The Psychopath & The Sociopath: A Masterclass

[Music] we've covered how to spot a psychopath or sociopath before but we've never gone this in-depth on the clinical diagnosis behind them antisocial personality disorder welcome to the med circle series antisocial personality disorder psychopaths sociopaths and how to spot them it's just so great to sit down with you I love talking with you sometimes we talk about some topics that I think are really really dreadful and hurtful yeah and I think this series is going to be more in that Lane yes it is it is yeah you brought up the cluster B yeah personality disorders I think it's so I'm so glad we're doing this having this conversation because a lot of folks out there are trying to make sense of these difficult patterns and they put in all kinds of words into search engines online cluster B is a something that comes out and a lot of people don't know how to make sense of it so let me give you some historical background this word cluster B it comes from how the personality disorders were traditionally organized in the diagnostic manual of psychiatry and psychology called the DSM the DSM are organized personality disorders there were ten of them into three groups cluster a cluster B and cluster C and they organized the disorders based on their manifestations now back in graduate school we we would remember these three clusters by calling them mad bad and sad that's how we that we sort of memorized them and by mad it was sort of that traditional like a madman like you know person who's just really off and almost like you know very disturbed bad meant almost badly behaved and that's our cluster B's and sad were people who are more anxious and avoid him that the cluster B disorders are also termed dramatic and erratic now these these disorders again are grouped by sort of how they affect a person today we're going to focus on cluster B the cluster B disorders are the difficult disorders they're antagonistic they're interpersonally challenging these are folks who as a rule almost always lack empathy they tend to be entitled so it's almost like narcissism becomes a nice sort of like the midpoint of a lot of these to sort like most of them have qualities of narcissism in different ways and as you said the four disorders that hang out in cluster B are antisocial personality disorder borderline personality disorder narcissistic personality disorder and something called histrionic Personality Disorder these are probably the most clinically vexing patterns we see in psychology and psychiatry because they can make for very difficult clients these patterns can interfere with us treating other issues the person may have like 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 it really you're constantly sort of like it's like you're trying to like fight two different battles at the same time and it's really one big kind of war if you will so it is a challenge and it's a challenge for people not only living with the cluster B patterns but also a challenge for the people living with those people who have cluster B patterns so that's what cluster B is dramatic erratic emotional antagonistic combative lacking empathy oftentimes internally very chaotic they can't regulate their emotions very easily and some of these are really clinically demanding borderline personality for example is very clinically challenging condition narcissistic histrionic clients they don't even tend to end up in therapy that often an antisocial personality disorder those folks often end up in prison we've talked about specific personality disorders but what is a personality disorder in general a personality disorder is a maladaptive pattern of behavior and relating that cuts across all situations in the person's life relationships work social functioning and even their sense of self it's the long-standing stability that makes these be called personality disorders because personality is considered to be a stable trait but their personality styles cause the person problems in all areas of their life but it's the maladaptive consistent and stable nature of these problematic personality patterns that lead to them being called personality disorder can someone be diagnosed as having cluster B disorder no yeah so you just have one of them and that's yeah you what would end up happening is like for example I as you know I do research on psychopathology and mental illness and mental health so when we analyze our data because these disorders are common sometimes we'll combine these patterns to see if we see any patterns there so partly it serves a sort of a research kind of an approach it becomes a shorthand for clinicians but we as clinicians have to be really really careful about using that term because cluster B is code for difficult patient and there's a that's really big yeah muster B is code for difficult patient now yeah I can already hear people though saying well I'm watching that my therapist said I have cluster B now I'm that's rude why would you say it can't feel good that's what I'm saying we have to be very careful with these labels it's really meant it's almost like again 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 one pattern of those disorders we chose four disorders they men have a little bit this a little bit of that and we might call it this sort of has a cluster B pattern to it it means that we might use very specific kinds of therapeutic techniques or realize that these patterns may interfere with the treatment of other disorders if you will but it does imply typically somebody whose interpersonally difficult I'll be honest with you I mean those of us in mental health will sometimes he even use that as shorthand in our own lives like I'm going to Thanksgiving it's going to be difficult to have cluster B relatives there you know anyone in the in the business will know like AHA she's got some really difficult family members but it's it's beyond difficult it's antagonistic and and almost like they often don't get it is it almost often that they don't want the help not necessarily I think you know because cluster B disorders taken so much territory I work with many clients of borderline personality disorder they desperately want help they desperately want help in fact sometimes need more help than even they can get in sort of like one or two weekly therapy sessions and many clients with borderline personalities sort are very vested in getting that help but it's difficult for them they feel so internally chaotic and frightened that therapy can be challenging not only for them but for the therapists who's trying to sort of sue this patient obviously when you're dealing with somebody with narcissistic personality you don't think anything's wrong so they're often gonna think I don't even need help and then you know histrionic Personality Disorder actually they're thinking of removing that from the diagnostic manual these are people who are dramatic and attention seeking and seductive and look at me how come I'm not getting all the attention kind of thing they almost also never end up seeking out treatment for that particular pattern the folks with antisocial personality disorder also almost never seek out treatment they get in trouble for something and then they're sometimes forced into treatment briefly describe what antisocial personality disorder is because that name is so misleading antisocial personality disorder is one of the most important one of the most unfortunately named diagnoses out there it throws my students off it throws off trainees it throws off lay people antisocial personality disorder is actually quite dangerous it can be quite dangerous it doesn't mean what we think a lot of people take the antisocial to mean oh these are people who don't want to be with other people almost as though they're socially anxious not at all the unfortunate term historically came from this idea that these were people who were anti society they were anti the norms of society they would break the rules of society that was really anti-social came from like I said such an unfortunate name because we use and say antisocial to mean someone who doesn't want to socialize what would you call it I would call it psychopathic personality disorder yes that's what I would term it an antisocial personality disorder is the diagnostic term for things that are called psychopathy and sociopathy in the popular literature in the media at large in all kinds of other writing in criminology writing but not it's not a diagnose those are not diagnostic terms but those two terms definitely ascribe more to antisocial personality disorder now what is it antisocial personality disorder is pattern whereby a person not only lacks empathy but they think the rules do not apply to them they do not adhere to them they break moral codes social codes legal codes they have a failure to take any kind of responsibility