Understanding Antisocial Personality Disorder


By: Christine Hammond, LMHC

I’m not sure who came up with the name “Antisocial” as this does not even begin to explain the disorder.  It would be like calling an aggressively trained pit bull a puppy who isn’t nice to people.  The former names of psychopath or sociopath are much more understandable names which create a more immediate understanding.  Since APDs (Antisocial Personality Disorder) tend not to care too much about what other people think, I’m guessing that this name is not the result of some political correctness however, it is the name now.

So what is APD?  Here is the technical DSM-V definition:

·      Identity:  Self-esteem derived from personal gain, power, or pleasure

·      Self-direction:  Personal gratification directed with failure to conform to laws or ethics

·      Empathy:  Lack of concern for feelings, needs or suffering of others

·      Intimacy:  Incapacity for intimate relationships

·      Manipulativeness:  Use of subterfuge to control others

·      Deceitfulness:  Dishonesty and fraudulence

·      Callousness:  Lack of remorse about one’s actions, aggression, or sadism

·      Hostility:  Frequent angry feelings, insults, or vengeful behavior

·      Irresponsibility:  Failure to honor financial agreements or promises

·      Impulsivity:  Acting on the spur of the moment without consideration of outcomes

·      Risk taking:  Engagement in dangerous, risky, and potentially self-damaging activities

The practical definition looks more like this:

·      No regard for morality

·      Lies all the time

·      Uses charm to manipulate

·      Sense of superiority

·      Recurring difficulties with all authority

·      Repeatedly violates the rights of others through intimidation

·      Hostility, aggression or violence

·      Lack of empathy or remorse about causing harm

·      Dangerous behaviors

·      Abusive relationships

·      Irresponsible work behavior

·      Failure to learn from the negative consequences

If you are wondering what this looks like in person, imagine Anthony Hopkins in his role as Hannibal in “Silence of the Lambs” or Angelina Jolie in her role as Lisa in “Girl, Interrupted”.  Both of them did an excellent job portraying APD.  Several studies have estimated that anywhere between 50-75% of the prison population has APD. 

So how do you deal with a person who might have APD?  Here are a few suggestions:

·      Because they are gifted liars, don’t believe what they say.  Actions speak louder than words.

·      Don’t waste your time being fake; they can smell a phony a mile away.

·      Be direct, firm and calmly unwavering in your decisions.

·      No emotion, they see this as weakness.

·      Their stories of people they have harmed is an intimidation tactic, show no reaction.

·      They threaten violence when backed into a corner, don’t look away as they can smell fear.

·      Don’t underestimate them; alcohol/drugs can empower and physically strengthen them.

·      Don’t threaten back; it is a waste of time.  If you say, “I’m going to call the police” then do it.

More often than not, counseling is very helpful in learning to deal with a person who has APD.  Relationships with APDs are not easy and often require boundaries with steel reinforcement and a strong support network.  This is not a time to tough it out alone.

 

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