Why does a psychopath win every time against a narcissist?

A narcissist deals with shame by offloading it on to other people, a psychopath deals with it by repeatedly bashing your head on the pavement.

Psychopaths have deeply internalised shame which is dealt with by violence. It isn’t that psychopaths do not register shame, but that it is only a fleeting emotion, quickly replaced by rage.

Psychopathy-related personality traits and shame management strategies in adolescents – PubMed
The purpose of this study was to examine whether there is a correlation between the amount of psychopathy-related personality traits and the type of shame management in adolescents. Two hypotheses were examined; first, that there is a positive correlation between psychopathy-related personality trai …

Psychopaths are not the cool calm robots of Quora fairy tales, they are creatures of hair trigger rage. Attempting to shame a psychopath is incredibly foolhardy, and rather than harsh words, or feigned indifference, you may be met by very real violence.

Narcissists like to appear to be at the top of the pecking order by affecting the superficialities of power, psychopaths have a system of working out who is there by raw, real world might, physical or otherwise.

Psychopaths are hierachical, like reptiles or apes – you will fight for your position and inciting shame in another is a challenge for their spot, or a refutation of the status they appear to be claiming.

A narcissist in a group of psychopaths who attempted to shame or devalue them in any way would soon receive a physical challenge to their assumed superiority. With psychopaths it’s put up or shut up. Got to pay the cost to be the boss.

As Mac Davidson says, there are no narcissists in prison.

If you ever find yourself in the unfortunate situation of being surrounded by psychopaths, be very civil and polite, do your best not to act haughty or superior as they are very sensitive to shame. Psychopaths do not care about being thought to be a good person, they only care about where they sit in the pecking order. Chances are you’re at the bottom, so act accordingly. Self depreciation is your go to here.

Beat them with brains,

Robert

Would psychopaths make good or poor soldiers and Marines?

Snipers. Now there’s an interesting lot. They aren’t like the average warfighter. A lot of warfighters, the guys in the regular infantry squads, they get to say about killing that, “It was either him or me,” or “I did what I had to do,” or even, “I did it for my friends.” They killed in hot blood, when the situation was severe and their options were limited, where engaging in fierce fighting was what was needed to be done. Not snipers. Snipers are interesting because they are the definition of “cold blooded killers.” They will be the guys who crawled miles through a jungle, with pests and reptiles crawling alongside them, through swamp water and ant hills, so that they could reach a lookout, a room, or some vantage point that they create a hide and wait. They may wait for days for their opportunity to do what they have patiently and painstakingly worked to do – to kill someone.

We say cold blooded, not because there is something inherently wrong with what a sniper does. They possess all of their mental faculties and have put in the time and training to do a very specific job within the military community. When they do it well, they are less an action figure, and more a patient and methodical master of a craft, slowly and adeptly moving their hands to action. They are cold blooded, only when juxtaposed with someone who is hot blooded, or reacting to a situation with violence of action. They are cold blooded because they are only acting, making all the choices and being 100% responsible for the death of another human individual.

One would think that that level of precision and sense of purpose in the act of killing would be hindered by the human condition and the natural response to empathize with other individuals, but it doesn’t and according to some research, shouldn’t.

Wanting someone to die, and even being willing to do the job doesn’t make one a psychopath. There are many people on this planet Earth that I would want to no longer be on it, but that doesn’t make me a psychopath. An example, the night bin Laden was killed, I broke down. For a few minutes I openly sobbed on my wife’s shoulder as the news continued on behind us. My life was fundamentally changed by this man, and because he was finally dead, I rejoiced at how many people would live because he was now dead and the hope that he would take his despotic brand of fundamentalist Islam with him. To say I was a psychopath because I wanted him dead is in radical contradiction to me breaking down for the lives of those who would live with him being gone.

The simple fact is that within good warfighters, this contradiction isn’t a contradiction at all. It is a natural desire to see good done, with the option of good through violence not being off the table. And yes, good through violence is a very real thing. Have you ever met a Nazi? Not one of these pansy poser white supremacist skinhead nazis, but a real member of the Einsatzgruppen Nazi death squads? No, cuz there was a bunch of them running around not too long ago? Your mother may have said that violence never solved anything, but violence solved Nazism, where diplomacy would have ensured that Nazi Germany still existed today, propagating their philosophy out into the world for the better part of the last century. Let that one boil around for a while.

Military people get that. They get that the truly violent are only overcome by righteous violence. When they join a moral force, in service of a moral nation, recruited from moral stock, they join with the understanding that some people just need to die for the world to be a better place. That said, they are also the first to ask if violence is necessary, understanding greater than anyone the costs involved.

That said, you need an extremely ethical and rational human being to be a good warrior. You don’t need a robot. This is true on more than one level.

The first is that you don’t win a war by being a killer. Simply put, you don’t. Hollywood and Call of Duty have convinced us that warfare is about being individuals possessing individual lethality, and making every soldier able to line up and beat every other soldier on the other side in one on one combat with the one possessing the greatest average of manliness or emotional detachment being the one on the winning side. This isn’t realistic because it places too much emphasis on how much a single person can contribute to the fight. Combat is a team sport. If you don’t understand the concepts of suppressive fire, fire and maneuver, and overlapping fields of fire, you won’t survive long in the modern battlefield. Modern combat units are eight to thirteen men moving and acting as close to one as training allows, with all thirteen attempting to kill one guy, until they move on to the next, and the next, and the next, so that eventually, rather than one great American soldier killing five guys before being picked off, eight guys kill dozens without ever losing a single one. It requires incredible empathy to operate as a part of a team and I wouldn’t want a psychopath one of mine. Simply put, individualism is a derogatory adjective in the military for the love of one’s self rather than care for the members of the unit. It doesn’t matter that he might kill really easily. Modern warriors need people who will have their backs.

Second, warfighting requires a great deal of rationality to be a warrior, and there is evidence that psychopaths are not often rational people. Research has been done on what happens when one damages the part of the brain responsible for empathy. People were able to perform certain tasks perfectly well, but when it came to testing rationality, they would often come to incredibly bad judgements. This isn’t saying they only made immoral choices. They made legitimately bad choices. What this led researchers to believe was that our emotions are a necessary part of us making rational decisions. This being a close analog to a psychopath in combat, I believe that not only would a psychopath be a terrible member of a team of combatants, but also a danger to himself.

All that to say, while there are many warfighters who display psychopathic tendencies, this is much more a failure of psychology to accurately identify the nature of the warrior mindset, and the suggestion that it might be a good idea is a failure of the popular media to educate civilians both on the nature of psychopathy and on what is required of being a warrior.

In his book Against Empathy: The Case for Rational Compassion, Paul Bloom makes several cases for why empathy is often a crutch to people actually doing the right thing. The context of the book is about cognitive psychology and politics, but makes the case that people often come to the wrong decision about what is best for large numbers of people because they put themselves too much in the shoes of another individual. In politics we might fail to end a particular social policy proven to be damaging to society because such an action would hurt one particular person who is benefited by it. In the same way, we would dismiss the need to kill in war because we too greatly empathize with the enemy soldier who is to be killed, or even knowing that war will kill innocents. However, looking out to the world we don’t even need to remember Nazi Germany to find people who needed to die, and which war was a necessary act. A look at the Islamic State will prove a rich target environment for people in need of removal from the human condition.

This question, of if we should use psychopaths to do the job, however, shows that we as a society have lost touch with this reality. We can’t even imagine a rational person able to kill or the need of it. Call it a luxury of a happy and healthy society, but it does symbolize a brokenness within us, that we place so much empathy in the enemy combatant, that we are unable to do what must be done to save the lives of others he will one day harm. We have castrated ourselves from the ability to end despotic regimes, and we are no longer capable of inflicting harm to do good. To me, this is something we need to get back, the ability to appreciate that harm must be levied against the harmful, but that that harm must be delivered by morally functioning and righteous individuals. A person who is mentally broken, simply will not do.


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5-21% of Corporate CEOs are Psychopaths

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Watch exclusive video series featuring Dr. Ramani on personality disorders HERE: https://bit.ly/2xAvojx Psychopath, sociopath, or just arrogant? Few people understand the science behind the psychopath and the sociopath. In this full-length masterclass video, clinical psychologist and personality disorder expert Dr. Ramani Durvasula does a deep dive on the psychopath, the sociopath, and everything you need to know about antisocial personality disorder (ASPD). There’s a fine line between someone who is overly-confident and someone who has antisocial personality disorder, which is the clinical diagnosis behind psychopathy and sociopathy. Not only are ASPD symptoms and behaviors difficult to spot, it’s also far more common than most people realize. Some of what Dr. Ramani covers…. – What causes antisocial personality disorder (ASPD) – nature or nurture? – What goes on in the brain of a psychopath or sociopath – and whether they can feel remorse or empathy – A deep-dive of the signs and symptoms of a psychopath and a sociopath – How to tell if your friend, coworker, or even your spouse is a psychopath or sociopath – The latest findings and research on ASPD, psychopaths, and sociopaths – How to handle a child who is showing signs of ASPD – How to cope with a parent, co-worker, boss, sibling, or family member who has psychopathic or sociopathic traits – Whether someone with antisocial personality disorder can recover / be cured “There is no ‘average’ person with antisocial personality disorder. You can find people with antisocial personality disorder everywhere from death row to the best table at the best restaurant in Los Angeles.” – Dr. Ramani Durvasula Get exclusive video series with Dr. Ramani by visiting the link above.

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Have you met anyone with these personality traits? Let us know in the comments below – we want to hear your story. Watch exclusive video series featuring Dr. Ramani on personality disorders HERE: https://bit.ly/320r2yR

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Andromeda
No one roasts a narcissist like Dr. Ramani. 😀

1K

Michael Hacker
She sounds like she has an IQ of 200. So lucid and articulate. Awesome.

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Richard S-C
I massively appreciate that this Doctor was willing to spend over 2 hours explaining something. Shows she cares about educating people.

293

The most useful advice she gave was “Respond don’t React”.

433

When she mentions careers that could be phsycopaths she needs to include politicians.

81

She is so educated in every facet of psychology that she doesn’t even pause to gather her thoughts when asked these questions. She immediately has such a well versed and thorough explanation in nearly every response. She’s such a joy to listen to and so incredibly gifted with communication.

2.6K

This was really interesting. When I was in college I dated a guy for a month. I saw my first sign he was trouble and dumped him on the spot. He told me he was the only man who would ever love me so I should marry him. I was transferring to my dream school in a few months. He followed me there in order to terrorize me. He was text book dangerous stalker. I had a lot of proof I could take to our female Dean. I went to her office and cried and begged her to do something. She refused to see my evidence or do anything. He was even honest with a lot of people about how he was hurting me. I was a straight A student and he was failing every class because of his obsession. Once she realized that she asked me to come back. I told her I’ve never loved a school more but if she wasn’t going to protect the women on campus I had no interest in returning. I had to basically go into hiding. I told him I wouldn’t tell my closest friends where I was going (because I feared for their safety). I didn’t tell them for a year just in case. Because of that I met my husband. He is the most wonderful man I’ve ever know. He esteems me in everyway. It’s been 10 years and we only grown in love with eachother every year. Women pay very close attention to red flags. They can save your life and your happiness

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111

I once heard it said: “You can judge the character of a person by the way they treat people who can’t do anything for them”. It’s something that always stuck w/ me,. When i’m entering a new relationship or friendship i make a point of observing how that person tends to treat other people, and it’s interesting and instructive how often it is radically different from how they interact w/ me.

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71

There is one thing that concerns me: her warning to parents whose child isolates himself (or herself) and doesn’t want to socialize with the family. There are so many other potential reasons for self-isolation. A child may simply be an introvert, which is a personality characteristic but not a disorder. The child may have few or no interests in common with the rest of the family. The child may be exceedingly shy or have social anxiety. The child could be autistic. Or, indeed, the child might be undergoing bullying or abuse from one or more other children (perhaps in the family, perhaps in school) or adults. That is potentially a sign that there may be a psychopath or sociopath somewhere in the child’s environment, but not necessarily the child himself. Now, I think Dr. Ramani was giving those warnings of self-isolation or lack of social interest in the context of a child who shows other signs of antisocial personality disorder — but I’m a little concerned that some people may miss that and think that self-isolation is in itself a warning sign for ASPD. I suspect she would be one of the first to say that that is a misinterpretation.

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34

Gaslighting is so traumatizing. I’m glad she said she won’t gaslight her patients.

27

Gosh, I wish she was my therapist.

942

Love her! She is so smart and insightful.

115

They should of showed this in my college psychology class.

29

Interesting how she says she avoids charming people at parties. I used to live in a lot of shared accomodation situations where we would interview lots of people as potential roommates. It got to the point that I would not allow exceedingly charismatic people to move in, because I had at various times in the past found these types of people to more likely be manipulative and users.

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39

Thank you. I was told by a therapist she has patients with bigger problems so I should be happy and that I was staying with my abusive boyfriend at the time for the sex. Totally gaslighting

23

It is not just romantic partners who cause damage, please talk about the 80% of society who excercize control in the work invironments (cultures, covert actions, and the failed systems that ignore this).

81

“When a signal is given to you, it’s only useful if you’re willing to heed it.” Dr. Ramani

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“…..anything that feels like a hustle, is probably a hustle!” 👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾👏🏾

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1:38:01 Seek help for domestic violence. Domestic violence services offer no help. The staff at these places are not professional and provide limited resources. I wish more therapists understood how little help there is out there for women who have been victims. Referring an abused women to in therapy to local domestic violence resources as the out is wrong. The therapist should help a women with a safety plan and teacher her how to gather evidence and help her cope with the Battered women’s syndrome.

