March 24, 2026 • 41 mins
In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack some of our difficulties understanding antisocial personality disorder in how it combines psychology, morality, philosophy, and societal judgment. We focus on: where’s the line for disorder; how can we diagnose without judgment; and what does this personality look like when it’s not disordered? We pull from historical examples of antisocial types in specialized roles and also hypothesize that America might have transitioned from a narcissistic nation to an antisocial one.
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Chapters 00:00 Introduction to Antisocial Personality & DSM Problems 02:46 Antisocial Personality Defined in the PDM 07:02 Where’s the Disorder Line? 17:29 Other Dark & Criminal Personalities 21:08 Morality & Antisocial Traits in Specialized Professions 23:37 Are We An Antisocial Society in America? 30:43 Are Antisocials Treatable? 34:37 Holding Empathy & Accountability for Antisocials 40:00 Closing Quote
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(00:00):
Welcome to the Personality Couch podcast,
where we discuss all things personality
and clinical practice.
I'm your host, Doc Bok,
and I'm here with my co-host, Doc Fish.
We are both licensed clinicalpsychologists
and private practice,
and today we are continuing our series
on antisocial personality.
And I have to be honest,
(00:21):
I have really struggled to wrapmy head around this one,
because I'm having to deconstruct
what I've learned in school,
and I have a lot of questions still.
So today is a little bit different vibe.
As I process with Doc Fish,
my questions of what is antisocial?
What does it look like whenit's not disordered?
And how do we diagnose this
(00:43):
without involving judgment and morals?
I am really struggling here,
so let's get to it.
For starters, there are afew main problems
that I think make understandingantisocial personality
really difficult.
So one problem is that the DSM focuses
on overt observable behaviorand criminality,
(01:05):
and ignores the internal workings
of the antisocial personality structures.
Now antisocial behavior
can be a symptom of many differentpersonality types.
Like not all criminals are antisocial,
and not all antisocial are criminals.
Exactly, yep.
So then another problem is just the line
(01:28):
where antisocial personalitiesare actually disordered
versus non-disordered isnowhere near clear.
Definitely not.
Yeah, and then a third problem
is that we do have to venture intothe concept of morals,
which overlaps with philosophyand religion
and not just psychology.
Right, yes, you're touching on the points
(01:49):
that I have personally beenvery confused about,
because it seems like historically,
we took this group of the misfitsand misbehaved
and lumped them all together.
And in history, judgmental labelsincluded things like
moral insanity and constitutionallyinferior.
(02:10):
I mean, come on, right?
I know, so those labels meant
that their psychological makeupwas inferior or abnormal,
which is technically very judgmental.
I believe it was Millon actuallythat noted
the guy who termed moral insanityin the early 1800s
was actually a major advocatefor the position
(02:32):
that those individuals shouldbe socially condemned.
Whoa, like condemning these individuals
based on their personality.
So no, no, not happening.
So then I ask from this very chaotic,judgmental, value
laid in place, like whatis antisocial then?
(02:53):
Like if we take out all the judgmentsand this like
ickiness, like, and we don't focuson criminal behavior,
what is antisocial personality?
Sure, thankfully, I think thePDM2 does a better job
than the DSM in explainingwhat antisocial is.
So I'll go through several key features.
So antisocial is largely thoughtto be deeply psychological,
(03:16):
like showing signs in early youth.
There's some evidence of perhapshaving a more aggressive
temperament in infancy, but definitelya higher threshold
for emotional stimulation.
So they often experience abuse andor traumatic childhoods
and they learn to believe essentiallyeveryone is selfish
(03:37):
or manipulative, dishonorable,and or weak.
So this results in a fear of beingmanipulated by others.
And so they have to manipulate first.
Right.
And then the stems from unconscious envy
and usually it's expressed through rage.
Okay, yeah, I can see that fromwhat I've read too.
(03:58):
And the traumatic childhood pieceis also consistent
with what I've read.
And I've also seen that they tend to have
highly narcissistic parents.
Ooh, okay, that's reallyinteresting because
they can become stuck inprimary narcissism
where they're focused on themselves
and their own satisfaction.
(04:19):
And they don't get that othersare separate from that.
What is primary narcissism?
It's actually somethingwe all go through.
It's developmentally appropriatein infancy.
When as an infant, we're like,oh, we're super powerful.
We're all powerful because I'm hungry
and all of a sudden I get milk.
Ooh.
(04:39):
And we don't understand that momis separate from the self.
It's really psychoanalytic stuff.
Yeah.
But applied to being stuckin that narcissism
as an antisocial, they might think like,
oh, I can do whatever I want
just to make sure that theirself interest is first,
which also means they have to have
(05:00):
all the power and control.
Right, yes.
And then I can see how this mindset
can absolutely lead to runningover people,
running over laws, like really anythingstanding in their way
as they are in pursuit of that control.
Right, the control and power isa way that they protect
(05:20):
and defend themselves.
And they learned it's necessaryfor their survival.
Yeah, I can see that.
Okay, so the PDM does giveus a little bit more
than the DSM does.
It's not focusing on criminal behavior.
And I do still have questionsthough about it,
which we're gonna get to as we go along.
(05:41):
But I do wanna say I can alsosee how this like,
"I can do anything I want"really could lead
to criminal behavior in pursuitof that control,
which I think is why theDSM picks that up.
Yeah.
Sure, I mean, I think it definitely can,
but it also doesn't haveto be pathological.
It could be something like,
(06:02):
well, I'm gonna go start this businessregardless of risk
because like, again, like I'm powerful.
Yeah, yeah.
Or maybe a mindset like this couldguide their pursuit
in politics or law, police, military.
Right, religious leadersof mega churches.
(06:22):
Uh-huh, yeah, so these types,
I can see how they would be drawnto positions of power
where they are presidingover others, right?
So in this temperament,
I can see at maybe a non-pathologicallevel,
maybe all levels, there's at least maybe
a counter-cultural angst in these types
(06:43):
where perhaps they're gonnapush boundaries,
cross boundaries and questionor stand up to authority
and they can be ruthless and reckless.
And I think in general,
these are very assertive, dominanttypes, right?
Yes.
Yeah, yeah, so then my biggest hangup
is that difference between disorderand not disorder.
(07:07):
Like that has to be a thing.
Every personality has disorderand not disorder,
but what does that looklike in this type?
Sure, so like where's the linefor that disorder?
Yeah, exactly. What are your thoughts?
Okay, you're gonna make mego first, aren't you?
So yes, firstly, I used to think
(07:27):
that the line for disordered was the DSM.
But now I don't know because ithas been pretty unhelpful
with this disorder in particular,among others,
but I feel like I just wanna chuckmy DSM out the window
for this one completely.
So I'm struggling, I'm not quite sure.
Right, and I think thatmakes me question,
(07:49):
like how do we even define disorderedin general?
And the DSM is pathology based
and it is like what's normalversus abnormal
because like you've taken abnormalpsych class, right?
Oh, of course, yeah, yeah.
So I don't know where that line is.
Yeah, so to your point, what I thinkyou're saying is like,
(08:11):
if you don't define normal,
how do you contrast abnormal against it?
Like what is a normal personality?
So for antisocial, is criminalbehavior the line
for disorder?
The DSM thinks it is, butI'm not so sure.
Right, because then we have to talk
(08:31):
about the line involvingcriminal behavior,
which involves morality and morality
isn't straightforward at all.
No, so then this brings in the question,
how do we diagnose without judgmentor imposing morals?
Because I mean, there hasto be a line, right?
A line that we can all agree upon.
(08:53):
So maybe it's like, don'tkill people, right?
Like that's not okay.
Well, unless it's your jobin the military.
Okay, so you're playing devil'sadvocate here.
But yes, if you have to do itfor your job, right?
But you can't just randomlygo and hurt people
because you're in a position of power.
(09:14):
Okay, I see what you're saying.
I think that most peoplewould like to say
that the line would be like,you can't destroy.
Okay, and then all the things thatfall under destruction.
Sure.
So the line between pop of color,antisocial personality
versus actual problem in society,
(09:36):
how bad do you think it has to be?
Oh boy, okay.
So we just talked a littlebit about military.
