The Psychopath & The Sociopath: A Masterclass

We've covered how to spot a

psychopath

or

sociopath

before, but we've never gone this deep into the clinical diagnosis behind them. Antisocial personality disorder. Welcome to the medical circle series. Antisocial personality disorder. Psychopaths. Sociopaths and how to detect them. It's like that. It's great to sit with you. I love talking to you. Sometimes we talk about some topics that I think are really scary and hurtful. Yes, and I think this series will be more in that sense. Yes it is. Yes, you mentioned the topic. Group B, yes, personality disorders. Think it is so. I'm so glad we're having this conversation because a lot of people are trying to make sense of these difficult patterns and putting all kinds of words into online search engines.

Cluster B is something that comes up and a lot of people don't know how to make sense of it, so let me give you some historical background. This word group B comes from how personality disorders were traditionally organized in the diagnostic manual of Psychiatry and Psychology are called DSM. The DSM is organized personality disorders. There were ten of them in three groups, a group B and a group C, and they organized the disorders based on their manifestations. Now, in graduate school, we would remember these three groups calling. they were angry, bad and sad, that's how we memorize them and by angry it was something like traditional, like a crazy person, like you know, a person who is really out of place and almost like you knew that very disturbed bad meant almost bad behaved and that is our group.

The B's and the sad ones were people who were more anxious and avoided him. Cluster B disorders are also called dramatic and erratic. Now these disorders are again grouped according to how they affect a person. Today we're going to focus on group B. B disorders are the difficult disorders, they're antagonistic, they're interpersonally challenging, they're people who, as a rule, almost always lack the empathy that they tend to be entitled to, so it's almost like if narcissism became kind of the middle ground of a lot of these to That is, most of them have qualities of narcissism in different ways and, as you said, the four disorders that are found in cluster B are the disorder of Antisocial personality, borderline personality disorder, narcissistic personality disorder, and something called histrionic personality disorder—these are probably the most clinically puzzling patterns we found.

Let's look at psychology and psychiatry because they can generate very difficult clients. These patterns can interfere with treatment of other problems the person may have, such as substance abuse, bipolar disorder, major depression, anxiety disorders, eating disorders, the list goes on if you have a cluster B disorder and these. other things, you're really constantly like you're trying to fight two different battles at the same time and it's really a big kind of war, so to speak, so it's a challenge and it's a challenge for people who don't just live with the patterns. Cluster B, but it's also a challenge for people who live with those people who have Cluster B patterns, so that's what Cluster B is dramatic, erratic, emotional, antagonistic, combative, lacking empathy, often internally, very chaotic, they can't regulate their emotions very easily and some of these are clinically demanding borderline personalities, for example, it's a clinically challenging condition, histrionic narcissistic clients, they don't even tend to end up in therapy, often a personality disorder antisocial, such people often end up in prison, we have talked about specific personality.

But what is a personality disorder in general? A personality disorder is a maladaptive pattern of behavior and relationships that cuts across all situations in a person's life, relationships, work, social functioning and even their sense of self, it is the lasting stability that makes These are called Personality Disorders because personality is considered a stable trait, but its personality styles cause problems for the person in all areas of their life, but it is the maladaptive, consistent and stable nature of these problematic personality patterns. which leads to them being called personality disorder. Can someone be diagnosed? like having a cluster B disorder, no, yeah, so you only have one of them and that's, yeah, what would end up happening is like, for example, I, as you know, I do research on

psychopath

ology and mental illness and mental health, so when we look at our data because these disorders are common, sometimes we combine these patterns to see if we see any patterns there, so in part it serves as a kind of research focus and becomes a shorthand for doctors, but We as doctors must be very careful when using it. term because group B is a code for difficult patient and there is one that is really big, yes, it must be B is a code for difficult patient now yes, I can listen to people, although they say well, I'm seeing that my therapist said I have group B, now I am that. rude why do you say it can't feel good?

That's what I'm saying, we have to be very careful with these labels, it actually means that it's almost like it's an organizational scheme, if we see, because what may happen, Kyle as a person, may not. meet the full diagnostic criteria for any pattern of those disorders, we chose four disorders, men have a little bit of this a little bit of that and we could call it this one has a cluster B pattern, it means we could use very specific types of therapeutic techniques or Realizing that these patterns can interfere with the treatment of other disorders, so to speak, but typically involves someone whose interpersonal relationships are difficult.

I'll be honest with you, I mean, those of us with mental health will sometimes even use that as shorthand for our own lives, like I'm going to Thanksgiving, it's going to be hard to have group B relatives there. You know, anyone in the business will know, like AHA, that they have some really difficult family members, but it's beyond difficult. antagonistic and almost as if they often don't understand it, it's almost common that they don't want the help, not necessarily. I think you know this, because Cluster B disorders take up a lot of territory. I work with many clients with borderline personality disorder who desperately want. help, they want help desperately, in fact, sometimes they need more help than they can get in one or two weekly therapy sessions and many clients with borderline personalities are very interested in getting that help, but it is difficult for them, they They feel so chaotic internally. and fear that therapy may be a challenge not only for them but also for the therapists who are trying to sue this patient, obviously when you are dealing with someone with a narcissistic personality you don't think anything is wrong so they will often think there is no I don't even need help and then you know, histrionic personality disorder, they're actually thinking about removing it from the diagnostic manual.

These are dramatic, attention-seeking, seductive people, and look at me, how come I don't get all the attention? In fact, they almost never end up seeking treatment for that particular pattern. People with antisocial personality disorder also do not seek treatment. They get in trouble for something and then sometimes they are forced to get treatment. They briefly describe what antisocial personality disorder is because. that name is so misleading antisocial personality disorder is one of the most important diagnoses, one that unfortunately has names that exist, it baffles my students, it baffles trainees, it baffles laymen, antisocial personality disorder is in actually quite dangerous, it can be quite dangerous. it doesn't mean what we think a lot of people understand by antisocial oh, these are people who don't want to be around other people almost as if they were socially anxious, not at all, the unfortunate term historically arose from this idea that these were people who were against of society, they were against the norms of society, they broke the rules of society, that was really antisocial, like I said, such an unfortunate name because we use and say antisocial to refer to someone who does not want to socialize what would you call it i would call it psychopathic personality disorder yes that's what i would call an antisocial personality disorder it's the diagnostic term for things that are called psychopathy and

sociopath

y in popular literature in the media generally in all kinds of other writings about criminology, but no, it's not a diagnosis, those are not diagnostic terms, but those two terms definitely attribute more to antisocial personality disorder.

Now what is it? Antisocial personality disorder is a pattern in which a person not only lacks empathy but believes that rules don't. they apply to them they do not adhere to them they break moral codes social codes legal codes they do not take any responsibility they are very deceptive they exploit other people to achieve their ends they will take risks that will put other people in danger danger then they are dangerous they are dangerous and here's the wringer personally i think it really hit to really call it antisocial personality disorder you're talking about someone who lacks remorse for the bad things they do and that's where it's scary they can faster it's scary sorry can they pretend can can a person pretend can fake remorse oh absolutely you can fake anything fake empathy you can fake remorse you can fake anything and they do they will do it when they're finally brought to the front of the press conference, they'll cry crocodile tears and a year later they'll do it again.

That's antisocial personality disorder. What groups of disorders do you think are most common in terms of personality disorders in general? In fact, I think Cluster B disorders may be more common and the only reason I think I'm going to say that is because when we research these disorders, they are the ones that are most compelling clinically, so we may see more clients with these patterns because, especially in the case of borderline personality, they are more likely to get help. That is. In the case of antisocial personality disorder, they are more likely to end up in prison.

So, it's these two groups of people that we study a lot because of this. type of distress that we see in borderline personality and the danger that antisocial personality can create, so in the end there are four disorders in that group as well, so it will increase your number a little bit, I think group B disorders are probably those with the highest prevalence rates in the three groups overall. Yes, well, there are more disorders and people have to seek help, so they are more disturbing. Who are you going to see? I would say that if you were working in the mental health business, you will see that in Cluster C there are things like avoidant personality disorder, which almost seems like a social attachment disorder, so you will see that sometimes, but sometimes Sometimes we don't even see it. we know which variant we're looking at social anxiety or avoidant personality and with cluster a disorders, the schizoid, this has a typo, the paranoid personalities, these are people who actually look pretty severe mentally, oh, they're incredibly socially withdrawn or They seem very strange.

They almost seem psychotic there, sometimes they are overrepresented in residentially unstable populations, such as homeless populations or people in and out of long-term psychiatric facilities. Is there hope for the people who are in the group? Damn in terms of hope for group B customers, it varies. it varies well, wait, we don't hear that answer much oh, it varies, yes, and that is the problem that speaks to how heterogeneous the disorders that make up this group are if I talk about bipolar disorder and I talk about anxiety, depression, ADHD, the doctor crosses For me, I will say there aren't many variables.

I would argue that the best research on treatment outcomes and best practices can be found for borderline personality disorder. I firmly believe that if you have a client with borderline personality disorder and you can provide trauma-focused care, dialectical behavioral therapy, whatever psychiatric medications they may need to manage other types of conditions that they have and other types of complementary therapies that will help them. With your symptoms the literature on treatment can actually show some good long term results, but the treatment has to be consistent over the long term and that is often beyond the financial ability of many people, that is what is so unfortunate. because I think there is tremendous hope for people with borderline personality if they get the type of treatment and if the client doesn't cooperate with it. treatment then all bets are off with narcissistic personality disorder, you know what I say about you're not going to see much change and when you do it's glacial and theThe amount of change you see is often not enough to make the people around you feel like things are better, but with antisocial personality disorder that disorder might be the most desperate of all.

These are people who will try to outwit and outsmart a therapist who will fake it and often receive a court order to go to therapy as a condition or probation. or something like that and they sit there for ten sessions and say, I don't need to say anything, I just need to sign the papers that I came here for ten sessions, so you can meet a lot of resistance and they often try. To bully a therapist you have to be a very specially trained therapist to work with that population, particularly those who have very, very difficult criminal records and if you are dealing with a more orderly and tied down antisocial personality, like the CEO variant they are very manipulative.

They can be very exploitative again, they will often try to outwit the therapist, they are not really motivated to change because they don't really believe there is anything to change so if anything they are just looking to beat the system which is not progress so I would do. say definitively that of all the groups they will have the worst results. What percentage of your customers do you think fall into the group B category? Oh, with some group B symptomatology, it means much more than 50% maybe yes, maybe even a little less, oh hell. no, no, no, actually, that's what I choose to focus on, but maybe forty percent, forty percent, you know, yeah, that's good, because now at least people are getting help or in the space to get home and there are people who specialize.

In this, like people who specialize in dialectical behavioral therapies that we call DBT, I would say they see 90 percent because they're working with clients who have many types of borderline personality symptoms, people who work in prisons probably see antisocial personality. and the 60 70 percent level, but I would say almost half of the clients that I work with I choose to do that because, like I said, although I would say that maybe even it's okay, I'll be 35% because most clients people I work with are trying to negotiate a family or other relationship with a person with a Cluster B disorder, a solid third of them are struggling with these issues, which leads perfectly into my next question, knowing that if anyone has seen this video so far, you have probably been diagnosed with a Cluster B family disorder or know someone who has it.

What could I ask you on your behalf? What would you think would be most beneficial for them to hear? Would they know? I think the big question is the people. What I have is from the person, there are two sides, from the side of the person who is experiencing it, it is what I do. Not only am I always miserable, I feel like I'm making people miserable, you know, and then from the other side, I think. The question would be what do I do. I feel like nothing I say to this person makes things better. In fact, all I do is feel like things are getting worse and I feel like I'm always walking on eggshells.