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00:00
[Music]
00:04
we’ve covered how to spot a psychopath
00:07
or sociopath before but we’ve never gone
00:09
this in-depth on the clinical diagnosis
00:12
behind them antisocial personality
00:15
disorder
00:15
welcome to the med circle series
00:17
antisocial personality disorder
00:19
psychopaths sociopaths and how to spot
00:22
them it’s just so great to sit down with
00:25
you I love talking with you sometimes we
00:27
talk about some topics that I think are
00:30
really really dreadful and hurtful yeah
00:34
and I think this series is going to be
00:36
more in that Lane yes it is it is yeah
00:38
you brought up the cluster B yeah
00:40
personality disorders I think it’s so
00:42
I’m so glad we’re doing this having this
00:44
conversation because a lot of folks out
00:47
there are trying to make sense of these
00:48
difficult patterns and they put in all
00:50
kinds of words into search engines
00:52
online
00:53
cluster B is a something that comes out
00:55
and a lot of people don’t know how to
00:56
make sense of it so let me give you some
00:58
historical background this word cluster
00:59
B it comes from how the personality
01:02
disorders were traditionally organized
01:04
in the diagnostic manual of psychiatry
01:07
and psychology called the DSM the DSM
01:10
are organized personality disorders
01:12
there were ten of them into three groups
01:14
cluster a cluster B and cluster C and
01:17
they organized the disorders based on
01:19
their manifestations now back in
01:21
graduate school we we would remember
01:24
these three clusters by calling them mad
01:27
bad and sad that’s how we that we sort
01:30
of memorized them and by mad it was sort
01:32
of that traditional like a madman like
01:34
you know person who’s just really off
01:35
and almost like you know very disturbed
01:38
bad meant almost badly behaved and
01:40
that’s our cluster B’s and sad were
01:42
people who are more anxious and avoid
01:43
him that the cluster B disorders are
01:47
also termed dramatic and erratic now
01:50
these these disorders again are grouped
01:52
by sort of how they affect a person
01:54
today we’re going to focus on cluster B
01:55
the cluster B disorders are the
01:57
difficult disorders they’re antagonistic
01:59
they’re interpersonally challenging
02:02
these are folks who as a rule almost
02:04
always lack empathy they tend to be
02:07
entitled so it’s almost like narcissism
02:10
becomes a nice sort of like the midpoint
02:12
of a lot of these to sort
02:13
like most of them have qualities of
02:15
narcissism in different ways and as you
02:17
said the four disorders that hang out in
02:20
cluster B are antisocial personality
02:23
disorder borderline personality disorder
02:26
narcissistic personality disorder and
02:28
something called histrionic Personality
02:30
Disorder these are probably the most
02:33
clinically vexing patterns we see in
02:36
psychology and psychiatry because they
02:38
can make for very difficult clients
02:40
these patterns can interfere with us
02:42
treating other issues the person may
02:44
have like substance abuse bipolar
02:46
disorder major depression anxiety
02:48
disorders eating disorders the list goes
02:50
on if you have a cluster B disorder and
02:52
these other things it really you’re
02:54
constantly sort of like it’s like you’re
02:56
trying to like fight two different
02:58
battles at the same time and it’s really
03:00
one big kind of war if you will so it is
03:03
a challenge and it’s a challenge for
03:05
people not only living with the cluster
03:06
B patterns but also a challenge for the
03:09
people living with those people who have
03:11
cluster B patterns so that’s what
03:13
cluster B is dramatic erratic emotional
03:16
antagonistic combative lacking empathy
03:22
oftentimes internally very chaotic they
03:25
can’t regulate their emotions very
03:26
easily and some of these are really
03:28
clinically demanding borderline
03:29
personality for example is very
03:30
clinically challenging condition
03:33
narcissistic histrionic clients they
03:35
don’t even tend to end up in therapy
03:36
that often an antisocial personality
03:38
disorder those folks often end up in
03:41
prison we’ve talked about specific
03:43
personality disorders but what is a
03:45
personality disorder in general a
03:47
personality disorder is a maladaptive
03:50
pattern of behavior and relating that
03:54
cuts across all situations in the
03:57
person’s life relationships work social
04:01
functioning and even their sense of self
04:03
it’s the long-standing stability that
04:07
makes these be called personality
04:08
disorders because personality is
04:10
considered to be a stable trait but
04:12
their personality styles cause the
04:15
person problems in all areas of their
04:18
life but it’s the maladaptive consistent
04:21
and stable nature of these problematic
04:23
personality patterns that lead to them
04:25
being called personality disorder
04:28
can someone be diagnosed as having
04:31
cluster B disorder no yeah so you just
04:35
have one of them and that’s yeah you
04:37
what would end up happening is like for
04:39
example I as you know I do research on
04:41
psychopathology and mental illness and
04:43
mental health so when we analyze our
04:45
data because these disorders are common
04:47
sometimes we’ll combine these patterns
04:49
to see if we see any patterns there so
04:51
partly it serves a sort of a research
04:52
kind of an approach it becomes a
04:55
shorthand for clinicians but we as
04:57
clinicians have to be really really
04:59
careful about using that term because
05:01
cluster B is code for difficult patient
05:04
and there’s a that’s really big yeah
05:07
muster B is code for difficult patient
05:10
now yeah I can already hear people
05:11
though saying well I’m watching that my
05:15
therapist said I have cluster B now I’m
05:18
that’s rude why would you say it can’t
05:19
feel good that’s what I’m saying we have
05:21
to be very careful with these labels
05:22
it’s really meant it’s almost like again
05:24
it’s an organizational scheme if we see
05:26
because what may happen Kyle as a person
05:28
may not meet the full diagnostic
05:31
criteria for any one pattern of those
05:33
disorders we chose four disorders they
05:35
men have a little bit this a little bit
05:37
of that and we might call it this sort
05:39
of has a cluster B pattern to it it
05:41
means that we might use very specific
05:43
kinds of therapeutic techniques or
05:45
realize that these patterns may
05:47
interfere with the treatment of other
05:50
disorders if you will but it does imply
05:53
typically somebody whose interpersonally
05:55
difficult I’ll be honest with you I mean
05:57
those of us in mental health will
05:58
sometimes he even use that as shorthand
05:59
in our own lives like I’m going to
06:01
Thanksgiving it’s going to be difficult
06:03
to have cluster B relatives there you
06:05
know anyone in the in the business will
06:07
know like AHA she’s got some really
06:08
difficult family members but it’s it’s
06:10
beyond difficult it’s antagonistic and
06:12
and almost like they often don’t get it
06:15
is it almost often that they don’t want
06:18
the help not necessarily I think you
06:22
know because cluster B disorders taken
06:24
so much territory I work with many
06:27
clients of borderline personality
06:28
disorder they desperately want help they
06:31
desperately want help in fact sometimes
06:33
need more help than even they can get in
06:35
sort of like one or two weekly therapy
06:37
sessions and many clients with
06:39
borderline personalities sort are very
06:41
vested in getting that help but it’s
06:43
difficult for them they feel so
06:44
internally chaotic and frightened that
06:46
therapy can be challenging not only for
06:48
them but for the therapists who’s trying
06:50
to sort of sue this patient obviously
06:52
when you’re dealing with somebody with
06:53
narcissistic personality you don’t think
06:55
anything’s wrong so they’re often gonna
06:57
think I don’t even need help and then
06:59
you know histrionic Personality Disorder
07:00
actually they’re thinking of removing
07:02
that from the diagnostic manual these
07:04
are people who are dramatic and
07:06
attention seeking and seductive and look
07:08
at me how come I’m not getting all the
07:09
attention
07:10
kind of thing they almost also never end
07:13
up seeking out treatment for that
07:15
particular pattern the folks with
07:17
antisocial personality disorder also
07:18
almost never seek out treatment they get
07:20
in trouble for something and then
07:22
they’re sometimes forced into treatment
07:24
briefly describe what antisocial
07:26
personality disorder is because that
07:27
name is so misleading antisocial
07:29
personality disorder is one of the most
07:32
important one of the most unfortunately
07:34
named diagnoses out there it throws my
07:37
students off it throws off trainees it
07:40
throws off lay people antisocial
07:42
personality disorder is actually quite
07:45
dangerous it can be quite dangerous it
07:47
doesn’t mean what we think a lot of
07:48
people take the antisocial to mean oh
07:50
these are people who don’t want to be
07:52
with other people almost as though
07:53
they’re socially anxious not at all the
07:56
unfortunate term historically came from
07:59
this idea that these were people who
08:01
were anti society they were anti the
08:05
norms of society they would break the
08:08
rules of society that was really
08:10
anti-social came from like I said such
08:13
an unfortunate name because we use and
08:14
say antisocial to mean someone who
08:16
doesn’t want to socialize what would you
08:17
call it I would call it psychopathic
08:19
personality disorder yes that’s what I
08:22
would term it an antisocial personality
08:23
disorder is the diagnostic term for
08:28
things that are called psychopathy and
08:31
sociopathy in the popular literature in
08:35
the media at large in all kinds of other
08:39
writing in criminology writing but not
08:42
it’s not a diagnose those are not
08:44
diagnostic terms but those two terms
08:46
definitely ascribe more to antisocial
08:49
personality disorder now what is it
08:51
antisocial personality disorder is
08:54
pattern whereby a person not only lacks
08:58
empathy but they think the rules do not
09:00
apply to them they do not adhere to them
09:02
they break moral codes social codes
09:06
legal codes they have a failure to take
09:09
any kind of responsibility
09:11
they’re very deceitful they exploit
09:14
other people to achieve their ends
09:16
they will take risks that will put other
09:17
people in danger so they’re dangerous
09:20
they’re dangerous and here’s the wringer
09:22
here’s the wringer I personally think
09:25
that to really hit to really call it
09:29
antisocial personality disorder you’re
09:31
talking about someone who lacks remorse
09:34
for the bad things they do and that’s
09:37
where it gets scary can they faster it
09:39
gets scary
09:40
I’m sorry can they fake it can can a
09:42
person fake can they fake remorse oh
09:44
absolutely you can fake anything a fake
09:46
empathy you can fake remorse you can
09:48
fake anything and they do they will when
09:50
they’re finally hauled in front of the
09:52
press conference they’ll cry crocodile
09:54
tears and a year later they’ll do it
09:56
again
09:56
that’s antisocial personality disorder
09:59
which clusters of disorders do you think
10:01
are most common in terms of the
10:03
personality disorders overall I actually
10:06
think that the cluster B disorders may
10:12
be more common and the only reason I
10:14
think I’m gonna say that is because when
10:16
we do research on these disorders
10:17
they’re the ones that are more
10:19
clinically compelling so we may see more
10:22
clients with these patterns because
10:24
especially in the case of borderline
10:25
personality they’re more likely to get
10:27
help that’s right in the case of
10:28
antisocial personality disorder they’re
10:30
more likely to end up in prison so
10:31
they’re these two groups of folks we
10:33
study a lot because of the this sort of
10:35
the distress we see in borderline
10:37
personality and the danger that can be
10:38
created by antisocial personality so
10:41
fewer the end there’s four disorders in
10:42
that group too so it’s gonna up your
10:44
your yes your a number up a little bit I
10:46
think that the cluster B disorders
10:48
probably are the ones that are have the
10:50
highest prevalence rates across the
10:52
three groups overall yeah well you have
10:54
more disorders and people are having to
10:57
go get help so they’re more disruptive
10:58
who that’s who you’re gonna see I’d say
11:00
if you were if you were working in the
11:02
mental health business you’ll see that a
11:03
lot in cluster C there’s things like
11:05
avoidant personality disorder which is
11:07
it almost looks like a social link
11:08
disorder so you will see that sometimes
11:11
but sometimes we don’t even know which
11:12
variant we’re seeing social anxiety or
11:14
avoidant personality and with the
11:16
cluster a disorders the schizoid this
11:19
gets a typo the paranoid personalities
11:21
these are people who actually look quite
11:23
severely mentally oh they’re incredibly
11:25
either socially withdrawn or they appear
11:27
as so odd they almost look psychotic
11:28
there sometimes over-represented in
11:30
residentially unstable like homeless
11:32
populations or people who are in and out
11:34
of long-term psychiatric facilities is
11:37
there hope for people who are in the
11:40
cluster be damned in terms of hope for
11:43
cluster B clients it varies it varies
11:46
well hold it we don’t hear that answer a
11:49
lot
11:49
oh it varies yeah and that’s the problem
11:51
that speaks to how heterogeneous the
11:53
disorders that make up this cluster if I
11:55
talk about bipolar disorder and I talk
11:57
about anxiety depression ADHD the doctor
12:01
cross for me will say there’s so much of
12:03
no very variable I would say that the
12:06
most good research on treatment outcomes
12:09
and best practices can be found for
12:11
borderline personality disorder I
12:13
believe firmly that if you have a client
12:15
with borderline personality disorder and
12:17
you can give them trauma focused care
12:20
dialectical behavioral therapy whatever
12:23
psychiatric medications they may need to
12:25
manage other sorts of conditions they
12:27
have and other kinds of adjunctive
12:30
therapies that will help them with their
12:31
symptoms the treatment literature can
12:34
really show some good long-term outcomes
12:36
but the treatment has to be consistent
12:38
in long term and that’s often passed
12:40
beyond the financial ability of a lot of
12:43
people that’s what’s so unfortunate
12:44
because I think there is tremendous hope
12:46
for people with borderline personality
12:47
if they get the kinds of treatment and
12:50
if the client won’t cooperate with the
12:51
treatment then all bets are off with
12:54
narcissistic personality disorder you
12:55
know what I say about that you’re not
12:56
going to see much change and when you do
12:59
it’s glacial and the amount of change
13:01
you see is often not enough for the
13:03
people around them to feel like things
13:05
are better but with antisocial
13:08
personality disorder that disorder might
13:10
be the most hopeless of all these are
13:13
folks who will try to outwit and outfox
13:15
a therapist who will fake it and often
13:18
court-ordered to go to therapy as a
13:21
condition of
13:22
or probation or something like that and
13:24
so they’ll sit there for ten sessions
13:25
and say I don’t need to say anything I
13:27
just need to sign that documents that I
13:29
came here for ten sessions so you can
13:31
get a lot of resistance and they often
13:33
try to intimidate a therapist you have
13:35
to be a very specially trained therapist
13:37
to work with that population
13:39
particularly those who have very very
13:41
difficult criminal histories and if
13:43
you’re dealing with sort of the more
13:44