they're very deceitful they exploit other people to achieve their ends they will take risks that will put other people in danger so they're dangerous they're dangerous and here's the wringer here's the wringer I personally think that to 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 gets scary can they faster it gets scary I'm sorry can they fake it can can a person fake can they fake remorse oh absolutely you can fake anything a fake empathy you can fake remorse you can fake anything and they do they will when they're finally hauled in front of the press conference they'll cry crocodile tears and a year later they'll do it again that's antisocial personality disorder which clusters of disorders do you think are most common in terms of the personality disorders overall I actually think that the cluster B disorders may be more common and the only reason I think I'm gonna say that is because when we do research on these disorders they're the ones that are more clinically compelling so we may see more clients with these patterns because especially in the case of borderline personality they're more likely to get help that's right in the case of antisocial personality disorder they're more likely to end up in prison so they're these two groups of folks we study a lot because of the this sort of the distress we see in borderline personality and the danger that can be created by antisocial personality so fewer the end there's four disorders in that group too so it's gonna up your your yes your a number up a little bit I think that the cluster B disorders probably are the ones that are have the highest prevalence rates across the three groups overall yeah well you have more disorders and people are having to go get help so they're more disruptive who that's who you're gonna see I'd say if you were if you were working in the mental health business you'll see that a lot in cluster C there's things like avoidant personality disorder which is it almost looks like a social link disorder so you will see that sometimes but sometimes we don't even know which variant we're seeing social anxiety or avoidant personality and with the cluster a disorders the schizoid this gets a typo the paranoid personalities these are people who actually look quite severely mentally oh they're incredibly either socially withdrawn or they appear as so odd they almost look psychotic there sometimes over-represented in residentially unstable like homeless populations or people who are in and out of long-term psychiatric facilities is there hope for people who are in the cluster be damned in terms of hope for cluster B clients it varies it varies well hold it we don't hear that answer a lot oh it varies yeah and that's the problem that speaks to how heterogeneous the disorders that make up this cluster if I talk about bipolar disorder and I talk about anxiety depression ADHD the doctor cross for me will say there's so much of no very variable I would say that the most good research on treatment outcomes and best practices can be found for borderline personality disorder I believe firmly that if you have a client with borderline personality disorder and you can give them trauma focused care dialectical behavioral therapy whatever psychiatric medications they may need to manage other sorts of conditions they have and other kinds of adjunctive therapies that will help them with their symptoms the treatment literature can really show some good long-term outcomes but the treatment has to be consistent in long term and that's often passed beyond the financial ability of a lot of people that's what's so unfortunate because I think there is tremendous hope for people with borderline personality if they get the kinds of treatment and if the client won't cooperate with the treatment then all bets are off with narcissistic personality disorder you know what I say about that you're not going to see much change and when you do it's glacial and the amount of change you see is often not enough for the people around them to feel like things are better but with antisocial personality disorder that disorder might be the most hopeless of all these are folks who will try to outwit and outfox a therapist who will fake it and often court-ordered to go to therapy as a condition of or probation or something like that and so they'll sit there for ten sessions and say I don't need to say anything I just need to sign that documents that I came here for ten sessions so you can get a lot of resistance and they often try to intimidate a therapist you have to be a very specially trained therapist to work with that population particularly those who have very very difficult criminal histories and if you're dealing with sort of the more neat and tied up antisocial personality sort of like the CEO variant they're they're very manipulative they can be very exploitative again they will often try to outwit the therapist they're really not motivated to change because they really truly don't think there's anything to change so if anything they're just really out to gain the system that's not progress so I would say definitely for them of all groups they'll have the worst outcomes what percentage of your clients do you think fall in the cluster B category Oh with some cluster B symptomatology well up mean well over 50% maybe yeah maybe even a little less oh heck no no no no actually that's what I choose to focus in but maybe forty percent forty percent you know yeah that's that is good though because now at least people are getting help or at in the space to get home and there are people out there who specialize in this like people who specialize in dialectical behavioral therapies we call DBT I'd say they see 90 percent because they're working with clients who have a lot of borderline personality sorts of symptoms people who work in prisons are probably seeing antisocial personality and the level of 60 70 percent but I'd say almost half of the clients I work with I choose to do that though because like I said although I would say maybe even all right I'll be 35% because the majority of clients 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 with these issues well that leads perfectly into my next question knowing that if somebody has watched this video this far they have been likely given a diagnosis of a disorder in the cluster B family or they knows anybody who has what what could I ask them on their behalf that you would think would be most beneficial for them to hear I would you know I think that the big question people have is from the person there's two sides of it from the side of the person who's experiencing it is what do I do I'm not only 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 ever makes things better in fact all I do is feel like things get worse and I feel like I'm always walking on eggshells what do I do what do I do yeah answer to that I meet them for the people who are experiencing the symptomatology you got to get therapy you're not you're not gonna think your way out of this one you're not gonna meditate your way out of this one you got to get therapy and with somebody who is trained in things like DBT and working with these kinds of patterns okay that's that they have to yes you know dr. Yip is one of the nation's leading experts on OCD and I interviewed her for our OCD series she really drove home the point of don't just go get therapy because then the therapist said yeah I treat OCD go find the person who that's what they do that's what they do they are OCD right so with these people you know I feel bad for someone who might have gone to a therapist who said they could treat it but they did it once 10 years ago and they had a bad experience yeah yeah I think that you especially with now again but something like narcissistic personality disorder if you actually do get them to therapy you can use a combination of some DBT techniques but also some cognitive behavioral work some humanistic work rapport building it's a lot of its relationship building you need a strong therapist to work with those clients because they will try to outfox you and so you've got if you almost have to be one step ahead of them like you can't fall for the charm you have to be almost charming you and our charm proof to work with the narcissistic clients and with the auntie's you know so it's all about expertise but the borderline clients are the ones who are most likely to actually seek out therapy and for them to say like I said you do it right what do you do you need to get help from somebody who knows what they're doing and it might even be a team of people who know what they're doing in fact DBT is best delivered in a team approach with a combination of group therapy and individual therapy and some medication management on the other side of it if somebody in your life is experiencing these cluster B patterns it's going to be difficult I'm