The Often Unmentioned Antisocial Personality Disorder

Brian M. Murray, MS, IMH

Antisocial Personality Disorder (APD) is a mental health condition where a person believes they are special and are entitled to violate the rights of others. They typically have a long-term pattern of lacking boundaries, resulting in manipulation and exploitation of family, friends, co-workers and complete strangers alike. This disorder is commonly mistaken for social phobia or social anxiety, which is a fear of being around other people or out in public places.  APD is not the same as social phobia/anxiety. A person with APD thinks inordinately highly of themselves and believes that they are deserving of special recognition from others, to the point of even being criminal about it.

Like most other personality disorders, they believe the problem is not with them, but with others. They very seldom, if ever, exhibit empathy or compassion for others unless it is to achieve an end result such as getting money or favorable treatment. This is the manipulation. They may come across as charming in an almost narcissistic way, engaging with others until they get what they want and then they go back to their normal behavior. When they don’t get their way, they often scheme to find a way to exploit others for personal profit and pleasure. Once they have what they want, they go right back to being disrespectful and disregarding.

The DSM-IV-TR, i.e. the clinical reference used by mental health clinicians for diagnosing clients, list other traits of APD (this is not an exhaustive list) as:

·         Being deceitful

·         Repeated lying

·         Conning others

·         Impulsivity

·         Irritability

·         Aggressiveness

·         Physical fights or assaults

·         Reckless disregard for the safety of others

·         Failure to plan ahead in life

·         Lack of remorse

·         Rationalizing the pain they have inflicted on others

Rationalizing the pain inflicted on others is a defense mechanism utilized to cast blame on somebody else - not themselves - for their behavior. For someone to be diagnosed with this disorder, they must be at least 18 years old, have had this pattern since they were about 15 years of age and have shown evidence of Conduct Disorder occurring before the 15 years of age marker.

A person who has APD, or any personality disorder, can go for psychotherapy and healing can occur. The prognosis for treatment of APD is long-term and often requires years of committed therapy in order to get favorable results. Because this disorder is a core identity issue, the person must re-learn their identity and how to overcome early life imprinting which indicates whom they have learned to be as a person. Strong defense mechanisms are often in place surrounding this core identity and require a skilled therapist to address the problem that is found there. There is no single marker that points to how personality disorders develop, whether environmental, familial or genetic. It appears that some combination of all factors contribute to the equation.

Sources: DSM-IV-TR (American Psychological Association), National Library of Medicine