Saturday, June 1, 2013

Dr. Sociopath

From a reader:

i just read your book, and it made clear to me many things i have been considering for some time. i am not exactly sure why i am writing to you. well, that's not true. i am interested in your impressions. i hope you respond.

i am a trauma surgeon, and have been practicing for many years now. you mentioned another book in yours, in which it was stated that surgeons could be high-functioning sociopaths. i have read that book, and it struck a chord when i read it. i care nothing about the patients i treat. i treat disease entities, not people. i do it for the intellectual challenge, and for the high that i derive from having to make multiple instantaneous decisions that i must act on, that have life and death implications. i am good at what i do, and i think that part of the reason for that is that i do it dispassionately. and quite frankly, i dont care about the outcome, other than the fact that i do not want to be criticized at a morbidity and mortality conference.

i can do ungodly things to humans, and feel nothing. at the same time, i am incapable of harming animals. from my reading, that goes against the grain in regard to the usual descriptions of a sociopath.

outside of my professional life, i have never harmed anyone, but i could. i love knives, and have quite an interest in knife fighting. i occasionally carry one, and there is no question in my mind that i could use it with deadly effect, given the right circumstances. i live in the a metropolitan area, and occasionally ride the tube. i have thought on numerous occasions, while sitting in a car, that i am the most dangerous person in that car and no one has the remotest clue of that. to look at me, all anyone would see would be a quiet man, obviously athletic and physically strong, but from all other outward appearances minding his own business and a threat to no one. if they only knew.

please do not get the impression from this that i have the desire to harm anyone. i do not. i know that i could, however, and i derive strength from that. i know that you understand.
i am divorced, but am presently married to a woman i have been in a relationship with for many years. i do love her, and would not want to harm her in any way. that being said, i have had many, many sexual partners (in the hundreds) that she knows nothing about. many of them have been prostitutes, but many were not. over the past few years or so, i have had many adventures with transexuals. i am not attracted to men in the least. it is the very visible sexual excitement, characterized by the presence of an erection, that excites me. that cant  be faked, and it is a real turn on for me, but only if the person looks like a woman. go figure.

i have a handful of children, all grown. i am not as close to them as i wish. i have one grand child.

i am a risk taker in other parts of my life as well. i have traded commodities for many years, and not very successfully. i have convinced myself many times that i have finally figured it out, only to be beaten once again by my own greed, and to once again have my trading account wiped out. i have no plans to stop. on a related issue, i do not like to gamble. i used to live and work in a resort/gambling mecca, and i never got the bug.
i have taken a couple of  the sociopath tests for purposes of self-diagnosis, and i dont seem to qualify. after reading your book though, there isnt much doubt in my mind.

i am in a position of authority where i work, but am not and have never been a bully. i despise bullies. i have had quite a number of positions, and have had my contract not renewed on a couple of occasions, for reasons that quite frankly i could not understand. i was very good at what i did, and had the results to prove it. i was not good at playing the political game, however, and i think that was in large part for my downfall. i have had some of that in this new position too. i need this job, so i am trying to be more aware of what is going on around me.

someone once identified me as a very sick, and dangerous individual, capable of practically anything. over that time, i have never harmed anyone and have tried to live my life as best i could. i continued to pursue some of my "activities" but in every other way, was a respected member of society, and a loving companion and father.

i have always had questions about myself. your book as helped answer them. when i started this note to you, i had planned to ask you your impressions. i suppose i really do not need to do that anymore...i have answered my own questions. i dont feel bad though. i consider my sociopathy a strength. it has helped me to deal with some very difficult situations. it also affords me the security that i have other, perhaps less admirable strengths that i can draw on, should the need ever arise.