telling you that right now and you're not a bad person for thinking it's difficult because a lot of you I feel guilty there's actually something happening to them how dare I think that this is difficult because it is because the nature of these patterns is somewhat antagonistic that that's again it may be that they're feeling insecure or chaotic inside and that's why they're lashing out at the end of the day it doesn't matter when somebody lashes out it doesn't feel good regardless of the reason and so I will tell people if you are and you are with somebody who's experiencing cluster B patterns definitely seek out individual therapy you may need to manage your expectations of that person and then ask yourself what would the landscape of a relationship look like with this person if things don't change in the cases yeah it may not change those are really good three takeaways real quick for people watching explain briefly what DBT yes DBT is dialectical behavioral therapy dialectical behavior therapy was developed by someone named dr. Marsha Linehan and she developed DBT actually specifically to address the crisis of suicidality in people who had borderline personality disorder because that's the dangerous issue people with borderline personality are experiencing so much inner pain and turmoil that they want to silence that pain they truly do believe often there are burden to others that they don't or they're not worthy to live it's really it's really agonizing for them and for the people around them who care for them and so DBT was initially really developed as a way for the person living with borderline personality disorder to see how they life always feels like a crisis to them how everything is black or white and so the dialectic is really to bring those two sides those two perspectives together and find that gray in the middle the other thing that dr. Linehan brought into this work was a real focus on mindfulness people with borderline personality disorder tend to react instead of responding sponding is a more thoughtful approach reacting is like you jump right in through DBT using mindfulness and sort catching yourself you help people construct more responsive rather than reactive kinds of approaches when they're faced with a stressor you know because the reacting often means people's feelings get hurt people get angry but to help them deal with that crisis and the fears that overtake a person with borderline personality sort of such as things like that they're going to be left that they're going to be alone that they can't take care of themselves many people with borderline personality disorder engage in a lot of negative self-talk dialectical behavioral therapy also draws from cognitive behavioral therapy where you push back and say you know it's interesting you say all these terrible things about yourself because my experience and you really do point out to them the good things and the strengths and you do some resilience building with them so and you have them do homework assignments between sessions so they do a lot more monitoring so they can help they can start seeing their own patterns DBT has been shown to reduce the the rate of suicidal thoughts suicidal actions in people with borderline personality disorder and it's really the only evidence-based treatment we know of right now that has any consistently good outcomes in person with persons with borderline personality I just want to touch on two things you said that really struck a chord with me the first one is mindfulness it is becoming a reoccurring theme and all of my conversations about mental health yes which makes me think if there's one thing we all could do to make our lives better it would be to be conscious of what we're doing mindful of what we're doing and then the second thing is that 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 and responding to those times but that's reacting to right seats in text yeah responding means you stop you think what's meaningful what would hurt what would make sure well how do I write this oh I don't hurt people you know that it's actually beneficial to either the receiver or other people who will be seeing this message you go through a series of cognitive steps but unfortunately technology doesn't I mean I wish all technology made you like I sure are sure are 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 are you sure because by then a lot of reacting would have come down and you're like I forget about it it's not that important you think about those emails that you write in a rage and hopefully you don't send them and you save it in the next morn you read and go thank goodness I can say no never ever put a name in a subject line of an email until you're ready to send it that's sort of a bit of advice but it's that react respond and mindfulness are linked and because everything these days is so quick quick quick and we're judged on speed and everything's designed not only for speed but not to catch ourselves before we go off the edge yes that we can send things without you know back in the day you'd have to like write the letter fold the letter put the letter in the envelope find the stamp write the addressed go to the mailbox that was nine times you could have said maybe I shouldn't send this you know and so we that's where that mindful sits mindfulness is a stop it's a feel it's a think but that does mean awareness of other people and if you don't have empathy all the mindfulness in the world may not necessarily pay out let's get into it 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 these are people that are characterized by lying deceit malice lack of empathy they exploit other people they break the law they are lack responsibilities they don't follow through on things they have very checkered work histories that kind of thing they'll use aliases they'll put other people at risk and they lack remorse or guilt or shame for the bad things that they do so that's what antisocial personality disorder is now there's a little interesting wrinkle in this diagnosis in order for a person to be diagnosed with antisocial personality disorder we also have to establish they had a diagnosis of something called conduct disorder prior to the age of 15 conduct disorder probably best sort of ascribes to what we might call juvenile delinquency these are kids who were who've either engaged in illegal activities like theft or assault but also things like torturing setting fires bullying peers abusing taking advantage of taking advantage of peers and that could even include like sexually exploiting younger peers they are there's sort of almost a willful cruelty even though they're children and they often won't to show remorse or even recognition of what the ramifications of these actions are so these are kids who may end up in juvenile detention who will have trouble with educational systems may drop out of school so you have to establish this track record that they were a kid who would have these kinds of problematic behaviors prior to the age of 15 and then after the age of 18 we diagnosed antisocial personality disorder so they don't have to get the diagnosis that before the age of 15 because someone could skip it someone could skip it in fact they often do right but you'll go back and tell me about when your teenage years it yeah then go you probably had yeah and they'll say yeah I skipped school all the time and I got expelled or I salted a kid or assaulted a teacher I stole my dad's money that kind of thing you know doesn't have to all be big-ticket stuff it could be the the if you will the the kind of bad childhood behavior like bullying or stealing candy a lot or stealing other kids lunch money that sort of thing those kinds of patterns yeah the play devil's advocate though couldn't that just be a symptom of bad parents sure it could absolutely but you'd absolutely get a disorder diagnosed you could yeah because even still that bad bad parenting has is the predictor of lots of psychiatric disorders you know what I'm saying so at the end of the day parenting has a lot to do with what what gets shape is it is it a guarantee so if a person has a traumatic neglectful or invalidating childhood is that a guarantee that things will go wrong for them and dealt with it absolutely not but is it a vulnerability absolutely what does it mean to be a psychopath ah so here's where things start getting until we get into sort of interesting sort of semantics territory here to be a psychopath it's a term that probably ascribes best to this thing we're calling antisocial personality disorder so psychopathy is not a diagnostic it's a descriptive term it's a sociological term but it's definitely not a diagnostic term okay but researchers will use it and that sort of thing so what's psychopathy is somebody who tends to be very calculating manipulative cunning smart malevolent dangerous