Wednesday, June 5, 2013

Mental health stigma = all the wrong incentives

American President Obama spoke in favor of ending the stigma for mental health disorders in a recent conference addressing the Sandy Hook Elementary School shootings:

The president stress[ed] that . . . the majority of the mentally ill are not violent. He said his main goal in hosting the conference is "bringing mental illness out of the shadows" and encouraging those suffering to get help.
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"We whisper about mental health issues and avoid asking too many questions," the president said. "The brain is a body part, too. We just know less about it. And there should be no shame in discussing or seeking help for treatable illnesses that affect too many people that we love. We've got to get rid of that embarrassment. We've got to get rid of that stigma."



Glenn Close, who has advocated on behalf of mental issues before:

"The truth is the stigma has hardly budged," Close said during a panel discussion on how to address negative attitudes moderated by Health and Human Services Secretary Kathleen Sebelius. Close referred to studies showing the public doesn't want to have those with mental illness as neighbors, supervising them at work or taking care of their children and believe they are violent.

Basically, the problem with stigmatizing those who come out regarding having a mental disorder and making their lives miserable because of it is that no one will want to get diagnosed with or disclose any sort of mental disorder. Which is the more appealing option?

Let's relate this to sociopaths for a second (although they are allegedly untreatable, as of yet). I have experienced severe and adverse reactions from the publication of the book, which was a little surprising to me, as someone who lives in a society that is governed by the rule of law with constitutional and other legal personal protections against discrimination, with an impeccable record of never having been arrested or accused of a crime, no history of violence, and having managed to integrate well enough to be a contributing member of society in my profession and circle of friends. Apart from a few broken hearts and hurt feelings and an inability to feel true remorse for other small infractions, I haven't done much to deserve being treated this way. But I am currently not being judged based on my record. Rather, I have identified myself as having a particular mental disorder and am now suffering the consequences of the accompanying stigma. Should I be legally protected based on my diagnosis and be judged solely on my actions or not? If not, what are the implications for me or the incentives for anyone else to be upfront about this disorder? And what are the chances of other sociopaths being forthcoming in the future? As a recent commenter put it so aptly:

In some ways it's easier to be a sociopath because you report that you are unencumbered by guilt and are less fearful than most people. You have less need for validation if you do not score high in narcissism. But what may be difficult to understand is that the lack of empathy that protects you from feeling unpleasant things also creates a pretty significant blind spot because it is difficult for you to anticipate the level of rage and fear you generate in the general public. In the abstract, this does not present a problem, and likely even amuses you. 

In reality, however, you have self identified as a monster and have essentially given those who sit at the top of these power structures the permission to dehumanize you. Why is this a problem? Because the "rules" that you feel do not apply to you in terms of maintaining social relationships now cut both ways. You might feel clever because you have escaped the obligations to conform because of guilt. But the other side of "coming out" as a sociopath is that now the rules that neurotypicals must follow in regards to their own behavior do not apply to you. You are stripped of your right to be treated as a human being because you have been reclassified as an "it." 

With the recent advances in brain imaging, it is not unlikely that that state governments will begin legislating the mandatory testing of "at risk" individuals. You can't hide a brain scan, and it will be a mark of Cain that ethically challenged neurotypicals will use to discredit/ruin you should your voice somehow feel like a threat to these invisible power networks. 

I've exposed my bias (I love someone who has sociopathic tendencies) which is why a scenario like this scares me. State identified Sociopaths could become to modern day governments what the Jews were to Hitler. Scapegoats. So if you think that you are a sociopath, please consider this blind spot with an eye to your own safety.

It's sort of funny because out of all of the things I have done in my life, writing the book and being open with my disorder seems like one of the better things, but it's the thing that has caused me the most trouble. My question to people is, what would you rather have had me do? Remained silent? Never have written about this issue? Cured myself of the disorder starting when I was child old enough to make my own decisions? I'm curious what people's proposed solution is for people like me.

Will it take some time, resources, tolerance, and courage to properly integrate people with mental disorders into society? Yes. Will some disorders be harder to integrate and/or more detestable or less obviously beneficial to you personally? Yes. Complain all you want about how bothersome "special" accommodations for the mentally disordered may be, but as I once read, blind people could equally consider street lamps to be a special accommodations for the sighted who can't manage to walk around outside at night without them. And the problem with a tyranny of the majority (apart from ethical, practical, and evolutionary reasons that we might want to encourage instead of discourage human diversity) is that it's very difficult to predict when you might suddenly find yourself defined as a minority.

You can choose to disenfranchise people from society, if you want, but those decisions will have long-lasting and often unpredictable consequences. And the American President doesn't think it's a good idea either.

Tuesday, June 4, 2013

Mind-blindness and empathy

Sociopaths can be very mind-blind about certain things, especially the inner emotional worlds of others.  Sociopaths are not the only ones who can be mind-blind, though. Despite normal people's professed empathy, I have noticed before and particularly since the publication of the book that many empaths can't seem to get into the mindset of a sociopath. I think a lot of it also has to do to a tendency that we all have to project our own feelings and thoughts about a situation onto another person.

