than any of these empath pussies.
They want to crucify you guys without looking at themselves.
I think that if you are going to write one of these self-help books then you should be an expert or guru. I think I could write a better book than she did.
Anyway, if you did recommend it, the empaths would go apeshit and whine some more and it would give you sociopaths plenty of ammo.
So there ya go. Two sides...

Friday, September 24, 2010

Criticisms of PCL-R confirmed by recent study

The blows keep coming to the PCL-R (Psychopathy Checklist Revisited). As one forensic psychologist blogger reports:

In a result with potentially momentous implications for forensic practitioners, the researchers found that Factor 1 of the Psychopathy Checklist-Revised (PCL-R) does not predict violence. As you know, Factor 1 purports to measure the core constellation of a psychopathic personality (superficial charm, manipulativeness, lack of empathy, etc.). When introduced in court, evidence of psychopathy has an enormously prejudicial impact on criminal offenders.

But, the PCL-R's much-ballyhooed ability to predict certain types of violence owes only to the instrument's second factor, according to the metaanalysis by researchers Min Yang, Steve Wong, and Jeremy Coid. And that's no surprise. After all, Factor 2 measures the criminogenic factors (criminality, irresponsibility, impulsivity, history of delinquency, etc.) that even a fifth-grader knows are bad signs for a future of law-abiding citizenship.

In my experience, the Factor 1 items -- the ones purporting to measure an underlying personality profile -- are the ones more likely to be inflated by some evaluators. That's because many of these items are pretty subjective. Glib? Superficially charming? If you don't like a guy -- and/or he doesn't like you -- you are more likely to rate these negative items as present. That's one of my hypotheses for the large evaluator differences and partisan allegiance effects found with the PCL-R in forensic practice.

Cumulatively, the emerging PCL-R findings beg the question:

Why introduce the Psychopathy Checklist in court if other violence risk tools work just as well, without the implicitly prejudicial effect of labeling someone as a "psychopath"?
I wonder -- would there be any prejudicial effect of labeling someone a "psychopath" if psychologists finally stopped conflating psychopathy with violence/criminality?
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