So like, we have special forces
and their purpose is to protect,
but also it's okay for themto do that elsewhere.
But if they come home and harm civilians,
that's controversy, right?
(09:58):
Like not okay.
So then maybe even more severe,
I think of the witch trials, likeSalem Witch Trials,
but witch trials in general,
that crossed over centuries, multipleplaces, countries.
Countries, yeah.
At some point in our society,we were okay with like,
oh, we're just gonna throwthis person in water
(10:18):
and see if they drown.
Right.
Like that was okay.
And that means something abouttheir morality.
Exactly, right.
Another step above that, Imean, we have Hitler,
we have that entire situation.
We can look back, I think, andsay, this is wrong.
But at some point in history,that was okay.
(10:40):
It was okay.
So I think what you're saying is,
there's a societal acceptancethat can happen
with some of these antisocial behaviors.
Like there can be a widespread acceptance
of culturally or in a nation,like that this is okay.
Or at least enough of a following
(11:02):
that it takes the lead, likewith Nazi Germany.
Like there certainly were peoplethat didn't agree
and that were standing up,but as a culture,
that became the forefront.
And that's what we think of,
Hitler with Nazi Germanyand the atrocities
that happened there.
And then with the witch trials,
that was really a folie a deux,
(11:22):
that was a shared delusionthat the people held.
So there wasn't as much challenging there
because they were kind ofof this group think,
this mindset, and maybe there'sthese antisocial pieces
inside of us that theseleaders bring out,
whoever the leaders are, ofactually causing harm
on other people until enough peoplestand up and say,
(11:46):
no, maybe another antisocial usingtheir energy for good.
Like, no, we can't do this toother human beings.
Right, and then that means thatright versus wrong
can't actually be the line.
No, no, but I want it to be.
I want it to be.
Yeah, because also these typescan show up in churches
(12:07):
as pastors and leaders, and especiallymega churches,
the types of characters that are drawn
to those positions of power,
where you have multiple campuses,
hundreds of thousands of attendees,global reach,
the type of person that wouldbe attracted to that
is often going to have a heavydose of narcissism.
(12:28):
It can turn malignant.
You can have these antisocial sentiments,
this "against" energy and withoutaccountability,
that can cause serious harmto a congregation
and to anyone who's kind of tuned in
to what that church is doing,
especially if they havea global platform.
Right. But yeah,
where's the line?
(12:48):
Is that disordered if this personis preaching things
from the pulpit that are horrible
and terrible towards other humans?
Well, I don't think that the linecan be harm to others
because we harm people as a society.
So I think that it might be asocially defined line
(13:09):
and then that changes.
Oh, I don't like that.
But I mean, through history,
the examples that you're giving,
that's what you're saying, right?
Is that like societally, socially,this is what we've done.
Like an antisocial idea or notionor leader is accepted
until they're not, right?
So what a society or systemdeems is okay,
(13:33):
really depends on the zeitgeistof the time, right?
So the social impact of personalityand culture.
I mean, that's been a theme throughoutmultiple series
that we've done here.
Like, yeah, that overlap is significant.
And then I do wanna complicatethis even further.
There's also clinical significance.
(13:55):
But then like who determinesthis and how?
Right, so like what makes it rise
to the clinical threshold?
Like is it interference with workor social life or home?
Like the DSM puts that asthe line, right?
That interference.
But as we know, some antisocialsblend into society
(14:18):
maybe as like white collar gurus, right?
Who push boundaries and maybedo corrupt things
but never get caught, right?
So are they disordered?
Right, and according to the DSM
in a generalized personalitydisorder, right?
Like there has to be distress.
There should be like an impacton work or relationships
(14:39):
or some other area of functioning
which can include harm to self or others.
Now antisocial is a self-orientedpersonality.
And so I do think that the stresscan fall on the other.
Okay, so example is if you'redriving your wife nuts
because you're an antisocial,is it a disorder?
Oh, maybe, maybe, maybe.
(15:00):
Probably not, but.
Another example is like
maybe you can have a whole worldwidetrafficking ring
filled with antisocial billionaires
and they don't get caught becauseof money and connections.
Is that not disorder level?
Like where's the line, right?
Where's the line?
Oh boy, yeah, I don't think we know.
(15:24):
I struggle with that.
Like I'm not okay with that
because this line has to be somewhere
which I think is why thecriminal behavior
has taken such a spotlight forthis disorder in the DSM.
And honestly, I get it, right?
Because that is a clearline, if you will.
But back to my point before, whatif you don't get caught
(15:46):
but you still have criminal intention?
Are you pathologically antisocialat that point?
I mean, yes, but also no
because you're making it work foryou until it doesn't.
So actually this reminds meof J. Edgar Hoover
who was not an antisocial.
(16:06):
Actually, he was a paranoidat disorder level.
Well, but not really because hewas the head of the FBI.
And so he made all of his pathologywork for him
and it was functional.
Right, so he was paranoid.
He's a great example actually, yeah.
So he made it work for him
because he actually had filingcabinets full of dirt
(16:29):
on everyone, like Hollywood, politicians,
and he used it to blackmail them.
But also he could because he wasthe head of the FBI, right?
So he could camouflage into society
but is it not disorder level?
Like even though maybe it'sstill crooked?
I think that maybe the answermight just be
(16:49):
like on a case by case basis.
So then we're back to the judgmentquestion, right?
Like who decides?
There has to be a judgment there.
So maybe a clinician decides withtheir DSM that's imperfect
or society decides.
Like the social world gets todecide who's antisocial
(17:10):
at the disorder level and who's not.
Right, right.
And again, right, the DSM only highlights
the antisocial behaviors.
Yeah.
Which could be part of other personalitystructures too.
Oh, definitely.
Do you have any thoughts on that?
Yeah, so I mean, I'm just thinking
of the different charactersthat get themselves
(17:31):
into trouble or that are drawnto these positions
of power and leadership.
And you can have the antisocial types.
Like I've definitely seenthat as caricatures
or even characters of megachurches in police,
law, politics for sure.
But then you also have individuals
who are just narcissistic, paranoid,like Hoover was.
(17:55):
Like there's so many different flavors.
And as we've been saying, not allcriminals are antisocials
and not all antisocials are criminals.
So and research tells us thatmost antisocials
aren't criminals actually.
So this need for dominancethough and control
like that sentiment can show up
(18:15):
in multiple different personality types.
So I already mentioned like thenarcissistic personality.
You brought up the paranoid,
a great example with Hoover, right?
So there's power and control,
but really it's coming from a placeof fear and paranoia.
And then there's sadistic too.
So sadistic wanting to causeharm on other people.
(18:37):
But what then sets antisocial apart?
I mean, it is a real personalitystructure.
Like it's legit.
I don't have any concerns about that
as I maybe do with some otherpersonalities,
but antisocial go against the grain,like against society.
They're thinking in countercultural ways.
(18:58):
And so then it's like, well,
is society going to acceptit or reject it?
At the non-disordered level,
they may be just countercultural
because of active self-focus.
Right.
So this is going to be differentfrom your
like kind of classic narcissistwho I would argue
is trying to blend in with societyand fit a certain image.
(19:20):
So they will go with the current
that gives them the ego cookies, right?
But then other dark structureslike the paranoid
is more focused on revenge
or taking the pain out on othersbefore they're annihilated.
Right, right.
So they're going to be like attackbefore I'm attacked.
Yeah.
And then we have the sadist,
(19:40):
which isn't in the DSM anymore,but it used to be.
Right.
So sadistic personalitiesare actively focused
on the pain of others.
So not an active self-focus;it's other focus,
but it's on their pain.
So they're going to be upset and cruel.
Right, as the end goal.
That's the means to the end
or that that is the end for them.
(20:01):
That's what they want versus someonewho's antisocial
might be mean and cruel, butit's a means to an end,
and the end being control, right?
But we don't always know whatthe motives are.
We just see the behavior andall of these types
have a healthy or unhealthy, shall I say,
a heaping dose of narcissism, oftenmalignant narcissism.
(20:23):
So you can see that flavor inthese types as well.
And all of these types can engagein criminal behavior,
but they don't have to.