exploitative they have very little empathy they don't really think through the consequences of their actions they really don't care about the consequences of their actions they break rules ethics laws they violate moral codes they're deceitful a real picnic yeah love to meet one of those but there it's not actually you can't be diagnosed as a psychic yeah you so if a person met those criteria and they had this is a long-standing pattern for them since childhood we call it antisocial personality disorder yeah I understood what about a sociopath so sociopath this is where people get very confused okay so psychopathy and sociopathy are very like you know they're leagues of Venn diagrams there's a lot of overlap but there's definitely they're distinct entities the sociopath in many ways is not as glib socially skilled successful and manifest is well put together in the way the psychopath does the psychopath in some ways is more chilling because they have an absolute lack of empathy and if they have a relationship with someone it is solely exploitative it's to get something from them sex money power connections you name it the sociopath in they're very unskilled way might get into a human relationship but they still don't have any empathy and in that relationship they still remain very cold and and stand still somewhat calculating but really more cold and rejecting the psychopath makes a better criminal the sociopath tends to be a messy sloppy and reactive your sociopath is your bar fighter the psychopath is a person who will kill that person three days later methodically you see what I'm saying so it's like the sociopath tends to be more reactive they tend to be more sloppy they tend don't tend to be as planful they're not as sophisticated as the psychopath who tends to be coolly efficient and in that way almost more dangerous because there was a book that was that was written called the mask of sanity and that's where they were described he was describing Psychopaths in that book and it was this idea that the psychopath can look sane because they actually there was some research that estimates that corporate heads like heads of major corporations of all kinds the rates of psychopathy and those folks is five to twenty one percent to twenty one so depending on how you measure psychopathy that would be one out of five major CEOs as hell yeah yeah yeah because those are there's all the stuff that the the power drive the the willingness has that sort of taking a prisoner's attitude to power in this absolutely almost scarily surgically precise focused way that's very profitable in preparing for this interview I was researching the term psychopathy and it was almost I would say 80% of the time correlated with serial killers almost like it was an interchangeable term like almost all serial killers are psychopaths probably almost all of them are because there's there's a precision to being a serial killer right because in order to be a serial killer you have to have killed two or more people so you got away with one right so you got away with one and there's some there tends to be some very stereotypical killing the keeping of trophies the taunting of law enforcement almost getting some pride out of getting everyone in the world rattled and paying attention to what you're doing if you even think of folks like the Son of Sam as OD a killer they were actually writing letters to the newspapers and to journalists and even to the police - you know even Jack the Ripper did that yeah and so it's this sense that there's something again very methodical and there's almost a sadistic pleasure that they're deriving from committing these crimes that's very much the Psychopaths game because it's very planful they think about it I just I just can't believe that those people who are likely a psychopath and perhaps one out of every five see also a psychopath are the same cat well look about where the overlaps are the utter lack of empathy the precision the singular focus yeah very those oh and could you have no because you have to have let her lack of empathy I was thinking could you have a psychopath who uses his makeup for good but it's not that way no because ultimately it's self-serving so I guess maybe the only way you might see that is let's say you have a psychopath out there who is running this incredibly successful corporation but in order to sort of launder money or to distract people raises tens and tens of millions of dollars for charitable causes and that money really does go to protecting people feeding people giving them health care or something like that so it's dirty money yeah but people get helped and let's face it that does happen it's a philanthropic psychopathy so you know it's money laundering to them people benefit I mean I guess viewers out there could think about is it worth it if somebody gets help that they wouldn't gotten helped otherwise but the money came from a really manipulative place out of curiosity if you're watching this do you feel like your boss is one of those who are 5% or 21% likely to be a psychopath I've never worked for a psychopath I can say that you know I don't think I have worked for a second but they work for people are deeply deeply deeply narcissistic yes a full-on psychopath you tend to see them in more competitive industries media business law maybe even sometimes medicine like high-stake athletics that kind of military yeah high stakes high visibility kinds of spaces where the profit lines are high and the stakes are high I mean let's face it when you hire people to do a job you're not doing a personality test you're looking at what they can do and if they're making money and you're hiring for a company then you're gonna look at the person who hires money and you may not ask questions about what how they're making how they're getting that done until after the fact window someone going back to entice or antisocial personality disorder when does someone cross the line between or from suave confidence to antisocial personalities well I mean obviously someone being suave and confident is not a is not a diagnosis or an indictment it is to me actually when I made soft people I actually get I get really put off like to me now charming people are terrifying that is wrong money yeah it's a Romany tats like personal life charming people I tend to excuse myself to the restroom and I will often join another table or something it terrifies okay so if we didn't know each other and we're at a party and I go oh doctor rowdy I've seen her videos on red circle let me get you a drink you look fantastic tonight I love your shoes wow you're so smart intelligent you would go oh my gosh thank you you have lost me I love your shoes I noticed probably start watching how after these mental health professionals I tend to be very complimentary yeah but complimentary that but then there's a point to which like I don't watch your angle yeah no that's the so that that's that it that that's the the struggle there so this idea then where's the line right suave and charming and sophisticated in all of that what you're looking though to is to see is our empathy is there a meaningful give-and-take in the conversation are they looking through you or are they looking at you is are they actually interested in what you're saying and if you continue to spend time with them are they present are they are they reciprocal are they warm how do they treat other people so obviously if they're not mistreating other people if they don't have a track record of having done bad things that kind of thing then then they're not that then they're suave and charming yeah and they're not a psychopath no obviously not almost charming people are not psychopaths yeah but it's again when you do what I do charm gets scary well let's dive deeper into that what does the average person who has antisocial personality disorder look like where do they what do that physically look like how do they dress how do they carry themselves that's a tricky question because there is no average person with antisocial personality disorder you can find people with antisocial personality disorder everywhere from death row to the best table at the best restaurant in Los Angeles so it's one bit is how they got there you know in both instances yeah absolutely that their and their personality sort of is likely what got them there so they look very different they can be in a $5,000 suit or a ten dollar prison jumpsuit they can be in a they can be in any number of professions they could be any race definitely proportionately more men more men how many more do you think I would say it's a gosh if I were to spit box I don't know the numbers off from top of my head I would hazard a guess that's probably five to one eight to one men versus what I'm doing eight to one yeah something like that yeah it's a quite a few many more men are there's are there women with