What I do? What I do? Yes, answer that. I know them for people who are experiencing the symptoms. You have to get therapy. No, you're not going to think your way out of this. You're not going to meditate your way out of this. I have to get therapy and with someone who is trained in things like DBT and working with these types of patterns, okay, that's what they have to do, yeah, you know, dr. Yip is one of the country's leading OCD experts and I interviewed her for our OCD series. She really reminded me of the point of not just going to therapy because then the therapist said yes, I treat OCD, find the person who does that. that's what they do, they're OCD, so with these people, you know, I feel bad for someone who could have gone to a therapist who told them they could treat them, but they did it once 10 years ago and had a bad experience. , Yes i think. what you're especially dealing with now again, but something like narcissistic personality disorder, if you really get them into therapy, you can use a combination of some DBT techniques but also some cognitive behavioral work, some humanistic work to build a relationship, It's a big part of relationship building, you need a strong therapist to work with those clients because they will try to outsmart you, so if you almost have to be one step ahead of them, you can't fall for the charm, you have that be almost charming for you and our charm. try working with narcissistic clients and with chicks, you know, it's all a matter of experience, but borderline clients are the ones who are most likely to seek therapy and be like, like I said, you're doing well, what are you doing?

You need to get help from someone who knows what they are doing and it could even be a team of people who know what they are doing. In fact, DBT is best taught in a team approach with a combination of group therapy and individual therapy and some medication management. On the other hand, if someone in your life is experiencing these Cluster B patterns, it's going to be difficult. . I'm telling you right now and you're not a bad person for thinking it's hard because a lot of you feel guilty that something is actually happening to you. How dare I think this is difficult?

Because it's because the nature of these patterns is somewhat antagonistic. Again, it could be that they feel insecure or chaotic inside and that's why lashing out at the end of the day, no matter when someone lashes out, doesn't feel good regardless of the reason, which is why I'll tell people if you're with someone. If you are experiencing Cluster B patterns, you are definitely looking for someone individual. therapy, you may need to manage your expectations about that person and then ask yourself what the landscape of a relationship with this person would be like if things don't change in cases, yes, it may not change, those are really good, three very quick takeaways for people watching briefly explain what DBT yes, DBT is dialectical behavioral therapy.

Dialectical behavior therapy was developed by someone named dr. She and Marsha Linehan actually developed DBT specifically to address the crisis of suicidality in people who had borderline personality disorder because that's the dangerous problem that people with borderline personality are experiencing so much internal pain and confusion that they want to silence that pain. which they really often believe in. there is a burden on others because they do not or are not worthy of living, it is really agonizing for them and for the people around them who care for them, so DBT was initially developed as a way for the person who lives with borderline personality disorder to see how life always seems like a crisis to them, how everything is black or white and therefore the dialectic is really bringing those two sides together, those two perspectives and finding that gray in the middle, the other than dr.

Linehan brought a real focus on mindfulness to this work. People with borderline personality disorder tend to react rather than respond. Responding is a more thoughtful approach. that kinds of reactive approaches when faced with a stressor, you know, because reacting often means that people's feelings get hurt, people get angry, but to help them deal with that crisis and the fears that take over a person with a borderline personality, things like that. so they're going to be left alone they can't take care of themselves many people with borderline personality disorder engage in a lot of negative self-talk dialectical behavioral therapy is also based on cognitive behavioral therapy where you step back and you say you know it's interesting you say all these terrible things about yourself because my experience and you really point out the good things and the strengths and build some resilience with them and ask them to do the homework. assignments between sessions so that they do a lot more monitoring so that they can help and they can start to see their own patterns.

DBT has been shown to reduce the rate of suicidal thoughts and suicidal actions in people with borderline personality disorder and is really the only evidence-based treatment. we know right now that it has consistently good results in person with people with borderline personality. I just want to touch on two things that you said that really struck a chord with me, the first is mindfulness, it's becoming a recurring topic and all my conversations about mental health, yeah, which makes me think if there's something that everyone What we could do to improve our lives would be to be aware of what we're doing and then the second thing is the difference between reacting and responding, yeah, that's huge everywhere we live in a very reactive world and especially when you think about tweeting and texting and responding to those moments, but that's reacting to the right places in the text, yes, responding means you stop, think about what's meaningful, what would hurt what.

I would make sure well, how do I write this? Oh, I don't hurt people. You know it's actually beneficial for the recipient or other people who will see this message. You go through a series of cognitive steps, but unfortunately the technology does not. I mean, I wish all the technology made you like, I'm sure, I'm sure, I'm sure, like you know, yeah, yeah, and honestly, they made you like in 60 seconds and then another and then another 60 seconds and then you're sure because by then you would have had to react a lot. You go down and say: I forget about that, it's not that important, you think about those emails that you write in anger and I hope you don't send them and you save them the next morning, you read and leave, thank God I can.

Say no, never put a name in the subject line of an email until you're ready to send it, that's kind of advice, but it's that reacting, responding and mindfulness are linked and because everything these days is very quick, quick, quick and we. We are judged on speed and everything is designed not only for speed, but also not to stop before we go over the limit. Yes, we can send things without you knowing in the past. Would you like to write the letter. Fold the letter. Put the. letter in the envelope find the stamp write the address go to the mailbox it was nine times you could have said maybe I shouldn't send this you know and that's where mindfulness sits mindfulness is a stop it's a feeling it's a thought but that It does mean awareness of other people and if you don't have empathy, all the attention in the world may not necessarily pay off, let's get into that.

What is antisocial personality disorder? So, antisocial personality disorder is a long-standing pattern of inability to comply with moral, legal, ethical or social codes, or really an unwillingness to do so, they are people who are characterized by lying, deceit, malice, lack of empathy, they exploit other people, they break the law, they lack responsibilities, they do not comply with the things that they have very marked. work histories those types of things will use aliases put other people at risk and lack remorse or guilt or shame for the bad things they do so that's what antisocial personality disorder is now there's an interesting little detail in this diagnosis To In order for a person to be diagnosed with antisocial personality disorder, we also have to establish that they had a diagnosis of something called conduct disorder before the age of 15.

Conduct disorder is probably best ascribed to what we could call juvenile delinquency. These are children who were the ones who engaged in illegal activities like theft or assault, but also things like torturing, setting fires, bullying their peers, abusing, taking advantage of their peers, and that could even include sexual exploitation of younger peers. There is a kind of almost deliberate cruelty even though they are children and often they don't do it to show remorse or even recognition of what the ramifications of these actions are, so these are children who may end up in juvenile detention centers, who will have problems with educational systems, they may drop out of school, so you We have to establish this history that they were children who would have these types of problematic behaviors before the age of 15 and then after the age of 18 we diagnosed them with a personality disorder antisocial so that they do not have to receive the diagnosis before the age of 18. 15 years because someone might skip it, someone might skip it, in fact they often get it right, but you'll come back and tell me about when you were a teenager, yeah, so go, you probably had yeah and they'll say yeah, I skipped school completely. that time and I was expelled or I salted a child or attacked a teacher.

I stole my dad's money. Those kinds of things, you know, don't all have to be expensive things, they could be, if you will, the bad kind of things. Childish behavior like bullying or stealing a lot of candy or stealing other kids' lunch money, those kinds of things, those kinds of patterns, yeah, devil's advocate game, although couldn't that just be a symptom of bad parents, sure? I could, but would you definitely understand? a diagnosed disorder,Romani and I sat down to watch an entire series about narcissism, and if you want to watch it, here's a little preview.

When we talk about narcissistic personality disorder, there is a long list of patterns and you have to have five of the nine. The list has to be something we call omnipresent, meaning it covers situations with a variety of people at work, at home, it's not just that they are narcissistic only to you and that they are kind and nice to everyone in the world, it tends to be widespread, but Here's the problem: It involves what we call social and occupational impairment and subjective distress, which is a fancy way of saying that you're ruining that person's life, they're aware that you're ruining their life, and they're uncomfortable with it. that, and that's where I don't see that many people with narcissistic personality disorder dr.

Sociopathic Roma relatives or someone can have sociopathic and psychopathic traits without having antisocial personality disorder. Yes, you can actually see that there is a problem now. It's like it started. Antisocial personality disorder has a type of specific diagnostic criteria set. You already know the terms of this one. early life experiences and all that stuff that you know that person can have who is coldly efficient and manipulative and singularly focused on success and who lacks empathy and exploits other people, maybe you come in just below the threshold at this point. , we are type. really where we are splitting hairs mmm, does that make sense?

Who cares what the word is? Thank you, you know, I mean, it's dangerous, it's problematic, you know, my work in this area focuses a lot on how people, how, these, how people with these patterns affect people in relationships. I can tell you this now that people with psychopathy and sociopathy are not 100% cut out for close intimate relationships, they just don't, they can't put down deep roots and I think what ends up happening is because they are so soft and charming and glib and successful, They absolutely attract partners many times for psychopathy, it is like a big game, they only want the trophy, they want the prize of everything or they value that partner, they are very attractive, they are very rich and successful, they can be a bridge to something they want or they just want sex, yeah, I mean, literally that might be simple and in fact that's seen when we look at the hare psychopathy checklist, which is a very famous and frequently used one. checklist investigates hair like hair, hair like, but hair like a bunny, the hare psychopathy checklist on that checklist, one of the things that actually one of the items gets about your inability to have long-term relationships, as if they had very short-term marriages. because a lot of times they are exploitative, they want something and they leave or they just have very brief sexual unions, they are very sexually exploitative, they will know that they will use people for sex and then they just spit them out and chew them up and leave them, you know, leave them out, and people get really hurt by that and they'll say God, she was so lovely, you seem so interested in me, but that's because they're so lovely and when that's why you avoid that.

That's why I avoid charming people because actually its harm comes from the fact that if you don't know what you're dealing with, it's very easy to get sucked in because it feels like a fairy tale, we really don't know much about it. Like a lot of fairy tale princes, they're probably psychopaths, okay, it's a nudist fairy tale, princes are probably psychopaths, they're too charming, I mean, I think you know we don't use his name Prince Charming, yeah, Prince Charming, Yes, Prince Charming. It's more Prince psychopathy today, yes, by the way, when people meet you now they won't be very nice to you.

I feel like beyond that circle not much, just an appropriate amount, as if there were the narcissistic woman. I say, no, no, actually. if i really succeed in dick but instead i stop and make sure everyone is okay, very funny, this comes with a lot of co-occurring disorders, yes, what are the most common antisocial personality disorders? The co-occurring disorders we see most frequently are substance use. Interestingly, you might actually see depression, but it's probably surprising that they would diagnose you because they won't, we would probably present more as irritability, yeah, what we call impulse control disorders, but impulse control could be like they attack to people, road rage, intermittent explosive disorder, but.

We may not diagnose both because your anger and stuff will probably fall under antisocial personality disorder, but actually the most common comorbid diagnosis is going to be substance use. Are there different forms of antisocial personality disorder that you know about in the diagnostic manual? There is no antisocial personality disorder and it does not have different types of descriptors, so to speak, in my research we have sometimes divided them into people who report having remorse and those who do not. It doesn't really differentiate that way, in fact, psychopathy research actually makes it take time to distinguish between psychopathy and sociopathy or between primary and secondary copying.

There are different ways to divide that pie and a lot of it has to do with it. with the forward-facing characteristics, how intelligent, well-organized, articulate, intelligent, charming, glib, all those things that we associate with success and that precision that is something different from what I call something like the sloppy bar fight , psychopathy or sociopathy, yes, why or rather. what wouldn't be considered an antisocial person is a personality disorder, but it's often what type of behavior, um, I would say I'm referring again to a lot of people who have mistakenly called narcissists um like they have a personality disorder. antisocial, but if in fact those narcissists are like that, I can't believe it.