I talk about this a little bit in the book, about how I used to think that people were just like me until basically my late teens and early 20's. And now that I am a little more aware, I realize that I make frequently incorrect assumptions about the inner worlds of others, but I'm happy to be corrected when appropriate. I notice it in others as well but some people aren't open to correcting their misperceptions. This particular brand of mind-blindness is often mixed with a touch of xenophobia, and a dash of hypocrisy, seeing the apparent flaws in someone else's worldview without acknowledging the limitations of one's own perception. The evolutionary plus of this blend of mind-blindness+xenophobia+hypocrisy is that it promotes social conformity. It makes people feel so sure of themselves that they don't think twice about forcing others to conform, even if it means something so drastic as killing them (witch hunts, Inquisition, modern religious states where we stone people, etc.) And conformity leads to a greater sense of cohesion amongst the rest of the group, which can be socially beneficial, particularly in times of war.

Although I acknowledge that humans being able to unscrupulously enforce their will on other people can sometimes benefit society, I don't really like being the target of this sort of social influence and scrutiny. It's why I sometimes don't like being around other white women -- they feel like we're similar enough that they know all about me, even sometimes believing they know me better than I know myself. They also feel invested enough in me and how I reflect on them and greater womanhood that if I step out of line, I could face severe consequences (Glenn Close in Dangerous Liaisons?).

I've been thinking a lot about mind-blindness with the publication of the book and subsequent promotional activities. I've been thinking about my own mind-blindness, including the ways that I have not been able to predict the spectrum/proportion of people's different reactions (In the past few weeks I've learned more about why exactly people hate sociopaths than I did in the past few years of the blog). I've also been a little amazed at other people's mind-blindness, as evidenced by the all-over-the-map reactions to the book and promotional activities -- seemingly contradictory things like thinking that I am both the epitome of evil (a clear and an imminent threat to society) and that I'm also a fraud.

I wonder about the nature of the fraud accusations. When people say "fraud," does it only mean that they believe the word "sociopath" does not accurately apply to me? Because I'm pretty upfront that maybe it doesn't and maybe I've been misdiagnosed and who knows what that word means anyway and the diagnostic criterion are notoriously subjective, but isn't that itself an interesting thing to note about sociopathy? That if someone like me can be diagnosed a sociopath, then maybe it doesn't mean much when other people are involuntarily diagnosed sociopaths and kept in prisons because of it? If they think I am a fraud because I am lying about what's happened to me in my life, I am surprised because I don't find my experiences to be particularly outrageous or extraordinary. But I guess when you say "diagnosed sociopath" people expect to see a particular thing and when they don't see that thing, instead of thinking to themselves -- maybe my idea of a sociopath is not accurate, maybe I am not an expert at identifying sociopaths -- they instead conclude, this woman is a fraud. Maybe because they would rather live in a world in which they can rely on their own gut assessments about people, and me not being what they expected me to look/act/sound like is a direct challenge to that worldview? Interestingly, I've gotten a lot less pushback about who I say I am from non-Americans and from men, presumably because they're projecting less of their own characteristics and worldview on me?

Maybe people are unimpressed or disgusted by sociopath behavior, but I'm recently not that impressed by empath behavior. If empathy only applies to people who look and act just like you (and even then, is largely based on inaccurate projections of one's own worldview on another), then what is so special about empathy?

Monday, June 3, 2013

Where on the dark triad are you?

From a reader:

I'm writing to you about the topic of Machiavellianism. I've noticed that you have not wrote an article concerning it at all yet, and I thought that considering it is a dark triad personality that that was surprising... in fact I suspect it is not an anomaly that it has been left out.

Machiavellianism according to the Oxford Dictionary has been defined as "the employment of cunning and duplicity in statecraft or in general conduct." And more relevantly - psychologically speaking - it describes the tendency to be emotionally cool and detached from others, resulting in the Machiavellian personality being more able or fully capable of disregarding conventional morality. In other words, the Machiavellian personality experiences low levels of emotion, intellectual empathy making the Machiavellian exceedingly crafty in their manipulation and all the more cunning, possessing a minute or no conscience at all.

The reason I took an interest to SociopathWorld (is it separated or joined words for SW?) was to explore my own personality, for sociopathy at the time of my limited knowledge in psychology seemed to fit adequately. As I delved deeper into the nature of sociopathy, I noticed it did not quite fit. Nevertheless, the topic fascinated me and I discovered psychology did too.

As to why I decided the Machiavellian personality fitted me more than the sociopathic one is because - on some level - I care about two people, however they are only somewhat important in comparsion to the pursuit of power and my own self-interest. Any means necessary will be used to this end - providing I will get off scot free: I will feign emotion, charm, manipulate, subliminally or openly blackmail, coerce, et cetera you aren't new these lists, haha.