antisocial personalities we're out there of course there are from the course but for sure you'd see it the only thing I could say in common is this would be a man that's the best I got for you you know but beyond that like I said they could be successful they may not be successful they could be living in the streets they could be living in a mansion that's where it's interesting whereas with other mental illnesses we might actually see sort of a truncation but even there we look at substance abusers they can be fabulously wealthy or they can be living in the streets you know there can be any race or ethnicity they could be you know I you know any gender it doesn't it doesn't matter you are the country's leading expert on narcissism perhaps the world's leading expert on our system I think that would be very narcissistic that's why you're the expert you already cut it out how is this different though than narcissism it's a very good question what I view them I've used them as on a continuum and here's a good rule of thumb all people with psychopathy are narcissistic not all narcissistic people are psychopathic okay and in that way I would say nearly all people with antisocial personality disorder are narcissistic but not the other way not all people in our statistic personality sort of have antisocial personality sir I would never diagnose both if you have antisocial personality disorder it's a built-in that you have many many traits of narcissistic personality so it's it's a continuum of sorts it really is and so narcissism sort of there's a form of narcissism we sort of term malignant or toxic narcissism these are people who have all the stuff associate with narcissism like the lack of empathy entitlement etc etc but there's also a really hard manipulative exploitative edge to them and they tend to be the more deceitful interpersonally brutal narcissists and then when you look at what a psychopath or a person with antisocial personality disorder now you jump the rails into a space where a person does not feel remorse for the bad things they do people with narcissism actually do feel guilty or shameful when they do a bad thing they don't they are they well more shame than Gayle Koosh aims a very public emotion but they will definitely they'll definitely feel bad about it whereas a person with antisocial personality sort of a psychopathy in general won't as a technical matter and this is a it's a fine point but I want to make it the way DSM allows us to diagnose antisocial personality disorder symptom number seven is the one that's called lack of remorse okay that there's a specific symptom called lack of remorse you can get the diagnosis though even if you do feel remorse and I struggle with that because I have interviewed and in my research we've interviewed many people who will say I did a bunch of really bad stuff and I did this bad stuff because I was living in a very dangerous neighborhood in Los Angeles I came up with the wrong kids I get that I had an abusive family I was gang involved we stole we assaulted I did time and I feel awful about the lives I've ruined and they're very in they're genuine they've done their time and they're actually now devoting their lives to better work they're participating in research like they feel bad yeah and there's the remorse rang true so they didn't get in our research they didn't get that but they still got the diagnosis I guess do you see what I'm saying where psychopathy requires that lack of remorse that's right well dr. Romani and I sat down for an entire series on narcissism and if you'd like to watch that here is a little preview [Music] [Applause] so when we talk about narcissistic personality disorder there's a long list of patterns and they have to have five of the nine on that list it has to be something we call pervasive meaning it cuts across situations with a variety of people in at work at home it's not just like their narcissistic to only you and they're nice and nice to everyone in the world tends to be pervasive but here's the rub it has to involve what we call social and occupational impairment and subjective distress that's a fancy way of saying it is messing up that person's life they're aware it's messing up their life and they're uncomfortable with it and that's where you don't see as many people with narcissistic personality disorder dr. Romany kin sociopathic or can someone have sociopathic and psychopathic traits without having antisocial personality disorder yes they can actually you can see that now here's a rub it's like began antisocial personality disorder has such a sort of specific diagnostic set of criteria you know terms of this the early life experience and all of that that you know you may have that person who is coolly efficient and manipulative and singularly focused on success and lacks empathy and exploits other people maybe they'll come in right under the threshold at this point we're sort of really where we're splitting hairs mmm does that make sense who cares what the word is thank you you know I mean it is it's dangerous it's problematic you know my work in this area is very much focused on how people how these how people with these patterns affect people in relationships I can tell you this now people with psychopathy and sociopathy 100% are not built for close intimate relationships they just don't they cannot put the roots down deep and I think what ends up happening is cuz they're so smooth and charm and glib and successful they absolutely draw partners in many times for the psychopathy it's like a it's like big-game hunting they just want the trophy they want the prize of it all or they value that partner they're very attractive they're very wealthy successful they may be a bridge to something they want or they just want sex yeah I mean it can literally be that that's simple and in fact you do see that in when we look at the hare psychopathy checklist which is a very famous frequently used checklist research the hair like hair hair like but hair like a bunny the hare psychopathy checklist in that checklist one of the things actually one of the items gets at their inability to be in long-term relationships like they have very short term marriages kind of thing because often times they're exploitative they want something and they get out or they just have very brief sexual unions are very sexually exploitative they'll you know they'll use people for sex and you know and then just sort of spit them up and chew them out and leave them you know leave them out and so people are very hurt by that and they'll say gosh she was so charming you seem so into me and but that's because they're so charming and when that's why you avoid that's why that's why I avoid charming people because really their damage comes from the fact that if you don't know what you're dealing with it's so easy to get drawn in because it feels like a fairy tale it really no little do we know that like many fairy tale princes probably are psychopaths okay it's a it's a nudist fairytale princes are most likely a psychopath they're just a little too charming I mean I think you know we don't do their name Prince Charming yeah Prince Charming yeah Prince Charming it's more Prince psychopathy today yeah by the way when people meet you now they're not gonna be very nice to you I feel like beyond that circle not a lot just an appropriate amount like there's the narcissism woman I'm like no no not really if I actually successful dick but instead actually stop and make sure everyone's okay very funny uh this does come with a lot of co-occurring disorders yes what are the most common an antisocial personality disorder the co-occurring disorders we most often see are substance use disorders interestingly you might actually see depression but it's probably wonder diagnosed because they won't we would probably present more as irritability yeah what we call impulse control disorders but that the impulse control might be like they lash out of people road rage intermittent explosive disorder but we may not diagnose both because it's likely that their rage and stuff is subsumed under the antisocial personality disorder but really the most common comorbid diagnosis is going to be substance use are there different forms of antisocial personality disorder you know in the in the diagnostic manual there's not there's antisocial personality disorder and it doesn't have different kinds of it doesn't have different kinds of descriptors if you will in my research we've actually sometimes split them out by people who report having remorse versus those who don't so it's not really differentiated in that way in fact the research on psychopathy actually makes it takes the time to distinguish between psychopathy and sociopathy or between primary and secondary side copy there's different ways you can slice and dice that pie and a lot of it has to do with the the