I did this, I'm so sorry and they're apologizing and they're going to do it again, that's probably more of a narcissism piece, a bipolar disorder, bipolar disorder could be misdiagnosed as antisocial personality disorder because it's very possible that during a phase manic A person's behavior can drift towards the illegal, he can consume a lot of drugs, he can request the services of prostitutes and you know, behave very badly with them, he can gamble a lot of money and participate in illegal activities to get more money to gamble, so can actually behave in a way that is risky and violates the law, so we would have to be very careful to make sure that when there were these types of increases in illegal behavior they occurred only during a manic state, so remember that has an antisocial personality, the behavior is consistent, it's not like six days a week they are a good guy and only on the seventh day they come out and put on their serial killer mask, they tend not to function well in society, even when they are charming and glib, they don't tend to have deep, high-quality personal relationships or people diagnosed with borderline or antisocial personality disorder when they're actually bipolar, they might be, but it's a good thing, someone should realize that pretty quickly, you know? what I say because then they should recognize that that person is in a manic episode and that has not been their typical behavior pattern but since one of the biggest mistakes we can make is to make a diagnosis based on a snapshot if all that What you did was focus on one day of a person's manic episode, yes, you could easily call it something, it's not, that's why we have to look at psychiatric patterns over time and also in some substance abuse disorders, I was able to see how someone who has a diagnosis of certain forms of substance abuse, particularly activating drugs like cocaine or methamphetamine, people who use those drugs are more likely to engage in risky behavior, may engage in illegal activities, obtain the drug, They can sell drugs, they can have high-risk sexual relations. activities while using the drug and if they are addicted and using it regularly, that may contribute to the likelihood that they will engage in these high-risk illegal behaviors that, over time, could resemble antisocial personality disorder.

What happens is get that person off drugs, get them clean, and see if the behavior changes or not. I make it a point to say this on almost every show because to me it's the difference between mental health therapy working or not, and it's that people should do it. You absolutely must get the correct diagnosis and don't take it as a new label or something new and terrible that's wrong with you, just take it as if that's the next step to getting the right treatment. In fact, we don't have to call. is a diagnosis we can call it a pattern this is the pattern I think I'm very I've been really we're talking about depression per se I'm sad I'm more irritable than usual da da da da da da you I know, we're looking at patterns and these are patterns that They make a person uncomfortable and prevent them from reaching their full potential because really my goal as a therapist is to make a person reach their full potential. be the best version of themselves dr. sues Varma in New York we did a series with her about depression she says my job is to give people what you just said an optimal life that's what I do people say yes but I can deal with that wouldn't you could you why Why don't we work hard to make it even better?

I love it, yes, that's good. I want people to understand that what we're doing here is providing the right education so they can access the right people, get the right diagnosis and get the right thing and you, Kylie, I want to say something about that because I know a lot of people who see Med Circle have experienced or may even be currently experiencing mental health issues or mental illness. I always tell people that this is part of your story. and if you have overcome this and you will overcome this, that is part of your strength and resilience and it is not a part of you that should be forgotten because I work with clients, for example, who are health professionals who are teachers and we can Use this as a way of saying that you have an empathy that another person may not have and that you can be kinder to a patient or you can be kinder to a student and, for me, I think that a lot of times people who have walked through fires who can be harnessed in a way that can not only lead you to greater potential but also benefit the people around you.

It's really like turning straw into gold, so I think that's absolutely critical as people don't see this as something being wrong with you. There is absolutely nothing wrong with you everything is fine we just want to take you to a better place but that you can use part of this this part of your story to improve the lives of others mmm that is so beautiful I would love to leave it there but I have more questions. I can't leave it on that perfect grade you just gave me when it comes to antisocial personality disorder. What am I not asking you?

Should I ask you? Know? Antisocial personality disorder. The big question is what if? You know, the big question about antisocial personality really is how to treat it, to which I'll usually say the answer is no, in most cases no, we know that over time people with antisocial personalities become tired. , it gets exhausting to be a person who keeps breaking the rules at ninety or seventy-five like you get tired of it, it's exhausting, right, but these are patterns that are very, very, very resistant to change. These are people that many therapists do not have the training to work with nor do all therapists want to work with this population, they feel threatened or intimidated and no one should work with a patient population that they do not feel comfortable with, but there is usually no motivation to the change because these people don't believe that anything is wrong, you know that really and and also the question is how does the person become this way, let's delve into that, explain the born part first, yes, you know, particularly in the area of psychopathy and antisocial personality disorder There has actually been a lot of research done on the type of brain function in people with antisocial personality disorder and there are several areas of the brain that have been implicated: the ventromedial prefrontal cortex, the anterior cingulate cortex, the amygdala, All of these fancy names are really simple.

If it comes down to something that's wrong upstairs, you know that their brains are not the same as everyone else's. However, what these researchers have discovered is that those brain differences in structure and chemistry collide with childhoods that can be characterized by abuse, neglect, violence, being the victim or witnessing. violence, frankly, invalidation, emotional abuse, those things could enhance any of those types of structural problems in the brain. We also know that there are areas in the brain that support empathy and that's one reason, yes, empathy, so the research has actually been done with people who qualify. ofpsychopaths or like antisocial personality disorder, I think they had been in prison, what they found was when they were able to tell the subjects of this research to think about something and forced them to empathize like they were being told a story and Tell me, can you really Stop and think about how that person felt in that story and how they focused and how that person felt?

That area of ​​the brain lit up, but it wouldn't have happened naturally for them, so they don't naturally feel empathy. so they are capable of what we might call cognitive empathy, they say yes I can get that and that area of ​​the brain will light up, but it doesn't happen spontaneously, so a relationship with them isn't really possible, but it isn't. completely broken, you can turn on the system. Wow now, if I take off my glasses when I get excited, if a child is born with something that doesn't work properly upstairs and it's a psychopathic or sociopathic tendency and they don't have an environment that is violent, they actually live in a high-pressure environment. support Can you raise someone not to be that way?

I've read case literature of exactly what you're describing a child who actually comes from a loving home, parents who love them, you know, a nurturing environment. It wasn't a lot of resources, it wasn't an impoverished or dangerous community or anything like that, and that kid started showing antisocial tendencies and kept falling apart and they became, you know, violent or predatory or bad-behaving adults, so to speak, and you know what they are. case reports that are not normative, it's definitely a very low probability event, so to speak, but it's interesting when you read some of the work done by some of the really great researchers in this area, Adrian Rein, for example, as a guy from the University of Pennsylvania and he's done some really excellent research on psychopathy and, you know, I was reading something or an interview that was done with him and he said, Listen, we'll get to the point where we'll be able to identify some of these patterns and kids, and if that's the case, we should really work with parents to help them identify some of these patterns early on.

Let's see if we can do some intervention with them? We're not there yet, but I have to say that when we see children engaging in patterns of behavior like bullying or acting out, we have to take the time to do the necessary assessments to determine why it might be happening with that child so much. at home and at school and what behaviors are manifesting because it is possible in some of these cases. If we could get ahead of some of them, then sure we could engage in some prevention work, but it's hard to do. You know, you can only demand so much.

I understand that when we have the behavior, we try to fix it. You're just saying based on the brain, yeah, because that's the mental health picture mm-hmm it's great, yeah, and what's so frustrating for a lot of people is that it's just an expert opinion if your child If you have ADHD or your child has bipolar disorder or your cousin is depressed, it's just someone's opinion, so when we can have something more definitive that can be tested, that's so exciting, that's where the hope has been and, of all personality disorders, really antisocial personality disorder is the area where a lot of work is done. the central nervous system and the central nervous system activity is taking place and you know the challenge is what do you do?

You give everyone in America a brain scan. No, you see what I'm saying, so it's kind of like where are we going? With this and the findings right now are very subtle, a lot of them happen after the fact, so a person goes and does bad things and then we look at what other things happen in their life, that's right, you know, and some of the research they have not done it. It hasn't been as good at describing how much abuse or deprivation or all those other types of conditions are present, how much of that shaped their brains and that's what the environment shapes the brain, so you have a little bit, we're like I'm playing a game. of chasing chicken eggs here and, but both things are definitely at play, there are vulnerable brains out there and when that vulnerable brain encounters a disabling environment, that's where unfortunately the problems arise, do you think we would ever reach a point where we would scan children to scan their brain and we could say yes, they are probably sociopaths or psychopaths, not in our lifetimes.

I don't believe it. I think I wouldn't be surprised if little by little we managed to remember. the brain is very complicated it is a very complicated system it is not that simple it is like there is a little its other organs are much more correct other organ systems are much simpler but the brain the brain hides four secrets and you know you could have four scans that look similar and yet the behavioral manifestations could be quite different because it is an intersection of many things about the person, from the person's gender to their ethnicity, where they live, what their parents did and the kind of early environment he has.

I know it's not that simple, it would be, but we're not there, that this extraordinary thing called the brain is, you know, that allows us to do everything from writing poetry to falling in love to driving a car, it's not that simple and I don't think so. For us to get it, we want it to be that simple, we want to be able to predict these patterns, I think it's pretty high order, so it feels like a science. For me it's a fiction movie, but who knows, maybe neuroscience will prove me wrong. Do you think or is there any proof that any of this is hereditary?

There is some evidence to show that it is hereditary. Now it's particularly from father to son and as we talk. About these rates are higher in men when we talk about antisocial personality disorder from a more biological model one of the things we talk about is something called the autonomic nervous system the autonomic nervous system has an arm called the sympathetic nervous system that we Se Popularly known as the fight or flight system, but the autonomic nervous system is associated with arousal, so when we worry about something, when we're scared, when we're anxious, you know, anything that threatens us, we get nervous.

We get excited, our heart rate increases, we sweat, our eyes get bigger, we get short of breath, it's like our skin crawls, you know, we make our hair stand on end, that kind of thing, all those our autonomic signs, the belief is that people with antisocial personality. The disorder has lower autonomic activation, meaning that under conditions of fear or threat they do not become as aroused, so they are willing to take risks and do not have the same anxiety. We avoid things that make us anxious, right? They don't get anxious so they don't avoid those same things that are really high risk, and in fact, there's research that shows that people with psychopathy have a lower resting heart rate, they're just more underaroused, so sometimes that It manifests itself in them getting really nervous.

Types of dangerous sports that seek thrills because they almost want to feel the arousal that the rest of us feel regularly day in and day out and that's how low it is believed that that autonomic nervous system under arousal could be inherited in our first video, you and me. I think it was the first one where you told a story saying that they could be in a car with a dead body in the trunk and get pulled over by the police and they probably wouldn't say it's totally cool, absolutely, where those are. that is a sociopath who is a psychopath or a psychopath and is born.

Psychopaths tend to be more natural born. Sociopaths are probably a little more informed and I mean it's a rule of thumb that it's not a perfect science, but definitely use that. that sociopathy tends to be a little bit more of a byproduct of the chaotic or neglectful early environment, whereas the psychopathy that you might have, which you definitely can have the neglectful early environment, is likely, but it's also likely that that kind of biological piece again , sociopaths tend to be a little more careless, disordered, reactive, at what age, in your personal experience, do you find that psychopaths or sociopaths are diagnosed?

You can't diagnose them until they are over 18 years old. I don't think it's a reliable diagnosis. None of the personality disorders are diagnosed in adolescence, except. for conduct disorder conduct disorder is not a personality disorder, it is a childhood disorder, oh, so you could diagnose a child with a conduct disorder, okay, because they keep breaking the rules, right? That child may not develop some sort of antisocial personality if you're really very lucky to be placed in some juvenile facility, perhaps, where they really get good rehabilitative care and don't commit crimes again. I mean, the odds are not in your favor, but it can happen that way, so conduct disorder is a childhood personality disorder.

The disorders are only diagnosed in adulthood. We are making room for the fact that the Personality can evolve and grow during adolescence until reaching emerging adulthood. I wouldn't really feel comfortable giving a definitive diagnosis of a personality disorder and anyone who is much younger than 20 or 21, that's so fascinating, that was my next question about where would you feel comfortable, yeah, I mean, I would talk of patterns. I say you definitely have the traits here, but you also have them. a teenager and I can tell you that as a parent of teenagers. I think I've probably seen what it's like to have all the symptoms of personality disorders and they, you know, wow, they're being really she still loves them, but I was like, oh my gosh.