neat and tied up antisocial personality
13:47
sort of like the CEO variant they’re
13:49
they’re very manipulative they can be
13:52
very exploitative again they will often
13:54
try to outwit the therapist they’re
13:56
really not motivated to change because
13:58
they really truly don’t think there’s
13:59
anything to change so if anything
14:02
they’re just really out to gain the
14:04
system that’s not progress so I would
14:05
say definitely for them of all groups
14:07
they’ll have the worst outcomes what
14:09
percentage of your clients do you think
14:11
fall in the cluster B category Oh with
14:14
some cluster B symptomatology well up
14:16
mean well over 50% maybe yeah maybe even
14:19
a little less oh heck no no no no
14:24
actually that’s what I choose to focus
14:26
in but maybe forty percent forty percent
14:28
you know yeah that’s that is good though
14:30
because now at least people are getting
14:33
help or at in the space to get home and
14:34
there are people out there who
14:35
specialize in this like people who
14:37
specialize in dialectical behavioral
14:38
therapies we call DBT I’d say they see
14:40
90 percent because they’re working with
14:43
clients who have a lot of borderline
14:44
personality sorts of symptoms people who
14:46
work in prisons are probably seeing
14:48
antisocial personality and the level of
14:50
60 70 percent but I’d say almost half of
14:52
the clients I work with I choose to do
14:54
that though because like I said although
14:56
I would say maybe even all right I’ll be
14:58
35% because the majority of clients I
15:00
work with are trying to negotiate a
15:02
family or other relationship with a
15:05
person with a cluster B disorder a solid
15:07
third of them are struggling with these
15:09
with these issues well that leads
15:10
perfectly into my next question knowing
15:12
that if somebody has watched this video
15:14
this far they have been likely given a
15:17
diagnosis of a disorder in the cluster B
15:20
family or they knows anybody who has
15:23
what what could I ask them on their
15:27
behalf that you would think would be
15:28
most beneficial for them to hear I would
15:31
you know I think that the big question
15:33
people have is
15:35
from the person there’s two sides of it
15:37
from the side of the person who’s
15:39
experiencing it is what do I do
15:42
I’m not only always miserable I feel
15:45
like I’m making people miserable you
15:48
know and then from the other side I
15:50
think the question would be what do I do
15:53
I feel like nothing I say to this person
15:55
ever makes things better in fact all I
15:57
do is feel like things get worse and I
15:59
feel like I’m always walking on
16:00
eggshells what do I do
16:01
what do I do yeah answer to that I meet
16:05
them for the people who are experiencing
16:07
the symptomatology you got to get
16:09
therapy you’re not you’re not gonna
16:10
think your way out of this one
16:11
you’re not gonna meditate your way out
16:13
of this one you got to get therapy and
16:15
with somebody who is trained in things
16:17
like DBT and working with these kinds of
16:20
patterns okay that’s that they have to
16:23
yes you know dr. Yip is one of the
16:26
nation’s leading experts on OCD and I
16:28
interviewed her for our OCD series she
16:31
really drove home the point of don’t
16:34
just go get therapy because then the
16:36
therapist said yeah I treat OCD go find
16:39
the person who that’s what they do
16:41
that’s what they do they are OCD right
16:43
so with these people
16:45
you know I feel bad for someone who
16:46
might have gone to a therapist who said
16:48
they could treat it but they did it once
16:49
10 years ago and they had a bad
16:51
experience yeah yeah I think that you
16:53
especially with now again but something
16:55
like narcissistic personality disorder
16:57
if you actually do get them to therapy
16:59
you can use a combination of some DBT
17:02
techniques but also some cognitive
17:03
behavioral work some humanistic work
17:06
rapport building it’s a lot of its
17:08
relationship building you need a strong
17:09
therapist to work with those clients
17:11
because they will try to outfox you and
17:14
so you’ve got if you almost have to be
17:15
one step ahead of them like you can’t
17:16
fall for the charm you have to be almost
17:18
charming you and our charm proof to work
17:20
with the narcissistic clients and with
17:23
the auntie’s you know so it’s all about
17:25
expertise but the borderline clients are
17:27
the ones who are most likely to actually
17:28
seek out therapy and for them to say
17:31
like I said you do it right what do you
17:33
do you need to get help from somebody
17:35
who knows what they’re doing and it
17:36
might even be a team of people who know
17:38
what they’re doing in fact DBT is best
17:40
delivered in a team approach with a
17:42
combination of group therapy and
17:43
individual therapy and some medication
17:46
management
17:46
on the other side of it if somebody in
17:49
your life is experiencing these cluster
17:52
B patterns it’s going to be difficult
17:54
I’m telling you that right now and
17:56
you’re not a bad person for thinking
17:58
it’s difficult because a lot of you I
18:00
feel guilty there’s actually something
18:01
happening to them how dare I think that
18:03
this is difficult because it is because
18:05
the nature of these patterns is somewhat
18:07
antagonistic that that’s again it may be
18:10
that they’re feeling insecure or chaotic
18:13
inside and that’s why they’re lashing
18:14
out at the end of the day it doesn’t
18:15
matter when somebody lashes out it
18:17
doesn’t feel good regardless of the
18:19
reason and so I will tell people if you
18:22
are and you are with somebody who’s
18:24
experiencing cluster B patterns
18:26
definitely seek out individual therapy
18:28
you may need to manage your expectations
18:30
of that person and then ask yourself
18:33
what would the landscape of a
18:34
relationship look like with this person
18:36
if things don’t change in the cases yeah
18:38
it may not change those are really good
18:40
three takeaways real quick for people
18:44
watching explain briefly what DBT yes
18:47
DBT is dialectical behavioral therapy
18:49
dialectical behavior therapy was
18:52
developed by someone named dr. Marsha
18:54
Linehan and she developed DBT actually
18:59
specifically to address the crisis of
19:02
suicidality in people who had borderline
19:05
personality disorder because that’s the
19:07
dangerous issue people with borderline
19:10
personality are experiencing so much
19:12
inner pain and turmoil that they want to
19:14
silence that pain they truly do believe
19:17
often there are burden to others that
19:18
they don’t or they’re not worthy to live
19:20
it’s really it’s really agonizing for
19:22
them and for the people around them who
19:23
care for them and so DBT was initially
19:26
really developed as a way for the person
19:30
living with borderline personality
19:30
disorder to see how they life always
19:34
feels like a crisis to them how
19:36
everything is black or white and so the
19:38
dialectic is really to bring those two
19:40
sides those two perspectives together
19:42
and find that gray in the middle the
19:45
other thing that dr. Linehan brought
19:46
into this work was a real focus on
19:48
mindfulness people with borderline
19:50
personality disorder tend to react
19:52
instead of responding sponding is a more
19:55
thoughtful approach reacting is like you
19:56
jump right in through DBT using
19:59
mindfulness and sort
20:00
catching yourself you help people
20:02
construct more responsive rather than
20:05
reactive kinds of approaches when
20:09
they’re faced with a stressor you know
20:11
because the reacting often means
20:12
people’s feelings get hurt people get
20:14
angry but to help them deal with that
20:16
crisis and the fears that overtake a
20:19
person with borderline personality sort
20:21
of such as things like that they’re
20:22
going to be left that they’re going to
20:24
be alone that they can’t take care of
20:25
themselves
20:26
many people with borderline personality
20:28
disorder engage in a lot of negative
20:29
self-talk dialectical behavioral therapy
20:31
also draws from cognitive behavioral
20:33
therapy where you push back and say you
20:36
know it’s interesting you say all these
20:37
terrible things about yourself because
20:38
my experience and you really do point
20:40
out to them the good things and the
20:41
strengths and you do some resilience
20:43
building with them so and you have them
20:45
do homework assignments between sessions
20:47
so they do a lot more monitoring so they
20:49
can help they can start seeing their own
20:50
patterns
20:50
DBT has been shown to reduce the the
20:54
rate of suicidal thoughts suicidal
20:57
actions in people with borderline
20:59
personality disorder and it’s really the
21:01
only evidence-based treatment we know of
21:03
right now that has any consistently good
21:05
outcomes in person with persons with
21:07
borderline personality I just want to
21:09
touch on two things you said that really
21:10
struck a chord with me the first one is
21:12
mindfulness it is becoming a reoccurring
21:15
theme and all of my conversations about
21:17
mental health yes which makes me think
21:19
if there’s one thing we all could do to
21:21
make our lives better it would be to be
21:23
conscious of what we’re doing mindful of
21:26
what we’re doing and then the second
21:28
thing is that difference between
21:29
reacting and responding yeah that’s huge
21:33
everywhere we live in a very reactive
21:34
world and especially when you think
21:36
about tweeting and texting and and
21:39
responding to those times but that’s
21:41
reacting to right seats in text yeah
21:43
responding means you stop you think
21:46
what’s meaningful what would hurt what
21:49
would make sure well how do I write this
21:51
oh I don’t hurt people you know that
21:53
it’s actually beneficial to either the
21:55
receiver or other people who will be
21:57
seeing this message you go through a
21:59
series of cognitive steps but
22:01
unfortunately technology doesn’t I mean
22:03
I wish all technology made you like I
22:06
sure are sure are sure like you know
22:08
yeah yeah and honestly they made you
22:10
like in 60 seconds and then another
22:13
and then another 60 seconds and then are
22:16
you sure because by then
22:17
a lot of reacting would have come down
22:19
and you’re like I forget about it it’s
22:20
not that important you think about those
22:22
emails that you write in a rage and
22:24
hopefully you don’t send them and you
22:26
save it in the next morn you read and go
22:27
thank goodness I can say no never ever
22:29
put a name in a subject line of an email
22:31
until you’re ready to send it that’s
22:32
sort of a bit of advice but it’s that
22:34
react respond and mindfulness are linked
22:36
and because everything these days is so
22:38
quick quick quick and we’re judged on
22:41
speed and everything’s designed not only
22:42
for speed but not to catch ourselves
22:45
before we go off the edge yes that we
22:48
can send things without you know back in
22:49
the day you’d have to like write the
22:51
letter fold the letter put the letter in
22:53
the envelope find the stamp write the
22:55
addressed go to the mailbox that was
22:56
nine times you could have said maybe I
22:58
shouldn’t send this you know and so we
23:00
that’s where that mindful sits
23:03
mindfulness is a stop it’s a feel it’s a
23:06
think but that does mean awareness of
23:09
other people and if you don’t have
23:10
empathy all the mindfulness in the world
23:12
may not necessarily pay out let’s get
23:14
into it
23:14
what is antisocial personality disorder
23:16
so antisocial personality disorder is a
23:19
long-standing pattern of inability to
23:24
comply with moral legal ethical or
23:27
social codes or really an unwillingness
23:29
to do so these are people that are
23:31
characterized by lying deceit malice
23:34
lack of empathy they exploit other
23:37
people they break the law they are lack
23:41
responsibilities they don’t follow
23:43
through on things they have very
23:45
checkered work histories that kind of
23:47
thing they’ll use aliases
23:49
they’ll put other people at risk and
23:51
they lack remorse or guilt or shame for
23:55
the bad things that they do so that’s
23:56
what antisocial personality disorder is
23:58
now there’s a little interesting wrinkle
24:00
in this diagnosis in order for a person
24:03
to be diagnosed with antisocial
24:04
personality disorder we also have to
24:07
establish they had a diagnosis of
24:09
something called conduct disorder prior
24:12
to the age of 15 conduct disorder
24:15
probably best sort of ascribes to what
24:17
we might call juvenile delinquency these
24:19
are kids who were who’ve either engaged
24:22
in illegal activities like theft or
24:25
assault but also things like torturing
24:27
setting fires bullying peers abusing
24:33
taking advantage of taking advantage of
24:35
peers and that could even include like
24:36
sexually exploiting younger peers they
24:40
are there’s sort of almost a willful
24:43
cruelty even though they’re children
24:45
and they often won’t to show remorse or
24:47
even recognition of what the
24:49
ramifications of these actions are so
24:51
these are kids who may end up in
24:52
juvenile detention who will have trouble
24:55
with educational systems may drop out of
24:57
school so you have to establish this
25:00
track record that they were a kid who
25:02
would have these kinds of problematic
25:04
behaviors prior to the age of 15 and
25:06
then after the age of 18 we diagnosed
25:09
antisocial personality disorder so they
25:11
don’t have to get the diagnosis that
25:14
before the age of 15 because someone
25:17
could skip it someone could skip it
25:18
in fact they often do right but you’ll
25:19
go back and tell me about when your
25:21
teenage years it yeah then go you
25:22
probably had yeah and they’ll say yeah I
25:24
skipped school all the time and I got
25:26
expelled or I salted a kid or assaulted
25:28
a teacher I stole my dad’s money that
25:31
kind of thing you know doesn’t have to
25:32
all be big-ticket stuff it could be the
25:35
the if you will the the kind of bad
25:38
childhood behavior like bullying or
25:41
stealing candy a lot or stealing other
25:44
kids lunch money that sort of thing
25:45
those kinds of patterns yeah the play
25:49
devil’s advocate though couldn’t that
25:51
just be a symptom of bad parents sure it
25:53
could absolutely but you’d absolutely
25:55
get a disorder diagnosed you could yeah
25:57
because even still that bad bad
26:00
parenting has is the predictor of lots
26:02
of psychiatric disorders you know what
26:04
I’m saying so at the end of the day
26:05
parenting has a lot to do with what what
26:08
gets shape is it is it a guarantee so if
26:11
a person has a traumatic neglectful or
26:14
invalidating childhood is that a
26:16
guarantee that things will go wrong for
26:17
them and dealt with it absolutely not
26:19
but is it a vulnerability absolutely
26:22
what does it mean to be a psychopath ah
26:25
so here’s where things start getting
26:26
until we get into sort of interesting
26:28
sort of semantics territory here to be a
26:31
psychopath it’s a term that probably
26:34
ascribes best to this thing we’re
26:36
calling antisocial personality disorder
26:38
so psychopathy is not a diagnostic
26:41
it’s a descriptive term it’s a
26:43
sociological term but it’s definitely
26:45
not a diagnostic term okay but
26:48
researchers will use it and that sort of
26:49
thing so what’s psychopathy is somebody
26:52
who tends to be very calculating
26:55
manipulative cunning smart malevolent
27:00
dangerous exploitative they have very
27:04
little empathy they don’t really think
27:07
through the consequences of their
27:08
actions they really don’t care about the
27:10
consequences of their actions
27:12
they break rules ethics laws they
27:15
violate moral codes they’re deceitful a
27:18
real picnic yeah love to meet one of
27:20
those but there it’s not actually you
27:24