At a younger age, when I began noticing my pathological emotional detachment from people, I knew I could use it to my advantage. I examined other people's weaknesses in an attempt to exploit them, but due to my own weaknesses (arrogance) I sometimes failed, facing frustration, I decided to research. I suspected I was the problem, and I eventually discovered that one must realize his own weaknesses in order to eradicate them. Other perceived weaknesses can be turned into a strength - my basic personality is more lenient towards being introverted - so I'm particularly hard to read, always think before I speak and make it count. Gradually, my ability to be extravert improved vastly too.

Would you say that I have sociopathic tendencies that do not overlap with the Machiavellian personality?

P.S: I saw an article regarding some INTJ personality types being sociopathic. If it helps, my personality type is XNTJ.

M.E.: Actually, if anything, have you considered whether you might be narcissistic? You mention arrogance, and your email comes across as being arrogant, but maybe it's just the subject matter you're talking about. Should we publish what you wrote and see how other people feel on the subject?

Reader:

Regarding my younger self, I'd say I was more cocky than actually arrogant. I enjoyed a bit of admiration, and I seemed a notch above everyone else I knew, as I have quite an insightful thought process which used to make me think, "this would all be better if people rolled over and let me take care of it, fucking idiots." I have confidence in my abilities, I simply asserted that confidence arrogantly, hence being cocky.

If I liked admiration, I could be flattered - flattery is like a weapon, and I had to make it ineffective. Made me feel powerful, rather than the satisfaction narcissists seem to withdraw from admiration.

Arrogance, to any degree is unattractive and therefore uncharming, didn't help my image, it had to go.

Sunday, June 2, 2013

Why we can't all be empaths

A lot of people think that the book and the blog argue that sociopaths are better than empaths. I make no such claim, I never have. But if people want me to justify my existence, I have some not-specious arguments about why we can be useful and an overall benefit to society. 

Even then, I acknowledge that the reason we work well are because there are so few of us, just like predators. If there were more sociopaths than there are already (maybe 25%), who knows, the world might be chaos. It would definitely throw our ecosystem off and certainly any competitive advantage that a sociopath has now would dwindle down to nothing.

So we can't all be sociopaths (or even have many more than we currently have), but we also can't all be empaths, at least not without throwing our ecosystem into a similar tailspin of chaos. Sociopaths within a society give that society an edge against other societies. And the very presence of sociopaths makes empaths behave in different, more robust and active ways that help propel a society forward instead of letting it stagnate or backslide. 

The NY Times provides an interesting economic analogy to this dynamic in "Why Can't America Be Sweden":

“We cannot all be like the Nordics,” Acemoglu declares, in a 2012 paper, “Choosing Your Own Capitalism in a Globalized World,” written with his colleagues James A. Robinson, a professor of government at Harvard, and Thierry Verdier, scientific director of the Paris School of Economics.

If the “cutthroat leader” – the United States — were to switch to “cuddly capitalism, this would reduce the growth rate of the entire world economy,” the authors argue, by slowing the pace of innovation.
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These findings, if substantiated, will disappoint those who long for a Swedish-style mixed economy with universal health care, paid maternal leave, child allowances, guaranteed pensions and other desirable social benefits.

In a more detailed paper, “Can’t We All Be More Like Scandinavians?” Acemoglu, Robinson and Verdier expand on their argument that the world is dependent on American leadership in technology and innovation to sustain global growth. In order to maintain its position at the forefront of global innovation, the authors contend, the United States must maintain an economic system that provides great rewards to successful innovators, which “implies greater inequality and greater poverty (and a weaker safety net) for a society encouraging innovation.”
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The three authors make the case that the interconnected world economy has reached what they call an “asymmetric equilibrium” in which the United States “adopts a ‘cutthroat’ reward structure, with high-powered incentives for success, while other countries free-ride on this frontier economy and choose a more egalitarian, ‘cuddly,’ reward structure.”

Directly challenging what they describe as the consensus view – that a country can substantially expand the welfare state without sacrificing its pioneering role in technological innovation – Acemoglu and his colleagues write that it is “the more ‘cutthroat’ American society that makes possible the more ‘cuddly’ Scandinavian societies based on a comprehensive social safety net, the welfare state and more limited inequality.”

In an e-mail, Acemoglu provided the following analogy: The U.S. is also the military leader of the world, and it cannot imitate Finland and reduce its military to a trivial size without taking into account the global repercussions of this (and I’m saying this as somebody who is strongly opposed to U.S. military interventions around the world).

Of course there are many criticisms to this argument (see the link to the original article), but it's not at all absurd to think that there is some element of truth to the idea that we can't all be the same and still see the sort of dynamic growth and prosperity we've become accustomed to. Similarly, the diversity that everyone (including sociopaths) provides has value to society as a whole.

Jim Fallon spoke similarly of sociopaths as being the members of society who do the "dirty work":

And not just the dirty work but the good work. You don't want your neurosurgeon to be empathetic and caring emotionally when they're working on you. You want them to be cold machines that don't care. Same thing with an investor. . . . A society almost demands that we have psychopaths. It's a very stable feature throughout society in history that these people are there. And they pop up in a very malignant way sometimes but these traits seem to be very useful to society so we almost ask for it, or our genes and our behavior ask for it. 

This is going to be especially useful in the zombie apocalypse. 

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.


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