Psychopathy advocacy

[Beorning]

Alright, here's something I recently stumbled upon on Youtube and I honestly don't know what to think about.

Turns out, there are some videos and channels on YT that try to engage in advocacy (in general sense, not a legal sense) and support for people with the darkest (IMO) personality disorders: psychopathy, sociopathy and narcissism. For example, here's this channel about psychopathy:

https://www.youtube.com/channel/UCEFyde_LYhSiWv92qIwLKnA/

It has interviews both with mental health experts and diagnosed psychopaths. There's also this woman:

https://www.youtube.com/c/KanikaBatra/

She claims to be a diagnosed sociopath and narcissist. Her channel has a lot of content explaining her life story and how she experiences things.

I wonder: what do you think about it? Personally, I'm conflicted. Being a psychologist by education (if not by profession), I know that personality disorders exist and they, medically, they are treated like other mental health conditions. On the other hand... I can't just separate my moral judgements from all of this is. There simply seems to be a difference between, say, someone with dependent PD (who ends up hurting only themselves) and someone with antisocial PD. People with ASPD do not care (at least to some extent) about others, lie, don't feel remorse... For me, such tendencies aren't simply a mental health problem, they are morally wrong. So, seeing people on YT come out and say "We're sociopaths, but we're really people like everyone else, don't stigmatize us" just feels... unsettling.

On the other hand, medically speaking, they *are* people with a mental health condition - and everyone deserves love and support, right? Because it's hard to deal with your mental health problems without some sort of support...

I honestly can't wrap my head around it. What do you guys think?

[Beorning]

Addendum: huh, it seems like you cannot link to YT channels? In that case, just look up "PsychopathyIs" and "Kanika Batra"...

[BlueOrange]

A diagnosis should be a tool for enabling change.

But many people want to use a diagnosis as an excuse to avoid change.

I have no interest in actually watching these people talk about how they are human and loveable. I’m sure that a sufficiently loving person can love them. But part of how they abuse and hurt people is to demand love, without being loving in return.

They’re engaging in their pathological selfishness by making these videos. I see no reason to reward their pathological selfishness.

[Thufir Hawat]

A diagnosis should be a tool for enabling change.

But many people want to use a diagnosis as an excuse to avoid change.

I have no interest in actually watching these people talk about how they are human and loveable. I’m sure that a sufficiently loving person can love them. But part of how they abuse and hurt people is to demand love, without being loving in return.

They’re engaging in their pathological selfishness by making these videos. I see no reason to reward their pathological selfishness.

More or less that.

[Azy]

They are mental disorders, and it isn't like those people wanted to be like that.  All that being said, as someone who has been abused by narcissists, I find it hard to have much sympathy for them.  Cognitive behavioral therapy can do wonders for anyone who wants to get help and puts in the work, but people with those disorders often like themselves just how they are, and see no reason to try and change. 

[BlueOrange]

They are mental disorders, and it isn't like those people wanted to be like that.  All that being said, as someone who has been abused by narcissists, I find it hard to have much sympathy for them.  Cognitive behavioral therapy can do wonders for anyone who wants to get help and puts in the work, but people with those disorders often like themselves just how they are, and see no reason to try and change.

Yes.

And sometimes people with those disorders hate themselves, and are keen to feel better. So they come up with a story about ‘not having a choice about who they are’. But the reality is that people can change, if they put in the effort and have competent support. Competent support is out there.

[Oniya]

You can't simply copy-paste channel links, because the forum software attempts to parse it as a single video - which it isn't.  If you use the URL tags, they link fine.  I've fixed the initial post so that you don't have those 'unavailable' messages on there.

That said, I have to agree with the statement that a diagnosis is only part of how you deal with any disorder - mental or physical doesn't matter.  You don't see people say 'Oh, I've been diagnosed with myopia - guess all I can do is hold the book closer.'  No - the second half of diagnosis is treatment.  My next-older sister continually diagnoses herself with conditions (and therefore has a fool for a patient) and then doesn't follow up.  So far, she's come to me with claims of anxiety disorder, ADHD, ASD - and when I recommend even therapy, she balks at it.  (I just realized that all her diagnosed conditions so far start with A.  I wonder if I should confiscate her copy of the DSM before she gets to the B's...  Just kidding, I think.)