can’t be diagnosed as a psychic yeah you
27:25
so if a person met those criteria and
27:28
they had this is a long-standing pattern
27:29
for them since childhood we call it
27:31
antisocial personality disorder yeah I
27:32
understood what about a sociopath so
27:35
sociopath this is where people get very
27:37
confused
27:37
okay so psychopathy and sociopathy are
27:40
very like you know they’re leagues of
27:41
Venn diagrams there’s a lot of overlap
27:43
but there’s definitely they’re distinct
27:44
entities the sociopath in many ways is
27:48
not as glib socially skilled successful
27:52
and manifest is well put together in the
27:55
way the psychopath does the psychopath
27:57
in some ways is more chilling because
27:59
they have an absolute lack of empathy
28:02
and if they have a relationship with
28:04
someone it is solely exploitative it’s
28:07
to get something from them sex money
28:09
power connections you name it the
28:12
sociopath in they’re very unskilled way
28:15
might get into a human relationship but
28:18
they still don’t have any empathy and in
28:20
that relationship they still remain very
28:22
cold and and stand still somewhat
28:25
calculating but really more cold and
28:27
rejecting the psychopath makes a better
28:29
criminal the sociopath tends to be a
28:31
messy sloppy and reactive your sociopath
28:34
is your bar fighter the psychopath is a
28:37
person who will kill that person three
28:39
days later methodically you see what I’m
28:41
saying so it’s like the sociopath tends
28:42
to be more reactive they tend to be more
28:44
sloppy
28:45
they tend don’t tend to be as planful
28:47
they’re not as sophisticated as the
28:49
psychopath who tends to be coolly
28:51
efficient and in that way almost more
28:53
dangerous
28:54
because there was a book that was that
28:58
was written called the mask of sanity
29:00
and that’s where they were described he
29:02
was describing Psychopaths in that book
29:04
and it was this idea that the psychopath
29:07
can look sane because they actually
29:09
there was some research that estimates
29:11
that corporate heads like heads of major
29:13
corporations of all kinds the rates of
29:16
psychopathy and those folks is five to
29:18
twenty one percent to twenty one so
29:21
depending on how you measure psychopathy
29:22
that would be one out of five major CEOs
29:25
as hell yeah yeah yeah because those are
29:28
there’s all the stuff that the the power
29:30
drive the the willingness has that sort
29:33
of taking a prisoner’s attitude to power
29:36
in this absolutely almost scarily
29:38
surgically precise focused way that’s
29:41
very profitable in preparing for this
29:43
interview I was researching the term
29:45
psychopathy and it was almost I would
29:48
say 80% of the time correlated with
29:50
serial killers almost like it was an
29:53
interchangeable term like almost all
29:55
serial killers are psychopaths probably
29:57
almost all of them are because there’s
29:59
there’s a precision to being a serial
30:02
killer right because in order to be a
30:03
serial killer you have to have killed
30:05
two or more people so you got away with
30:07
one right so you got away with one and
30:10
there’s some there tends to be some very
30:12
stereotypical killing the keeping of
30:17
trophies the taunting of law enforcement
30:19
almost getting some pride out of getting
30:23
everyone in the world rattled and paying
30:24
attention to what you’re doing if you
30:26
even think of folks like the Son of Sam
30:27
as OD a killer they were actually
30:29
writing letters to the newspapers and to
30:32
journalists and even to the police – you
30:34
know even Jack the Ripper did that yeah
30:36
and so it’s this sense that there’s
30:38
something again very methodical and
30:40
there’s almost a sadistic pleasure that
30:42
they’re deriving from committing these
30:45
crimes that’s very much the Psychopaths
30:47
game because it’s very planful they
30:49
think about it I just I just can’t
30:51
believe that those people who are likely
30:54
a psychopath and perhaps one out of
30:57
every five see also a psychopath are the
31:00
same cat well look about where the
31:01
overlaps are the utter lack of empathy
31:03
the precision the singular focus yeah
31:07
very
31:08
those oh and could you have no because
31:12
you have to have let her lack of empathy
31:13
I was thinking could you have a
31:14
psychopath who uses his makeup for good
31:17
but it’s not that way
31:19
no because ultimately it’s self-serving
31:21
so I guess maybe the only way you might
31:22
see that is let’s say you have a
31:23
psychopath out there who is running this
31:26
incredibly successful corporation but in
31:28
order to sort of launder money or to
31:30
distract people raises tens and tens of
31:33
millions of dollars for charitable
31:34
causes and that money really does go to
31:38
protecting people feeding people giving
31:41
them health care or something like that
31:43
so it’s dirty money yeah but people get
31:45
helped and let’s face it that does
31:46
happen it’s a philanthropic psychopathy
31:49
so you know it’s money laundering to
31:51
them people benefit I mean I guess
31:54
viewers out there could think about is
31:56
it worth it if somebody gets help that
31:58
they wouldn’t gotten helped otherwise
31:59
but the money came from a really
32:01
manipulative place out of curiosity if
32:04
you’re watching this do you feel like
32:07
your boss is one of those who are 5% or
32:10
21% likely to be a psychopath I’ve never
32:13
worked for a psychopath I can say that
32:15
you know I don’t think I have worked for
32:17
a second but they work for people are
32:18
deeply deeply deeply narcissistic yes a
32:21
full-on psychopath you tend to see them
32:23
in more competitive industries media
32:26
business law maybe even sometimes
32:29
medicine like high-stake athletics that
32:32
kind of military yeah high stakes high
32:36
visibility kinds of spaces where the
32:39
profit lines are high and the stakes are
32:41
high I mean let’s face it when you hire
32:43
people to do a job you’re not doing a
32:45
personality test you’re looking at what
32:47
they can do and if they’re making money
32:48
and you’re hiring for a company then
32:51
you’re gonna look at the person who
32:52
hires money and you may not ask
32:53
questions about what how they’re making
32:56
how they’re getting that done until
32:57
after the fact
32:58
window someone going back to entice or
33:00
antisocial personality disorder when
33:03
does someone cross the line between or
33:05
from suave confidence to antisocial
33:09
personalities well I mean obviously
33:10
someone being suave and confident is not
33:12
a is not a diagnosis or an indictment it
33:15
is to me actually when I made soft
33:16
people I actually get I get really put
33:19
off like to me now charming people are
33:20
terrifying
33:21
that is wrong money yeah it’s a Romany
33:23
tats like personal life charming people
33:25
I tend to excuse myself to the restroom
33:27
and I will often join another table or
33:29
something it terrifies okay so if we
33:31
didn’t know each other and we’re at a
33:32
party and I go oh doctor rowdy I’ve seen
33:34
her videos on red circle let me get you
33:36
a drink you look fantastic tonight I
33:38
love your shoes wow you’re so smart
33:40
intelligent you would go oh my gosh
33:41
thank you you have lost me I love your
33:43
shoes I noticed probably start watching
33:48
how after these mental health
33:50
professionals I tend to be very
33:52
complimentary yeah but complimentary
33:54
that but then there’s a point to which
33:55
like I don’t watch your angle yeah no
33:57
that’s the so that that’s that it that
33:59
that’s the the struggle there so this
34:01
idea then where’s the line right suave
34:04
and charming and sophisticated in all of
34:06
that what you’re looking though to is to
34:08
see is our empathy is there a meaningful
34:11
give-and-take in the conversation are
34:13
they looking through you or are they
34:15
looking at you is are they actually
34:18
interested in what you’re saying and if
34:19
you continue to spend time with them are
34:21
they present are they are they
34:24
reciprocal are they warm how do they
34:27
treat other people so obviously if
34:29
they’re not mistreating other people if
34:31
they don’t have a track record of having
34:33
done bad things that kind of thing then
34:35
then they’re not that then they’re suave
34:36
and charming yeah and they’re not a
34:38
psychopath no obviously not almost
34:40
charming people are not psychopaths yeah
34:43
but it’s again when you do what I do
34:46
charm gets scary well let’s dive deeper
34:48
into that what does the average person
34:51
who has antisocial personality disorder
34:53
look like where do they what do that
34:56
physically look like how do they dress
34:58
how do they carry themselves that’s a
34:59
tricky question because there is no
35:01
average person with antisocial
35:02
personality disorder you can find people
35:04
with antisocial personality disorder
35:06
everywhere from death row to the best
35:09
table at the best restaurant in Los
35:10
Angeles so it’s one bit is how they got
35:13
there you know in both instances yeah
35:16
absolutely that their and their
35:17
personality sort of is likely what got
35:19
them there so they look very different
35:20
they can be in a $5,000 suit or a ten
35:24
dollar prison jumpsuit they can be in a
35:26
they can be in any number of professions
35:29
they could be any race definitely
35:32
proportionately more men
35:34
more men how many more do you think I
35:36
would say it’s a gosh if I were to spit
35:38
box I don’t know the numbers off from
35:39
top of my head I would hazard a guess
35:41
that’s probably five to one eight to one
35:43
men versus what I’m doing eight to one
35:44
yeah something like that yeah it’s a
35:45
quite a few many more men are there’s
35:49
are there women with antisocial
35:50
personalities we’re out there of course
35:51
there are from the course but for sure
35:54
you’d see it the only thing I could say
35:56
in common is this would be a man that’s
35:59
the best I got for you you know but
36:01
beyond that like I said they could be
36:02
successful they may not be successful
36:04
they could be living in the streets they
36:06
could be living in a mansion that’s
36:08
where it’s interesting whereas with
36:10
other mental illnesses we might actually
36:12
see sort of a truncation but even there
36:14
we look at substance abusers they can be
36:16
fabulously wealthy or they can be living
36:17
in the streets you know there can be any
36:18
race or ethnicity they could be you know
36:20
I you know any gender it doesn’t it
36:23
doesn’t matter you are the country’s
36:25
leading expert on narcissism perhaps the
36:27
world’s leading expert on our system I
36:29
think that would be very narcissistic
36:31
that’s why you’re the expert you already
36:33
cut it out how is this different though
36:35
than narcissism it’s a very good
36:37
question what I view them I’ve used them
36:39
as on a continuum and here’s a good rule
36:40
of thumb all people with psychopathy are
36:44
narcissistic not all narcissistic people
36:47
are psychopathic okay and in that way I
36:50
would say nearly all people with
36:52
antisocial personality disorder are
36:54
narcissistic but not the other way not
36:57
all people in our statistic personality
36:58
sort of have antisocial personality sir
37:00
I would never diagnose both if you have
37:02
antisocial personality disorder it’s a
37:04
built-in that you have many many traits
37:06
of narcissistic personality so it’s it’s
37:09
a continuum of sorts it really is and so
37:12
narcissism sort of there’s a form of
37:14
narcissism we sort of term malignant or
37:17
toxic narcissism these are people who
37:19
have all the stuff associate with
37:21
narcissism like the lack of empathy
37:22
entitlement etc etc but there’s also a
37:25
really hard manipulative exploitative
37:28
edge to them and they tend to be the
37:31
more deceitful interpersonally brutal
37:34
narcissists and then when you look at
37:37
what a psychopath or a person with
37:38
antisocial personality disorder now you
37:40
jump the rails into a space where a
37:43
person does not feel remorse for the bad
37:45
things they do people with narcissism
37:48
actually do feel guilty or shameful when
37:51
they do a bad thing they don’t they are
37:54
they well more shame than Gayle Koosh
37:56
aims a very public emotion but they will
37:58
definitely they’ll definitely feel bad
38:01
about it whereas a person with
38:03
antisocial personality sort of a
38:04
psychopathy in general won’t as a
38:06
technical matter and this is a it’s a
38:09
fine point but I want to make it the way
38:11
DSM allows us to diagnose antisocial
38:15
personality disorder symptom number
38:19
seven is the one that’s called lack of
38:21
remorse okay that there’s a specific
38:23
symptom called lack of remorse you can
38:25
get the diagnosis though even if you do
38:29
feel remorse and I struggle with that
38:30
because I have interviewed and in my
38:34
research we’ve interviewed many people
38:36
who will say I did a bunch of really bad
38:38
stuff and I did this bad stuff because I
38:41
was living in a very dangerous
38:42
neighborhood in Los Angeles I came up
38:44
with the wrong kids I get that I had an
38:46
abusive family I was gang involved we
38:49
stole we assaulted I did time and I feel
38:53
awful about the lives I’ve ruined and
38:54
they’re very in they’re genuine they’ve
38:56
done their time and they’re actually now
38:57
devoting their lives to better work
38:59
they’re participating in research like
39:01
they feel bad yeah and there’s the
39:02
remorse rang true so they didn’t get in
39:04
our research they didn’t get that but
39:06
they still got the diagnosis I guess do
39:08
you see what I’m saying where
39:09
psychopathy requires that lack of
39:11
remorse that’s right
39:12
well dr. Romani and I sat down for an
39:15
entire series on narcissism and if you’d
39:17
like to watch that here is a little
39:19
preview
39:20
[Music]
39:20
[Applause]
39:23
so when we talk about narcissistic
39:25
personality disorder there’s a long list
39:28
of patterns and they have to have five
39:30
of the nine on that list it has to be
39:32
something we call pervasive meaning it
39:35
cuts across situations with a variety of
39:36
people in at work at home it’s not just
39:40
like their narcissistic to only you and
39:42
they’re nice and nice to everyone in the
39:43
world tends to be pervasive but here’s
39:45
the rub it has to involve what we call
39:48
social and occupational impairment and
39:52
subjective distress that’s a fancy way
39:54
of saying it is messing up that person’s
39:57
life they’re aware it’s messing up their
39:59
life and they’re uncomfortable with it
40:01
and that’s where you don’t see as many
40:04
people with narcissistic personality
40:05
disorder
40:06
dr. Romany kin sociopathic or can
40:11
someone have sociopathic and
40:13
psychopathic traits without having
40:15
antisocial personality disorder yes they
40:17
can actually you can see that now here’s
40:19
a rub it’s like began antisocial
40:21
personality disorder has such a sort of
40:23
specific diagnostic set of criteria you
40:25
know terms of this the early life
40:28
experience and all of that that you know
40:30
you may have that person who is coolly
40:33
efficient and manipulative and
40:36
singularly focused on success and lacks
40:39
empathy and exploits other people maybe
40:42
they’ll come in right under the
40:43
threshold at this point we’re sort of
40:45
really where we’re splitting hairs mmm
40:49
does that make sense who cares what the
40:51
word is thank you you know I mean it is
40:54
it’s dangerous it’s problematic you know
40:56
my work in this area is very much
40:58
focused on how people how these how
41:01
people with these patterns affect people
41:03
in relationships I can tell you this now
41:05
people with psychopathy and sociopathy
41:08
100% are not built for close intimate
41:10
relationships they just don’t they