I know and that's where I really learned that teenagers are up and down and all over the place and they're at it again, that's just a developmental thing and that's why we want to be very careful, the last thing we want to do is label it as a teenager. coming. on their own and have them pathologize this process where they're trying to find themselves and if we look at ourselves as teenagers like we're anything but posh, oh god, that's the truth mm-hmm regarding personality disorders. antisocial, what demographics? Besides men, do you find it more effective? This is where it gets a little complicated from a socio-political point of view.

Unfortunately, what we see in this is something that, as I reviewed the literature from my research, these patterns tend to be overdiagnosed and people at lower levels. income groups and ethnic minority groups and the belief is that that's because those groups are also disproportionately incarcerated and targeted by law enforcement, so the belief is that it's almost like the feeling of pathologizing people. people who are different from the norm and that is why those statistics I think we have to be very, very, very careful with these disorders, once again, they do not know how to discriminate per se, but since they are based on moral, social, ethical codes and legal, and those codes are enforced by other entities, now you are bringing in the politics.

You see, that's where it gets complicated and those things don't belong in mental health, but we have to be aware of them, so in fact, what we see sometimes is that sometimes women who probably have a personality disorder antisocial personality disorder will be misdiagnosed with another borderline personality disorder syndrome because we don't think of women as having antisocial personality disorder and therefore there are men who could very well have a type of borderline personality disorder who are diagnosed with antisocial personality disorder. antisocial personality, so things like gender race social class are those other important things when a therapist or psychiatrist brings their own personal biases and, yes, their practice bias bias just because of the normal ice bias and that's why you know that ideally you have multiple sets of eyes on the case data that you don't You don't always know because it surprises me when every once in a while I see that you know, you know, the diagnosis, you know, systems are behind on a client.

I mean, really, you know, I have to say I'm not watching. It's this way, so it's not a precise science, that's why these labels don't tell us much. I think it's better that we focus on patterns, yes I have had patterns in our life, what do you expect or think we can? are developed when it comes to the causes of antisocial personality disorder, you know, this is actually, I mean a lot of what's being done in personality, you know, kind of research that focuses a lot on personality. antisocial because we know it, but it is dangerous for society.

So what do I think we will learn? I think newer and newer neuroimaging tools that look at, specifically, functional neuroimaging tools that actually look at brain function in real time, are going to shed really important light on how they work. Brains work differently and then once therapies or treatments are appliedto people to see if you actually see any change in functioning and if that's also associated with a change in behavior, you know again that these are not patterns that are that susceptible to change. I think we might be able to isolate what this looks like in the brain, if we can then act on it, you know, the jury is out and then it would become more medical, are there medications that might be the same? surgical right, you know, and then you, but you face bigger issues, like consent for treatment, it's very we in the United States of America, an adult has to consent to treatment, you can't just open a person's skull and start playing with it. you just know how it works and I think as much as we think well, there could be all these magic solutions, people have to agree to accept the therapy and you know there are reasons for that, obviously, but if a person doesn't think that something is wrong, you know.

Whether it's psychotherapy, whether it's medication, whether it's newer therapies, whether it's new types of brain stimulation techniques, whether it's psychosurgery, a person has to give consent and it has to really be medically indicated, so we have to be careful and how we think about those things. . Emily, someone comes to see you as a patient and tells you that my husband is a sociopath. I am convinced of what your first reaction is. First of all I hear this regularly and my heart hurts mmm because what it means they have been putting up with is someone who is probably verbally abusive or ignoring them negligent lacks empathy cruel like cold is distant is manipulative like they use that word and me It gives a real sense of what they've been putting up with and when they pick up the phone and call me "It often means they've been putting up with it for a while.

How severe do the symptoms of a sociopath get? I mean, I like all the disorders, it's in a range, you know? I mean, it's not like there's a version, obviously, at the milder levels. We're often talking about someone who is cold, angry, brooding, resentful, mean, you know, at the most extreme levels, you'll seem like the violence manifests itself so obviously at the most extreme levels, you're often talking about victims of more physical domestic violence, but I think even at mild levels it can look like emotional abuse. What if someone comes to you and says? I heard this word sociopath and no.

I'm not really sure what it is, but I think my husband might be one of them. Can I say I'm breaking it down for you because I think a lot of people use the word sociopath interchangeably with narcissist. Yes, and like I said, these are labels. I am interested in the notebook or subject. I will say don't use the word. tell me what it's like no no don't show me a trash can tell me show me what's inside yeah okay metaphor and then I say tell me what the patterns are and then once they start designing it I say okay this is what the pattern is If it makes you feel better to have a word that you explain, no, sometimes they want to keep digging, but then we break that pattern, so when someone is experiencing that, like I said, they're experiencing all those things, coldness, distance. manipulation that lies in all those things and it almost doesn't matter if you are a sociopath or a narcissist, none of the patterns are that susceptible to change and none of the patterns feel good, so they throw the bucket and bring out the verbal abuse, coldness, all those things you mentioned, yeah, who cares what we call it, this type of person is unlikely to change, no, they're not going to change.

You're not going to go No, that leaves that person with two options, yeah, stay with it, yeah, and deal with it or get out and when I say they're not going to change, I mean it very, as you can reflectively see, let's say you get . that person's okay, I never thought I'd get to this point, you go, let me try and he wants to make a good faith attempt at therapy and he really recognizes it and goes in there and maybe makes some minor changes on some little little little little little little ones. small small percentages of cases, you might see that since most of the people who are out there and most of the people watching are not going to be the exception to the rule, I'm going with the idea that if your partner doesn't supports no problem on your part, you are responsible for all this, then the probability of change is zero.

You know you have to add that recognition of change, so assuming that's who this person is, they won't change and when I call them out they look at me like you know that's cool, I'm not, you know there's nothing wrong with me, it's you and Laughton blame the person, then they'll say you're an idiot, you're a Dumb, maybe it's you who has a problem, they'll then suffer a whole new litany of emotional abuse, so you're right, both options are leave or stay, and if they stay, they will understand that they will stay. in conditions that really are not going to change much, but what capacity do we have to be impartial?

Lee tells a therapist that our partner doesn't, I get it every day 10 times a day so that when people listen, you go to a therapist. office and you are paying good money why would you lie? I know I'm not saying they're lying. What I'm saying is if I say okay, like me, my name is Jennifer and I have a husband named Paul and I'm Saying Paul is manipulative and cold, how accurate is that because maybe I'm just angry, so in which case you will be guided from that perspective and that is why it is great to work with couples, because if you work with a couple, then you can see both sides unfortunately, if Paul is in fact a sociopath, he will be manipulative, you know, so you have to be a really skilled therapist. to figure that out and smell it, you'd be surprised how many clients manage to do it.

They pull out their phone and show me the text messages and that's when I get a real idea. I see the emails. This is so good, yeah, I bet you guys don't realize you can do that even with the therapist, you can't always. some therapist listens, it's me, when my clients come in, they may bring old photo albums, I welcome everyone, show me the text messages, that helps your therapist, although any of your viewers, your therapist can Say no and I never want to. contesting how another therapist works, so I'm not saying we all will, I certainly will because I'm there because of the large number of clients I work with who have been in narcissistic or sociopathic or psychopathic relationships, it's really important to me.

I never gaslight my patients, yeah, you know, maybe you're not telling me the truth, that's what the world has been telling this person for a while, well, maybe it's not so bad and they gasped elatedly. around the world and I refuse to be someone. Who does it? There's a reason why this person picked up the phone came to my office once he spent the money to see me and if it's to come and say I'm going to give you this kind of mythological version and I think sometimes clients do that absolutely Absolutely, so what is happening is that probably nothing is changing at home because I am working in good faith so at some point they will stop coming because saying that nothing you are doing is helping me, but I have to say that it is important to me honor your truth is that I am a humanistic therapist and I really miss my orientation being existential humanist and a big part of that is that you are what I care about and for some reason you come here and say this is your experience with this person and it doesn't apply to me I doubt that I just want to understand it, that's so good.

I love the permission to present evidence and also call it to a therapist who is open to that. You know why they do that. although Kyle sometimes people mention that because everyone has doubted them and they feel like they are losing their grip on reality, that's what gaslighting does to people, it's a doubt, it's a test of their reality and I could go on. for 20 years and sometimes they have stopped trusting their own reality so much that they hand over the text messages because they don't think anyone will believe them, it's actually a pretty heartbreaking gesture, I'm not kidding, I've had clients come in. boxes of stuff and you know, it's heartbreaking because I don't think anyone has been listening to this person and they literally feel like he's losing his grip on reality and no to me it's devastating, so Jennifer comes in and she's irritated. with her husband Paul because he's a sociopath and you say look the evidence would suggest he's a sociopath but I guess Jennifer didn't marry him when he was doing all those things yeah here's the thing with these patterns narcissism sociopathy , psychopathy, these are long-standing patterns now because of the allure that we see particularly in psychopathy and narcissism, they can often keep you covered up long enough to catch on.

Okay, sociopathy tends to be a little more sloppy. I'm not really sure why people fall. for that but some people just want to get married desperately and they're just taking whoever is in front of them and saying okay I guess I can work with this and sometimes sociopaths don't tend to do that. be as successful as psychopaths, but if that person perhaps brings enough practical characteristics that you can live with, you may initially be willing to overlook the rest, so get to know this person, these red flags have been here since the beginning, returning to a conversation we had earlier in this series. about being aware and aware because when you are aware and aware you can see that Paul has characteristics that may not be good in a marriage, yes, but people are very easy to deny it and then get married.

Thinking that I will get better, that is the biggest mistake a person can make. Nothing will get better once you are married. If anything, I bet things will probably get a little worse. Yeah, you know, I'll quote my father. that he's not a therapist, he said he, look, you better be as good by the time you get married because it's just possible. I mean, some things may get better with time, you know, but I have to say you're absolutely right and every client I've ever worked with, male or female, gay or straight, whatever, culture Amy, has said they owned it, these signs were there all along and if anything they feel angry at themselves, they feel ashamed and humiliated, why didn't I do it? see this before and you will recognize it family tradition they wanted to get married they wanted to be parents they thought this person could take care of them they felt bad for them because they had a bad childhood those are the reasons why they have until the end and like we will fix this it's almost like If we got the house and it's like a fixer-upper, what could the house be and then we'll fix it up?

Yes, it's not a good idea. I will share a personal story. I had a six-year relationship that broke up in therapy. We didn't break up in therapy, but I'm in my therapist's office reviewing the relationship and I mentioned something that happened in our first few weeks of dating and that event occurred. throughout our relationship and I told my therapist yes, but I didn't know it was happening, you were in denial, I wasn't in denial, I saw it happen at first, he said that wasn't going to happen anymore and he just I did it. I don't know what was going on, he doesn't, I'll know, you just chose not to see it and I left his office angry because he went to tell me who are you to tell me that I'm going to do it, you know, but after a few. weeks I came back even though you were right I was in denial I saw it all the time I just chose to pretend it wasn't like that or make rationalizations.

I mean, the other pattern I see people do is like they're having a bad day at work, the kids. They are very noisy their father has been very sick I'm going to wait until we move into the new house I mean, it never ends well anyone can write those rationalizations and while those things may be true, their causes of stress that type of bad behavior is emotionally unacceptable Abuse is unacceptable any day of the week mmm perfect, I want to stop it right there, there were so many great takeaways and my big problem was going to the therapist with evidence, yeah, I've never done that and probably should have, yeah.