[BlueOrange]

When it comes to junk diagnosis, ASD and ADHD seem to be the generally popular choices. Pretty much anything that isn’t right in your head will produce social difficulties or difficulties regulating attention (or both).

But yes, a diagnosis is exactly as useful as the effectiveness of the treatment it recommends.

[Azy]

The long and the short of it though is the person has to want the help and put the work in.  It's not easy.  Most things worth having aren't.  I also wish finding good help was easier.  Like my insurance, every other specialist has a co pay.  However, if it has anything to do with mental health, my deductible has to be met first, and then they pay for it with the co pay.  Ergo, the only place I can go is a community outreach program.  I learned the hard way it's a lot like playing roulette.   

[BlueOrange]

Yeah :(

Nothing makes me more motivated to interfere in American politics than the suffering of the Americans I meet in online support groups. I will always be grateful for the fact that I was able to access psychiatry while unemployed.

[RedRose]

That's one thing I didn't understand before knowing unemployed people in America do not have (much?) opportunity, asking someone online to diagnose.

As for psychopaths and sociopaths, I notice not all countries define them the same: in my country the "nice ones" are the second ones, if you will, meaning they lack many feelings but still feel stuff and still know more or less what is wrong and will not, say, go around kicking puppies, while first ones... Ted Bundy, etc. The sociopath may be the shark lawyer, the psycho is in jail or should be. I've known people who were considered low key sociopaths and giving the right conditions (not being their enemy) you could get along with them and they behaved normally. Sometimes yo uwould see something scary underneath. A few would more or less own it up if they knew you wouldn't run away.

[Oniya]

Well, sometimes it's not even 'asking someone online'.  If you type 'sociopath quiz' into your search engine, these are the top two results (just the text, not the actual links)

Where Are You On The Psychopathy Spectrum? - BuzzFeed
ht tps://www.buzzfeed.com › tomchivers › where-are-yo...
Apr 15, 2016 — Take our scientifically rigorous test. ... The following test, set by Dr Dutton, will give you an idea of where you are on that spectrum.

Can You Pass The Sociopath Test? - Playbuzz
ht tps://www.playbuzz.com › joycemartin10 › can-you-...
Nov 15, 2020 — This 15 question quiz is based on a real psychological test that analyzes levels of sociopathy and narcissism. Will you pass?

Buzzfeed.  Well known as a respected name in the medical field.

I actually clicked through to something called 'HealthyPlace', and got their list of 15 questions

Spoiler: Click to Show/Hide

1. Are you superficially charming and intelligent?
2. Do you have delusions or other signs of irrational thinking?
3. Are you overly nervous or anxious?
4. Are you generally reliable?
5. Do you regularly tell lies or say insincere things?
6. Do you feel remorse or shame?
7. Is your behavior antisocial for no good reason?
8. Do you have poor judgment, and fail to learn from experience?
9. Are you pathologically egocentric, and incapable of love?
10. Do you experience emotions like most other people do?
11. Do you lack insight?
12. Do you often have to fake your actions and responses to others?
13. Does your partying behavior get out of hand?

possible trigger, self-harm

14. Do you make false suicide threats?

15. Is your sex life impersonal, trivial or poorly integrated?
16. Have you failed to follow a life plan?

Most of these are so vague as to be applicable to a huge number of people.  (1 and 5 could describe most people in retail or phone support - don't let the customer know how absolutely done with them you are.  I've been there.)  Number 10 requires the test-taker to make a judgement about how 'other people' experience things.  Number 15 doesn't even take into account that someone might not have a sex life for a variety of reasons (being ace, having a strong opinion about premarital sex, etc.)  It also appears that all of them would expect a 'yes' answer to indicate psycho/sociopathy. 

Genuine psychological tests, administered by professionals, often ask the same question several ways to make certain that you aren't faking it, and don't give you the obvious 'check all the yes boxes to proceed to mental disorder claim.'  In fact, they usually do that 'Strongly agree, agree, disagree, strongly disagree' thing (because there are degrees of most behavioral disorders).