So back to your point thatdifference is really
the core drives and desires,which we may or may not
be privy to based on their behavior.
Yeah, but these dark personalitiesare confusing.
And I actually think we should doa differential diagnosis
(20:47):
section in this series becauseit's really hard
to understand how they're different
because they overlap a lot.
And it's really hard to knowwhat's driving the bus
with this behavior.
Right, like #confusing.
Right.
And also let's definitely lookat those differential
diagnoses one day.
Yes, yes, we'll get there.
We'll get there.
All right, but morality, let's focuson that for a second.
(21:12):
Morally, we technically do needantisocials in society.
We need all of the personalities.
Yeah, exactly.
Just like a Crayola box with allthe different colors.
Like we need all the colors,we need all the hues.
And I'm just thinking of examplesof maybe adaptive
antisocial personalities.
So Navy SEALs, right?
(21:33):
They take risks to defy gravity and water
and do these secret missions.
And then I also think of like secretservice agents, right?
Like they are literally preparedto take a bullet
for the president regardless ofpolitical affiliation.
I mean, like that's defyingthe odds, right?
Yeah, yeah.
(21:54):
So antisocial are going to pushboundaries and laws
and rules of the land and they'regonna ask the questions,
take names, make enemies.
And that kind of makes me think too,
like at one point women couldn't vote.
So sometimes we need personalitiesthat challenge
and push the envelope and do whatnone of us dare to do.
(22:14):
Like this stuff maybe otherpeople are afraid of.
Right, and sometimes theways that the world
is operating do need questionedand need challenged.
And we need brave men and womenwho aren't afraid
to put themselves out there and tokind of lead the charge.
And that reminds me like withthe women's voting,
it reminds me of the movie"Iron Jawed Angels"
(22:37):
which is about women suffragists
and the types that are like Alice Paul
and other really big personalitiesthat were like,
I'm gonna like hunger strike for this.
I believe in this so much thatI'm gonna go against
even basic nourishment to showhow much that I support
and defend women havingthe right to vote.
(22:58):
We need people like that.
But then for me, the line is like,
we need to use this power for good.
Like can we push the envelopefor the greater good
and not for self-focus and control?
Kind of on the other side of the coin,
this type of temperament in leadershipcan also go awry.
Like it can rot and becomepretty damaging
(23:24):
to people and to societies andto our history as well.
Okay, so we do need leaders
because society is set up ina hierarchical way.
And I was actually thinkingthe other day,
maybe we're transitioning
out of a narcissistic society right now.
Ooh, so we've been shining America'sgold plated shit
(23:46):
for a while now.
But everything is broken and we know it.
Yeah.
So in my opinion,
I think that we did elect anantisocial leader.
I actually agree.
Yeah, as I was kind of reading
and really, really trying tounderstand antisocial
(24:08):
that leapt off the page at me too,
is kind of this antisocial sentiment
in our nation in America.
And yeah, absolutely.
We've been polishing a turd
and have always been kindof narcissistic.
And I do think that,
if you look at kind of the behavior
of our leader and leaders,
(24:29):
there's almost this like,
let's take a wrecking ball tothe systems as well.
But okay, so interesting.
I do read historical books for fun.
And one that I read recently is called"State of Confusion."
It's by a political psychologist
who analyzed the American psyche.
And he believes that our behavior now
(24:51):
is a reaction to the trauma of 9/11.
So prior to 9/11,
we were kind of on our ownprotected island.
Like we have a real geographicaladvantage here
in the States.
And outside of Pearl Harborand World War II,
like we hadn't really hada big ego insult
like we did on 9/11.
So he believes a lot of this behaviorand divisiveness,
(25:14):
polarization really came out ofthis unresolved trauma,
especially as a narcissisticnation, right?
We're not gonna address that.
So, but we're a traumatized nation now
and look what this kind of lackof dealing with that hurt
and that ego insult is doing.
That is so fascinating.
I could definitely see that.
(25:35):
And then we also have a paranoidincrease with the pandemic.
And so now malignant narcissismis prominent.
Yeah.
And then I think that makes it hard
to distinguish narcissismfrom antisocial.
Oh, for sure.
There's a ton of overlap withmalignant narcissism,
antisocial, paranoid, all of that.
And the pandemic certainly broughtout kind of an anxiety
(25:59):
in all of us, a fear.
And honestly, I think that wehave elected a leader
in whom I see both,
the malignant narcissism,paranoid elements,
definitely antisocial behavior.
And as I was reading aboutthe antisocial,
as I said before, the politicalmood of the times
really came to light for me,
(26:20):
that we are living in times ofantisocial leadership.
Yeah.
Sure.
So Michael Stone's continuum ofnegative personalities
does put antisocial as worse thanmalignant narcissism,
but it also means that malignantnarcissism
is part of antisocial.
Exactly.
So the core is different though.
And I do think our current leaderis not about image,
(26:44):
but is definitely aboutpower and dominance.
So regardless of politics,
regardless of all of that,what your view is,
like putting your name on everything,
technically is narcissistic.
Yeah, yeah.
But is it about image
or is it about power and dominance
and owning and conquering everything?
(27:06):
Yeah, oh that's a good point.
Yeah, or there could be an image element,
but maybe it's secondary tothe power and control.
Yeah.
So I'm also thinking like, adog on a fire hydrant,
they mark their territory, right?
Yeah.
Like some of that behavior.
(laughing) Yes, oh my goodness.
So yes, we do need antisocials in society.
(27:28):
However, we do not necessarily need
pathological antisocial behaviorin society.
No, no.
So we need antisocials to better society,but not destroy it.
So then I come back to, how can weuse this power for good?
(27:48):
Right, well, so they're alsogoing to destroy things
as they try to better it.
They are bulldozers essentially, right?
They're going to bulldoze the systems
and the norms and the rules.
And then, so like that goes back to the,
is this good or bad question?
Like morality, we don't haveclear lines anywhere.
(28:10):
It actually reminds me ofTimothy McVeigh.
He was in combat and he came backand he was essentially like,
murder in war is no differentthan murder at home.
But then he blew up a whole buildingwith people in it
with the Oklahoma City bombings.
So that's not acceptable.
(28:31):
Right, right.
But yeah, destroying thingsto make it better.
I want to go back to what you said there
because it actually made me think of
a consultation that I had with a retired
secret service agent.
And she probably was an antisocialstructure,
seemingly not at, I don't know,
I'm not going to get into disorderand not disorder.
(28:53):
But the gist that I got ofthe meeting was like
kind of tearing me down beforeshe built me back up
it was a very interesting energy.
But it wasn't destructivein the sense of like
hurting me per se,
but the energy was definitely aforce to be reckoned with.
But at the same time,
(29:14):
this individual really seemedto want to help,
but like about blew my wigoff in the process.
I don't wear a wig.
That's the point.
Oh my gosh.
But it's this energy, big energy, right?
So they can totally come in and bulldoze
in order to build back up.
(29:34):
Like they are so intense.
Now, sometimes it's super necessary,
especially when there's crises,like they get things done.
Others may not like the process.
They may like what happens afterthere's the bulldozing
and all of that stuff.
But at the very foundation,like they do act.
Yeah, they're movers and shakersfor better or for worse.
(29:58):
And sometimes we need to be shaken up
and sometimes we don't.
So yeah, so this is where I come back to
like using power for good.
Like for me, it's, I have a clearline of don't hurt people.
No, like, but I also recognizeyour point earlier
where it's like, but whatif it's your job?
(30:19):
Like this morality, psychology,
like my brain is just, it's toomuch scrambled eggs.
Right, because unfortunately,
I think that feels like anidealistic line.
That would make sense.
Yeah, I do have an idealist personality,so that fits.
That's okay, that's okay.
(30:40):
But here's another line to think about.
Where's the line with treatability?
Geez, yeah, that's one I've beenthinking about too,
as I'm learning more about antisocial.
And this is another complicated one.
There is a stereotype that likein general as a class,
antisocials are not treatable.
But that ignores severity andindividual differences.
(31:05):
Yeah, I was taught that in my personalitytraining, yeah.