I mean, if I said, but I warn people you know, before you show up at the therapist's office bringing a bottle cap with five boxes of Records and you finish and open your phone, your therapist may say, you know, I just want to listen. about their reality, they don't want the therapy to be pierced by external realities, as I said, I respect how other therapists work given the nature of the populations I work with, that I must say sometimes clarifies something and allows them to almost feel heard. and that normalizes things for them because sometimes they say: I have to show you this because otherwise I will.

I feel like no one could believe something so extravagant. I mean, I believe you, if this helps you, of course, you know, I'm just trying to give them the feeling that I'm trying to help them feel sane and whole again yeah, by any possible path yeah, water, what's the first sign that someone should look like they think someone they know is a psychopath, I mean, if you come to find out that they are breaking important rules, moral codes, codesethics or laws now, obviously, on a first date, a person doesn't want to say, unless they have something like "I just broke the law," a bracelet around their ankle, you know I don't think most people They like to put their criminal record in front of you on a first date, so you know, but pay attention to even see how they might handle breaking the rules in a relationship.

I don't know, they might take something that doesn't belong to them, if you know it from someone like me, I'm not a place of business, a hotel or something, it may seem like a small transgression, but it will be enough to make you feel uncomfortable, they can share something that they did at work that feels like it's on the wrong side of the shadow, you know there's enough of those little things that start to add up and you know the danger is like, wow, they're really skilled. like they're a hustler, their player, you know, like you think you're in some kind of cool movie with them, but it's not cool, they're actually breaking the rules and they do it over and over again and that could be a sign or sign, you know they just are and then it can end up culminating in more and more things and you can find out.

I think one of the most devastating things people have said to me when they've been in relationships with psychopaths. is what they learned along the way, they find out that this person had a history of incarceration, that he could actually be married to someone else at the same time that he lied about his occupational history, that he lied about unpaid bills and now they are ruining his credit, you might try to buy a house and find out that they had two bankruptcies in the past or something, so it may be something that you don't learn from the beginning nowadays with Google, you might be able to Look at people Psychopaths tend to use aliases, They may not be who you think they are.

Wow, can you see it? A psychopath looks different depending on the role he plays in your life, for example, a partner or a co-worker. Verse, you absolutely must remember a The psychopath front game is the best game in town, smooth, simplistic, charming, intelligent, articulate, perfectly put together. I mean, you really need to know what you're looking at so you can catch them in what they're doing, so that If they're trying to attract you as a new partner, they'll bring their game, if they're trying to impress someone in the workplace, they'll bring their game. , however, if you are someone disposable. or expendable to them or to someone they consider you to be at their service so help you God is all I have to say if you find yourself in a relationship with a psychopath or believe that your husband or boyfriend, let's say, is a psychopath, is there any questions? you could ask them to find out if you're right.

I'd say what you wanted was to look for inconsistencies in his story and figure it out. talk to people who know them now. I'm not saying you need to go to CSI about this and start this interrogation of everyone who's ever met them, but try to see if there's continuity if the dates line up, if his life story lines up, if you know he might have said they went to college in one place and another person says yes when they graduated. You were working at this job and you feel that something is not right. Psychopaths often go to great lengths to isolate their partner from other people who know their stories.

They look for that pattern. Why haven't you been introduced to anyone in the past? I often say they did me wrong and make up some dramatic story about how everyone did this to them so they have nothing to do with anyone from their past, it's pretty rare that someone cuts everyone off, all the friends, all the family, to the entire extended family, it may be that they are on a new path to start and are kind. of reinventing themselves and that you are in the line of sight of a scammer type of person right now, so look for psychological inconsistencies.

Psychopathy is not an all-time diagnosis, no, but can someone have psychopathic tendencies but not be psychopathic? a psychopath, you know, I mean, it's you, but again you're splitting your hair, you're splitting your hair because there's no diagonal if you have five psychopathic tendencies then you're a psychopath, right? You know, people who have tastes really are. They break the rules in this consistent way and they are cold and they don't take responsibility and they are deceitful and manipulative and exploitative. I mean, these things tend to go together, it's very rare that a person exploits other people, but then they're really sweet and they sell cakes and they run a Girl Scout troop like you're not going to see those things together, these things get grouped together. , so the more you have the more likely you are to deal with someone who is truly a psychopath, I like the conclusion of looking for inconsistencies and this person and if you are in a relationship with them, you have the option to leave, but if you have a partner job. for example, you can't necessarily leave them, so how do you adapt to working with a psychopath?

If you suspect you're working with a psychopath, what you want to do is really want to cover your bases. Remember that Human Resources is not. I'm going to help you unless you have documentation, you can't just walk in and say, "Hey, the person in the next cubicle is a psychopath, they'll say, "Okay, that's it, I look at the red circle," you know. , so if I mean me." always tell people every time you start a new job you almost have to be a little paranoid you start you save every email you create folders you get that stuff off the server you print it like you know all these steps you should really follow If you think you're working with a psychopath but you want to make sure you document things, you want to avoid having one-on-one meetings with him, you want to make sure a third party is present, you want to make sure minutes are taken. of the meetings you want, you know, most of the time people scan the minutes and they don't really pay attention, pay attention to those minutes because that might be the only documentation you have and then you want to make sure you have alliances at work, people you can trust. but what you don't want to do is gossip about the psychopath because they are better than you at that, they are already stabbing you in the back and in many other places you can't see, you know the way ahead. they will play this game better than you so you better play a fair game yeah yeah and then try to beat them at their own game yeah very good advice.

What about family members? How can you tell if your mom, yeah, I mean it's incredibly painful because I have to tell you one thing that I've seen in more than a few family systems is that some people don't refuse to believe it like I refuse to believe that just we are being dramatic and They will say that they are not psychopaths and then you will have these families that will also be schisms, they were not divided, as people will say. I think you're exaggerating. I think you know they're actually going to gaslight the person who's doing it. accusation, so it can be very painful if you realize that one or God forbid, both of your parents are psychopaths.

It's a very painful revelation, but I have to tell you that you probably realized that when you were a child, psychopathic parents tend to be abusive. Negligent manipulator, one of the most famous psychopaths out there is Bernie Madoff mm-hmm, okay if you look at him, he is used as a classic example of a psychopath and he was very rich and raised his children in tremendous comfort, certainly not them. was hitting. with a stick or, you know, lock them in the basement or deprive them, but there was a cruel touch to him and his children would recognize that if you look at any retelling of that story, it's definitely not a comfortable relationship, some people are high functioning. psychopathic parents, a father who is a CEO or a mother who is really, you know, successful at whatever she's done and they'll report that she has two parents, the public persona and this really cruel, crippling, malicious, horrible person who would come back home and keep in mind the dichotomy of how fluidly your parents would go between those two worlds and so on and subject their children to kinds of unrealistic expectations, so people, it's not like a person wakes up at 30 and say, oh dad, he was a psychopath, you know.

You know, is there such a thing as a self-aware psychopath? The funny thing about psychopaths is that I don't even think they'll get mad if you call them psychopaths because they don't care what anyone thinks of them, so if you go up, they'll laugh, you wouldn't even be a narcissist if you got super defensive, they psychopaths like you want to call me a psychopath, call me a psychopath that's how they respond but do they think hmm yeah I'm a psychopath yeah? I know that they are not affected by the evaluations or labels that other people put on them.

What they don't like. I know it doesn't affect them, but do they recognize that they are psychopaths? Maybe yes, maybe yes, maybe yes. in some cases they might and if anything it's like there's a sadistic glee mmm-hmm you see what I'm saying, they might recognize it, like how cool I became, how cool, like I'm a psychopath and getting away with it. mine or I'm a psychopath and look how much money I'm making or you know, it's almost like I don't know, it's like finding a bag of money on the street that was dropped by an armored truck and you' It's like there's no one around and I'm picking this up and I'm walking down the street and I'm getting my way, like your whole life is about getting your way, so if anything, that bathroom might even be like a badge of honor, but no.

I do it again, I think they are immune to other people's criticism, that's where they are different from the daffodil, the daffodil hates being criticized, right, psychopaths don't care, yeah, what are we talking about, what are we not? We are talking? about when it comes to identifying a psychopath what people need to know I think with a psychopath it's really about looking for inconsistencies inconsistency in mood inconsistency in life history inconsistency in their stories the problem is that we want to believe when we meet someone new who's stories are real I just met a cool person who we make the puzzle pieces fit even when they don't.

I tell people to be cynical when the dates don't match. Recreate it. Listen. Google is doing some of. This is possible - no, I'm not, I mean, it's not like I want everyone to do it. I said go out and play as a junior detective, but if you're isolated from someone who knows something about this person, pay attention to what you know first. you completely because of your recreation of the events you look for things that don't add up, you have this huge job like you are very successful but you don't have enough money to get through the month, but can you help me this month?

Like next month, the big payouts are coming out, I mean, I've got everything covered from then on, you know, anything that feels like a hustle is probably a hustle, we're seeing that there are certain programs, like for example, transition to prison. and you know other programs that work more with incarcerated groups with antisocial personality disorders that have found some usefulness in some forms of social skills training, group therapies, some luck with cognitive behavioral therapies, there has been some good work there, You know, listen at the end of the day it's like you know the old joke about how many psychologists it takes to change a light bulb but you have to want to change.

It's the same with antisocial personality disorder. You know that the person has to want to change and you know that you can. or not, I have to be honest with you, it's more of those slick, simplistic charmers, almost if you want to call them white collar psychopaths, that's what you're going to get absolutely, we're there, I mean, I think there's absolutely no chance. of change there, I think that actually in criminal populations it is possible to do some level of job training, social skills training, work focused on meaning and purpose and, in fact, I would bet on the incarcerated population more than the type of the skilled, you know, the sophisticated and successful group of psychopaths, frankly, because there is almost no motivation for change, they are being rewarded for their behavior, that's right, they are there in their world, they are killing, they are killing it, They are killing. that and the world is telling them that they are killing it too, right, yeah, so maybe cured is the wrong word, yeah, could a psychopathic person at least get to a point where they don't break the rules?

I mean, that's it. obviously the goal and that's the goal of rehabilitation after prison and that type of thing is that there is no recidivism and we try to prevent recidivism is where we are trying to prevent a person from committing crimes again, but you know criminal behavior or illegal behavior is only part of what we see as an antisocial personality disorder, we are also seeing a violation of ethics, morals or social norms, so, for example, someone who has an antisocial personality or psychopathy is They are very likely to cheat on their romantic partner if they have one and they will probably continue to do so because they really are, they are almost immune to it, any sense of morality and that is not going to change, which can make it very difficult to maintain any type of relationship. of trust with someone. well, so I think some of theTreatment goals may be in terms of illegal behavior, they may be willing to take some of that effort if they want to more legal behavior, but even then you will see that their tendency will be to want to take moral and ethical shortcuts, what is it really like?

Treatment for these people, you know, a lot of it is, again, it's cognitive behavioral, it's challenging their beliefs and changing their beliefs and thoughts and a hope to change their behavior. really what you're trying to do right and that's where you're rejecting their cognitions rejecting their schemas about their sense of how the world works trying to improve their sense of empathy, you know you really help them focus on this is how people get hurt. , especially if it's kind of not a person-on-person crime, but a violent crime, something that feels more remote than somehow helping them see that this is hurting someone else and the people around them now. a person who is really a stone cold psychopath, they don't care, so I don't care if I'm hurting someone, I don't care and if that's the case, how are you going to make changes there if I?

Don't think that something I'm doing is wrong, like if someone tells me tomorrow that it's wrong to turn off the light in my room when I sleep, oh why is that a problem. That's a very good way. To say that, that's how far away it is, yeah, what do you mean I have to make a hundred million dollars? Yes, do it, you know I will and no one will stop me or it will be a game again. I'm going to bring out the Bernie. Madoff case because it's like a real textbook, kind of antisocial psychopathic personality, kind of person in a way it's almost like it's a trick for him at some point how much money does a person make?