These links get passed around Facebook, Twitter, whatever, just like 'What V:tM Clan are you?' or 'What's your Game of Thrones house?' - and have just as much scientific reliability.

[BlueOrange]

OMG, that quiz is spectacularly awful. I’ve seen professional diagnostic instruments confuse people. But that quiz is awful. Whoever the hell HealthyPlace are, I would never go there for any kind of advice or… anything.

[DukeJohn]

This stuff sounds like something a narcissist would do.

[Azy]

The Buzzfeed quiz was only a few questions, but according to it I'm a very warm and empathetic person.  It's not wrong.   

[BlueOrange]

The Buzzfeed quiz was only a few questions, but according to it I'm a very warm and empathetic person.  It's not wrong.

You seem very warm and friendly :)  But they get no prizes for getting something right when it's that obvious

[Azy]

I've been told by a close friend I have a heart of gold until royally pissed off.   

[Beorning]

Yes.

And sometimes people with those disorders hate themselves, and are keen to feel better. So they come up with a story about ‘not having a choice about who they are’. But the reality is that people can change, if they put in the effort and have competent support. Competent support is out there.

That's true. But here's something I'm wondering about: couldn't a case be made that psychopaths / sociopaths *are* being stigmatized by the society? Even taking only YT into account, there are tons of videos on spotting sociopaths in real life, defending yourself from sociopaths, recovering from relationships with sociopaths etc. I suspect that a case could be made that, for average person, a sociopath equals "pure evil, kill it with fire". As much as harmful sociopaths can be to other people, facing this kind of stigma probably doesn't help those sociopaths who are trying to change...

You can't simply copy-paste channel links, because the forum software attempts to parse it as a single video - which it isn't.  If you use the URL tags, they link fine.  I've fixed the initial post so that you don't have those 'unavailable' messages on there.

Ah, thanks :)

Well, sometimes it's not even 'asking someone online'.  If you type 'sociopath quiz' into your search engine, these are the top two results (just the text, not the actual links)

Yeah, these tests definitely aren't diagnostic tools. Especially the second one.

BTW. Regarding stuff online - there are surprisingly many comments by sociopaths over at Quora, if you look for sociopathy-related questions. These don't seem like answers made by some narcisstic need to get sympathy - especially as some of them are made by anonymous persons. And yet, they do show that being a sociopaths sucks big time, as it does come with depression, alienation and feeling dead inside...

And if you're wondering why I'm looking this stuff up, I'd like to find answers to some questions. Such as, can someone be a sociopath and feel guilt and empathy, at least to an extent? Also, can a sociopath behave morally due to having developed some sort of intellect / philosophy-derived moral code (meaning, such a person wouldn't necessary feel empathy, but would help others because they would genuinely believe it's the right thing to do)?

[Blythe]

So...sociopathy is not a diagnosis in the mental health profession. Nor is psychopathy.

Technically these (most often) fall under the blanket of Antisocial Personality Disorder. (Can also fall under Narcissistic Personality Disorder, but generally when we're talking about pop culture buzzwords like sociopath or psychopath, it's probably APD that has the most similarity)

https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928

So...the symptom list. Let's talk about it. The traits here are not exactly an "all or nothing" list. More like a "mix 'n match" where a person will probably have most of the list, but not quite all. Disorders rarely present as the kind of picture-perfect representations that we read about. It's frankly much more messy than that.

One thing, if we are going to talk about stigma and treatment, is important to keep in mind: there is a genetic component to APD, and there are some really problematic environmental components, including childhood abuse. So...how do we approach that? Let's talk about what a personality disorder IS, first.

Personality disorders are maladaptive attempts to address how to live in the world successfully. A survival mechanism outside the accepted limits of personality. A person with a personality disorder was faced with repeated problematic (and likely traumatic) situations and did eventually push through them...but they did so in ways that a regular person wouldn't have. (Example: A lot of us would never hurt someone else, even if it meant we would be hurt. But if we look at some people who were abused, sometimes they turn that abuse outward to avoid being on the receiving end themselves. Abusive families, gangs, and school bullying can often follow that framework)

When a person engages in maladaptive methods long enough...it becomes part of them.

