How to get Dr. Irene's Advice: Look here!

Ask The Doc Board Archives

The CatBox Archives

Stories Archives

 

Below is an Interactive Board sampler. A fuller listing is found in the "Stories" menu above.

4/14 Interactive Board: Codependent Partners

3/23 Interactive Board: He's Changing... I'm Not...

3/1 Interactive Board: D/s Lifestyle

1/14 Interactive Board: My Purrrfect Husband

12/12 Interactive Board: What if He Could Have Changed?

10/23 Interactive Board: Quandary Revisited

8/24 Interactive Board: Quandary! What's Going On?

7/20: Dr. Irene on cognitive behavior therapy and mindfulness

6/12 Interactive Board: Unintentional Abuse

11/7 Interactive Board: Is This Abusive?

12/29 Interactive Board: There Goes the Wife...

11/4 Interactive Board: A New Me!

10/8 Interactive Board: Seeming Impossibility

9/8 Interactive Board: My Ex MisTreats Our Son

5/1 Interactive Board: I feel Dead - Towards Him

4/26 Interactive Board: Why is This So Hard?

4/19 Interactive Board: I Lost My Love...

4/7 Interactive Board: Too Guilty!

Sociopathy and Anger

Dr. Irene On Sociopathy

by Irene Matiatos, Ph.D.

Numerous email inquiries from victim people ask about the prognosis of their abuser. Often readers specifically ask about antisocial personality traits (a.k.a. sociopathy): the lack of empathy and remorse they perceive in their loved one. They wonder if their abuser is "fixable". Here is an example of this type of email.

Here's an interactive email from someone with Antisocial Personality Disorder. 

What's an Antisocial Personality?

 Please refer to the accepted diagnostic criteria of the American Psychiatric Association for Antisocial Personality Disorder. But before you diagnose your loved one, hold still and don't jump the gun! Keep reading.

It is important to note that an individual may have antisocial traits, but does not meet criteria for the Personality Disorder, which is more serious.  The same source (DSM-IV)1 qualifies what is meant by the term, "Personality Disorder" as opposed to "personality trait:

"Personality traits are enduring patterns of perceiving, relating to, and thinking about the environment and oneself that are exhibited in a wide range of social and personal contests. Only when personality traits are inflexible and maladaptive and cause significant functional impairment or subjective distress do they constitute Personality Disorders."  (p. 630)

Word of caution: Use this information as a guideline. Do not make lay diagnoses. You don't have the background. You will not be able to determine the difference between a "trait" and a "disorder." Also, be aware that other disorders may mimic or account for the phenomena. For example, situational stress and transient mental states resulting from  Mood or Anxiety Disorders or Intoxication may mimic, but do not constitute a Personality Disorder. 

Are the Antisocial Personalities "Bad Guys"?

Ok, with all that out of the way, what does all this mean? We've all heard about the rotten criminals who kill people for profit or malice, and who feel no remorse. We think of this group as suffering from antisocial personality disorder. Unless otherwise crazy (e.g.,. psychotic), in all likelihood they are antisocial personalities.

Nevertheless, antisocial personality types, without getting into the fine points of traits vs. disorder, are not always "bad guys". Sometimes they are "good guys." Many antisocial types are very successful and productive citizens. They are CEOs, Presidents, famous people, etc. Antisocial types accomplish lots of good stuff

Antisocial type who are very, very smart are often very, very good at what they do. The really, really, really smart ones never get caught! They seamlessly manipulate their way to whatever, and no one is the wiser. The pretty good ones may get to where they aspire, but they eventually slip up and are found out. In my blatantly unhumble opinion, even though I have never met the person, I can think of one such President whom I think fits the Bill...but my mouth is zipped.

Remember, abuse occurs behind closed doors. You know your spouse, Roger or Sally, is Satan in disguise - but everyone else thinks they're The Best. While these people are not necessarily "bad guys" to the world, they make your life Hell. That's because they "love" you.

What About My Abuser?

In general, the "sicker" the individual, the worse the prognosis. The same is true with any disorder. This generalization is heavily qualified by the individual's motivation for recovery

Abusive individuals typically have antisocial qualities. Antisocial qualities detract from motivation to fix the underlying problem. There is no reason to change when one is getting the stuff they think they want - like the frustration-reducing "satisfaction" of blaming/beating up their victim; the "satisfaction" of an affair, substance abuse, gambling, etc. The victim's withdrawal and  insistence that they recover may be the only motivation they have.

Unlike the victim who spends so much time in a place of guilt, questioning the self, the abusive-antisocial doesn't. This person blames the other. The antisocial person's problems are perceived as originating from outside the self, often from the "withholding" other who should give them X, Y, and Z. Funny thing, the victim-codependent doesn't give X, Y, and Z because they don't want to, but because they can't! What is being asked for can only be given by the self.

The antisocial variable, in my opinion, is the key that separates the "true" victim from the "true" abuser. I'm speaking broadly. The antisocial variable is certainly a factor in sociopathy, but it is also found in narcissism, in BPD, and elsewhere. It's the part of the individual that simply does not care...

Even though both victims and abusers have suffered childhood abuse and both can appear abusive, only the truly abusive (i.e., antisocial) person expects that which can't be given. This individual, deep down, thinks the problem is with YOU (That the problem is outside the self is what essentially defines "personality disorder.") The victim, deep down, thinks the problem is with THEMSELVES.

Want to get even more confused? There is an interaction between the victim and the abuser. Since there are no absolutes, if Alice is 70% codependent and 30% abusive and is dating Benny, who is 80% abusive and 20% codependent, Alice will be "the victim." If Benny leaves Alice and starts dating Joe, who is 60% codependent and 40% abusive, Alice is likely to be "the abuser."  Go figure...

 So...What About MY Abuser?

What about your abuser? What about yourself for that matter? Well, for those of you who are old enough to understand, lets put it this way: "Only your hairdresser knows for sure". For the young 'uns: who knows? Your guess is almost as good as mine.

For More Information

The clearest description of the underlying thinking inherent in the various personality disorders is found in Beck & Freeman et al. Cognitive Therapy of Personality Disorders.

1The Diagnostic and Statistic Manual of Mental Disorders, Fourth Edition (DSM-IV). American Psychiatric Association, 1994.