Well, that's not the price you have to pay. Honestly, yeah, yeah, that's all he was and I felt like that's what he was even though literally so many people's lives were destroyed by his decisions, it didn't even feel like the game was more important than the games. other people and that's what it is. like they're gamers who really only care about the game so someone is watching this. I doubt they are psychopaths, they are probably not in a relationship with someone, anyone, they are a family member, a family member, or work with them, or work with them, yes they probably are.

They are going to be advised to go seek therapy themselves in that therapy session. What do you ask the therapist? Because what I want to happen to them is that they don't have to go to five therapy sessions to figure out what it is. a psychopath and all these things that you're educating them about and giving them the tools to ask the therapist so that maybe in the first session they can play a bunch of games, it depends on the psychopath's relationship, is this your child? Is this your coworker? Is this your husband? You know this, because obviously the nature of the relationship will have a lot to do with what you need to know, for example, if it is your child, the question that many parents will have is: Am I responsible?

This we will address the whole child topic in our next video, so let's say this is for a loved one, so you mean one part of a romantic couple, is it possible that he can change because he keeps telling me that he will? we have kids together, can I expect him to be a decent co-parent if we have kids? Should he be afraid? You know, I keep giving him second chances, but it never works, so why don't you know if it's possible for him to change those are the kind of questions that you're going to know that someone should probably ask and you know, in general, if that person has any experience in psychopathy or antisocial personality, will be able to give you some direct answers on that, like I said, these people are not made for long-term intimate relationships, they are not, and what if someone is in a position where their partner earn all the money?

They have nothing in common. scenario and they have five children and they come to a therapist and say: you're telling me he's not going to change and you're telling me to leave. For all these reasons, I simply won't tell him to leave. I would do it. So I don't tell them, okay, but they say this is going to be very difficult and that person says I want to stay in the relationship now, what's your response to that? So I'll say look at the history of what he's been like so far. How is he going to continue to be fine?

He hasn't been listening to you. He's not going to start. He's been cheating on you. He's going to continue. He's been disrespecting you. That's going to continue like everything you're seeing. I said, at least you've already done it, the roadmap. No. they expect nothing you expect nothing do you help them with coping strategies? things like continuing if they can continue staying in therapy group therapy. I make sure that people, women in particular who are in relationships with men who have antisocial personality disorder or psychopathy, have access to domestic services. resources of violence because that's not an uncommon pattern in these relationships, encourage them to cultivate some of their own interests, encourage them to cultivate friendships and their partner will probably try to isolate them from those friendships, but create, you know, even if it's communities online, you know and me.

I want to tell listeners in the medical circle that the guidance we are providing right now is not intended to serve a person who is in a violent relationship if you are in a relationship in which you or other children or other dependent adults in your environment are in danger, you should seek help immediately, you should seek domestic violence services, law enforcement and keep in mind that if you are browsing those online resources on a computer, make sure you clear your cache every time because it is not unusual in those relationships that a couple goes Review and look for everything that you've looked for, it's that level of control, so I want listeners to understand that what we're talking about are situations where it hasn't escalated to violence, financial abuse, things that they put you at abject risk that this This is not a substitute for the counseling that someone needs in that type of situation and can go back and forth with psychopaths.

It is not uncommon to create an exit strategy for the relationship. Every part of her is a part of her now, unfortunately, this is where Sometimes it exactly starts to get you into the world of restraining orders and really painful custody hearings. If the antisocial personality pattern has more financial resources in you, they may try to crush you in court. They will be able to charm the judge. They will be able to charm the lawyers. They will be able to charm custody evaluators. I've seen these things go very, very bad for people. People who lose custody of their children.

People who get limited custody. Sometimes the psychopathic parent wants custody of that child not because they are interested in the child, but because they want to hit the other parent, which is not good for anyone in this situation, so I tell people that they need a plan, they need a plan. strategy, you need support and after all, it still might not go your way and I wish I could give people It's like a really sugarcoated version of this, but people say well, the judge is going to see through him, not necessarily well. I'm glad you're not giving a sugarcoated notion because what we're doing here is giving reality the The reality of mental health and the reality on this topic is what was just described and let's not shy away from reality because it makes us feel right at the right time, let's lean into it so we can work within the realms of what is real and do. the best decisions we can, yeah, and I think you've given a lot of our viewers practical steps that they absolutely need to take, but you have to do it.

I mean, these relationships can get dangerous, yeah, you know, and also listen, I'll tell you. You say this, if a person's psychopathic or antisocial personality is very high functioning, like the head of a company or something like very high in a political structure or something, the world may not believe them, yeah, and that's me, even It's more horrible, and in fact, wealthier women tend to be less likely to seek out domestic violence resources, which is not an uncommon situation in these relationships. I mean, this is a dark space and, again, I think some people may be watching now and scratching their heads and saying how did the person not see this, how did they get in in the first place listen and you know, a lot of flashing, a lot of sizzling, all of it.

Around you they say oh my God, she is so generous, he is so kind, oh my God, he is. he's taken us all on this fantastic vacation or you know he's looking after you or actually, you know, let's say you have a child and he's offering to look after him; That all seems very good to the world and many people do not stop in those circumstances to ask the right questions, that is a really good conclusion for people who know someone who is in a relationship with a psychopath; make sure to ask him, check, yeah, yeah, and when I sat down with Kevin Hines. that he survived what would normally be a fatal jump off the Golden Gate Bridge, really drove home the point of checking in with people asking how are you, but not seriously, oh hi, how are you?

Well, that's the surface that never heard that. really come on, hey, you're in a relationship with this person, but what's that like how you feel? Yes, relationships with people often don't like to pull that curtain back. I don't know if it's because they don't want to do it. know the answer or if they feel like they're being nosy or it feels intrusive or something like that, especially if you want to say, I think even if you don't know someone well, it's cool that you've met them, how are you? Well, it's a good relationship. I think people often say: why would you ask me that?

I think it's an interesting question because if it's a great relationship and it's healthy, you'd say I'm very lucky, like it's a really, really happy relationship. relationship at the very least would make anyone stop and think dr. Ramani explained why a child cannot be diagnosed as a cycle first because it is a pattern, a type of diagnostic label that is reserved for people over 18 years of age. Antisocial personality disorder is not diagnosed until someone is over 18 years old, but in children. we can look for patterns that really fit delinquency mm-hmm these can be milder patterns like truancy, cheating on schoolwork, to more severe ones like physically or sexually assaulting peers could be things like torturing animals I'm starting fires all of these behaviors you know, if you have, I think three or more of these types of behaviors qualify a child to be diagnosed with something called conduct disorder.

Now these children are typically handled through the school and juvenile justice systems, they can be placed in special school settings, they can be sent. to a kind of special boarding school environment if the family has the money, unfortunately some of them can also end up in juvenile detention environments, where we know that they are grouped with other kids doing these things, so sometimes they learn more about criminality in those environments, so if you notice these patterns in a child, they're bullying you, any of those things you want to act on, Swift leads early, early and intensely.

I think part of the reason this is always so complicated is that sometimes it's the kids that the kids is that childhood in all those childish fights that are just kids being kids, that's kids being kids and that's often It is used in defense of something that people could get ahead of, but it is not as simple as today, we have a new problem to analyze. with kids and that's their online activity, you might not have a kid that's going to school and causing trouble there, but what you might have is a kid that's really getting into dark spaces online, whether it's through social networks or even websites and some type of social networks. networks that are not commonly used, you want to watch your video games, while your research associating violent video game play or video game play and violent behavior is equivocal at best, we're not really seeing patterns consistent, your child is blocked.

They are in a room all day playing those video games alone, are they socially isolated, how do they treat their siblings, are they interactive at family gatherings or are they distant and remote, so there are many places where you can witness this child and there are many of many. ways, it's not just the acting, part of it is also that extreme social withdrawal, you're their parent, they don't have cybersecurity, you can go through their stuff and that's a good thing, yes, it's a good thing, but yes As a parent, you're in a position where you feel your child is showing some of these signs and symptoms.

Be glad he's at least not 18 so you can understand that you can take control, yes, a lot. of parents hear, a lot of these kids are more knowledgeable about electronic spaces than their parents, that's all, so they can really know how to bury things and you know there can be websites and extreme websites that parents don't even know they exist. It is becoming more and more challenging to monitor all of these types of situations that children might be in.going to really dangerous places. At that point, you can really only engage in early intervention, like I said, partly through schools and partly through people.

They have this as a specialization and at that moment they expect the best. I've talked to a lot of our viewers and it helps me learn what helps them and one of the things they've shared with me is that when they're watching videos like this and you just look to see if they're isolating if they're interacting with people they have family functions and you checked this list come back. In this video he reproduces those answers again that Dr. Romani just gave and wrote down those questions and for the next week, two weeks a month, write down what you're observing because we're so caught up in getting the kids to school, making lunches, and missing the parenting that we do and don't. .

I don't always pay attention, no, so if you write that down and you really take the time to look and write, yeah, then you can take something to a therapist and say this is what I've been observing, so we have a history here. and we start to speed up the therapy process so that they get as much correct information as possible and one thing that is also complicated is Kyle and you and as a parent I can understand that some parents are just in a place of denial and don't even want to let each other carry, they feel like it's scary to think not only that something could be wrong but that their child could be potentially dangerous to other people and the parents think, well, maybe it's different at the new school, maybe it is. be different next year this is something you know maybe maybe this is a phase exactly maybe it is, but it's better that you explore it instead of saying two years later I wish I had started something back then and started trying to get to the bottom of the matter.

This is difficult if the child objects enough, even taking him to a mental health professional may get him nowhere, but I think to let the parents at least know that they tried, the more resources you put into something early, the more likely will have to achieve it. have a good result yes, what would you like more parents to do? Knows? I think so. I wish more parents were willing to have emotional conversations with their children early on. I must say that we are having a real crisis of emotional expression. in our culture and I think that unfortunately it is concentrated in men and boys who we do not give permission to talk about their feelings, we see vulnerability as weakness, we see talking about feelings as weakness, we feminize it and that is opposed to making it weak as well.

I think a lot of the bubbles that we see in men are just the inability to talk about their feelings, their fears, their Angs, their vulnerabilities and I think sometimes fathers are even afraid to go there to open those Pandora's boxes and with the technology that children have. they become almost like they're talking, we're speaking two different languages ​​in a home and it's just to give permission for those conversations and you know, and I think parents often feel like they have to give their kids solutions, sometimes everything what they need what I do is let them talk let them talk and listen I listen I have to realize that all the time I have a very long trip to school for my daughter I used to try to say well let's fix it and I had it It took a while to say : I'll let her talk.

I'll let her talk and talk and talk and not try to find a solution every time and which is difficult when you're a psychologist. Well, I find it funny. It's hard, I think it would be very easy for you to just listen, it's like you want to write because it's your child, and I think a lot of parents, even well-meaning parents, know that it's time for you, like you said, to come home. You're making dinner You're running around You're doing homework all this time Something like let's just lay under the covers and have an emotional conversation, when does that happen?

Good timing, take advantage of the moment to just make a lightbulb go on in my head. I recorded it in our depression series with dr. I sued Varma because at nine years old I was diagnosed with clinical depression and put on Prozac completely suicidal and I shared more of my history of depression throughout that, but during or throughout my life, but during that time I remember having episodes of as I would say. panic or anxiety or just emotional outbursts and I would end up in my room in bed and just wishing my mom would come in and talk to me.

No, I wouldn't go, he would be the classic red, no. I would never go, that's so important and I was there, oh God, hopefully, and when I heard that knock on that door, that door opened, it was like a relief, yeah, because I'm going, she'll let me talk now, yeah, and It was like this. a I didn't realize until you said that thing about letting them talk, yeah, give me that outlet to be like this, this is what I feel here, yeah, because for some reason I couldn't manage my health and a healthy well-being, I think.