APD is possible to detect early; it's something you're likely to spot later on if a youth had Conduct Disorder, for one, and if you know a youth is in a problematic environment or was subject to extreme living conditions (neglect, abuse, the victim of worse crimes). That's the thing about maladaptive behaviors for personality disorders: you're looking at years-long patterns.

There's this weird stereotype that APD sufferers are either these mentally superior cold-blooded types or hack'n'slash wannabe killers, and it's not strictly true.

People with APD can be people that struggle to understand society's rules and, if provoked (whether it's a justified provocation or not), react accordingly. Oftentimes they do want to understand, because failure to understand almost always leads to consequences including financial ones (like loss of a job), legal ones (jail or divorce), or emotional ones (isolation).

But this is an important caveat: while it's important to understand that people with APD did not choose their illness, once they understand they have a problem, they do choose how to (or 'if' they want to) respond to that problem.

Meaning that their right to be understood and accepted ends the moment they decide their right to harm is more important than your right not to be harmed.

There are people with APD that do learn to participate in the social contract of society & often do just fine; you don't typically hear about people like that because...well, they're doing fine. People that are doing fine don't really have a reason to tell you much about what's going on in their lives, mostly as very little other than day-to-day life will be going on. They may have the usual ups and downs many of us have, but it's often not especially remarkable.

There's a complex dance here, but ultimately you can be understanding of the suffering of a person with this disorder while holding them accountable for what they do. Their right to the same stations in society are contingent on their ability--as are ALL our stations in society--on obeying the social contract: following laws, not doing lasting harm, a certain amount of ability to provide for one's self, etc.

One thing worth noting is that it is VERY hard to convince someone with APD to seek treatment. The ones that do get treatment are either getting treatment because they legally messed up to a point where it's required or because their actions are finally causing hurt to the one person they understand most: themself. They aren't likely to go in to any office thinking they have APD specifically.

So with that: can someone with APD feel empathy? A key component of the disorder is specifically about their disregard for others, and empathy is an altruistic trait. While it's not impossible for someone with APD to feel empathy, I would imagine it's a bit...rare, and it's likely a diminished/changed form of it compared to a person with a regularly functioning brain.

TL;DR: We can feel empathy for people with a disorder without divorcing them of the consequences of their actions. APD is a lot more complex and painful than the public gives it credit for, but that doesn't mean we let our guards down either.

[BlueOrange]

That's true. But here's something I'm wondering about: couldn't a case be made that psychopaths / sociopaths *are* being stigmatized by the society? Even taking only YT into account, there are tons of videos on spotting sociopaths in real life, defending yourself from sociopaths, recovering from relationships with sociopaths etc. I suspect that a case could be made that, for average person, a sociopath equals "pure evil, kill it with fire". As much as harmful sociopaths can be to other people, facing this kind of stigma probably doesn't help those sociopaths who are trying to change...

Pick any social group, and you'll find some people who are saying 'kill it with fire'.  The mentally ill are an especially common target.  (Notice how everyone says "The Nazis were horrible for persecuting the Jews", but they don't often say that about Nazi persecution of queer people & the mentally ill.)  People feel comforted when they can put things into neat little boxes, and pretend that they know everything they need to know, because the box has a label on it.  Real life and real people are more complex than boxes with labels.

BTW. Regarding stuff online - there are surprisingly many comments by sociopaths over at Quora, if you look for sociopathy-related questions. These don't seem like answers made by some narcisstic need to get sympathy - especially as some of them are made by anonymous persons. And yet, they do show that being a sociopaths sucks big time, as it does come with depression, alienation and feeling dead inside...

Yep.  Blythe's comments are especially good when it comes to handling this paradox.