Wow, well, I was thinkingin McWilliams book,
she quotes Malloy's ideathat the stereotype
is actually a vindictivedynamic in society
where, "moral judgment impinges
on professional assessment."
Ooh.
Well, why?
(31:25):
Because antisocial is writeoff others' needs.
And so we just like write offthe antisocials needs.
Yeah, so our judgment of antisocial
recreates their original trauma
and furthers the dynamic thatmakes them who they are
because we don't give them a chance.
I think you're on to something there.
(31:47):
Now, little tangent, like subtopic.
Where would the line be betweenlike empathy
and accountability then?
Yeah, that's also been a burningquestion for me
during this series.
So I am going to self-disclose.
I am an Enneagram One.
So I see things in blackand white by nature,
tend to be more idealistic.
(32:07):
And I have a strong moral compass
and sense of right or wrong.
So having such a gray area,
like a gray personality disorder
that kind of butts up against morality
has been very, very challenging
because my scaffolding feelslike it's gone in this.
Like my educational scaffolding
is like out the window with this type.
(32:28):
Can't use the DSM.
Well, you can, but witha grain of salt,
with other, you have to thinkabout it a little more.
But yeah, not just with that,
but like it's kind of buttingup against my sense
of right and wrong.
Like where's my line?
What do I believe?
So this personality runs that line
of both right and wrong.
And it's like, it's not my placeto judge until it is.
(32:52):
And then my brain just explodesand I stop
and it's too much.
The dissonance here is reallysubstantial for me.
Yeah.
Yeah.
And one of the things that cliniciansdo need to face
and make peace with when workingwith antisocials
is their own antisocialness,
which is super hard for some personalities.
(33:13):
I think I would be one of those.
So you're telling me I need tolean into my darkness
a little more?
Perhaps.
No more talk of darkness
Just kidding.
Fun fact, fun fact.
I think Phantom of the Opera,
I think he, Phantom was actuallya paranoid,
(33:35):
hiding behind his mask with maybesome of the erotomania
with being obsessed with Christine.
Anyway, now I'm deflecting withsongs and musicals, but-
That's hilarious.
Yes.
Yeah, I think that's interesting,
but that's not the point of this.
The point is for me to getin touch with my,
let my darker side get in.
Yeah, it's like we're talkingabout darkness.
(33:56):
So you're just bringing in the sunshine.
Well, remember that one episode
where we discussed the blinds metaphor,
because your blinds are so openand sunny and expressive.
And so I do imagine it's harderto close the blinds
and sit with the darker stuff.
Oh, definitely.
Yeah, I don't like going intothe basement of my mind
(34:17):
unless I have to, thank you very much.
And this episode has beenreally challenging
to sit with some of these questions.
This series has really,
so I feel like I have cobwebsall over me,
which is why I brought in Phantomof the Opera.
That's so funny.
(laughing) So how do we talk aboutthe antisocial personality
(34:40):
with empathy for both the victims, right?
Because antisocial can doa lot of damage too,
but how do we hold empathyfor the victims
and also the antisocials?
Like that feels very uncomfortable.
So my colleague who is notafraid of darkness,
help me out here.
Sure, well, come join me in the basement.
(35:02):
Into the cellar I go!
Oh my gosh, okay.
So multiple things can exist.
So psychological and emotionalpain is valid
regardless of whatever behaviorcomes out of it.
So I like to simplify things
by thinking about children's behaviors.
And I think we're all walkingchildren anyway,
(35:23):
but one child will stub their toe
and they're gonna melt down.
They're gonna seek comfortfrom their mama.
Then another one over herewill stub their toe
and they're gonna punch the walland they're gonna scream.
And then maybe write their name
on the said wall that hurt them.
Oh no, we went there, yep.
(laughing)
So they both hurt their toeand that's valid,
(35:47):
but behaviorally it's not okay tobe destructive in pain.
Right, so that's true.
Yeah, so the origins are valid,the pain is valid,
but the behavior that stems from it
is where there needs tobe accountability.
So I can have empathy for the abuse
that often contributes to thepsyche of antisocial.
(36:07):
And I also have a moral compass
and can say, "Uh-uh, don'tcross this line.
You cannot destroy."
In whatever form that means,
like killing, tearing apart,abusing others,
flagrant disregard for othersor the laws of the land.
Sure, that's actually one ofmy therapy boundaries
that I address in intake isyou can talk about
and process anything, but youcan't knock over a lamp.
(36:32):
Or as a mom, I can say, "Well,you can be angry,
that's totally fine, you can't hit me."
Right, that's a great way to put it.
Yeah, and this is where I actually think
back to the original question,is it treatable?
I think institutions, while imperfect,
do offer a better chance for success
(36:52):
for antisocials in treatment
because those boundaries are fortified
within the structure or hierarchyof the system.
So the boundaries are baked in
to the inpatient or prisonsystem, for example.
So if you try anything,
consequences will be swift and immediate
because the structure helpskeep them in place.
(37:14):
Exactly.
Yeah, but in contrast, treatmentwith antisocials
in a little private practice mayprove more challenging,
especially if we're talkingdisorder level here.
So let's think about it.
Antisocials have frequent contractviolations.
The therapeutic relationshipis a contract.
Like we have rules and policiesthat we follow
(37:35):
and you get treatment within this frame.
However, there's nothing fortifying
those boundaries externally.
So what would keep an antisocial
from stiffing you on the bill,taking you to court
or pursuing a license board complaint
to have the final power play?
Ooh, even if it's suicide, becausethat does happen
(37:56):
sometimes as in like theend power is mine.
Oh my goodness.
I've read that.
That is dark.
Yeah.
So it is risky treating moresevere antisocials
in an outpatient setting,
especially without major reinforcedboundaries.
And I would say honestly, youraverage private practice,
(38:18):
just based on the structure of it alone
is typically not gonna be adequate.
And then further, most of usaren't cut out for it.
Like I don't think most of us who'vegone into this field
have the tools or the backbone, honestly.
I agree.
Treatment does need to be incorruptible.
(38:39):
Like boundaries cannot be bent, ever.
Bending or breaking boundaries,even in empathy
or maybe especially in empathywill be seen as weakness.
Yes.
Because empathy is not understood
by disordered antisocials.
And then as providers,
this goes against our empathetic,helpful nature.
(39:00):
Yeah.
And in a lot of ways,
I think your stereotypical therapistis the opposite
of an antisocial, which can backfire.
Sure.
Now as a schizoid, I candetach from empathy
and not show it at all.
Like, I keep my internal empathyfor the antisocial,
but like it's mine.
They don't care.
And I'm not gonna let them see it.
(39:22):
But I do think a lot of therapistshave a rescuer desire
because they wanna help.
So it's really hard.
Right.
Yeah. And I think some will go in
not really realizing what they'regetting themselves into
and maybe lean too heavilyinto the empathy
and empathize with them.
And then that empathy getsturned on its head
(39:43):
and they are exploited forthe last power play.
Like that can be a reallydangerous dynamic.
So, but yeah, the bottomline here is that
some antisocials can make progress.
Some antisocials can make progress.
Well, I'm gonna leave us with a quote
from a Danish psychiatrist, GeorgeSturup in 1951.
(40:09):
He says, "Don't forget these people.
They have no one and they are people.
They are desperately lackingin terrible pain.
Those who understand this are so rare.
You must not turn their back on them."
Mm, that is powerful.
Yeah. Wow.
Okay. So to recap today,
(40:30):
other than like antisocial are toughfor me to understand,
we know that, right?
Like I feel like everythingI've been taught
about them is wrong.
But with that, I think we all have to get
a little bit more comfortablewith the darkness
that's inside of all of us
to be able to sit with these types.
And honestly, that's not my strongsuit, but I'm trying.
(40:52):
We've all got our boundaries, Doc Bok.
Yeah, yeah, we do.
We do, and limitations.
So anyway, if you're interestedin learning more,
we also have blogs, visuals,and references
that coincide with each episode
at www.personalitycouch.com.
And if you're a provider lookingto consult about a case,
or if you're in need of psychodynamictherapy
(41:13):
or a deep dive psychological evaluation
that's not forensic in nature,
our private practice, Quest Psych,can help with that.
I'll provide a link in the show notes.