We, as parents, are not art, we do not wait for our child to come looking for us, we have to be, we have to be the early warning mechanisms that we have to control in our children, that balance will change one day, but not forever. be our responsibility, but it's really about paying attention and, again, it's something that I've regretted as a very busy mother and there were times when I wanted to give her advice when all she needed was to be listened to, you know, and I guess we learned and evolved and kept trying to get it right mm-hmm if a parent takes their child to a therapist and gets diagnosed.

I always forget that in conduct disorder, conduct disorder, what are the chances with the right intervention that this child won't do it? develop psychopathic tendencies as an adult, you know that my knowledge based on Syria is not good enough to give you a specific probability. I would feel uncomfortable doing it because this is a high stakes game, let me put it this way, your mistakes are many. much better if you take them to a therapist than if you don't, yeah, you're improving your odds, you know, I think a lot, it's a lot, it's going to depend on the child's behavior pattern and the environments that they're in. in the resources to help the child there will be other complementary programs for that child, for example, there are some programs that use things like martial arts and those types of physical programs to channel some of the strong feelings that these children have. in the martial arts discipline, so you will see some of those types of programs.

Someone I know works on those types of programs with gang-affiliated youth, so there are different types of innovative programs that target kids using art and music. using physicality, you want to use as many of these resources as possible to give that child the opportunity to express themselves when maybe they can't find the words, maybe they can find another way out. Give us some advice for parents on this. In those initial therapy visits with that child, you know when you bring a child in for therapy initially, while different therapists who work with children under 18 work differently, most of them from Stalin, we're going to want to meet with parents once and sit with you. because a lot of times a child won't be able to relate his own developmental story, like if there were complications in the birth and his milestones or all that, so let the parents do that and then they'll have to work it out with the therapist. how you are going to communicate it to the child who is in adolescence; that child might want a private space and then agree with the therapist when she will contact you or he will contact you if the child is in danger if there are symptoms that concern them you want to make sure the teen feels okay with that, with younger children it is less of an issue it tends to be more of an open book and more open conversation you as a parent should ask some questions about how they work you know with your child and what kinds of things they are going to expect from you. a child, they will expect their child to do something between sessions, so I think it ends up becoming collaborative.

I also have to say that Cuyler can be useful. families to go into family therapy where everyone is in the room mom dad or whoever the caregivers are Dino whether it's the caregivers whether it's a single parent the siblings and the child because these tend to be systemic problems I think there is a real risk of some type of labeling that one child is the problem child and that child is probably already experiencing that sense of identity within the family, especially if there are other siblings who follow the rules and don't believe that by having family therapy there could be an opportunity for everyone they benefit. to be a little more aware of the dynamics, but it is early intervention, it is regular intervention, it is multimodal intervention, which means that we are using different techniques to help them, it is monitoring and then it is a leap of faith, what is at stake is never It's both when it comes to a child.

Yes, I agree and what aren't we telling parents about psychopathic tendencies and their children? We have to tell them. You know, we're learning more and more about this. I mean, I think it's something that movies sometimes show in this kind of scary horror. type of film sequence is an area where there are some specialists who are working in this area, it is difficult because there are so many moving parts here to listen to the child who comes from a violent, deprived and abusive home. I'm not so sure I'll be seeing this if the parents are abusing them.

I don't know if they're watching videos to figure out how to help their kids, so those kids are probably going to have worse outcomes in getting custody of the child or something. Now you're trying, yes, but in that type of scenario exactly now that the child has a constant caregiver for that family member or another person who may have intervened in this child's life, there is a regular intervention and that child can be really different and have curved arms. you know they're going to do that, they're going to do Stonewall and they're children and you're going to keep trying to find that way to reach them and that's why therapists use all kinds of techniques, even games with a child, I mean the therapist children, I work with very, very creative and very talented children, it is a very difficult job to do and there are people who specialize in this and there are also experts who cross that line between the justice system and psychology who are working, they know the programs cutting-edge for youth who are vulnerable to ongoing crime, ongoing criminal behavior, or who are participating in it.

First I want to thank you for sharing that because hopefully this is and I think it will change the path of many, I hope so. I don't think people understand and I think for me, especially in a day when you know working clinically with clients is the devastation that occurs when someone abuses a child, yeah. to me it's a passion it's a fight it's an absolute there's something about it that the pure innocence of a child puts his trust in the adults around him and that trust is betrayed that ramification lasts a lifetime it's a self-doubt, to sometimes it's self-harm, it can be a mental illness on the positive side, yes we can often see resilience, growth, empathy and many other things, and we can also see darker patterns like psychopathy and sociopathy, but I think I can't emphasize enough how important it is to protect our children they are our children or not their children they are my children they are our children these are the people who will take care of the world as we age and our total disregard at times towards the well-being of the children is concerning to me, that's why I want people to listen to this and really get the feeling of paying attention to the children around you, pay close attention because for many people that I've worked with over the years, even the students I have talked to if a person had listened and paid attention to them when they were children.

Things could have been very different. Yes, you mentioned in previous videos that people know once they become adults if their parents have antisocial personality disorder. I may not know the label, but it means that most likely if they had a psychopathic father or a sociopathic father or, you know, an antisocial personality patient, I mean your parents, I should say that they would have had a father with whom would end. the family that would have been very common as missing or physically hurt, either themselves or their mother, or you know other people in the family or they could have gone to jail, you know, for actually committing some kind of crime. atrocious, so something is going to happen. be some kind of bell maybe they don't know what it's called but they will know I don't know yeah, it's not subtle it's not subtle how many of these how many of these children who are now adults have relationships with their parents who are a psychopath or sociopath, you know, It depends, you know, it really depends on the nature of the parent's transgressions, obviously someone abandoned the child, some people out of curiosity, as an adult, may come back and want to try to have a relationship with that parent if they were horriblyabused by that parent and often they won't, but listen, it's surprising how many people who had abusive parents still stay in the game with their parents.

I don't know, maybe it's almost like a loop that they get stuck in. I'm still trying to think that they can win them over or that something would change their behavior, so some do, certainly many don't because the parent's transgressions are so horrible or they just cut them out of the child's life and never come back. , Well I think. Of all the categories, children and parents are the most difficult because I have the choice, although it can be very difficult to leave my partner. I have the option of leaving my job if my boss has antisocial personality disorder, but I can.

I'm not going to look for a new birth mother. No, I can't have it. I guess I could have another child, but I still have the one I have. Yeah, well, I mean, if you're talking about him being your father, can you leave a father? Surely you're right, you can, you're right, you know, I mean, I think the anguish that I see in people is when they realize that their parents just did a bad job, they were negligent, they were abusive, they just weren't, They shouldn't have been. A parent's conclusion, yes that awareness is devastating because you are right, you only have one set of parents now and they may not always be biological parents, sometimes adoptive parents come into the picture in that person's life and that is the only father they have.

I know it may be a little more, it could be a more complex dynamic than you think, if that abuse from the adoptive parents is making you wonder why this has gone differently, but ultimately it is the feeling of loss of not was. I feel like I've been robbed. I could have had a healthy relationship with my parents, which is a very important relationship, not only for a child, obviously critically important for a child, but also, even in adulthood, the person feels that something has been stolen from them, without However, think about that as getting caught up in the fact that someone is assigned a job they probably weren't good at, i.e. your parents.

Some people who are good at this actually look for mentoring figures and other adults, it could be a grandparent, it could be an aunt or uncle, it could be some other trusted adult in the family system or it could even be a mentor they know in the path as a college in high school college, what you know at work is that they find someone who becomes that father or mother figure for them and they have that relationship there is still a longing, gosh, I just wish this would have been my father, I was born to life doesn't always look the way we want, you know, and when fighting, I say this is My parents need to be right and fight for something that is completely useless and that you will never get and that feels like a waste of time, so I want to divide this into two categories, the first category for people who are in that position. where look, I go to Thanksgiving every year and I see my parents and I have to know how to deal with them and the second one is for the people who say, you know what I'm over from them, I've broken up but I need to get back on my feet. of that, that's good and maybe both people need to read, yeah, so let's start with the first one.

What do you say to people who still want or feel they need to have a relationship with their parents? Do you know when people feel like they need? If you need that, then I say: You have to manage your expectations. You have to be realistic about it. They will never be cheerleaders. They may be downright jealous of you. They may try to undermine you. They may try to take money or resources from you. They may try to manipulate you because these are all things they have already done, so they are not going to stop. Yeah, so can you go instead of waiting for something?

You're waiting for me to love you and maybe it'll never come or me. I'm proud of you, that may never come and that's why you're waiting for something that may not come and that may be heartbreaking, but if you can say listen, I want to know. I like the idea that I have a father out there somewhere and I. Know that they will always be wrong if you can accept that and really manage their expectations. Then move on, have your relationship with them, but keep being surprised that they are acting wrong after a lifetime of acting wrong, that's what actually feels illogical.

You know, it's easy to be illogical because it's a matter of the heart, but you have to be realistic. about the expectations you bring to this situation which, first of all, is so simple mm-hmm, my favorite things are the simple ones because they are often underestimated and the most powerful, yes this has been happening your whole life just because you Now you're an adult and you can point out what it is, doesn't mean it's going to be different now, no, and if you could just let it go, let it go, realize that this is the depth of the hand you were dealt, yeah, and just like Anika, look.

You know sometimes you're going to have to fold your hand and say I'm done playing this. I'm fine, you know you say let it go and gather for me, it translates to forgive and mash that jaggon. I want to hear all about that answer because my definition of forgiveness is losing hope that the past could have been different. It doesn't mean I'm saying what you did was okay, it was terrible, but I'm going to abandon the idea. that my childhood could have been different because I couldn't not, I mean, that's fair. Actually, what you're describing I tend to use the word acceptance, except I use the word acceptance.

Forgiveness for me is something that happened and no longer. Does that bother you mm-hmm I don't know many people who have made it to that bar like I forgive people who might cancel dinner plans mm-hmm I can live with that I don't know if I would forgive someone who fundamentally betrayed my trust It depends , it depends, but yeah, we could have a whole conversation about the only one of you who knows it's about forgiveness. Here's the problem with forgiveness. Okay, when we give it to someone else, we hope they will treasure it and treat it as something truly almost divine. gift that is, thank you so much for this because it feels almost like an absolution, right, I'm going to honor this and do it right and I'm so sorry for the pain that I caused you, thank you, thank you for being grateful. to you for seeing this better part of me and them making real change, that's an example of how forgiveness works hmm, but where forgiveness can be devastating is when you try your best to forgive someone and they turn around and he does it again. to you again what would they do what would they do yeah, for me forgiveness isn't even about that for me it's about okay, it's me really taking a moment with myself to go, you know, that's okay, or am I going to insist? in this. and you get angry and you know, reflect on it or I'll leave and you're okay with them doing it again if I'm not okay with it, but I accept that that's their behavior, okay, I accept, yeah, that's why I can.

I have made the right decision to have them in my life and I have to know what is coming because if you forgive them, because for me forgiveness is very much a and many people argue that what you do philosophically forgiveness is an act towards oneself. okay, it's for yourself, so I can, but for me that's letting go, as I can say, letting something go, when you let something go, it doesn't necessarily mean that you've let go of the resentment, does that make sense, like I thought? this. Come on, I'll tell you that even though this relationship has changed, yeah, that's not forgiveness, forgiveness is really like a reset now if you read Desmond Tutu's work on this and you know he was a Nobel Prize winner. from South Africa, if you read his work, he gives much more nuance to accepting forgiveness and, in fact, his work is one of my favorite works.

I'm sorry because it really says yes, this has changed the DNA of this relationship since there's no getting over that, but I mean, I think we're talking about that, you know, so we're circling around that leak of forgiveness, letting go. go and accept, but people use the word acceptance, but they don't really mean it, they will say I accept. Um, what do you mean you just did that to me again, Michael, slow down, sister, you just said you accepted that, yeah, you know, I didn't really mean it, so they didn't accept it and you didn't forgive him, You know? so be clear on your terms and listen to some people, you can really transgress them and they might actually forgive you and they'll be fine and you're going to do it again and you're going to do it again and that's not what most of the people I have signed up for Yes and sometimes when people feel that I have given you this divine gift of my forgiveness and you continue to abuse it, that feels like external devastation to the people in your practice.