forward-facing characteristics how intelligent well-put-together articulate smart charming glib all that stuff we associated with success and that precision that's sort of different than what I call kind of like the sloppy bar fight psychopathy or sociopathy yes why or rather what would not be considered antisocial person a personality disorder but often is what type of behavior um I would say that I mean again many people that mistakenly have called narcissists mmm as having antisocial personality disorder but if indeed that narcissists is like I can't believe I did this I'm so sorry and they're they're apologizing and they go do it again that's probably more of the narcissism piece um bipolar disorder bipolar disorder could be mistakenly diagnosis antisocial personality disorder because it's very possible that during a manic phase a person's behavior may drift into the illegal they may use a lot of drugs they may solicit the services of prostitutes and you know behave very badly with them they may gamble a lot of money and engage in illegal activity to get more money to gamble so they may actually behave in a way that is risky and in violation of the law so we'd have to be very very careful to ensure that when there were these sorts of upticks of illegal behavior that it occurred only during a manic up so you got to remember an antisocial personality the behavior is consistent it's not like six days a week they're a nice guy and only on day seven do they go out and put their serial-killer mask on they tend to not work well in society even when they're charming and glib they don't tend to have high quality deep personal relationships or people diagnosed with border or antisocial personality disorder when in fact they're bipolar they could be but it's good it's gonna be somebody should catch that pretty quick okay you know what I'm saying because then they should recognize that that person is in an episode of mania and this has not been their typical pattern of behavior but since one of the biggest errors we can make is make a diagnosis on the basis of a snapshot if all you did was focus on one day of one person's manic episode yeah you could easily then completely call it something it's not so that's why we have to look at psychiatric patterns over time and so also in some substance abuse disorders I could see how somebody who has a diagnosis of certain forms of substance abuse particularly activating drugs like cocaine or methamphetamine people use those drugs are more likely to engage in risky behavior they may engage in illegal activities procure the drug they may sell the drug they may engage in high-risk sexual activities while they use the drug and if they're an addict and they're using regularly that may contribute to the likelihood that they're engaging in these high-risk illegal behaviors which over time could look like antisocial personality disorder what would have to happen is get that person off the drugs get them clean see if the behavior changes or not I make a point to say this in almost every series because for me it is it is the difference between mental health therapy working or not and that is people must must must get the right diagnosis absolutely and do not take that as a new label or a new terrible thing that's wrong with you only take it as that that's the next step to get the right treatment well any in fact we don't have to call it 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 know so it's we're looking at patterns and these are patterns that make a person uncomfortable and make it so that they're not achieving at their fullest potential because really my goal as a therapist is to get a person to achieve at their fullest potential to be the best version of themselves dr. sue Varma in New York we did a series with her on depression she goes my job is to give people what you just said an optimal life that's what I do people go yeah but I can deal with it I don't you could you could why why don't we work hard to make it even better right I love that yes that's good I want people to understand what we're doing here is providing the education right so that they can get into the right people get the right diagnosis and get the right thing and you Kylie I want to say something to that because I know many people who watch Med Circle have lived with an experience or may even currently be experiencing mental health or mental illness issues I always say to people this is part of your story and if you've come through this and you will come through this that that's part of your strength and resilience and it's not a piece of you to be forgotten because I work with clients for example who are health care practitioners who are teachers and we can use this as a way say you have an empathy that someone else may not and you may be gentler with a patient or you may be kinder to a student and to me I think that many times that people who've walked through the fires that can be harnessed in a way that actually can not only bring you to a fuller potential but benefit the people around you it's really like spinning straw into gold so I think that that's what's absolutely critical as people don't view this as there's something wrong with you there's absolutely nothing wrong with you everything's right we just want to get you to a better place but that you can use part of this this part of your story to enhance the lives of others mmm that's so beautiful I would love to leave it right there but I have more questions I can't leave it on that perfect note that you just gave me when it comes to antisocial personality disorder what am I not asking you that I need to be asking you you know antisocial personality disorder the big question is what if I you know the big question around antisocial personality sort of really is kind of be treated you know to which I'm typically going to say the answer's no in most cases no we do know that over time people with antisocial personalities sort of kind of get tired out they kind of it's it gets exhausting to be a person who keeps breaking the rules at ninety or seventy-five like you'll get tired it's exhausting right but these are patterns that are very very very very resistant to change these are folks that many therapists don't have the training to work with nor do all therapists even want to work with this population they feel threatened or intimidated and nobody should work with a patient population they don't feel comfortable with but there's typically no motivation for change because these folks don't think anything's wrong you know they really and and and it's also the question is how does the person becoming this way let's dive into that explain first of the born part yes so there is you know particularly in the area of psychopathy an antisocial personality disorder there's actually been a lot of research done on sort of brain function in people with with antisocial personality disorder and there are various brain areas that have been implicated the ventromedial prefrontal cortex the anterior cingulate cortex the amygdala all these fancy names are really simply boiled down to somethings wrong upstairs you know their brains aren't the same as everybody else's however what these researchers have found is that that those brain differences in structure and chemistry colliding with childhoods that may be characterized by abuse neglect violence being the victim or witnessing violence frankly invalidation emotional abuse those things might potentiate any of those sorts of structural issues in the brain we also know that there are areas in the brain that subserve empathy and that one reason yeah empathy so the research has been done actually with people who qualify sort of psychopaths or as antisocial personality disorder I think they had they had been in prison what they found was when they were able to tell these the subjects in this research to think about something and forced them into empathy like they're told them a story and say can you really stop and think how that person in that story felt and the person concentrated 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 find themselves to empathy so they're capable of what we might call cognitive empathy they're like yeah I can get that and that area of the brain will light up but it doesn't happen spontaneously so a relationship isn't really possible with them but it's not entirely broken you can turn the system on Wow now if I just take my glasses off when I get excited if a child is born with something not functioning correctly upstairs and it is a psychopathic or sociopathic tendency and they don't have an environment that is violent they actually live in a very supportive environment can it can you raise somebody not to be that way I have read case literature of exactly what you're describing a kid who is actually from the loving home parents who love them you know a nurturing