You can already sense what I think an antisocial personality is when you have read my page about a normal personality and normal behavior. There I tried to outline a model of a normal personality.
Most psychological and scientific literature consider rigid and inflexible thought and behavioral patterns as abnormal. However, I consider this criterion as difficult to use in practice and therefore vulnerable to misuse, because a lot of ‘normal’ people also have rather rigid and inflexible thinking patterns.
However, when talking about an antisocial personality or a psychopath (nowadays scientists like to call them sociopaths; they try to be friendly), suddenly everyone seems to know what such a person is. Made very popular by the iconic Anthony Hopkins playing Hannibal Lecter, since then everybody seems to see this character as the prototype for a psychopathic or antisocial personality. Nothing is further from the truth! Actually, only a very small percentage of all such personality disorders is really sort of a Hannibal Lecter. They are extremely violent, egoistic, often very clever and their lust for power and dominance is extreme.
But most antisocial personalities can not be recognized as being obviously violent or murderous. On the contrary, they are charming, clever, often charismatic and most of the time extremely friendly in public. Especially women can be a victim of a psychopath. Often later in their marriage they realize that they have been married to a psychopath. Difficult to imagine? Well, if you know what cognitive therapy sees as a psychopath, then you will not be that surprised.
According to the American Psychiatric Association in the DSM-IV-TR (classical handbook of psychiatric diagnoses) an antisocial personality disorder is a “pervasive pattern of disregard for and violation of the rights of others occuring since age 15”. Strangely enough it is the only personality disorder that can not be diagnosed before the age of 15! I haven’t found a very clear reasoning for this and find it a bit random. However, the key focus in this disorder is clearly a disrespect for social norms and other living beings. So, repeated lying, impulsivity, aggressiveness, consistent irresponsibility and a lack of remorse or guilt are typical features.
Cognitively they are extremely egocentric, and their view of self is extremely positive: they do not make mistakes, only others. That’s also the reason they do not want to be controlled by others, be it partners or bosses. They think they are entitled to different rules than others, being more clever and deserving more attention and praise. In this sense, this personality disorder resembles the narcissistic personality. The main difference between these two is rather difficult to find: the literature is not always clear on this. However, the essential difference seems to be the pervasive pattern of violating the rules and the rights of others. They seem to do this because they simply like to do it, they get feelings of lust or excitement when they hurt or have control over other living beings. A narcissist usually has a different kind of motivation for hurting others: because they think they deserve some rights or attention and everyone standing in their way to receive such rights has to be punished.
Emotionally, both a narcissistic and antisocial personality disorder lack empathy or are unable to see the world through another one’s eyes. They seriously have a ‘technical’ inability to adopt another person’s perspective, they can not understand how to feel what another person feels. In an antisocial personality this can be very extreme, as a psychopath has expressed this during an interrogation as follows: “I only knew that my victim was suffering when I looked and listened to her screams and saw her eyes and mouth wide open…” However, in such cases such extreme antisocial personalities can not really feel any compassion or pity. They simply do not have the right brain areas to experience pity. A narcissistic personality can lack this kind of empathy as well, but that is less common. However, usually both an antisocial and narcissistic personality disorder are present but then the first is being diagnosed as the primary disorder.
The cliché that a psychopath completely lacks social skills or any affective responses is untrue as well. The whole range is possible: there are psychopaths who truly lack much spontaneous emotional responses, others show all emotional responses you can imagine. Social skills can be highly trained and sofisticated or rather blunt and clearly inadequate. However, all antisocial personality disorders do have significant emotional processing deficits: they simply process emotions differently than the average ‘normal’ person. Their lack of empathy on a continuum of less to much is truly an essential feature.
Interpersonal relationships are another key feature of antisocial personality disorder. By that, I mean the lack of adequate social relationships because of their inability to truly feel and empathize with others. Because of their extreme egocentrism and this lack of being able to read someone’s mind and emotions, they truly can not consider and respect the feelings or rights of the other person. When they seem to respect others they either do that because of own personal gains or because they try to manipulate the other. In stating this, drawn from the literature, I fully realize that with such kind of reasoning a psychopath will always BE an antisocial one. It is impossible to cure them! This question, ‘Is a psychopath curable?’ will be answered later on this page.
Because an antisocial personality disorder can be so diverse in its forms and behavior a continuum of types has been developed ranging from type I (1) to XII (12), from being violent to himself (and not to others) to being extremely violent to others (Hannibal Lecter or Ted Bundy types). This continuum is very handy to ascertain the degree of ‘antisociality’.