41:12
cannot put the roots down deep and I
41:14
think what ends up happening is cuz
41:16
they’re so smooth and charm and glib and
41:19
successful they absolutely draw partners
41:22
in many times for the psychopathy it’s
41:24
like a it’s like big-game hunting they
41:27
just want the trophy they want the prize
41:28
of it all or they value that partner
41:31
they’re very attractive
41:32
they’re very wealthy
41:34
successful they may be a bridge to
41:35
something they want or they just want
41:36
sex yeah I mean it can literally be that
41:38
that’s simple and in fact you do see
41:40
that in when we look at the hare
41:43
psychopathy checklist which is a very
41:45
famous frequently used checklist
41:48
research the hair like hair hair like
41:51
but hair like a bunny the hare
41:53
psychopathy checklist in that checklist
41:56
one of the things actually one of the
41:57
items gets at their inability to be in
42:00
long-term relationships like they have
42:01
very short term marriages kind of thing
42:04
because often times they’re exploitative
42:05
they want something and they get out or
42:07
they just have very brief sexual unions
42:09
are very sexually exploitative they’ll
42:11
you know they’ll use people for sex and
42:13
you know and then just sort of spit them
42:15
up and chew them out and leave them you
42:16
know leave them out and so people are
42:18
very hurt by that
42:19
and they’ll say gosh she was so charming
42:21
you seem so into me and but that’s
42:23
because they’re so charming and when
42:24
that’s why you avoid that’s why that’s
42:26
why I avoid charming people because
42:27
really their damage comes from the fact
42:29
that if you don’t know what you’re
42:30
dealing with it’s so easy to get drawn
42:32
in because it feels like a fairy tale
42:34
it really no little do we know that like
42:37
many fairy tale princes probably are
42:39
psychopaths okay it’s a it’s a nudist
42:43
fairytale princes are most likely a
42:46
psychopath they’re just a little too
42:47
charming I mean I think you know we
42:49
don’t do their name Prince Charming yeah
42:50
Prince Charming yeah Prince Charming
42:52
it’s more Prince psychopathy today yeah
42:55
by the way when people meet you now
42:58
they’re not gonna be very nice to you I
43:00
feel like beyond that circle not a lot
43:03
just an appropriate amount like there’s
43:06
the narcissism woman I’m like no no not
43:08
really if I actually successful dick but
43:12
instead actually stop and make sure
43:14
everyone’s okay very funny uh this does
43:18
come with a lot of co-occurring
43:19
disorders yes
43:20
what are the most common an antisocial
43:22
personality disorder the co-occurring
43:24
disorders we most often see are
43:26
substance use disorders interestingly
43:29
you might actually see depression but
43:32
it’s probably wonder diagnosed because
43:34
they won’t we would probably present
43:35
more as irritability yeah what we call
43:39
impulse control disorders but that the
43:41
impulse control might be like they lash
43:43
out of people road rage intermittent
43:45
explosive disorder but we may not
43:46
diagnose
43:47
both because it’s likely that their rage
43:49
and stuff is subsumed under the
43:50
antisocial personality disorder but
43:52
really the most common comorbid
43:54
diagnosis is going to be substance use
43:56
are there different forms of antisocial
43:58
personality disorder you know in the in
44:00
the diagnostic manual there’s not
44:01
there’s antisocial personality disorder
44:03
and it doesn’t have different kinds of
44:05
it doesn’t have different kinds of
44:07
descriptors if you will in my research
44:10
we’ve actually sometimes split them out
44:11
by people who report having remorse
44:13
versus those who don’t so it’s not
44:16
really differentiated in that way in
44:18
fact the research on psychopathy
44:19
actually makes it takes the time to
44:21
distinguish between psychopathy and
44:23
sociopathy or between primary and
44:26
secondary side copy there’s different
44:27
ways you can slice and dice that pie and
44:29
a lot of it has to do with the the
44:31
forward-facing characteristics how
44:33
intelligent well-put-together articulate
44:35
smart charming glib all that stuff we
44:38
associated with success and that
44:41
precision that’s sort of different than
44:43
what I call kind of like the sloppy bar
44:45
fight psychopathy or sociopathy yes why
44:48
or rather what would not be considered
44:53
antisocial person a personality disorder
44:55
but often is what type of behavior um I
44:58
would say that I mean again many people
45:02
that mistakenly have called narcissists
45:04
mmm as having antisocial personality
45:06
disorder but if indeed that narcissists
45:08
is like I can’t believe I did this I’m
45:10
so sorry and they’re they’re apologizing
45:11
and they go do it again that’s probably
45:13
more of the narcissism piece um bipolar
45:16
disorder bipolar disorder could be
45:19
mistakenly diagnosis antisocial
45:21
personality disorder because it’s very
45:23
possible that during a manic phase a
45:25
person’s behavior may drift into the
45:28
illegal they may use a lot of drugs they
45:32
may solicit the services of prostitutes
45:33
and you know behave very badly with them
45:36
they may gamble a lot of money and
45:38
engage in illegal activity to get more
45:40
money to gamble so they may actually
45:42
behave in a way that is risky and in
45:46
violation of the law so we’d have to be
45:48
very very careful to ensure that when
45:52
there were these sorts of upticks of
45:54
illegal behavior that it occurred only
45:56
during a manic up
45:57
so you got to remember an antisocial
45:59
personality the behavior is consistent
46:01
it’s not like six days a week they’re a
46:03
nice guy and only on day seven do they
46:05
go out and put their serial-killer mask
46:06
on they tend to not work well in society
46:10
even when they’re charming and glib they
46:12
don’t tend to have high quality deep
46:13
personal relationships or people
46:15
diagnosed with border or antisocial
46:19
personality disorder when in fact
46:20
they’re bipolar they could be but it’s
46:24
good it’s gonna be somebody should catch
46:26
that pretty quick okay you know what I’m
46:27
saying because then they should
46:28
recognize that that person is in an
46:30
episode of mania and this has not been
46:31
their typical pattern of behavior but
46:34
since one of the biggest errors we can
46:35
make is make a diagnosis on the basis of
46:37
a snapshot if all you did was focus on
46:40
one day of one person’s manic episode
46:42
yeah you could easily then completely
46:44
call it something it’s not so that’s why
46:46
we have to look at psychiatric patterns
46:48
over time and so also in some substance
46:51
abuse disorders I could see how somebody
46:53
who has a diagnosis of certain forms of
46:55
substance abuse particularly activating
46:58
drugs like cocaine or methamphetamine
47:00
people use those drugs are more likely
47:02
to engage in risky behavior they may
47:04
engage in illegal activities procure the
47:06
drug they may sell the drug they may
47:08
engage in high-risk sexual activities
47:10
while they use the drug and if they’re
47:12
an addict and they’re using regularly
47:13
that may contribute to the likelihood
47:16
that they’re engaging in these high-risk
47:17
illegal behaviors which over time could
47:20
look like antisocial personality
47:22
disorder what would have to happen is
47:24
get that person off the drugs get them
47:25
clean see if the behavior changes or not
47:27
I make a point to say this in almost
47:30
every series because for me it is it is
47:33
the difference between mental health
47:35
therapy working or not and that is
47:37
people must must must get the right
47:40
diagnosis absolutely and do not take
47:43
that as a new label or a new terrible
47:46
thing that’s wrong with you only take it
47:48
as that that’s the next step to get the
47:50
right treatment well any in fact we
47:52
don’t have to call it a diagnosis we can
47:53
call it a pattern this is the pattern I
47:55
think I’m very I’ve been really we’re
47:58
talking about depression per se I’m sad
47:59
I’m more irritable than usual da da da
48:01
da da da you know so it’s we’re looking
48:03
at patterns and these are patterns that
48:05
make a person uncomfortable and make it
48:08
so that they’re not achieving at their
48:10
fullest potential
48:11
because really my goal as a therapist is
48:14
to get a person to achieve at their
48:17
fullest potential
48:18
to be the best version of themselves dr.
48:21
sue Varma in New York we did a series
48:22
with her on depression she goes my job
48:25
is to give people what you just said an
48:27
optimal life that’s what I do people go
48:31
yeah but I can deal with it
48:32
I don’t you could you could why why
48:35
don’t we work hard to make it even
48:36
better right I love that yes that’s good
48:38
I want people to understand what we’re
48:40
doing here is providing the education
48:42
right so that they can get into the
48:45
right people get the right diagnosis and
48:47
get the right thing and you Kylie I want
48:48
to say something to that because I know
48:49
many people who watch Med Circle have
48:52
lived with an experience or may even
48:53
currently be experiencing mental health
48:56
or mental illness issues I always say to
48:58
people this is part of your story
49:01
and if you’ve come through this and you
49:04
will come through this that that’s part
49:06
of your strength and resilience and it’s
49:08
not a piece of you to be forgotten
49:10
because I work with clients for example
49:11
who are health care practitioners who
49:13
are teachers and we can use this as a
49:16
way say you have an empathy that someone
49:19
else may not and you may be gentler with
49:21
a patient or you may be kinder to a
49:24
student and to me I think that many
49:26
times that people who’ve walked through
49:28
the fires that can be harnessed in a way
49:31
that actually can not only bring you to
49:33
a fuller potential but benefit the
49:35
people around you it’s really like
49:36
spinning straw into gold
49:38
so I think that that’s what’s absolutely
49:39
critical as people don’t view this as
49:41
there’s something wrong with you there’s
49:43
absolutely nothing wrong with you
49:43
everything’s right we just want to get
49:45
you to a better place but that you can
49:48
use part of this this part of your story
49:50
to enhance the lives of others mmm
49:53
that’s so beautiful I would love to
49:55
leave it right there but I have more
49:56
questions I can’t leave it on that
49:59
perfect note that you just gave me when
50:02
it comes to antisocial personality
50:04
disorder what am I not asking you that I
50:07
need to be asking you you know
50:09
antisocial personality disorder the big
50:12
question is what if I you know the big
50:16
question around antisocial personality
50:18
sort of really is kind of be treated you
50:20
know to which I’m typically going to say
50:21
the answer’s no in most cases no
50:25
we do know that over time people with
50:27
antisocial personalities sort of kind of
50:28
get tired out they kind of it’s it gets
50:31
exhausting to be a person who keeps
50:34
breaking the rules at ninety or
50:36
seventy-five like you’ll get tired it’s
50:37
exhausting right but these are patterns
50:42
that are very very very very resistant
50:44
to change these are folks that many
50:47
therapists don’t have the training to
50:49
work with nor do all therapists even
50:51
want to work with this population they
50:52
feel threatened or intimidated and
50:54
nobody should work with a patient
50:55
population they don’t feel comfortable
50:57
with but there’s typically no motivation
51:01
for change because these folks don’t
51:03
think anything’s wrong you know they
51:04
really and and and it’s also the
51:06
question is how does the person becoming
51:08
this way let’s dive into that explain
51:10
first of the born part yes so there is
51:13
you know particularly in the area of
51:14
psychopathy an antisocial personality
51:16
disorder there’s actually been a lot of
51:18
research done on sort of brain function
51:21
in people with with antisocial
51:23
personality disorder and there are
51:25
various brain areas that have been
51:27
implicated the ventromedial prefrontal
51:29
cortex the anterior cingulate cortex the
51:33
amygdala all these fancy names are
51:36
really simply boiled down to somethings
51:38
wrong upstairs you know their brains
51:40
aren’t the same as everybody else’s
51:43
however what these researchers have
51:46
found is that that those brain
51:48
differences in structure and chemistry
51:51
colliding with childhoods that may be
51:55
characterized by abuse neglect violence
52:00
being the victim or witnessing violence
52:03
frankly invalidation emotional abuse
52:07
those things might potentiate any of
52:10
those sorts of structural issues in the
52:13
brain we also know that there are areas
52:14
in the brain that subserve empathy and
52:17
that one reason yeah empathy so the
52:19
research has been done actually with
52:21
people who qualify sort of psychopaths
52:23
or as antisocial personality disorder I
52:25
think they had they had been in prison
52:27
what they found was when they were able
52:31
to tell these the subjects in this
52:33
research to think about something and
52:36
forced them into empathy like they’re
52:38
told them a story
52:39
and say can you really stop and think
52:40
how that person in that story felt and
52:43
the person concentrated and how that
52:45
person felt that area of the brain lit
52:46
up but it wouldn’t have happened
52:47
naturally for them so they don’t
52:49
naturally find themselves to empathy so
52:51
they’re capable of what we might call
52:52
cognitive empathy they’re like yeah I
52:54
can get that and that area of the brain
52:55
will light up but it doesn’t happen
52:56
spontaneously so a relationship isn’t
52:59
really possible with them but it’s not
53:00
entirely broken you can turn the system
53:02
on Wow
53:04
now if I just take my glasses off when I
53:08
get excited if a child is born with
53:11
something not functioning correctly
53:13
upstairs and it is a psychopathic or
53:16
sociopathic tendency and they don’t have
53:19
an environment that is violent they
53:21
actually live in a very supportive
53:23
environment can it can you raise
53:26
somebody not to be that way I have read
53:27
case literature of exactly what you’re
53:29
describing a kid who is actually from
53:31
the loving home parents who love them
53:34
you know a nurturing environment plenty
53:36
of resources they weren’t it wasn’t an
53:38
impoverished or dangerous community or
53:40
anything and that child started
53:42
displaying antisocial tendencies and it
53:45
kept unraveling and they became you know
53:47
violent or predatory or
53:48
poorly behaved adults if you will and it
53:52
you know those are case reports that’s
53:54
not normative that’s definitely a very
53:56
low probability event if you will but
54:00
it’s interesting when you read some of
54:02
the work being done by some of the
54:03
really great researchers in this area
54:06
Adrian rein for example as a guy at the
54:07
University of Pennsylvania and he’s done
54:09
some really great research on
54:11
psychopathy and you know I was reading
54:13
something or an interview done with him
54:15
and he had said like listen we’re gonna
54:16
get to the point where we may be able to
54:18
identify some of these patterns and
54:19
children and if that’s the case we
54:22
really should work with parents to help
54:24
them identify some of these patterns
54:26
early on do you see if we can do some
54:29
intervention with them we’re not quite
54:31
there yet but I must say that when we
54:32
see kids who are engaging in patterns of
54:34
behavior like bullying or acting out we
54:37
have to spend the time to do the
54:39
necessary assessments to determine why
54:41
what might be going on for that child
54:43
both at home and in school and what
54:46