And if you're wondering why I'm looking this stuff up, I'd like to find answers to some questions. Such as, can someone be a sociopath and feel guilt and empathy, at least to an extent? Also, can a sociopath behave morally due to having developed some sort of intellect / philosophy-derived moral code (meaning, such a person wouldn't necessary feel empathy, but would help others because they would genuinely believe it's the right thing to do)?

can someone be a sociopath and feel guilt and empathy, at least to an extent?
Yes.  Things are very rarely binary.  'Sociopath' isn't in the Diagnostic and Statistical Manual.  And most of the things that are in the DSM are not well understood.  Anyone who says "Sociopaths can't X" or "Sociopaths always Y" is showing signs of Neat Little Box Syndrome.

can a sociopath behave morally due to having developed some sort of intellect / philosophy-derived moral code?
The Dalai Lama seems to think so.  Consider his comments about how 'the smart selfish person accumulates good karma for themselves'.  Personally, I think that rules and a code are potentially very valuable as a sort of scaffolding: practice empathic behaviour long enough, and empathic feelings may be able to grow.

So...sociopathy is not a diagnosis in the mental health profession. Nor is psychopathy.

And a whole bunch of other excellent stuff.  I want to make a very fine distinction about a very specific point, though.

Meaning that their right to be understood and accepted ends the moment they decide their right to harm is more important than your right not to be harmed.

I don't think anyone actually has a right to be understood and accepted.  I think we all have a need to be understood and accepted, but having a need does not necessarily mean you have a right to have those needs met.  (Consider Blythe's excellent comments on this other thread.)  I've had a pretty recent experience where I had to confront my phobia of not being understood.  Someone was making a very sincere effort to understand me, but we simply weren't able to build the bridge together.  Ultimately, I had to recognize that some people want to understand me, some people can understand me, and the people I'm happiest with are in the overlap.

Which is me being really finicky.

TL;DR: We can feel empathy for people with a disorder without divorcing them of the consequences of their actions.

That, indeed, is the point.

[Blythe]

I don't think anyone actually has a right to be understood and accepted.  I think we all have a need to be understood and accepted, but having a need does not necessarily mean you have a right to have those needs met.  (Consider Blythe's excellent comments on this other thread.)  I've had a pretty recent experience where I had to confront my phobia of not being understood.  Someone was making a very sincere effort to understand me, but we simply weren't able to build the bridge together.  Ultimately, I had to recognize that some people want to understand me, some people can understand me, and the people I'm happiest with are in the overlap.

Yeah, I could have worded that better. "Need" would have been a far better word than "right."

[BlueOrange]

Yeah, I could have worded that better. "Need" would have been a far better word than "right."

Very gracious of you :)

I'm very pedantic by nature, and I'm very highly attuned to these issues right now.  It's a tiny bit of fine-tuning with respect to a whole bunch of excellent points that you made really well.

[Azy]

Personality disorders are interesting.  That's what I wrote my research paper on for my class.  I suck at research papers, but I learned some interesting stuff.  It almost always is long term abuse, and almost always a young person, because that is when their brains are wiring themselves.  I found one paper that looked at DNA methylation, which is basically your body adding certain chemicals and enzymes that can cause your DNA to express differently than they normally would have.  They compared the brains of children who had been abused, and veterans with PTSD.  In the veterans their amygdala, or emotion center of the mid brain, was hyperactive only when the veteran was exposed to their triggers.  In the children the amygdala reacted very strongly to every little thing, whether it had been part of their abuse or not. 

The current way to diagnose these disorders consists on nine questions that meat the criteria. To be diagnosed the patient has to circle yes on at least 5 of them.  Another paper I read said that some researchers are thinking there is a better way using 5 facets of personality.  People with personality disorders tend to score high in neuroticism, and low in agreeableness. 

As far as being compassionate toward them, I'm not exactly a neutral party to ask.  When your own mother tells you she doesn't love you because she can't, and she refuses to get any help, it's frustrating and extremely hurtful.   

[BlueOrange]

Oooh. I was especially interested in the point about the amygdala being hyperactive all the time in childhood abuse victims. This aligns well with my instincts, but it’s always comforting to know that someone has investigated it and found something robust.

As for sympathy, I’m right there with you. Sympathy for people who don’t get treatment is impossible for me too. There’s only so much you can suffer at someone’s hands and still have sympathy for them. Others are welcome to have sympathy if they want to, but I won’t be joining in.

[Thufir Hawat]

So...sociopathy is not a diagnosis in the mental health profession. Nor is psychopathy.