Friday, May 31, 2013

Sociopaths = team players

So says the Psychology Today blog ("Despite Popular Opinion, Psychopaths Can Show They Care"):

The quintessential psychopath shows callous disregard for others, a complete lack of empathy, a glibness and superficial charm, and an impulsive and antisocial lifestyle. We would never, given this set of qualities, expect such individuals to make decisions that would benefit anyone but themselves. Their lack of empathy should make it nearly impossible for them to understand how other people are feeling. Yet, when you think about it, the ability of psychopaths to con and smooth talk their way into situations that allow them to take advantage of people requires some pretty sensitive people-reading skills. Perhaps behaving in psychopathic ways isn’t a matter of lack of ability to empathize, but is instead due to lack of proper incentive. If that’s the case, it should be possible to put the psychopath’s people-reading skills to good use.

Following this logic, psychologists Nathan Arbuckle and William Cunningham (2012) explored the possibility that, under the right circumstances, people high in psychopathy would willingly behave in ways that would benefit someone other than themselves. The people in this study were not hardened criminals, but were drawn from the somewhat ordinary psychology study population of college undergraduates. However, based on the notion that psychopathy isn’t an all-or-nothing kind of trait, Arbuckle and Cunningham reasoned that even college students can have at least some of the remorseless selfishness and glibness shown in clinical populations. In fact, the questionnaire measure they used to measure psychopathy seems capable of sniffing out the “everyday” psychopaths who stroll through college campuses.

They set up a game where "participants would either benefit themselves alone, or benefit themselves and the person for whom they were playing (team member vs. stranger)."

In the first study, the findings supported the hypothesis that people high in psychopathy would be more likely to take bets that would benefit their team rather than a group of strangers. However, the findings could suggest that the people high in psychopathy were simply trying to improve their own situation, and not necessarily that of the group’s. Therefore, in the second study, the setup was slightly different. Now the bets would benefit only the team, not oneself alone. With this slight tweaking of the experimental condition, the people high in psychopathy continued to make decisions that would benefit their team even when they, personally, didn't stand to benefit from their bets.

Along that same vein, my sister emailed my family this recent NY Times op-ed, "The Gift of Siblings." My brother said he cried at this paragraph:

My siblings have certainly seen me at my worst, and I’ve seen them at theirs. No one has bolted. It’s as if we signed some contract long ago, before we were even aware of what we were getting into, and over time gained the wisdom to see that we hadn’t been duped. We’d been graced: with a center of gravity; with an audience that never averts its gaze and doesn’t stint on applause. For each of us, a new home, a new relationship or a newborn was never quite real until the rest of us had been ushered in to the front row.

Thursday, May 30, 2013

Benefiting from sociopaths

I have gotten a lot of pushback from a statement that I make in the book: "I believe that most people who interact with sociopaths are better off than they otherwise would be." I don't necessarily mean it in the sense that the sociopath has directly benefited the person in a specific way, although I don't think that's an entirely outrageous statement either. When I think of the percentages of people I have harmed (even unintentionally) with the number of people that I have benefited in some small way, from things as small as holding a door open for them (people love good manners) to getting them a job (I love it when people owe me favors even more than I like them repaying those favors), the scale tips drastically in the direction of positive -- maybe 99.9% of people I interact with benefit in some small way?

Yes, true, those that are harmed tend to be harmed in larger ways than the corresponding benefit of having someone open a door for you. But even the people who get harmed benefit from their interactions with a sociopath in a way. They have the choice of either wallowing in the role of a victim or of taking the opportunity to learn from the experience (and who better to teach you about yourself than a sociopath). It's a little bit like how surviving cancer can give someone a healthier outlook on life. Life is filled with challenges and suffering. We will never eliminate it, and there are a lot of unintended negative consequences when we try (see Taleb's Antifragile). Even when we do successfully eliminate bad things from our lives, we invent new reasons to be upset -- so-called "first world problems". When we overcome challenges, even when they come in the form of a sociopath, we come out stronger. If there was never any opposition to your worldview or no one around to exploit the sloppiest of your mental shortcuts or delusions about the way the world works, then your mind (and our society, think Rome) would atrophy the same way your muscles do when they're not used. Hitting the gym is hard and can even be painful, but the result is a stronger you.

A reader said something similar:

I just finished reading your book... And wow.  I'm not a sociopath - I have very definite negative feelings.  