behaviors are manifesting because it is
54:49
possible in some of these cases if we
54:50
could get ahead of some of this
54:52
then sure we might be able to engage in
54:54
some prevention work but it’s that’s
54:57
difficult to do you know you can only
54:59
mandate so much that I understand when
55:01
you we have the behavior we try to fix
55:04
it you’re saying just on the basis of
55:05
the brain yeah because that’s the the
55:07
mental health landscape mm-hmm is so
55:11
great yeah and what’s so frustrating to
55:14
a lot of people is that it’s just a
55:17
experts opinion whether or not their kid
55:20
has ADHD or their kid has bipolar
55:22
disorder or that their cousin is
55:24
depressed it’s just somebody’s opinion
55:26
right so when we can have something more
55:29
definitive that can be test that’s so
55:31
exciting to that’s what the hope has
55:32
been in and of all the personality
55:34
disorders really antisocial personality
55:37
disorder is the area where a lot of this
55:38
work on the central nervous system and
55:40
the activity of the central nervous
55:42
system is being conducted and you know
55:45
the challenge is what do you do you give
55:47
everyone in America a brain scan no you
55:50
see what I’m saying so it’s sort of like
55:52
where do we go with this and the
55:54
findings right now are very subtle a lot
55:56
of them happen after the fact so a
55:58
person goes and does bad things and then
56:01
we do the scan
56:02
what other things happen in their life
56:03
that’s right you know and some of the
56:05
research hasn’t been as good at sort of
56:06
describing how much abuse or deprivation
56:11
or all those other kinds of conditions
56:12
are present how much of that shaped
56:15
their brains and that’s the thing the
56:16
brain is shaped by its environment so
56:19
you have a bit we’re kind of doing
56:20
playing a chicken egg chase game here
56:22
and but definitely both things are at
56:25
play there are vulnerable brains out
56:27
there and when that vulnerable brain
56:29
meets an invalidating environment that’s
56:32
where that’s sadly where the issues
56:34
arise do you think we would ever get to
56:38
a point where we would do a scan on kids
56:43
for scan their brain and we could say
56:47
yes they are likely to be a sociopath or
56:51
psychopath not in our lifetimes I don’t
56:53
think so I think that I wouldn’t be
56:55
surprised if slowly we get to remember
56:56
the brain is a very complicated it’s a
56:59
very complicated system it’s not so
57:01
simple it’s like there’s like a little
57:02
it’s other organs are much more
57:05
right other organ systems are a lot more
57:07
straightforward but the brain the brain
57:09
hides four secrets and you know you
57:12
could have four scans that look similar
57:13
and yet the behavioral manifestations
57:15
could be quite different because it’s an
57:17
intersection of so many things the
57:20
person’s everything from the person’s
57:22
gender to their ethnicity to where they
57:24
live to what their parents did to what
57:26
kinds of early environment they have you
57:28
know there’s it’s not that simple it
57:30
would that it were would that it were
57:32
but we’re not there that this this
57:34
extraordinary thing called the brain is
57:36
you know that allows us to do everything
57:38
from you know write poetry to fall in
57:40
love to drive a car it’s it’s not that
57:43
simple and I don’t think we’re gonna get
57:45
it we want it to be that simple we want
57:47
to be able to predict these patterns I
57:50
think it’s a pretty high order as is it
57:52
so it feels like a science fiction film
57:54
to me but who knows maybe maybe
57:56
neuroscience will prove me wrong do you
57:59
think or is there any proof that any of
58:03
this is hereditary there is some
58:06
evidence showing that it runs in
58:08
families now it’s particularly
58:10
father-to-son and as we talked about
58:12
these rates are higher in men when we
58:14
talk about antisocial personality
58:16
disorder from a more biological model
58:19
one of the things we talk about is
58:21
something called the autonomic nervous
58:23
system the autonomic nervous system has
58:26
an arm of it called the sympathetic
58:27
nervous system that we’ve popularly
58:29
referred to as the fight-or-flight
58:30
system but the autonomic nervous system
58:33
is associated with arousal so when we
58:36
get worked up about anything when we’re
58:37
frightened when we’re anxious you know
58:39
anything that is threatening up to us we
58:42
get aroused our heart rate increases we
58:45
sweat our eyes become wide we become
58:49
short of breath those are sort of we get
58:52
our skin you know we put a hair stand up
58:54
on edge kind of thing all those our
58:56
autonomic signs the belief is that
58:58
people with antisocial personality
58:59
disorder have a lower autonomic arousal
59:02
meaning that under conditions of fear or
59:05
threat they don’t get as aroused which
59:07
is why they’re willing to take risks and
59:08
they don’t have the same anxiety we
59:11
avoid things that make us anxious right
59:12
they don’t get anxious so they don’t
59:13
avoid those same things that are really
59:15
high
59:15
risk and in fact there’s research that
59:17
shows that people with psychopathy have
59:19
a lower resting heart rates they just
59:21
are more under aroused so sometimes that
59:24
manifests in them getting into really
59:25
dangerous thrill-seeking types of sports
59:27
because they almost want to feel the
59:30
arousal the rest of us feel on a regular
59:32
basis day after day and that low it’s
59:34
believed that that that autonomic
59:36
nervous system under arousal could be
59:38
inherited in our first video you and I
59:42
ever made I think it was our first one
59:43
you told a story saying that they could
59:47
be in a car with a dead body in the
59:50
trunk and get pulled over by the police
59:52
and be they won’t probably call totally
59:55
cool
59:56
absolutely the place are those the thats
59:59
a sociopath that’s a psychopath or a
60:01
psychopath and they are born Psychopaths
60:05
tend to be more born sociopaths are
60:07
probably a little bit more made you know
60:09
and I mean that’s a rule of thumb that’s
60:11
not perfect science but definitely use
60:13
that you see that that that sociopathy
60:15
tends to be a bit more a byproduct of
60:17
the chaotic or negligent early
60:21
environment whereas psychopathy you
60:25
could have that you can definitely have
60:27
the negligent early environment it’s
60:28
probably likely but either’s likely also
60:30
that biological sort of piece again the
60:32
sociopaths tend to be a bit more sloppy
60:34
messy reactive what age in your personal
60:41
experience do you find Psychopaths or
60:43
sociopaths being diagnosed you can’t
60:44
diagnose them until they’re over 18 I
60:46
don’t think it’s a reliable diagnosis
60:48
none of the personality disorders are
60:50
diagnosed in adolescence except for the
60:54
conduct disorder conduct disorder is not
60:57
a personality disorder it’s a childhood
60:59
disorder oh so you could diagnose a kid
61:01
with conduct disorder okay because they
61:03
keep breaking the rules right it’s
61:05
possible that kid will not go on to
61:06
develop antisocial personality sort of
61:08
if you’re really really really really
61:09
lucky they’d be put into some perhaps a
61:11
juvenile center where they really get
61:13
good rehabilitative care and they don’t
61:15
commit crime again
61:16
I mean the odds are not in your favor
61:18
but it can happen that way so conduct
61:20
disorder is a disorder of childhood
61:22
personality disorders are only diagnosed
61:24
in adulthood we’re making we’re making
61:27
room for the fact that the personality
61:28
can
61:29
used to evolve shape and grow during the
61:32
adolescent years into emerging adulthood
61:34
I actually really wouldn’t feel
61:36
comfortable giving a definitive
61:37
diagnosis of a personality disorder and
61:39
anyone who’s much younger than 20 or 21
61:41
that’s so fascinating that was my next
61:44
question to where you would feel
61:45
comfortable yeah I mean I would talk
61:47
about patterns I say you definitely have
61:49
the traits here but you also have a
61:50
teenager and I can tell you as the
61:52
parent of teenagers I think I’ve
61:54
probably seen what it feels like every
61:55
personality disorders symptoms and them
61:58
you know like wow they’re being really
61:59
she still love them but I was like oh my
62:03
gosh you know and that’s where I really
62:05
learned that teenagers are up down and
62:07
all around and they are again that’s
62:08
just that’s a developmental issue and
62:10
that’s why we want to be very careful
62:11
the last thing you want to do is toss a
62:14
label on it adolescent who’s coming into
62:17
their own and make them pathologize this
62:20
process of them trying to find
62:21
themselves and if we look at any of
62:23
ourselves when we are teenagers like we
62:25
were anything but graceful oh goodness
62:27
that is the truth mm-hmm in regards to
62:30
antisocial personality disorders what
62:33
demographic besides men do you find more
62:37
effective this is where it gets a little
62:38
tricky socio-politically unfortunately
62:41
what we see in this is something that as
62:42
I’ve reviewed the literature from my
62:44
research that these patterns tend to be
62:46
over diagnosed and people from
62:49
lower-income groups and ethnic minority
62:52
groups and the belief is it’s that’s
62:54
because those groups are also
62:56
disproportionately incarcerated and the
62:58
target of law enforcement so the belief
63:02
is that it’s almost like the sense of
63:03
pathologizing people who are different
63:05
than the norm and that’s why those
63:08
statistics I think we have to be very
63:09
very very careful with so again these
63:13
disorders don’t know to discriminate per
63:15
se but since they’re based on moral
63:18
social ethical and legal codes and those
63:21
codes are enforced by other entities
63:24
there’s now you’re bringing politics in
63:27
you see that’s where it gets tricky and
63:28
that which those things don’t belong in
63:30
mental health but we have to be mindful
63:31
of them so we and in fact what we do
63:34
sometimes see is that sometimes women
63:36
who probably have antisocial personality
63:39
disorder will get misdiagnosed with
63:41
another syndromes
63:42
borderline personality disorder because
63:44
we don’t think of women as having
63:46
antisocial personality disorder and so
63:48
and there are men out there who might
63:50
very well have borderline personality
63:51
sort of who get diagnosed with
63:52
antisocial personality disorder
63:54
so things like gender race social class
63:57
is those other things for matter when a
63:59
therapist or psychiatrist brings their
64:02
own personal you know prejudices and
64:05
yeah their practice bias bias by just
64:08
the normal ice bias and that’s why that
64:10
you know ideally you have multiple pairs
64:12
of eyes on case data which you don’t
64:14
always have you know because I’ve been
64:16
surprised when I do every so often get
64:19
to see you know past you know diagnostic
64:22
you know systems late on a client I’m
64:24
like really you know I got to say I’m
64:26
not seeing it this way so it’s not it’s
64:28
not a precise science that’s why these
64:30
these labels don’t tell us much I think
64:31
we’re better off focusing on patterns
64:33
yeah I’ve had patterns in our lifetime
64:37
what do you hope or think that we could
64:41
develop when it comes to the causes of
64:43
antisocial personality disorder you know
64:45
this is actually I mean a lot of what is
64:47
being done in you know in personality
64:49
just sort of research very much focuses
64:51
on antisocial personality because we do
64:53
know but it’s it’s dangerous to society
64:55
so what do I think we’ll learn I do
64:57
think that newer new newer and newer
65:00
tools neuroimaging tools that look at
65:03
namely functional neuroimaging tools
65:06
that really look in real-time at brain
65:09
function those are going to shed some
65:11
really important light on how these
65:13
brains work differently and then once
65:17
therapies or treatments are applied to
65:19
folks to see if you actually see any
65:21
franc shift in functioning and whether
65:24
that’s also associated with a behavioral
65:27
change you know again these are not
65:29
patterns that are that amenable to
65:31
change I think that we might be able to
65:33
isolate what the snapshot of what this
65:35
looks like in the brain whether we can
65:37
then acts on it you know there the jury
65:40
is out like and it would it then become
65:42
something that’s more medical is there
65:44
medication that could be even is it
65:45
surgical right you know and then you but
65:47
you face bigger bigger ticket issues
65:49
like consent to treatment we are very we
65:52
in the United States of America
65:54
an adult has to consent to treatment
65:56
can’t just crack open a person’s skull
65:58
and start fiddling around in it you just
66:00
know how it works and so I think that as
66:02
much as we think well there could be all
66:03
these magical solutions people have to
66:06
agree to uptake therapy and you know
66:08
there’s reasons for that obviously but
66:11
if a person doesn’t think something’s
66:12
wrong whether it’s psychotherapy whether
66:15
it’s medication whether it’s newer
66:17
therapies you know newer sorts of brain
66:20
stimulation techniques whether it’s
66:22
psychosurgery you a person has to
66:25
consent to that and it has to be really
66:26
medically indicated so we have to be
66:29
careful and how we think about those
66:30
things
66:31
dr. Emily someone comes to you a patient
66:33
and they say my husband is a sociopath I
66:36
am convinced what’s your first reaction
66:38
I first of all hear this regularly and I
66:41
get heartbroken for them mmm because
66:44
what it means that they’ve been enduring
66:46
is somebody who is likely verbally
66:48
abusive or ignoring them neglectful
66:51
lacks empathy is cruel as cold is
66:57
distant is manipulative like they use
66:59
that one word and it gives me some real
67:02
insight into what they’ve been enduring
67:03
and by the time they pick up the phone
67:05
and call me
67:06
it often means they’ve been enduring it
67:07
for a while how severe do the symptoms
67:13
of a sociopath become I mean I mean I
67:17
like all disorders it’s on a range right
67:19
you know I mean it’s not like there’s
67:21
one version obviously in the milder
67:23
levels you’re often talking about
67:24
someone who’s cold angry brooding
67:27
resentful mean-spirited you know at the
67:29
more extreme levels it you’ll you seem
67:31
violence manifested so obviously at the
67:34
more extreme levels you you’re often
67:35
talking about victims of more physical
67:37
domestic violence but I think even at
67:38
the mild levels it can look like
67:40
emotional abuse what if somebody comes
67:42
to you and they say I heard this word
67:45
sociopath and I don’t I’m not really
67:49
sure what it is but I think my husband
67:50
might be one what how can I tell I break
67:54
it down for them because I think a lot
67:55
of people use the word sociopath
67:57
interchangeably with narcissistic yeah
67:59
and like I said these are labels I’m
68:01
interested in the pad or matter I’ll say
68:04
don’t use the word tell me what it’s
68:06
like don’t don’t show me a bucket dump
68:08
tell me show me what’s in it yes okay
68:09
metaphor and so I I say tell me what the
68:12
patterns are and then once they start
68:14
laying it out I say okay here’s what the
68:16
pattern is if it makes you feel better
68:17
to have a word you explain no sometimes
68:20
they want to keep doing digging and
68:21
doing research but then we break down
68:23
that pattern so when somebody is
68:24
experiencing that like I said they’re
68:26
experiencing all those things coldness
68:27
distance manipulation lying all those
68:30
things and it almost doesn’t matter
68:32
whether it’s a sociopath or narcissist
68:34
neither pattern is that amenable to