But for now, I am closingthis dark chapter
and will reopen it in two weeks.
Be well, be kind, and we'llsee you next time
on the Personality Couch.
(41:36):
This podcast is for informationalpurposes only
and does not constitute a professionalrelationship.
If you're in need of professional help,
please seek out appropriate resourcesin your area.
Information about clinicaltrends or diagnoses
are discussed in broad anduniversal terms
and do not refer to any specificperson or case.
Welcome to the Personality Couch podcast,
where we discuss all things personality
and clinical practice.
I'm your host, Doc Bok,
and I'm here with my co-host, Doc Fish.
We are both licensed clinicalpsychologists
and private practice,
and today we are continuing our series
on antisocial personality.
And I have to be honest,
(00:21):
I have really struggled to wrapmy head around this one,
because I'm having to deconstruct
what I've learned in school,
and I have a lot of questions still.
So today is a little bit different vibe.
As I process with Doc Fish,
my questions of what is antisocial?
What does it look like whenit's not disordered?
And how do we diagnose this
(00:43):
without involving judgment and morals?
I am really struggling here,
so let's get to it.
For starters, there are afew main problems
that I think make understandingantisocial personality
really difficult.
So one problem is that the DSM focuses
on overt observable behaviorand criminality,
(01:05):
and ignores the internal workings
of the antisocial personality structures.
Now antisocial behavior
can be a symptom of many differentpersonality types.
Like not all criminals are antisocial,
and not all antisocial are criminals.
Exactly, yep.
So then another problem is just the line
(01:28):
where antisocial personalitiesare actually disordered
versus non-disordered isnowhere near clear.
Definitely not.
Yeah, and then a third problem
is that we do have to venture intothe concept of morals,
which overlaps with philosophyand religion
and not just psychology.
Right, yes, you're touching on the points
(01:49):
that I have personally beenvery confused about,
because it seems like historically,
we took this group of the misfitsand misbehaved
and lumped them all together.
And in history, judgmental labelsincluded things like
moral insanity and constitutionallyinferior.
(02:10):
I mean, come on, right?
I know, so those labels meant
that their psychological makeupwas inferior or abnormal,
which is technically very judgmental.
I believe it was Millon actuallythat noted
the guy who termed moral insanityin the early 1800s
was actually a major advocatefor the position
(02:32):
that those individuals shouldbe socially condemned.
Whoa, like condemning these individuals
based on their personality.
So no, no, not happening.
So then I ask from this very chaotic,judgmental, value
laid in place, like whatis antisocial then?
(02:53):
Like if we take out all the judgmentsand this like
ickiness, like, and we don't focuson criminal behavior,
what is antisocial personality?
Sure, thankfully, I think thePDM2 does a better job
than the DSM in explainingwhat antisocial is.
So I'll go through several key features.
So antisocial is largely thoughtto be deeply psychological,
(03:16):
like showing signs in early youth.
There's some evidence of perhapshaving a more aggressive
temperament in infancy, but definitelya higher threshold
for emotional stimulation.
So they often experience abuse andor traumatic childhoods
and they learn to believe essentiallyeveryone is selfish
(03:37):
or manipulative, dishonorable,and or weak.
So this results in a fear of beingmanipulated by others.
And so they have to manipulate first.
Right.
And then the stems from unconscious envy
and usually it's expressed through rage.
Okay, yeah, I can see that fromwhat I've read too.
(03:58):
And the traumatic childhood pieceis also consistent
with what I've read.
And I've also seen that they tend to have
highly narcissistic parents.
Ooh, okay, that's reallyinteresting because
they can become stuck inprimary narcissism
where they're focused on themselves
and their own satisfaction.
(04:19):
And they don't get that othersare separate from that.
What is primary narcissism?
It's actually somethingwe all go through.
It's developmentally appropriatein infancy.
When as an infant, we're like,oh, we're super powerful.
We're all powerful because I'm hungry
and all of a sudden I get milk.
Ooh.
(04:39):
And we don't understand that momis separate from the self.
It's really psychoanalytic stuff.
Yeah.
But applied to being stuckin that narcissism
as an antisocial, they might think like,
oh, I can do whatever I want
just to make sure that theirself interest is first,
which also means they have to have
(05:00):
all the power and control.
Right, yes.
And then I can see how this mindset
can absolutely lead to runningover people,
running over laws, like really anythingstanding in their way
as they are in pursuit of that control.
Right, the control and power isa way that they protect
(05:20):
and defend themselves.
And they learned it's necessaryfor their survival.
Yeah, I can see that.
Okay, so the PDM does giveus a little bit more
than the DSM does.
It's not focusing on criminal behavior.
And I do still have questionsthough about it,
which we're gonna get to as we go along.
(05:41):
But I do wanna say I can alsosee how this like,
"I can do anything I want"really could lead
to criminal behavior in pursuitof that control,
which I think is why theDSM picks that up.
Yeah.
Sure, I mean, I think it definitely can,
but it also doesn't haveto be pathological.
It could be something like,
(06:02):
well, I'm gonna go start this businessregardless of risk
because like, again, like I'm powerful.
Yeah, yeah.
Or maybe a mindset like this couldguide their pursuit
in politics or law, police, military.
Right, religious leadersof mega churches.
(06:22):
Uh-huh, yeah, so these types,
I can see how they would be drawnto positions of power
where they are presidingover others, right?
So in this temperament,
I can see at maybe a non-pathologicallevel,
maybe all levels, there's at least maybe
a counter-cultural angst in these types
(06:43):
where perhaps they're gonnapush boundaries,
cross boundaries and questionor stand up to authority
and they can be ruthless and reckless.
And I think in general,
these are very assertive, dominanttypes, right?
Yes.
Yeah, yeah, so then my biggest hangup
is that difference between disorderand not disorder.
(07:07):
Like that has to be a thing.
Every personality has disorderand not disorder,
but what does that looklike in this type?
Sure, so like where's the linefor that disorder?
Yeah, exactly. What are your thoughts?
Okay, you're gonna make mego first, aren't you?
So yes, firstly, I used to think
(07:27):
that the line for disordered was the DSM.
But now I don't know because ithas been pretty unhelpful
with this disorder in particular,among others,
but I feel like I just wanna chuckmy DSM out the window
for this one completely.
So I'm struggling, I'm not quite sure.
Right, and I think thatmakes me question,
(07:49):
like how do we even define disorderedin general?
And the DSM is pathology based
and it is like what's normalversus abnormal
because like you've taken abnormalpsych class, right?
Oh, of course, yeah, yeah.
So I don't know where that line is.
Yeah, so to your point, what I thinkyou're saying is like,
(08:11):
if you don't define normal,
how do you contrast abnormal against it?
Like what is a normal personality?
So for antisocial, is criminalbehavior the line
for disorder?
The DSM thinks it is, butI'm not so sure.
Right, because then we have to talk
(08:31):
about the line involvingcriminal behavior,
which involves morality and morality
isn't straightforward at all.
No, so then this brings in the question,
how do we diagnose without judgmentor imposing morals?
Because I mean, there hasto be a line, right?
A line that we can all agree upon.
(08:53):
So maybe it's like, don'tkill people, right?
Like that's not okay.
Well, unless it's your jobin the military.
Okay, so you're playing devil'sadvocate here.
But yes, if you have to do itfor your job, right?
But you can't just randomlygo and hurt people
because you're in a position of power.
(09:14):
Okay, I see what you're saying.
I think that most peoplewould like to say
that the line would be like,you can't destroy.
Okay, and then all the things thatfall under destruction.
Sure.
So the line between pop of color,antisocial personality
versus actual problem in society,
(09:36):
how bad do you think it has to be?
Oh boy, okay.
So we just talked a littlebit about military.
So like, we have special forces
and their purpose is to protect,
but also it's okay for themto do that elsewhere.
But if they come home and harm civilians,
that's controversy, right?
(09:58):
Like not okay.
So then maybe even more severe,
I think of the witch trials, likeSalem Witch Trials,
but witch trials in general,
that crossed over centuries, multipleplaces, countries.
Countries, yeah.
At some point in our society,we were okay with like,
oh, we're just gonna throwthis person in water
(10:18):
and see if they drown.