environment plenty of resources they weren't it wasn't an impoverished or dangerous community or anything and that child started displaying antisocial tendencies and it kept unraveling and they became you know violent or predatory or poorly behaved adults if you will and it you know those are case reports that's not normative that's definitely a very low probability event if you will but it's interesting when you read some of the work being done by some of the really great researchers in this area Adrian rein for example as a guy at the University of Pennsylvania and he's done some really great research on psychopathy and you know I was reading something or an interview done with him and he had said like listen we're gonna get to the point where we may be able to identify some of these patterns and children and if that's the case we really should work with parents to help them identify some of these patterns early on do you see if we can do some intervention with them we're not quite there yet but I must say that when we see kids who are engaging in patterns of behavior like bullying or acting out we have to spend the time to do the necessary assessments to determine why what might be going on for that child both at home and in school and what behaviors are manifesting because it is possible in some of these cases if we could get ahead of some of this then sure we might be able to engage in some prevention work but it's that's difficult to do you know you can only mandate so much that I understand when you we have the behavior we try to fix it you're saying just on the basis of the brain yeah because that's the the mental health landscape mm-hmm is so great yeah and what's so frustrating to a lot of people is that it's just a experts opinion whether or not their kid has ADHD or their kid has bipolar disorder or that their cousin is depressed it's just somebody's opinion right so when we can have something more definitive that can be test that's so exciting to that's what the hope has been in and of all the personality disorders really antisocial personality disorder is the area where a lot of this work on the central nervous system and the activity of the central nervous system is being conducted 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 sort of like where do we go 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 do the scan what other things happen in their life that's right you know and some of the research hasn't been as good at sort of describing how much abuse or deprivation or all those other kinds of conditions are present how much of that shaped their brains and that's the thing the brain is shaped by its environment so you have a bit we're kind of doing playing a chicken egg chase game here and but definitely both things are at play there are vulnerable brains out there and when that vulnerable brain meets an invalidating environment that's where that's sadly where the issues arise do you think we would ever get to a point where we would do a scan on kids for scan their brain and we could say yes they are likely to be a sociopath or psychopath not in our lifetimes I don't think so I think that I wouldn't be surprised if slowly we get to remember the brain is a very complicated it's a very complicated system it's not so simple it's like there's like a little it's other organs are much more right other organ systems are a lot more straightforward 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's an intersection of so many things the person's everything from the person's gender to their ethnicity to where they live to what their parents did to what kinds of early environment they have you know there's it's not that simple it would that it were would that it were but we're not there that this this extraordinary thing called the brain is you know that allows us to do everything from you know write poetry to fall in love to drive a car it's it's not that simple and I don't think we're gonna get it we want it to be that simple we want to be able to predict these patterns I think it's a pretty high order as is it so it feels like a science fiction film to me but who knows maybe maybe neuroscience will prove me wrong do you think or is there any proof that any of this is hereditary there is some evidence showing that it runs in families now it's particularly father-to-son and as we talked 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 of it called the sympathetic nervous system that we've popularly referred to as the fight-or-flight system but the autonomic nervous system is associated with arousal so when we get worked up about anything when we're frightened when we're anxious you know anything that is threatening up to us we get aroused our heart rate increases we sweat our eyes become wide we become short of breath those are sort of we get our skin you know we put a hair stand up on edge kind of thing all those our autonomic signs the belief is that people with antisocial personality disorder have a lower autonomic arousal meaning that under conditions of fear or threat they don't get as aroused which is why they're willing to take risks and they don't 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 rates they just are more under aroused so sometimes that manifests in them getting into really dangerous thrill-seeking types of sports because they almost want to feel the arousal the rest of us feel on a regular basis day after day and that low it's believed that that that autonomic nervous system under arousal could be inherited in our first video you and I ever made I think it was our first one 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 be they won't probably call totally cool absolutely the place are those the thats a sociopath that's a psychopath or a psychopath and they are born Psychopaths tend to be more born sociopaths are probably a little bit more made you know and I mean that's a rule of thumb that's not perfect science but definitely use that you see that that that sociopathy tends to be a bit more a byproduct of the chaotic or negligent early environment whereas psychopathy you could have that you can definitely have the negligent early environment it's probably likely but either's likely also that biological sort of piece again the sociopaths tend to be a bit more sloppy messy reactive what age in your personal experience do you find Psychopaths or sociopaths being diagnosed you can't diagnose them until they're over 18 I don't think it's a reliable diagnosis none of the personality disorders are diagnosed in adolescence except for the conduct disorder conduct disorder is not a personality disorder it's a childhood disorder oh so you could diagnose a kid with conduct disorder okay because they keep breaking the rules right it's possible that kid will not go on to develop antisocial personality sort of if you're really really really really lucky they'd be put into some perhaps a juvenile center where they really get good rehabilitative care and they don't commit crime again I mean the odds are not in your favor but it can happen that way so conduct disorder is a disorder of childhood personality disorders are only diagnosed in adulthood we're making we're making room for the fact that the personality can used to evolve shape and grow during the adolescent years into emerging adulthood I actually really wouldn't feel comfortable giving a definitive diagnosis of a personality disorder and anyone who's much younger than 20 or 21 that's so fascinating that was my next question to where you would feel comfortable yeah I mean I would talk about patterns I say you definitely have the traits here but you also have a teenager and I can tell you as the parent of teenagers I think I've probably seen what it feels like every personality disorders symptoms and them you know like wow they're being really she still love them but I was like oh my gosh you know and that's where I really learned that teenagers are up down and all around and they are again that's just that's a developmental issue and that's why we want to be very careful the last thing you want to do is toss a label on it adolescent who's coming into their own and make them pathologize this process of them trying to find themselves and if we look at any of ourselves when we are teenagers like we were anything but graceful oh goodness that is the truth mm-hmm in regards to antisocial personality disorders what demographic besides men do you find more effective this is where it gets a little tricky socio-politically unfortunately what we see in this is something that as I've reviewed the literature from my research that these patterns tend to be over diagnosed and people from lower-income groups and ethnic minority groups and the belief is it's that's because those groups are also disproportionately incarcerated and the target of law enforcement so the belief is that it's almost like the