68:36
change and neither pattern feels good so
68:39
they dump out the bucket and they’re
68:41
pulling out verbal abuse coldness all of
68:46
those things that you mentioned yeah who
68:48
cares what we call it right this type of
68:50
person is unlikely to change no they’re
68:53
not gonna change they’re not going No
68:55
so that leaves that person with two
68:57
options yeah stay with it
69:00
yeah and deal with it or get out and
69:01
when I say they’re not gonna change I
69:03
say that very as you can see reflexively
69:06
let’s say let’s say you get that person
69:09
is like okay I never thought it would
69:12
get to this point you’re leaving let me
69:14
give this a shot and they want to make a
69:17
good-faith attempt in therapy and
69:19
they’re really owning it and they get in
69:21
there and they maybe make some minor
69:23
changes in some small small small small
69:26
small small small percentage of cases
69:29
you might see that since most people out
69:31
there and most people watching are not
69:33
going to be the exception to the rule
69:34
I’m going with the idea that if their
69:36
partner is not endorsing any issues on
69:39
their end that they’re responsible for
69:42
any of this then they likelihood of
69:43
change is zero you know you have to add
69:45
that acknowledgement of change so
69:47
assuming that that’s what this person is
69:49
like they won’t change and when I bring
69:50
it to their attention they look at me
69:53
like you know I that’s great I’m not you
69:56
know there’s nothing wrong with me this
69:57
is you and Laughton blame the person so
69:59
they’ll say you’re an idiot you’re a
70:02
fool maybe you’re the one with a problem
70:04
they’ll then they’ll undergo a whole new
70:06
litany of emotional abuse so you’re
70:08
right the two options are to either get
70:10
out or stay and if they stay to
70:12
understand they’re staying under
70:13
conditions that really aren’t going to
70:14
shift that much but how able are we to
70:18
unbias Lee
70:20
tell a therapist how our significant
70:23
other no I get it every day 10 times a
70:25
day so then people are by the time
70:27
listen you go into a therapist office
70:29
and you’re paying good money why would
70:30
you lie I know I’m not saying that
70:32
they’re lying I’m saying if I say all
70:34
right like I my name is Jennifer and I
70:37
have a husband named Paul and I’m saying
70:39
Paul is manipulative and cold how
70:42
accurate is that because maybe I’m just
70:44
angry okay then in which case you’re
70:46
gonna get your guidance from that
70:47
perspective and that’s why it’s great to
70:49
work with couples right because if you
70:51
get to work with a couple then you get
70:52
to see both sides unfortunately if Paul
70:54
in fact is a sociopath he’s gonna be
70:56
manipulative you know so you have to be
70:58
a really skilled therapist to sort of
70:59
suss that out and smell that out you’d
71:02
be amazed how many clients pull out
71:04
their phone and show me the text
71:05
messages and that’s when I get a real
71:07
sense of it I see the emails this is so
71:10
good yeah I bet you people don’t realize
71:13
that they can even do that with the
71:14
therapist they can’t always some
71:16
therapist listen I’m I when my clients
71:20
come in they might bring in old photo
71:21
albums I welcome all that they show me
71:23
the text messages it helps your
71:25
therapist though any of your viewers
71:27
your therapist may say no and I don’t
71:29
ever want to impugn how another
71:31
therapist works so I’m not saying all of
71:34
us will do that
71:34
I certainly will because I am there
71:37
because of the sheer number of clients I
71:39
work with who have been in narcissistic
71:42
or sociopathic or psychopathic
71:44
relationships it’s really important to
71:46
me to never Gaslight my patients yeah
71:48
you know maybe you’re not telling me the
71:50
truth that’s what the world has been
71:51
telling this person for a while like
71:53
well maybe it’s not that bad
71:54
and they went gasps elated by the world
71:56
and I refuse to be someone who does
71:58
there’s a reason this person picked up
72:01
the phone came to my office once spent
72:04
the money to see me and if it’s to come
72:06
in and say I’m gonna give you this sort
72:08
of mythological version and do I think
72:10
sometimes clients do that absolutely
72:11
absolutely and so then what’s happening
72:14
is probably nothing is changing at home
72:16
because I’m working in good faith so at
72:19
some point they’re either gonna stop
72:19
coming cuz saying nothing you’re doing
72:20
is helping me but but I have to say that
72:24
it is important for me to honor their
72:26
truth is I’m a humanistic therapist and
72:28
I really miss my orientation be
72:30
humanistic existential and a big part of
72:32
that is that your
72:33
is what matters to me and for some
72:35
reason you’re coming in here and saying
72:36
this is your experience of this person
72:38
and it’s not my place to doubt that I
72:40
just want to understand it that is so
72:44
good I love a the permission to bring
72:49
evidence as well call it to a therapist
72:51
who’s open for that you know why they do
72:54
that though Kyle sometimes people bring
72:55
that in because they’ve been doubted by
72:57
everyone and there they feel like
72:59
they’re losing their grip on reality
73:00
that’s what gaslighting does to people
73:02
it’s a doubt it’s a test your reality
73:04
and it could be going on for 20 years
73:05
and sometimes to them they’ve stopped
73:08
trusting their own reality so much that
73:11
they hand over the text messages because
73:13
they don’t think anyone will believe
73:14
them it’s actually a rather
73:15
heartbreaking gesture I am not kidding
73:17
you I’ve had clients come into boxes of
73:20
stuff and you know and I mean it’s
73:21
heartbreaking because I think god no one
73:23
has been listening to this person and
73:25
they literally feel like they’re losing
73:27
their grip on reality and not to me is
73:29
devastating
73:30
so I Jennifer comes in and she’s
73:33
irritated with her husband Paul because
73:35
he’s a sociopath and you tell her look
73:38
the evidence would suggest that he’s a
73:39
sociopath but I would assume Jennifer
73:42
didn’t marry him when he was doing all
73:44
those things yeah here’s the thing with
73:47
these patterns narcissism sociopathy
73:49
psychopathy these are long-standing
73:52
patterns now because of the charm
73:56
particularly we see in psychopathy and
73:58
narcissism they can often keep a lid on
74:00
it long enough to get a ring on it okay
74:04
sociopathy tends to be a bit more sloppy
74:06
I’m not quite sure why people fall for
74:08
that but they do some people just
74:10
desperately want to get married and
74:11
they’re just sort of taking whatever
74:14
person is in front of them they’re like
74:16
okay I guess I can work with this and
74:17
sometimes is that sociopaths don’t tend
74:20
to be as successful as Psychopaths but
74:22
if that person maybe brings enough
74:25
practical characteristics they can live
74:27
with they may be willing initially to
74:29
overlook the rest so know this person
74:30
these red flags were here from the jump
74:33
going back to a conversation we had
74:35
previously in this series about being
74:38
mindful and being aware and conscious
74:41
because when you’re mindful aware and
74:43
conscious you can hopefully see that
74:46
Paul is
74:47
characteristics that are maybe won’t be
74:49
good in a marriage yeah and but people
74:51
are so easily go into denial and then
74:55
get married thinking I’ll get better
74:56
well that’s the biggest mistake a person
74:58
can make any nothing’s gonna get better
74:59
once you’re married if anything I put my
75:01
good bet on things are probably gonna
75:02
get a little worse yeah you know I’ll
75:04
quote my father who’s not a therapist he
75:06
said look it better be so good by the
75:09
time you get married because it’s only
75:10
gonna I mean it’s possible some things
75:14
could get better with time you know but
75:16
we I have to say that it is you’re
75:18
absolutely right and every single client
75:21
I have ever worked with man or woman gay
75:26
or straight you name it Amy culture they
75:30
have said they owned it these signs were
75:32
there all along and if anything they
75:34
feel angry at themselves they feel
75:35
ashamed and embarrassed humiliated why
75:38
didn’t I see this sooner and they’ll own
75:41
it family tradition they wanted to get
75:43
married they wanted to be a parent
75:47
they thought this person could take care
75:49
of them they felt bad for them because
75:50
that they had a bad childhood those are
75:53
those the reasons they get all the way
75:55
in and like we’ll fix this it’s almost
75:57
like we’ll get the house and it’s like a
75:58
fixer-upper
75:59
what could the house and then we’ll fix
76:00
it yeah not a good idea I’ll share a
76:02
personal story I had a six-year
76:05
relationship broke up in therapy about
76:09
it we didn’t break up in therapy but I’m
76:10
in my therapists office reviewing the
76:13
relationship and I brought something up
76:15
that happened in our first few weeks of
76:18
dating and that event occurred
76:21
throughout our relationship and I told
76:24
my therapist yeah but I didn’t know it
76:26
was happening you were in denial I
76:28
wasn’t in denial
76:30
I saw it happen in the beginning he said
76:32
that wasn’t that’s not gonna happen
76:34
anymore and I just didn’t know what was
76:36
happening he wasn’t I’ll you know you
76:37
just chose not to see him and I left his
76:39
office angry because I go who are you to
76:42
tell me that I’m gonna now you know but
76:43
then after a few weeks I came back
76:44
though you were right I was in denial I
76:47
saw it all along I just chose to pretend
76:51
like it wasn’t or make rationalizations
76:53
I mean the other pattern I see folks
76:54
make is like he’s having a bad day at
76:56
work the kids are really noisy his
76:59
father’s been really sick
77:00
I’m wait until we move by the new house
77:03
I mean it never ends right any anyone
77:05
can write those rationalizations and
77:07
while those things may be true their
77:09
causes of stress that kind of bad
77:11
behavior is unacceptable emotional abuse
77:13
is unacceptable any day of the week mmm
77:17
perfect I want to stop it right there
77:20
that was there was so many great
77:21
takeaways and my big one was going to
77:24
the therapist with evidence yeah I’ve
77:28
never done that and I probably should
77:30
have yeah I mean if I said but I warn
77:32
folks that you know like before they
77:34
show up to the therapists office
77:36
bringing a bottle cap with five boxes of
77:39
Records and they end up and they open
77:44
their phone their therapist may say we
77:46
you know I only want to hear about your
77:47
reality they don’t want the therapy to
77:49
be punctured by outside realities like I
77:52
said I respect how other therapists work
77:54
given the nature of the populations I
77:57
work with that I must say it sometimes
77:59
elucidate something and it allows them
78:02
to almost feel heard and it normalizes
78:05
things for them because they’ll
78:06
sometimes say I have to show you this
78:07
because otherwise I am I feel like no
78:11
one could believe something this
78:12
outlandish I say I believe you
78:14
if this helps you by all means you know
78:17
I’m just trying to give them a sense
78:18
that I’m trying to help them feel sane
78:20
and whole again yes by whatever path
78:22
possible yes water what’s the first sign
78:25
someone needs to look at as if they
78:27
think somebody they know is a psychopath
78:28
I mean if you come to find out that
78:31
they’re breaking major rules moral codes
78:35
ethical codes or laws now obviously on a
78:39
first date a person doesn’t I mean
78:41
unless that they’ve got their like their
78:43
I just broke the law bracelet around
78:45
their ankle you know they’re not going
78:50
to I don’t think that most people are
78:53
gonna like put their rap sheet in front
78:55
of you on a first date so you know but
78:58
pay attention even to look at how they
78:59
might handle rule-breaking
79:02
in a relationship I don’t know they
79:06
might take something that doesn’t belong
79:07
to them if you’re you know from a like I
79:10
don’t a place of business or a hotel or
79:11
something it may feel like a small
79:13
transgression
79:14
but it’ll be enough to make you uneasy
79:15
they may share something that they did
79:17
at work that feels like it’s on the
79:19
wrong side of shady you know there’s
79:21
enough of those little things start to
79:23
accumulate and you know the danger is it
79:25
like wow they’re they’re really slick
79:27
like they’re a hustle their player you
79:29
know like you think you’re in some sort
79:30
of cool movie with them but it’s not
79:33
cool it’s actually they’re breaking
79:36
rules and they’re doing it over and over
79:38
again and that might be a sign or a
79:40
signal you know they just are it’s and
79:43
then may end up culminating in more and
79:45
more stuff and you may find it out I
79:46
think one of the most devastating things
79:48
that people have said to me when they’ve
79:50
been in relationships with Psychopaths
79:51
is what they learned down the road they
79:54
come to find out that this person had a
79:56
history of incarceration that they may
79:58
actually be married to someone else at
80:00
the same time that they lied about their
80:02
occupational history that they lied
80:05
about a bills that went unpaid and which
80:08
are now are ruining their credit you
80:09
might go try to buy a house and find out
80:11
oh they had two bankruptcies in their
80:13
past or something so it’s a it may be
80:15
something you don’t learn early on
80:17
nowadays with Google you might be able
80:20
to look into people Psychopaths have a
80:22
tendency to use aliases they may not be
80:24
who you think they are Wow
80:26
does it look do a psychopath look
80:28
different depending on the role they
80:30
take in your life for example a
80:32
significant other versa coworker verse
80:35
absolutely you gotta remember a
80:38
Psychopaths front game is the best game
80:41
in town
80:41
smooth glib charming intelligent
80:46
articulate perfectly put together I mean
80:50
you’re you really need to know what
80:53
you’re looking at to be able to catch
80:54
them in what they’re doing so they’re
80:58
gonna be if they’re trying to attract
80:59
you as a new partner they’re gonna bring
81:01
their a-game if they’re trying to
81:03
impress somebody in the workplace
81:04
they’re gonna bring their a-game however
81:06
if you’re someone who’s disposable or
81:09
dispensable to them or someone they
81:11
views you’re in their service god help
81:14
you is all I have to say if you find
81:16
yourself in a relationship with a
81:18
psychopath or you believe that your
81:20
husband or boyfriend let’s say is a
81:22
psychopath are there any questions you
81:25
could ask them to
81:26
maybe find out if you’re right I would
81:28
say that what you wanted use look for
81:30
inconsistencies in their story and find
81:33
out talk to people who know them now I’m
81:34
not saying you need to go CSI on this
81:36
and start this interrogation of everyone
81:38
who’s ever known them but try to see if
81:41
there’s continuity if the dates line up
81:42
if their life story lines up if you know
81:45
he might have said he went to college in
81:47
one place and another person’s like yeah
81:49
when they graduated they were working at
81:51
this job and you’re like something’s not
81:53
adding up
81:54
psychopaths often go out of their way to
81:57
isolate their partner from other people
81:59
who know their histories look for that
82:02
pattern – why aren’t you being
82:04
introduced to anyone in the past they’ll
82:05
often say I was done wrong and I’ll make
82:07
up some dramatic story about how
82:09
everyone did this to them so they have
82:11
nothing to do with anyone from their
82:13
past that’s pretty rare that somebody
82:15
would cut off everyone all friends all