Right.
Like that was okay.
And that means something abouttheir morality.
Exactly, right.
Another step above that, Imean, we have Hitler,
we have that entire situation.
We can look back, I think, andsay, this is wrong.
But at some point in history,that was okay.
(10:40):
It was okay.
So I think what you're saying is,
there's a societal acceptancethat can happen
with some of these antisocial behaviors.
Like there can be a widespread acceptance
of culturally or in a nation,like that this is okay.
Or at least enough of a following
(11:02):
that it takes the lead, likewith Nazi Germany.
Like there certainly were peoplethat didn't agree
and that were standing up,but as a culture,
that became the forefront.
And that's what we think of,
Hitler with Nazi Germanyand the atrocities
that happened there.
And then with the witch trials,
that was really a folie a deux,
(11:22):
that was a shared delusionthat the people held.
So there wasn't as much challenging there
because they were kind ofof this group think,
this mindset, and maybe there'sthese antisocial pieces
inside of us that theseleaders bring out,
whoever the leaders are, ofactually causing harm
on other people until enough peoplestand up and say,
(11:46):
no, maybe another antisocial usingtheir energy for good.
Like, no, we can't do this toother human beings.
Right, and then that means thatright versus wrong
can't actually be the line.
No, no, but I want it to be.
I want it to be.
Yeah, because also these typescan show up in churches
(12:07):
as pastors and leaders, and especiallymega churches,
the types of characters that are drawn
to those positions of power,
where you have multiple campuses,
hundreds of thousands of attendees,global reach,
the type of person that wouldbe attracted to that
is often going to have a heavydose of narcissism.
(12:28):
It can turn malignant.
You can have these antisocial sentiments,
this "against" energy and withoutaccountability,
that can cause serious harmto a congregation
and to anyone who's kind of tuned in
to what that church is doing,
especially if they havea global platform.
Right. But yeah,
where's the line?
(12:48):
Is that disordered if this personis preaching things
from the pulpit that are horrible
and terrible towards other humans?
Well, I don't think that the linecan be harm to others
because we harm people as a society.
So I think that it might be asocially defined line
(13:09):
and then that changes.
Oh, I don't like that.
But I mean, through history,
the examples that you're giving,
that's what you're saying, right?
Is that like societally, socially,this is what we've done.
Like an antisocial idea or notionor leader is accepted
until they're not, right?
So what a society or systemdeems is okay,
(13:33):
really depends on the zeitgeistof the time, right?
So the social impact of personalityand culture.
I mean, that's been a theme throughoutmultiple series
that we've done here.
Like, yeah, that overlap is significant.
And then I do wanna complicatethis even further.
There's also clinical significance.
(13:55):
But then like who determinesthis and how?
Right, so like what makes it rise
to the clinical threshold?
Like is it interference with workor social life or home?
Like the DSM puts that asthe line, right?
That interference.
But as we know, some antisocialsblend into society
(14:18):
maybe as like white collar gurus, right?
Who push boundaries and maybedo corrupt things
but never get caught, right?
So are they disordered?
Right, and according to the DSM
in a generalized personalitydisorder, right?
Like there has to be distress.
There should be like an impacton work or relationships
(14:39):
or some other area of functioning
which can include harm to self or others.
Now antisocial is a self-orientedpersonality.
And so I do think that the stresscan fall on the other.
Okay, so example is if you'redriving your wife nuts
because you're an antisocial,is it a disorder?
Oh, maybe, maybe, maybe.
(15:00):
Probably not, but.
Another example is like
maybe you can have a whole worldwidetrafficking ring
filled with antisocial billionaires
and they don't get caught becauseof money and connections.
Is that not disorder level?
Like where's the line, right?
Where's the line?
Oh boy, yeah, I don't think we know.
(15:24):
I struggle with that.
Like I'm not okay with that
because this line has to be somewhere
which I think is why thecriminal behavior
has taken such a spotlight forthis disorder in the DSM.
And honestly, I get it, right?
Because that is a clearline, if you will.
But back to my point before, whatif you don't get caught
(15:46):
but you still have criminal intention?
Are you pathologically antisocialat that point?
I mean, yes, but also no
because you're making it work foryou until it doesn't.
So actually this reminds meof J. Edgar Hoover
who was not an antisocial.
(16:06):
Actually, he was a paranoidat disorder level.
Well, but not really because hewas the head of the FBI.
And so he made all of his pathologywork for him
and it was functional.
Right, so he was paranoid.
He's a great example actually, yeah.
So he made it work for him
because he actually had filingcabinets full of dirt
(16:29):
on everyone, like Hollywood, politicians,
and he used it to blackmail them.
But also he could because he wasthe head of the FBI, right?
So he could camouflage into society
but is it not disorder level?
Like even though maybe it'sstill crooked?
I think that maybe the answermight just be
(16:49):
like on a case by case basis.
So then we're back to the judgmentquestion, right?
Like who decides?
There has to be a judgment there.
So maybe a clinician decides withtheir DSM that's imperfect
or society decides.
Like the social world gets todecide who's antisocial
(17:10):
at the disorder level and who's not.
Right, right.
And again, right, the DSM only highlights
the antisocial behaviors.
Yeah.
Which could be part of other personalitystructures too.
Oh, definitely.
Do you have any thoughts on that?
Yeah, so I mean, I'm just thinking
of the different charactersthat get themselves
(17:31):
into trouble or that are drawnto these positions
of power and leadership.
And you can have the antisocial types.
Like I've definitely seenthat as caricatures
or even characters of megachurches in police,
law, politics for sure.
But then you also have individuals
who are just narcissistic, paranoid,like Hoover was.
(17:55):
Like there's so many different flavors.
And as we've been saying, not allcriminals are antisocials
and not all antisocials are criminals.
So and research tells us thatmost antisocials
aren't criminals actually.
So this need for dominancethough and control
like that sentiment can show up
(18:15):
in multiple different personality types.
So I already mentioned like thenarcissistic personality.
You brought up the paranoid,
a great example with Hoover, right?
So there's power and control,
but really it's coming from a placeof fear and paranoia.
And then there's sadistic too.
So sadistic wanting to causeharm on other people.
(18:37):
But what then sets antisocial apart?
I mean, it is a real personalitystructure.
Like it's legit.
I don't have any concerns about that
as I maybe do with some otherpersonalities,
but antisocial go against the grain,like against society.
They're thinking in countercultural ways.
(18:58):
And so then it's like, well,
is society going to acceptit or reject it?
At the non-disordered level,
they may be just countercultural
because of active self-focus.
Right.
So this is going to be differentfrom your
like kind of classic narcissistwho I would argue
is trying to blend in with societyand fit a certain image.
(19:20):
So they will go with the current
that gives them the ego cookies, right?
But then other dark structureslike the paranoid
is more focused on revenge
or taking the pain out on othersbefore they're annihilated.
Right, right.
So they're going to be like attackbefore I'm attacked.
Yeah.
And then we have the sadist,
(19:40):
which isn't in the DSM anymore,but it used to be.
Right.
So sadistic personalitiesare actively focused
on the pain of others.
So not an active self-focus;it's other focus,
but it's on their pain.
So they're going to be upset and cruel.
Right, as the end goal.
That's the means to the end
or that that is the end for them.
(20:01):
That's what they want versus someonewho's antisocial
might be mean and cruel, butit's a means to an end,
and the end being control, right?
But we don't always know whatthe motives are.
We just see the behavior andall of these types
have a healthy or unhealthy, shall I say,
a heaping dose of narcissism, oftenmalignant narcissism.
(20:23):
So you can see that flavor inthese types as well.
And all of these types can engagein criminal behavior,
but they don't have to.
So back to your point thatdifference is really
the core drives and desires,which we may or may not
be privy to based on their behavior.
Yeah, but these dark personalitiesare confusing.
And I actually think we should doa differential diagnosis
(20:47):
section in this series becauseit's really hard
to understand how they're different
because they overlap a lot.
And it's really hard to knowwhat's driving the bus
with this behavior.
Right, like #confusing.
Right.
And also let's definitely lookat those differential
diagnoses one day.