Several years ago, I was "ruined" by someone I believe is a sociopath.  A lot of what you described in the book fits her quite well, though she's never had (to my knowledge, at least) a professional diagnosis.  Her manipulation and seduction of my (at the time) fiance wound up destroying my relationship with him shortly before we were supposed to get married.  Now...well, if I still knew how to get in touch with her, I might thank her for what she did.  She didn't do it out of the kindness of her heart, obviously, but I'm now in a much better and happier relationship with a new man, and while I've had difficulty trusting some people after that incident, my life is better than it had been before I met this sociopath.

It's hard being an empath, honestly.  I'm a bit on the cold side of people without sociopathic tendencies; I can analyze cost/benefit and act on that.  It's my preferred method of engaging with the world.  But emotions can come into play, especially guilt and poor self-image.  I live with a young woman who lets her emotions so fully control her actions that she has no life direction, no job, no ability to stay focused on any one thing for more than a couple months at a time (in the past year she's decided she wants to be a vet, a pediatrician, a pathologist, and now a specialist in herpetology so that she could work at zoos).  Her ability to feel emotions is damaging to her ultimate well-being.

It's terrifying for us, to think about sociopaths who are good at manipulating and enjoy manipulating, because we lie to ourselves and pretend that we don't manipulate others and others aren't actively manipulating us.  But that's not true.  I know how to manipulate my husband into doing what I want. I don't always, but I have that power.  And he knows how to manipulate me into doing what he wants.  He doesn't always choose to do so.  The difference is that in our viewpoint, sociopaths don't feel obligated to buy into and perpetuate that lie.  

Reading your book was a very uncomfortable thing for me because you were so honest.  But I learned a long time ago that the discomfort I'm feeling is because I learned to view the world in a slightly different way.  I can't just sit back and pretend that sociopaths are nameless, faceless people out in the world.  By putting your own voice out there, I was able to engage with you, the author of the book, and understand your unique self at least a little bit.  I received a wealth of understanding from reading this book, and now I need to take the time to ponder.

Reading your book was a terrific, frightening, wonderful experience.  I cannot think about sociopaths in the same way anymore.  So thank you.

Wednesday, May 29, 2013

The upside of candor

There have been a lot of interesting consequences from writing the book. I'll try to schedule an AMA on reddit or a Q&A on this blog soon to talk about them. One of the more positive ones is the support I have gotten from most of my friends and family.

I was talking to my sister, who has just started reading my book. She and I have never been close. She is by far the most emotional member of my family and we never shared much in common. We talk on the phone maybe once or twice a year. She wanted to call to tell me that she felt like she was understanding some of our interactions and my past history better than she ever had before. It felt really good to be better understood by someone that I've known for most of my life but from whom I have always felt distanced. She did admit that she felt a little badly for the death of the baby opossum, but she also told me that she loved me and was proud of me. And perhaps the first time in our lives it meant something to me because I knew that it wasn't because I had tricked her into thinking I was something that I'm really not. She was actually seeing me and still seeing things she liked.

Along these same lines, my other sister sent me a link to this interview with memoirist and former alcoholic Mary Karr:

When you surrender, you get used to a certain level of candor—you know, the old thing, you’re only as sick as your secrets. You develop a confidence in truth-telling. Part of my drinking was so much about trying not to feel things, to not feel how I actually felt, and the terrible thing about being so hidden is if people tell you they love you. . . it kinda doesn’t sink in. You always think, if you’re hiding things, How could you know who I am? You don’t know who I am, so how could you love me? Saying who I am, and trying to be as candid as possible as part of practicing the principles, has permitted me to actually connect with people for the first time in my life. It’s ended lifelong exile.

They always say God is in the truth, and I’ve ended loneliness and been able to feel connected by saying who I am and how I feel. I’m sort of comfortable to the degree to which I’m an asshole. It’s not like I’m not an asshole—people know the ways I’m an asshole and it’s within the realm of acceptable asshole-ocity. 