82:17
family all extended family it may be
82:19
that they’re on a fresh start path and
82:22
they’re sort of reinventing themselves
82:23
and that you’re in the in the you’re in
82:25
the eyeline of a grifter kind of person
82:27
at this point so look for
82:29
inconsistencies psych psychopathy is not
82:32
a diagnosis of all time no but can
82:35
someone have psychopathic tendencies but
82:39
not be a psychopath you know I mean
82:41
they’re you then again you’re splitting
82:42
hairs you’re splitting hairs because
82:44
like because there’s no diagonally if
82:46
you have five psychopathic tendencies
82:47
then you’re a psychopath right you know
82:49
the people who have like really are
82:53
breaking rules in this consistent way
82:54
and they’re cold and they’re and they
82:58
fail to take responsibility and they’re
83:00
deceitful and they’re manipulative and
83:03
they’re exploitative I mean these things
83:04
tend to hang together it’s very rare
83:07
that a person exploits other people but
83:09
then they’re really sweet and they do
83:10
bake sales and they run a Girl Scout
83:12
troop like you’re not going to tend to
83:14
see those things kind of hanging out
83:15
together these things cluster together
83:17
so the more of them you have the more
83:19
likely you are to dealing with somebody
83:21
who is truly a psychopath I like the
83:24
takeaway of looking for inconsistencies
83:26
and this person and if you’re in a
83:31
relationship with them you do have the
83:32
option to leave but if you have a
83:34
co-worker for example you can’t
83:37
necessarily leave them so how do you
83:39
adapt for working with a psychopath
83:41
if you suspect you’re working with a
83:43
psychopath that you what you want to do
83:45
is you really really really want to
83:47
cover your bases
83:49
remember HR is not going to help you
83:51
unless you have documentation you can’t
83:53
walk into a try and say hey the person
83:55
in the next cubicle is a psychopath
83:56
they’ll be like okay that’s I watch the
83:58
red circle of it you know so if you I
84:02
mean I always tell people anytime you
84:04
start on a new job you almost have to be
84:06
kind of paranoid you start you save
84:08
every email you make folders you get
84:10
that stuff off the server you print it
84:12
off like you knows all these steps that
84:14
you really should engage in if you think
84:15
you’re working with a psychopath but you
84:18
want to make sure you document things
84:20
you want to avoid having meetings with
84:22
them one-on-one you want to ensure that
84:23
there’s a third party present you want
84:25
to ensure minutes are being taken of
84:27
meetings you want to you know most times
84:28
people scan minutes and don’t really pay
84:30
attention pay attention to those minutes
84:33
because that might be the only
84:33
documentation you have and then you want
84:38
to make sure you have alliances at work
84:40
people that you can trust but what you
84:41
don’t want to do is gossip about the
84:43
psychopath because they’re better than
84:44
at that than you are they’re already
84:46
stabbing you in the back and numerous
84:48
other places you can’t see you know a
84:50
way ahead of you they’re gonna play this
84:52
game better than you so you’re best off
84:55
playing a clean game yeah yeah then
84:57
trying to beat them at their own game
84:58
yeah really good advice what about for
85:02
family members how do you tell how do
85:05
you know if your mom yeah I mean that’s
85:09
incredibly painful cuz I got to tell you
85:10
one thing I’ve seen in more than a few
85:12
family systems is some people who won’t
85:14
refuse to believe it like I refuse to
85:16
believe that we’re just being dramatic
85:17
and they’ll say they’re not a psychopath
85:19
and so you’ll have these families that
85:20
also be schism didn’t split like people
85:23
will say I think you’re exaggerating I
85:24
think that you know they’ll actually
85:25
Gaslight the person who’s making the
85:27
accusation so it can be very painful if
85:30
you come into the realization that one
85:33
or god forbid both of your parents is a
85:35
psychopath that’s a very painful
85:38
revelation but I gotta tell you you
85:39
probably figured that out as a child
85:41
psychopathic parents tend to be abusive
85:43
neglectful manipulative one of the more
85:48
famous Psychopaths out there
85:50
is Bernie Madoff mm-hmm okay he’s used
85:52
as a classical example of a psychopath
85:55
when you look and he was very wealthy
85:58
and he raised his children up with
86:00
tremendous comfort he certainly wasn’t
86:02
beating them with a stick or you know
86:04
locking them in the basement or
86:05
depriving them but there was a cruel
86:08
edge to him and his kids would
86:10
acknowledge that if you watch any
86:11
retelling of that story there’s well
86:13
it’s definitely not a comfortable
86:14
relationship
86:15
some people have high-functioning
86:16
psychopathic parents a dad who’s a CEO
86:19
or a mom who’s really really you know
86:21
successful at whatever it is she’s done
86:24
and they’ll report like having two
86:27
parents the public person and this
86:29
really cruel invalidating malevolent
86:32
horrible person that would come home and
86:34
they’d note the dichotomy how seamlessly
86:37
their parent would go between those two
86:39
worlds and so on and put through and put
86:42
their child through unrealistic kinds of
86:44
expectations so um people it’s not like
86:47
a person wakes up at 30 and says oh dad
86:49
was a psychopath you know you know is
86:52
there such thing as a self-aware
86:55
psychopath you know the funny thing
86:58
about Psychopaths is I don’t even think
86:59
they’d get mad if you call them
87:00
Psychopaths because they don’t care what
87:02
anybody thinks of them so if you go up
87:04
they’ll laugh it off you wouldn’t be
87:06
like even a narcissist to get super
87:08
defensive the Psychopaths like you want
87:10
to call me a psychopath call me a psycho
87:12
so that’s how they respond but do they
87:13
think hmm yeah I am a psychopath yeah I
87:16
know they’re not affected about by the
87:18
evaluations or labels placed on them by
87:20
other people what they don’t like
87:22
I know they’re not affected by it but do
87:24
they recognize that they are a
87:26
psychopath
87:28
maybe yeah maybe yeah they might in some
87:31
cases they might and if anything it’s
87:33
like there’s a there’s a sadistic glee
87:36
mmm-hmm you see what I’m saying like
87:38
it’s they may recognize it like how cool
87:41
that I got like how cool like I’m a
87:42
psychopath and I’m getting away with it
87:44
or I’m a psychopath and look how much
87:46
money I’m making or you know it’s almost
87:47
like if you I don’t know it’s like
87:49
finding a bag of money on the street
87:50
dropped by a armored truck and you’re
87:53
like no one’s around and I’m picking
87:54
this up and I’m walking down the street
87:55
and I’m getting away with this like
87:57
their whole life is about getting away
87:58
with stuff so if anything that bath
88:01
might even be like a badge of honor
88:03
but I don’t again I think they’re
88:05
impervious to the criticisms of other
88:09
people that’s where they’re different
88:11
than the narcissus the narcissus hates
88:13
being criticized right the Psychopaths
88:15
don’t mind yes
88:17
what are we talk what are we not talking
88:20
about when it comes to identifying a
88:22
psychopath that people need to know I
88:24
think that with a psychopath it is it is
88:25
really about looking for inconsistencies
88:28
inconsistency in mood inconsistency in
88:31
life history
88:32
inconsistency in their stories the
88:34
problem is we so want to believe when we
88:36
meet someone new that their stories are
88:38
real I’ve just met a supercool person
88:41
that we we make the puzzle pieces fit
88:44
even when they don’t I tell people be a
88:47
cynic when the dates don’t line up
88:49
recreate it listen Google’s making some
88:51
of this stuff possible – no I’m not I
88:53
mean it’s not like I want everyone to I
88:54
said go out there and play like junior
88:57
detective but if you’re being isolated
88:59
from anybody who knows anything about
89:01
this person pay attention to that you
89:04
know before you entirely by their their
89:07
recreation of the events look for things
89:09
that don’t add up they have this huge
89:11
job like they’re so successful but they
89:13
don’t have enough money to get through
89:14
the month but can you help me out this
89:16
month like next month the big payouts
89:18
gonna come come out I mean so I’ve got
89:20
everything covered from then on in you
89:22
know anything that feels like a hustle
89:24
is probably a hustle we are seeing that
89:27
there are certain there programs like
89:28
for example prison transition programs
89:31
and you know other programs working with
89:34
more like incarcerated antisocial
89:38
personality disordered groups that have
89:41
found some utility in some forms of
89:43
social skills training group therapies
89:46
some some luck with cognitive behavioral
89:49
therapies there has been some good work
89:50
there you know listen at the end of the
89:52
day it’s like you know the old joke of
89:54
how many psychologists does it take to
89:56
change a lightbulb one but needs to want
89:58
to change it’s the same thing with
89:59
antisocial personality disorder you know
90:02
the person has to need to want to change
90:04
and you know you may or may not have it
90:06
I have to be honest with you it’s more
90:08
of those slick glib charming almost if
90:12
you want to call them white-collar
90:13
Psychopaths that are you’re gonna get
90:16
absolutely
90:17
we’re there I mean I think there’s
90:18
absolutely no chance of change there I
90:20
think actually in the in the criminal
90:22
populations you may be able to do some
90:25
level of job training social skills
90:28
training meaning and purpose focus work
90:30
and I actually would put my bet on the
90:32
incarcerated population more than I
90:33
would on the sort of the slick you know
90:36
the slick sophisticated successful group
90:39
of psychopaths quite frankly because
90:40
there’s almost no motivation for change
90:41
they’re getting rewarded for their
90:43
behavior that’s right
90:44
they’re there in their world they’re
90:46
killing they’re killing it they’re
90:47
killing it and the world is telling them
90:48
they’re killing it
90:49
too right yeah so maybe cured is the
90:52
wrong word yeah could a and a person who
90:57
is psychopathic could they at least get
90:59
to a point where they’re not breaking
91:02
the rules I mean that’s obviously the
91:04
goal and that’s that’s the goal of you
91:06
know rehabilitation after prison and you
91:08
know that kind of thing is that there is
91:10
no recidivism and we try to avoid
91:12
recidivism is where we’re trying to
91:14
prevent a person from committing crimes
91:16
again but you know criminal behavior or
91:19
illegal behaviors just only one part of
91:22
what we see an antisocial personality
91:23
disorder we’re also seeing violation of
91:25
ethics or morality or social norms so
91:29
for example somebody who is antisocial
91:31
personality or psychopathy is very
91:33
likely to cheat on a romantic partner if
91:35
they have one they’re going to probably
91:36
keep doing that because it really are
91:39
they’re really almost immune to it any
91:41
sense of morality and so that’s not
91:45
going to change which can make it very
91:46
difficult to maintain any kind of
91:48
trusting relationship with somebody like
91:51
that so I think that some of the
91:52
treatment targets may be in terms of
91:54
illegal behavior they may be willing to
91:56
bring some of that hustle if you will to
91:58
a more legal behavior but even then
92:00
you’ll sort of see that their tendency
92:02
is going to want to take moral and
92:04
ethical shortcuts what does the
92:06
treatment actually look like for these
92:08
people you know a lot of it is again
92:09
it’s cognitive behavioral it’s it’s it’s
92:11
challenging their beliefs and changing
92:14
them their beliefs and thoughts and a
92:16
hope of changing their behavior that’s
92:18
really what you’re trying to do right
92:19
and so it’s that’s where you’re sort of
92:23
pushing back on their cognitions pushing
92:24
back on their schemas on their sense of
92:27
how the world works trying to enhance
92:29
their sense of empathy
92:31
you know to really help them focus on
92:32
this is how people are being hurt
92:34
especially if it’s a kind of it’s not
92:36
like person on person crime like violent
92:38
crime something that feels more remote
92:40
that to help them sort of see that this
92:43
is hurting somebody else and the people
92:46
around them now in a person who’s really
92:49
a cold stone-cold psychopath they don’t
92:53
care so I don’t care if I’m hurting
92:55
someone it doesn’t matter to me and so
92:57
if that’s the case what how are you
93:00
gonna make change there if I don’t think
93:02
something I’m doing is wrong like if
93:03
some if I’m somebody tells me tomorrow
93:06
like it’s wrong to turn off my bedroom
93:08
light when I sleep oh my gut yeah why is
93:10
that a problem
93:11
that is that’s a really good way to put
93:13
that that’s how far it is yeah what do
93:17
you mean I gotta make a hundred million
93:18
dollars yeah do it you know I’m gonna do
93:20
it and no one’s gonna stop me or it’s a
93:23
game again I’m gonna bring up the Bernie
93:24
Madoff case because he’s sort of like a
93:26
real textbook kind of a psychopathic
93:29
antisocial personality sort of person in
93:31
some ways it’s almost like it was
93:33
gamesmanship to him at some point how
93:34
much money does one person well it isn’t
93:36
that the price it’s got to the truth
93:38
yeah yeah that’s all it was and it felt
93:40
like that’s what it was despite
93:42
literally so many people’s lives being
93:46
destroyed by his decisions absolutely
93:49
didn’t even seem to it was the game was
93:52
more important than the other people and
93:53
that’s what it is like they are players
93:55
who really only care about the game so
93:58
someone’s watching this I doubt they’re
94:00
psychopathic no probably are in a
94:02
relationship with somebody is nobody who
94:04
are family members a family member or
94:08
work with them or work with them yeah
94:10
they are likely going to be advised to
94:14
go seek therapy for themselves in that
94:16
therapy session what do they ask the
94:19
therapist because what I want what I
94:22
want to have happen for them is that
94:23
they don’t have to go to five therapy
94:26
sessions to figure out what is a
94:28
psychopath and what all these things
94:30
that you’re educating them on and giving
94:33
them the tools to ask the therapist so
94:35
that maybe in the first session they can
94:37
make a ton
94:38
of a game it depends on the relationship
94:41
of the psychopath is this your child is
94:43
this your coworker
94:45
is this your husband you know because
94:47
obviously the nature of the relationship
94:49
it’s gonna have a lot of bearing on what
94:52
you need to know for example if it’s
94:54
your child the question a lot of parents
94:56
are gonna have is am I responsible for
94:58
this will we’ll go into the whole child
95:01
thing in our next video right so let’s
95:03
assume that this is for a loved one so
95:06
you mean like a part of romantic
95:08
romantic partner is it possible he can
95:12
change because he keeps telling me he
95:14
will we have kids together can I expect
95:18
that he’s going to be a decent co-parent
95:21
if we have kids should I be scared
95:26
you know I keep giving him second
95:29
chances but it never works out why not
95:33
you know is it possible he’ll change
95:36
those are the kinds of questions you’re
95:37
gonna you know that somebody should
95:39
probably ask and you know by and large
95:41
if that person has any expertise
95:43
whatsoever in psychopathy or antisocial
95:44
personality they’re going to be able to
95:46
give you some straight answers on that
95:48
like I said these people are not made
95:50