Do you find that your patients talk a lot about their parents? a number one is like Freud's stereotype and I know that we don't start there, we start with what brought them, which could be marital problems, work problems, low self-esteem, problems with their weight, anything, but it is current, these other rare time they produce. One person comes up and says, "I'd like to figure out the damage caused by weight at age 35 at some point, especially since my work is with people who are trying to be survivors of narcissistic psychopathic or other types of toxic relationships." Will I need to understand where its precedent came from?

Why do you think putting up with this is okay? And many times we receive some of those answers in their childhood. That's why we explored there. I am NOT a psychoanalyst. trained therapists or dynamically oriented psychedelics, but I firmly believe that when we observe the patterns of someone's life we ​​learn about things like attachment, the nature of their sense of security in their close relationships, we learn why they were rewarded and why they were not. rewarded or if they were rewarded at all we learn what they learned about love and what a relationship is like we learn if they've had a history of trauma we learn a lot from understanding those early relationships yeah, I think that's really It's wonderful that people I listened to it because, hopefully, they have taken or will take the step of going to therapy and not being afraid to speak the truth.

Yes, when it comes to their parents. Yes. In my personal experience going to therapy, I have found that I am often protective. Yes, my parents to the therapist, he would ask me a point-blank question and I would paint it so that my parents looked better than maybe they really were and I found myself doing that and then of course we discussed why I was doing that , but coming from that honest place of your upbringing is super powerful in therapy, yeah, yeah, and it's not always easy for people to feel like they're being disloyal, it's something that goes back to childhood, you know, kids get They feel incredibly loyal to their parents and that's why, even as adults, we cling to them. some of that and coming out, you know, there's some self-protection in therapy that's not necessary because the therapist will probably never meet your parents, your parents might even be dead, you know, and people still feel that it's deeply unfair. so it's an interesting space for people about how protective they can be even of their abusers, yeah, you know, when they talk about those stories in the future.

I think I know the answer to this, but do you find that people who were raised by parents or A parent with antisocial personality disorder end up in a relationship with someone who maybe is antisocial. People who witness abusive relationships as children. There is a risk that they will enter into such relationships. It's a certain level. Violence became normalized on some level. They think that it could be all they deserve, probably where there was domestic violence there was also at least verbal abuse towards those children, if not also physical abuse, so it is a feeling of devaluation, that is why I said that I get so angry when I hear that the Children are exposed to traumatizing environments early because it changes their view of the world and, more importantly, their view of themselves and, ultimately, the decisions they make now, again.

I always want to emphasize to listeners if you come from a family of origin where there was antisocial personality or psychopathy. and there was abuse, are you condemned to repeat those cycles? No, no, a lot of this is awareness. Yes, you really do try your best. You receive therapy. You are very aware and aware. It is when you are not aware. It's when you are. denying that you run the risk of making those kinds of mistakes, yes, but it is awareness followed by action, awareness and then going to therapy, awareness and seeking this education, awareness and talking to friends to get the support system that action is very critical, but it is also awareness and mindfulness and you know and allow yourself when you are given a signal, it is only useful if you are willing to warm up, that is not the truth, that is the truth. when I say that again, when you are given a sign, yes, and there are many, there are many, it is only useful if you pay attention to that sign, yes, and when many people realize that there was that sign and I chose ignore it. for various reasons if they had just taken a step and walked away then so much the better yes I have done it all of us many other times yes last night I was telling my friend I told him when this was in my relationship he should have done it.

I just called him, but you didn't know it, but Kyle, this is where I'm going to be nice to you and everyone listening to myself, is that there's a point in thethat sometimes, if we walk away too soon, we are forever paralyzed by the H of regrets, regret, did I walk away too soon? I mean, all I want is for people to feel like they can take advantage of that moment by taking in the information and experiences around them, trust their feelings, and when they start to feel uncomfortable, they can give of themselves. Permission to communicate or walk away with as little harm as possible If you walked away at that first sign, you may have spent the rest of your life wondering if I was too much of a runaway guy and didn't give him this. a total chance versus I watched this to the end and if anything I said the funeral was too long this body was buried in the food and the wine were gone and now we're standing yeah you are and I take some uh, I feel good about it knowing that well at least I know, I know, I know that there isn't and you know my goal is to keep people away from obsessing over those nagging doubts like this it doesn't feel good to pay attention to those signs seek help for communicate some and if when you communicate with a colleague, for example, you receive a very strange rejection or you receive a lot of projection or they blame you, yes, it is already difficult to go to work every day, yes, but you mentioned it in a previous series. that between four or five percent and 21 percent of large corporations have a CEO, yeah, yeah, so what can anyone do?

I mean, I think it really comes down to how close you are to that psychopathic leader, that psychopathic leader maybe. Running the whole show now is not going to make it easy because the culture is filtered from the top down, so a really psychopathic boss can create a really toxic culture where there is a lot of backstabbing, subterfuge, lying, deceit, and people screwing each other. to each other. others under the bus, so it can be a really toxic workplace when there's someone at the top, you may not have daily contact with the person at the top of the ship, but you may have known contact with the people at the middle. that they're still affected by that kind of company culture in terms of what they need to do long term, it's not something they can do much about.

I mean, we've certainly seen in recent years more and more reports about the real dangers. of abusive workplaces and what people have endured in those environments and honestly how many people said, when I even said something, they didn't believe me or they told me, people don't say anything because that person is protected because they're making too much money. for this company, there's a reality there, it just says you're in this kind of David and Goliath battle, you're not going to win, yeah, you're really not going to win it and I wish I could sit here and say no, really, and can. go to HR and you can get a lawyer and everything may be a happy ending, it may not be and by the time this whole story unfolds you may be so broken psychologically, but friend, the battle may not be worth it, so it's really about picking your battles and being very realistic about how everything is going to turn out, but with all that being said, you know when you're in these workplaces where maybe some of your direct reports, someone you directly report to is a psychopath. , the key again.

It's something I've talked about in other medical circle videos is documenting, documenting, because like I said, if you decide to go down the route of talking to HR, you know, they're only going to be able to do a lot of documentation work. Many people don't like to hear this, but it's a realistic answer: sometimes you just can't win in those workplaces or you'd be willing to take on litigation and I really take my hat off to your bravery and I'm also rooting for you to succeed. in this. Some people don't have the resources or the patience.

At the moment they may not be, in some industries it would just end if it doesn't turn out the way you hope it never will. being able to go back to work in that industry, so it can be a really painful decision, sometimes the easiest thing is to find a new position, but for some people that is difficult because that psycho supervisor or boss may not give them a good recommendation. go into the sunsetSo you can really end up hurt from the time you spend with this psycho boss, so you know it can be pretty grim depending on the situation.

What does a psychopathic boss look like? They are very toxic. They tend to lie. I believe or say. They're very tall, quite short, ooh, but they're very toxic, they're very, they tend to lie, they tend to manipulate, they tend to pit people against each other, they thrive under division, they like it when there's a lot of infighting because it tends to. . tends to benefit them, they can be quite abusive than yelling, shouting hostility, shouting things that you would think would get them in legal trouble or at least you know HR problems, but it doesn't, they tend to take credit for things that They are not responsible. because they steal other people's ideas, they have inhumane demands on their workers, they don't show any empathy towards them, they are punitive, they would hire fire, you know, almost frivolously, yes, they would abuse their subordinates, maybe they are inappropriate with people. they work sexually or otherwise, so it's a bad scene, it's a bad scene and there's no way as an employee to handle them.

First of all, they now have power over you in this system, as I said in the best telling ever, you save all your information you have the irrefutable evidence you show up to HR that there is someone above this person in the pecking order and They say we don't care how much profit they make so we run a clean workplace. We're going to get rid of them and give them a promotion. I wish that was the story. Many times this is not the case and many people will report the processes they were put through to turn them into something like this. drop a penny if you really know, tell the truth: what a horrible psychopathic supervisor, a boss was his reach Ramatizing and so he's not even worth it anymore and that's why he can ruin a person and it's your job, it's your livelihood and because of that a psychopathic boss is usually very good at his job, he tends to make money in terms of being sick, whatever the outcome, yeah, yeah, whatever it is, I forgot about that, so of course the company will not reward.

It's true, they don't want it to be true, because this person is really willing to do sometimes the dark and cowardly things that you have to do to be successful in certain sectors, so it's one and they will try to argue, like listen to my management . The techniques are being misunderstood, you know, one person's bullying is another person's, I don't know, hard-driving type of supervisor, mm-hmm, if someone decides they don't want to take action with HR and they don't want to quit their job, what advice do you give them? Number one, you have to take care of yourself, you may know that you will be terribly depressed on Sunday nights when you know that you will face another day in that workplace, it is important that you seek therapy therapy is a confidential space, keep this in mind .

However, I do let people know that if you are going to pursue civil litigation, they will try to obtain your therapist's records, so know to be open with your therapist that this is a possibility that you will welcome. I'm just preparing people for worst-case scenarios and really psycho bosses and workplaces that are going to come in and try to run a smear campaign against you, so you have to be prepared for all that stuff, but get the help you need. You know, it builds friendships in the workplace. I was reading a very interesting study recently and they were talking about how when you have a toxic or psychopathic boss, their subordinates can gang up against their, you know, against their only enemy, if you like, common enemy and sometimes them. they end up starting their own companies or creating creative solutions to solve problems, like creating their own community independent of the psycho boss, like they come together and provide each other soup and of course the psycho boss feels good, yeah, because I I'm your boss like me. fact, yes I am a visionary leader or he can get really annoying or she can get really paranoid, why is everyone ganging up against me?

But either way, you may be able to find support from other grassroots people who working with you may not even be grassroots. I mean, I've worked with people who are at one executive level and it's the person at the next executive level that's causing them misery, so it's not like that, I mean, even you know that. it could be at the top of the top, up, it could be at the bottom, lower, it doesn't matter, it's just that that person has power over you, but it's to get the support you need, take care of you and then little by little, start working on that exit strategy.

These types of experiences are what have led some people to follow new professional careers. Back to school. Do things they never thought about, like moving to another country. Some people just see it as a wake-up call. It is not for some people. It's complete devastation, they may have worked for decades to establish themselves in a career and just watch a boss steal them away. hmm well, if it's not your boss, it could be your coworker. Yeah, what advice do you have when dealing with a partner? worker, which is a different dynamic, the same goes for a coworker, actually in some ways it can be a little more problematic because you know you're almost a little less protected, at least when it's top down you can Show more. negative effects on your job, like if you get demoted or something, you can probably make your case better, but when it comes to a coworker, they may be impeding your career progress again by stealing your ideas and creating alliances with His work partners. and turn them against you by spreading lies about you in the workplace.

It's very easy to try to go into the gutter around these things, for example to complain on social media. I have a psycho boss. I have a psycho coworker. I never go there. this kind of thing is a big no no, we are worried about HR and then they will have reason to fire you, you are just hurting yourself, some people are in such desperate situations that they want to ask their clients for help. Community social networks are not private, they are public, they are a public space, so you must be very cautious when trying to obtain the support of other people.

Social media is not the way to talk to friends, talk to a therapist. You've got everything covered, all your eyes dotted, all your stuff crossed, a psycho coworker might be finding your vulnerability, you're in armor and using it against you, so you need to make sure you're as stitched together as possible. I understand that excellent advice and Thank you again for explaining to our viewers how they can deal with people in their life who may have antisocial personality disorder in all aspects. Subscribe below and remember that this video is just scratching the surface for more in-depth videos on mental health topics.

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