I don't know if being more honest and open will improve my relationships in the long run, but that's the hope. It's probably a very ironic thing for me to say, but I don't really have any desire to let my disorder define me or my life. That doesn't mean that I don't acknowledge that I have issues and struggle with things that to a large extent have prevented me from having lasting stable relationships and work situations, but I've always been really open to trying new things.

Tuesday, May 28, 2013

Defining my disorder

This was an interesting NY Times op-ed ("Defining My Dyslexia") of someone's firsthand account of dealing with dyslexia and coming to see it as having both helped and hurt him in his life. I thought there were some interesting parallels:

Last month, at the Emily Hall Tremaine Foundation Conference on Dyslexia and Talent, I watched several neurobiologists present evidence that the dyslexic brain, which processes information in a unique way, may impart particular strengths. Studies using cognitive testing and functional M.R.I.’s have demonstrated exceptional three-dimensional and spatial reasoning among dyslexic individuals, which may account for the many successful dyslexic engineers. Similar studies have shown increased creativity and big-picture thinking (or “gist-detection”) in dyslexics, which correlates with the surprising number of dyslexic entrepreneurs, novelists and filmmakers.

The conference’s organizers made a strong case that the successes of the attending dyslexic luminaries — who ranged from a Pulitzer-winning poet to a MacArthur grant-winning paleontologist to an entrepreneur who pays a dozen times my student loans in taxes every year — had been achieved “not despite, but because of dyslexia.”

It was an exciting idea. However, I worried that the argument might be taken too far. Some of the attendees opposed the idea that dyslexia is a diagnosis at all, arguing that to label it as such is to pathologize a normal variation of human intellect. One presenter asked the audience to repeat “Dyslexia is not a disability.”

On what role people with a disorder should have in helping to define that diagnosis:

At the heart of the conference was the assumption that a group of advocates could alter the definition of dyslexia and what it means to be dyslexic. That’s a bigger idea than it might seem. Ask yourself, “What role should those affected by a diagnosis have in defining that diagnosis?” Recently I posed this question to several doctors and therapists. With minor qualifications, each answered “none.” I wasn’t surprised. Traditionally, a diagnosis is something devised by distant experts and imposed on the patient. But I believe we must change our understanding of what role we should play in defining our own diagnoses.

Before I went to medical school, I thought a diagnosis was synonymous with a fact; criteria were met, or not. Sometimes this is so. Diabetes, for example, can be determined with a few laboratory tests. But other diagnoses, particularly those involving the mind, are more nebulous. Symptoms are contradictory, test results equivocal. Moreover, the definition of almost any diagnosis changes as science and society evolve.

Diagnostics might have more in common with law than science. Legislatures of disease exist in expert panels, practice guidelines and consensus papers. Some laws are unimpeachable, while others may be inaccurate or prejudiced. The same is true in medicine; consider the antiquated diagnosis of hysteria in women. Those affected by unjust diagnoses — like those affected by unjust laws — should protest and help redefine them.

I like that part, particularly "Diagnostics might have more in common with law than science. Some laws are unimpeachable, while others. . . inaccurate or prejudiced". He mentions as an example the role that people with autism have had in helping to change the common understanding of what that disorder means, particularly outside of clinical settings in which most disorders are studied. Once people started coming forward in droves as having autism, it helped spawn the neurodiversity movement and got people to challenge their false assumptions.

Some people might balk at  efforts to redefine disorders (particularly one as nefarious sounding as sociopathy) as not being all bad or even having positive effects on both the life of people with the disorder and the world around them. I don't see why, though. Wouldn't you want to think that people (even sociopaths) are not all bad? That they have special skills that could benefit society? That they might also have rewarding lives? I guess I just don't ever see the long term wisdom in further marginalizing already fringe  groups.

Join Amazon Prime - Watch Over 40,000 Movies

.

Comments are unmoderated. Blog owner is not responsible for third party content. By leaving comments on the blog, commenters give license to the blog owner to reprint attributed comments in any form.