Yes, yes, we'll get there.
We'll get there.
All right, but morality, let's focuson that for a second.
(21:12):
Morally, we technically do needantisocials in society.
We need all of the personalities.
Yeah, exactly.
Just like a Crayola box with allthe different colors.
Like we need all the colors,we need all the hues.
And I'm just thinking of examplesof maybe adaptive
antisocial personalities.
So Navy SEALs, right?
(21:33):
They take risks to defy gravity and water
and do these secret missions.
And then I also think of like secretservice agents, right?
Like they are literally preparedto take a bullet
for the president regardless ofpolitical affiliation.
I mean, like that's defyingthe odds, right?
Yeah, yeah.
(21:54):
So antisocial are going to pushboundaries and laws
and rules of the land and they'regonna ask the questions,
take names, make enemies.
And that kind of makes me think too,
like at one point women couldn't vote.
So sometimes we need personalitiesthat challenge
and push the envelope and do whatnone of us dare to do.
(22:14):
Like this stuff maybe otherpeople are afraid of.
Right, and sometimes theways that the world
is operating do need questionedand need challenged.
And we need brave men and womenwho aren't afraid
to put themselves out there and tokind of lead the charge.
And that reminds me like withthe women's voting,
it reminds me of the movie"Iron Jawed Angels"
(22:37):
which is about women suffragists
and the types that are like Alice Paul
and other really big personalitiesthat were like,
I'm gonna like hunger strike for this.
I believe in this so much thatI'm gonna go against
even basic nourishment to showhow much that I support
and defend women havingthe right to vote.
(22:58):
We need people like that.
But then for me, the line is like,
we need to use this power for good.
Like can we push the envelopefor the greater good
and not for self-focus and control?
Kind of on the other side of the coin,
this type of temperament in leadershipcan also go awry.
Like it can rot and becomepretty damaging
(23:24):
to people and to societies andto our history as well.
Okay, so we do need leaders
because society is set up ina hierarchical way.
And I was actually thinkingthe other day,
maybe we're transitioning
out of a narcissistic society right now.
Ooh, so we've been shining America'sgold plated shit
(23:46):
for a while now.
But everything is broken and we know it.
Yeah.
So in my opinion,
I think that we did elect anantisocial leader.
I actually agree.
Yeah, as I was kind of reading
and really, really trying tounderstand antisocial
(24:08):
that leapt off the page at me too,
is kind of this antisocial sentiment
in our nation in America.
And yeah, absolutely.
We've been polishing a turd
and have always been kindof narcissistic.
And I do think that,
if you look at kind of the behavior
of our leader and leaders,
(24:29):
there's almost this like,
let's take a wrecking ball tothe systems as well.
But okay, so interesting.
I do read historical books for fun.
And one that I read recently is called"State of Confusion."
It's by a political psychologist
who analyzed the American psyche.
And he believes that our behavior now
(24:51):
is a reaction to the trauma of 9/11.
So prior to 9/11,
we were kind of on our ownprotected island.
Like we have a real geographicaladvantage here
in the States.
And outside of Pearl Harborand World War II,
like we hadn't really hada big ego insult
like we did on 9/11.
So he believes a lot of this behaviorand divisiveness,
(25:14):
polarization really came out ofthis unresolved trauma,
especially as a narcissisticnation, right?
We're not gonna address that.
So, but we're a traumatized nation now
and look what this kind of lackof dealing with that hurt
and that ego insult is doing.
That is so fascinating.
I could definitely see that.
(25:35):
And then we also have a paranoidincrease with the pandemic.
And so now malignant narcissismis prominent.
Yeah.
And then I think that makes it hard
to distinguish narcissismfrom antisocial.
Oh, for sure.
There's a ton of overlap withmalignant narcissism,
antisocial, paranoid, all of that.
And the pandemic certainly broughtout kind of an anxiety
(25:59):
in all of us, a fear.
And honestly, I think that wehave elected a leader
in whom I see both,
the malignant narcissism,paranoid elements,
definitely antisocial behavior.
And as I was reading aboutthe antisocial,
as I said before, the politicalmood of the times
really came to light for me,
(26:20):
that we are living in times ofantisocial leadership.
Yeah.
Sure.
So Michael Stone's continuum ofnegative personalities
does put antisocial as worse thanmalignant narcissism,
but it also means that malignantnarcissism
is part of antisocial.
Exactly.
So the core is different though.
And I do think our current leaderis not about image,
(26:44):
but is definitely aboutpower and dominance.
So regardless of politics,
regardless of all of that,what your view is,
like putting your name on everything,
technically is narcissistic.
Yeah, yeah.
But is it about image
or is it about power and dominance
and owning and conquering everything?
(27:06):
Yeah, oh that's a good point.
Yeah, or there could be an image element,
but maybe it's secondary tothe power and control.
Yeah.
So I'm also thinking like, adog on a fire hydrant,
they mark their territory, right?
Yeah.
Like some of that behavior.
(laughing) Yes, oh my goodness.
So yes, we do need antisocials in society.
(27:28):
However, we do not necessarily need
pathological antisocial behaviorin society.
No, no.
So we need antisocials to better society,but not destroy it.
So then I come back to, how can weuse this power for good?
(27:48):
Right, well, so they're alsogoing to destroy things
as they try to better it.
They are bulldozers essentially, right?
They're going to bulldoze the systems
and the norms and the rules.
And then, so like that goes back to the,
is this good or bad question?
Like morality, we don't haveclear lines anywhere.
(28:10):
It actually reminds me ofTimothy McVeigh.
He was in combat and he came backand he was essentially like,
murder in war is no differentthan murder at home.
But then he blew up a whole buildingwith people in it
with the Oklahoma City bombings.
So that's not acceptable.
(28:31):
Right, right.
But yeah, destroying thingsto make it better.
I want to go back to what you said there
because it actually made me think of
a consultation that I had with a retired
secret service agent.
And she probably was an antisocialstructure,
seemingly not at, I don't know,
I'm not going to get into disorderand not disorder.
(28:53):
But the gist that I got ofthe meeting was like
kind of tearing me down beforeshe built me back up
it was a very interesting energy.
But it wasn't destructivein the sense of like
hurting me per se,
but the energy was definitely aforce to be reckoned with.
But at the same time,
(29:14):
this individual really seemedto want to help,
but like about blew my wigoff in the process.
I don't wear a wig.
That's the point.
Oh my gosh.
But it's this energy, big energy, right?
So they can totally come in and bulldoze
in order to build back up.
(29:34):
Like they are so intense.
Now, sometimes it's super necessary,
especially when there's crises,like they get things done.
Others may not like the process.
They may like what happens afterthere's the bulldozing
and all of that stuff.
But at the very foundation,like they do act.
Yeah, they're movers and shakersfor better or for worse.
(29:58):
And sometimes we need to be shaken up
and sometimes we don't.
So yeah, so this is where I come back to
like using power for good.
Like for me, it's, I have a clearline of don't hurt people.
No, like, but I also recognizeyour point earlier
where it's like, but whatif it's your job?
(30:19):
Like this morality, psychology,
like my brain is just, it's toomuch scrambled eggs.
Right, because unfortunately,
I think that feels like anidealistic line.
That would make sense.
Yeah, I do have an idealist personality,so that fits.
That's okay, that's okay.
(30:40):
But here's another line to think about.
Where's the line with treatability?
Geez, yeah, that's one I've beenthinking about too,
as I'm learning more about antisocial.
And this is another complicated one.
There is a stereotype that likein general as a class,
antisocials are not treatable.
But that ignores severity andindividual differences.
(31:05):
Yeah, I was taught that in my personalitytraining, yeah.
Wow, well, I was thinkingin McWilliams book,
she quotes Malloy's ideathat the stereotype
is actually a vindictivedynamic in society
where, "moral judgment impinges
on professional assessment."
Ooh.
Well, why?
(31:25):
Because antisocial is writeoff others' needs.
And so we just like write offthe antisocials needs.
Yeah, so our judgment of antisocial
recreates their original trauma
and furthers the dynamic thatmakes them who they are
because we don't give them a chance.
I think you're on to something there.