A lot about this topic has been said and written, also on the Internet. However, having looked at many sources and using my knowledge about neuropsychology and neuroscience, I have come to the following conclusion: psychopaths are NOT born as psychopaths. There is very little to no evidence that points to the opposite conclusion that a child is born as antisocial. So that’s pretty assuring isn’t it? And it makes sense as well, from an evolutionary standpoint. The human race would not have survived when only psychopaths were born. The essence of a psychopathic or antisocial personality is that he (or she) does harm to others or himself. When everyone of them would do that in a group, this group wouldn’t last very long in nature. It would soon become extinct. Very interesting books about such personalities who have murdered are John Douglas’ The anatomy of motive (1999) and The cases that haunt us (2001). Although not exactly hard science, Douglas’ experience in the field has learned us a great deal about these personality disorders. Another classic in this field is the book of the renowned scientist Robert Hare: Without conscience (1999). A much more scientific and neuropsychological book about psychopathy is that of James Blair et al (2005): The Psychopath: Emotion and the Brain. I do not agree with his conclusion that a psychopath is nót an antisocial personality disorder but a genetically determined disorder. It is a bit more complicated: yes, there seem to be people who are born with a serious brain defect, lacking anxiety or empathy. Such people could very likely develop into an extreme psychopath. However, environmental factors like upbringing are very important as well. So let me put it clearly again: almost all people are NOT born antisocial.
Usually, antisocial behavior is learned. Due to someone’s upbringing, more specifically, a very special kind of upbringing, a child can develop very intense emotions like anxiety or anger. According to behavioral learning theories such a child can develop antisocial behaviors to cope with its anxieties and angers. When its antisocial behaviors are stimulated or reinforced, an antisocial personality grows. You can read my page about Normal personality to understand how such a mind, such a self-image is formed.
Science estimates that roughly 1 to 3% of the total population has an antisocial personality disorder and much less an extreme psychopathic character (more men than women). However, again, I have never found solid based evidence to back these numbers. If you look around in the real world there are probably many more of these personalities around than science claims. Just like Hare has written fairly recently (2007) there are many more psychopaths around in business, in a corporate environment. Most people do not detect such personalities because they have a wrong sense or idea about psychopaths (due to popular films like Silence of the Lambs).
In Babiak and Hare’s book Snakes in Suits: when psychopaths go to work (2007), they explain what exactly these persons are. Although they seem to treat an antisocial personality disorder as being different from a psychopath (again: I and many other psychologists do not agree), they clearly explain that in a ‘normal’ business environment there are relatively many psychopaths around, some more aggressive, some less. Some highly skilled in social communications (though manipulating and lying), some highly charismatic and clever. I like their main message: there are more psychopaths around then you think. So watch out and be careful.
There are many who say or think that an antisocial personality disorder can not be treated. Others may be overly optimistic and state that it actually can be treated. All evidence I have read seems to suggest that the truth lies somewhere in the middle (as it proverbially always is). Yes, there are patients in which the type of brain damage is so serious that with our current knowledge and technical equipment this condition can never be cured. Not in a sense that such a personality will become completely friendly and tame. But this is only true for the extreme antisocial personalities, the type 11 or 12 personalities who have done a lot of extreme harm to other living beings. Luckily, most of these personalities can learn to behave and control themselves so that they can live a life within normal society. However, behavior therapy is a very long and tedious process. Its success depends on how serious brain dysfunctions are in an antisocial personality and how skilled a therapist is. And of course, how intense and frequent the therapy is.
Cognitive behavior therapy is used to alter an antisocial personality, to alter his/her ideas about himself, society and others. Different and more constructive behavioral patterns are taught and practiced to reduce the chances of violent behaviors. Of course, having learned antisocial ideas and behaviors for more than 25 years, change won’t come overnight and easy. Furthermore, it takes years in a restricted environment (usually a jail) to convince a psychopath to change his ideas and behavior freely. However, there are not much options. Either such persons will remain incarcerated for life, as the civilized United States seems to like, or very intense and long attempts for reeducation are tried (as in the civilized Europe). What we do know from research that when such long programs are used, the relapse of someone treated like this for years is much less than for inmates who just got a jail sentence. We know such programs can work. But are we willing to pay the price? In my personal opinion: we should.
One of the very 'fascinating' personality disorders (but also the most destructive) is the antisocial personality disorder. Although science uses a very rough estimate of about 1 to 5% of the normal population, this simply can not be true when you just look around. How much the true incidence really is, is unknown. More important: how can you recognize an antisocial personality? At your work? At home? At school? On this page I have tried to explain the key features of such a personality. Known in public as a ‘psychopath’, Hare and some researchers try to show that a psychopath is something different than an antisocial personality. But he has not convinced me yet. Probably this has a lot to do with the fact that an antisocial personality is a continuum, ranging from slightly violent to extreme violent to others. Nevertheless, such personalities always do harm, to themselves and to others, so they should be adequately detected and treated. We all would benefit when that happened more effectively and efficiently.
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