Technically these (most often) fall under the blanket of Antisocial Personality Disorder. (Can also fall under Narcissistic Personality Disorder, but generally when we're talking about pop culture buzzwords like sociopath or psychopath, it's probably APD that has the most similarity)

https://www.mayoclinic.org/diseases-conditions/antisocial-personality-disorder/symptoms-causes/syc-20353928

So...the symptom list. Let's talk about it. The traits here are not exactly an "all or nothing" list. More like a "mix 'n match" where a person will probably have most of the list, but not quite all. Disorders rarely present as the kind of picture-perfect representations that we read about. It's frankly much more messy than that.

One thing, if we are going to talk about stigma and treatment, is important to keep in mind: there is a genetic component to APD, and there are some really problematic environmental components, including childhood abuse. So...how do we approach that? Let's talk about what a personality disorder IS, first.

Personality disorders are maladaptive attempts to address how to live in the world successfully. A survival mechanism outside the accepted limits of personality. A person with a personality disorder was faced with repeated problematic (and likely traumatic) situations and did eventually push through them...but they did so in ways that a regular person wouldn't have. (Example: A lot of us would never hurt someone else, even if it meant we would be hurt. But if we look at some people who were abused, sometimes they turn that abuse outward to avoid being on the receiving end themselves. Abusive families, gangs, and school bullying can often follow that framework)

When a person engages in maladaptive methods long enough...it becomes part of them.

APD is possible to detect early; it's something you're likely to spot later on if a youth had Conduct Disorder, for one, and if you know a youth is in a problematic environment or was subject to extreme living conditions (neglect, abuse, the victim of worse crimes). That's the thing about maladaptive behaviors for personality disorders: you're looking at years-long patterns.

There's this weird stereotype that APD sufferers are either these mentally superior cold-blooded types or hack'n'slash wannabe killers, and it's not strictly true.

People with APD can be people that struggle to understand society's rules and, if provoked (whether it's a justified provocation or not), react accordingly. Oftentimes they do want to understand, because failure to understand almost always leads to consequences including financial ones (like loss of a job), legal ones (jail or divorce), or emotional ones (isolation).

But this is an important caveat: while it's important to understand that people with APD did not choose their illness, once they understand they have a problem, they do choose how to (or 'if' they want to) respond to that problem.

Meaning that their right to be understood and accepted ends the moment they decide their right to harm is more important than your right not to be harmed.

There are people with APD that do learn to participate in the social contract of society & often do just fine; you don't typically hear about people like that because...well, they're doing fine. People that are doing fine don't really have a reason to tell you much about what's going on in their lives, mostly as very little other than day-to-day life will be going on. They may have the usual ups and downs many of us have, but it's often not especially remarkable.

There's a complex dance here, but ultimately you can be understanding of the suffering of a person with this disorder while holding them accountable for what they do. Their right to the same stations in society are contingent on their ability--as are ALL our stations in society--on obeying the social contract: following laws, not doing lasting harm, a certain amount of ability to provide for one's self, etc.

One thing worth noting is that it is VERY hard to convince someone with APD to seek treatment. The ones that do get treatment are either getting treatment because they legally messed up to a point where it's required or because their actions are finally causing hurt to the one person they understand most: themself. They aren't likely to go in to any office thinking they have APD specifically.

So with that: can someone with APD feel empathy? A key component of the disorder is specifically about their disregard for others, and empathy is an altruistic trait. While it's not impossible for someone with APD to feel empathy, I would imagine it's a bit...rare, and it's likely a diminished/changed form of it compared to a person with a regularly functioning brain.

TL;DR: We can feel empathy for people with a disorder without divorcing them of the consequences of their actions. APD is a lot more complex and painful than the public gives it credit for, but that doesn't mean we let our guards down either.

Kudos, Blythe.

If you'd allow me to be pendantic, the only thing I disagree with is the "example". That doesn't fit my experience, like at all...but it's also a very minor thing!

But the part I like best is this:
"There's a complex dance here, but ultimately you can be understanding of the suffering of a person with this disorder while holding them accountable for what they do. Their right to the same stations in society are contingent on their ability--as are ALL our stations in society--on obeying the social contract: following laws, not doing lasting harm, a certain amount of ability to provide for one's self, etc."