(31:47):
Now, little tangent, like subtopic.
Where would the line be betweenlike empathy
and accountability then?
Yeah, that's also been a burningquestion for me
during this series.
So I am going to self-disclose.
I am an Enneagram One.
So I see things in blackand white by nature,
tend to be more idealistic.
(32:07):
And I have a strong moral compass
and sense of right or wrong.
So having such a gray area,
like a gray personality disorder
that kind of butts up against morality
has been very, very challenging
because my scaffolding feelslike it's gone in this.
Like my educational scaffolding
is like out the window with this type.
(32:28):
Can't use the DSM.
Well, you can, but witha grain of salt,
with other, you have to thinkabout it a little more.
But yeah, not just with that,
but like it's kind of buttingup against my sense
of right and wrong.
Like where's my line?
What do I believe?
So this personality runs that line
of both right and wrong.
And it's like, it's not my placeto judge until it is.
(32:52):
And then my brain just explodesand I stop
and it's too much.
The dissonance here is reallysubstantial for me.
Yeah.
Yeah.
And one of the things that cliniciansdo need to face
and make peace with when workingwith antisocials
is their own antisocialness,
which is super hard for some personalities.
(33:13):
I think I would be one of those.
So you're telling me I need tolean into my darkness
a little more?
Perhaps.
No more talk of darkness
Just kidding.
Fun fact, fun fact.
I think Phantom of the Opera,
I think he, Phantom was actuallya paranoid,
(33:35):
hiding behind his mask with maybesome of the erotomania
with being obsessed with Christine.
Anyway, now I'm deflecting withsongs and musicals, but-
That's hilarious.
Yes.
Yeah, I think that's interesting,
but that's not the point of this.
The point is for me to getin touch with my,
let my darker side get in.
Yeah, it's like we're talkingabout darkness.
(33:56):
So you're just bringing in the sunshine.
Well, remember that one episode
where we discussed the blinds metaphor,
because your blinds are so openand sunny and expressive.
And so I do imagine it's harderto close the blinds
and sit with the darker stuff.
Oh, definitely.
Yeah, I don't like going intothe basement of my mind
(34:17):
unless I have to, thank you very much.
And this episode has beenreally challenging
to sit with some of these questions.
This series has really,
so I feel like I have cobwebsall over me,
which is why I brought in Phantomof the Opera.
That's so funny.
(laughing) So how do we talk aboutthe antisocial personality
(34:40):
with empathy for both the victims, right?
Because antisocial can doa lot of damage too,
but how do we hold empathyfor the victims
and also the antisocials?
Like that feels very uncomfortable.
So my colleague who is notafraid of darkness,
help me out here.
Sure, well, come join me in the basement.
(35:02):
Into the cellar I go!
Oh my gosh, okay.
So multiple things can exist.
So psychological and emotionalpain is valid
regardless of whatever behaviorcomes out of it.
So I like to simplify things
by thinking about children's behaviors.
And I think we're all walkingchildren anyway,
(35:23):
but one child will stub their toe
and they're gonna melt down.
They're gonna seek comfortfrom their mama.
Then another one over herewill stub their toe
and they're gonna punch the walland they're gonna scream.
And then maybe write their name
on the said wall that hurt them.
Oh no, we went there, yep.
(laughing)
So they both hurt their toeand that's valid,
(35:47):
but behaviorally it's not okay tobe destructive in pain.
Right, so that's true.
Yeah, so the origins are valid,the pain is valid,
but the behavior that stems from it
is where there needs tobe accountability.
So I can have empathy for the abuse
that often contributes to thepsyche of antisocial.
(36:07):
And I also have a moral compass
and can say, "Uh-uh, don'tcross this line.
You cannot destroy."
In whatever form that means,
like killing, tearing apart,abusing others,
flagrant disregard for othersor the laws of the land.
Sure, that's actually one ofmy therapy boundaries
that I address in intake isyou can talk about
and process anything, but youcan't knock over a lamp.
(36:32):
Or as a mom, I can say, "Well,you can be angry,
that's totally fine, you can't hit me."
Right, that's a great way to put it.
Yeah, and this is where I actually think
back to the original question,is it treatable?
I think institutions, while imperfect,
do offer a better chance for success
(36:52):
for antisocials in treatment
because those boundaries are fortified
within the structure or hierarchyof the system.
So the boundaries are baked in
to the inpatient or prisonsystem, for example.
So if you try anything,
consequences will be swift and immediate
because the structure helpskeep them in place.
(37:14):
Exactly.
Yeah, but in contrast, treatmentwith antisocials
in a little private practice mayprove more challenging,
especially if we're talkingdisorder level here.
So let's think about it.
Antisocials have frequent contractviolations.
The therapeutic relationshipis a contract.
Like we have rules and policiesthat we follow
(37:35):
and you get treatment within this frame.
However, there's nothing fortifying
those boundaries externally.
So what would keep an antisocial
from stiffing you on the bill,taking you to court
or pursuing a license board complaint
to have the final power play?
Ooh, even if it's suicide, becausethat does happen
(37:56):
sometimes as in like theend power is mine.
Oh my goodness.
I've read that.
That is dark.
Yeah.
So it is risky treating moresevere antisocials
in an outpatient setting,
especially without major reinforcedboundaries.
And I would say honestly, youraverage private practice,
(38:18):
just based on the structure of it alone
is typically not gonna be adequate.
And then further, most of usaren't cut out for it.
Like I don't think most of us who'vegone into this field
have the tools or the backbone, honestly.
I agree.
Treatment does need to be incorruptible.
(38:39):
Like boundaries cannot be bent, ever.
Bending or breaking boundaries,even in empathy
or maybe especially in empathywill be seen as weakness.
Yes.
Because empathy is not understood
by disordered antisocials.
And then as providers,
this goes against our empathetic,helpful nature.
(39:00):
Yeah.
And in a lot of ways,
I think your stereotypical therapistis the opposite
of an antisocial, which can backfire.
Sure.
Now as a schizoid, I candetach from empathy
and not show it at all.
Like, I keep my internal empathyfor the antisocial,
but like it's mine.
They don't care.
And I'm not gonna let them see it.
(39:22):
But I do think a lot of therapistshave a rescuer desire
because they wanna help.
So it's really hard.
Right.
Yeah. And I think some will go in
not really realizing what they'regetting themselves into
and maybe lean too heavilyinto the empathy
and empathize with them.
And then that empathy getsturned on its head
(39:43):
and they are exploited forthe last power play.
Like that can be a reallydangerous dynamic.
So, but yeah, the bottomline here is that
some antisocials can make progress.
Some antisocials can make progress.
Well, I'm gonna leave us with a quote
from a Danish psychiatrist, GeorgeSturup in 1951.
(40:09):
He says, "Don't forget these people.
They have no one and they are people.
They are desperately lackingin terrible pain.
Those who understand this are so rare.
You must not turn their back on them."
Mm, that is powerful.
Yeah. Wow.
Okay. So to recap today,
(40:30):
other than like antisocial are toughfor me to understand,
we know that, right?
Like I feel like everythingI've been taught
about them is wrong.
But with that, I think we all have to get
a little bit more comfortablewith the darkness
that's inside of all of us
to be able to sit with these types.
And honestly, that's not my strongsuit, but I'm trying.
(40:52):
We've all got our boundaries, Doc Bok.
Yeah, yeah, we do.
We do, and limitations.
So anyway, if you're interestedin learning more,
we also have blogs, visuals,and references
that coincide with each episode
at www.personalitycouch.com.
And if you're a provider lookingto consult about a case,
or if you're in need of psychodynamictherapy
(41:13):
or a deep dive psychological evaluation
that's not forensic in nature,
our private practice, Quest Psych,can help with that.
I'll provide a link in the show notes.
But for now, I am closingthis dark chapter
and will reopen it in two weeks.
Be well, be kind, and we'llsee you next time
on the Personality Couch.
(41:36):
This podcast is for informationalpurposes only
and does not constitute a professionalrelationship.
If you're in need of professional help,
please seek out appropriate resourcesin your area.
Information about clinicaltrends or diagnoses
are discussed in broad anduniversal terms
and do not refer to any specificperson or case.
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