sense of pathologizing people who are different than the norm and that's why those statistics I think we have to be very very very careful with so again these disorders don't know to discriminate per se but since they're based on moral social ethical and legal codes and those codes are enforced by other entities there's now you're bringing politics in you see that's where it gets tricky and that which those things don't belong in mental health but we have to be mindful of them so we and in fact what we do sometimes see is that sometimes women who probably have antisocial personality disorder will get misdiagnosed with another syndromes borderline personality disorder because we don't think of women as having antisocial personality disorder and so and there are men out there who might very well have borderline personality sort of who get diagnosed with antisocial personality disorder so things like gender race social class is those other things for matter when a therapist or psychiatrist brings their own personal you know prejudices and yeah their practice bias bias by just the normal ice bias and that's why that you know ideally you have multiple pairs of eyes on case data which you don't always have you know because I've been surprised when I do every so often get to see you know past you know diagnostic you know systems late on a client I'm like really you know I got to say I'm not seeing it this way so it's not it's not a precise science that's why these these labels don't tell us much I think we're better off focusing on patterns yeah I've had patterns in our lifetime what do you hope or think that we could develop when it comes to the causes of antisocial personality disorder you know this is actually I mean a lot of what is being done in you know in personality just sort of research very much focuses on antisocial personality because we do know but it's it's dangerous to society so what do I think we'll learn I do think that newer new newer and newer tools neuroimaging tools that look at namely functional neuroimaging tools that really look in real-time at brain function those are going to shed some really important light on how these brains work differently and then once therapies or treatments are applied to folks to see if you actually see any franc shift in functioning and whether that's also associated with a behavioral change you know again these are not patterns that are that amenable to change I think that we might be able to isolate what the snapshot of what this looks like in the brain whether we can then acts on it you know there the jury is out like and it would it then become something that's more medical is there medication that could be even is it surgical right you know and then you but you face bigger bigger ticket issues like consent to treatment we are very we in the United States of America an adult has to consent to treatment can't just crack open a person's skull and start fiddling around in it you just know how it works and so I think that as much as we think well there could be all these magical solutions people have to agree to uptake therapy and you know there's reasons for that obviously but if a person doesn't think something's wrong whether it's psychotherapy whether it's medication whether it's newer therapies you know newer sorts of brain stimulation techniques whether it's psychosurgery you a person has to consent to that and it has to be really medically indicated so we have to be careful and how we think about those things dr. Emily someone comes to you a patient and they say my husband is a sociopath I am convinced what's your first reaction I first of all hear this regularly and I get heartbroken for them mmm because what it means that they've been enduring is somebody who is likely verbally abusive or ignoring them neglectful lacks empathy is cruel as cold is distant is manipulative like they use that one word and it gives me some real insight into what they've been enduring and by the time they pick up the phone and call me it often means they've been enduring it for a while how severe do the symptoms of a sociopath become I mean I mean I like all disorders it's on a range right you know I mean it's not like there's one version obviously in the milder levels you're often talking about someone who's cold angry brooding resentful mean-spirited you know at the more extreme levels it you'll you seem violence manifested so obviously at the more extreme levels you you're often talking about victims of more physical domestic violence but I think even at the mild levels it can look like emotional abuse what if somebody comes to you and they say I heard this word sociopath and I don't I'm not really sure what it is but I think my husband might be one what how can I tell I break it down for them because I think a lot of people use the word sociopath interchangeably with narcissistic yeah and like I said these are labels I'm interested in the pad or matter I'll say don't use the word tell me what it's like don't don't show me a bucket dump tell me show me what's in it yes okay metaphor and so I I say tell me what the patterns are and then once they start laying it out I say okay here's what the pattern is if it makes you feel better to have a word you explain no sometimes they want to keep doing digging and doing research but then we break down that pattern so when somebody is experiencing that like I said they're experiencing all those things coldness distance manipulation lying all those things and it almost doesn't matter whether it's a sociopath or narcissist neither pattern is that amenable to change and neither pattern feels good so they dump out the bucket and they're pulling out verbal abuse coldness all of those things that you mentioned yeah who cares what we call it right this type of person is unlikely to change no they're not gonna change they're not going No so 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 gonna change I say that very as you can see reflexively let's say let's say you get that person is like okay I never thought it would get to this point you're leaving let me give this a shot and they want to make a good-faith attempt in therapy and they're really owning it and they get in there and they maybe make some minor changes in some small small small small small small small percentage of cases you might see that since most people out there and most people watching are not going to be the exception to the rule I'm going with the idea that if their partner is not endorsing any issues on their end that they're responsible for any of this then they likelihood of change is zero you know you have to add that acknowledgement of change so assuming that that's what this person is like they won't change and when I bring it to their attention they look at me like you know I that's great I'm not you know there's nothing wrong with me this is you and Laughton blame the person so they'll say you're an idiot you're a fool maybe you're the one with a problem they'll then they'll undergo a whole new litany of emotional abuse so you're right the two options are to either get out or stay and if they stay to understand they're staying under conditions that really aren't going to shift that much but how able are we to unbias Lee tell a therapist how our significant other no I get it every day 10 times a day so then people are by the time listen you go into a therapist office and you're paying good money why would you lie I know I'm not saying that they're lying I'm saying if I say all right like I 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 okay then in which case you're gonna get your guidance from that perspective and that's why it's great to work with couples right because if you get to work with a couple then you get to see both sides unfortunately if Paul in fact is a sociopath he's gonna be manipulative you know so you have to be a really skilled therapist to sort of suss that out and smell that out you'd be amazed how many clients pull out their phone and show me the text messages and that's when I get a real sense of it I see the emails this is so good yeah I bet you people don't realize that they can even do that with the therapist they can't always some therapist listen I'm I when my clients come in they might bring in old photo albums I welcome all that they show me the text messages it helps your therapist though any of your viewers your therapist may say no and I don't ever want to impugn how another therapist works so I'm not saying all of us will do that I certainly will because I am there because of the sheer number of clients I work with who have been in narcissistic or sociopathic or psychopathic relationships it's really important to me to 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 like well maybe it's not that bad and they went gasps elated by the world and I refuse to be someone who does there's a reason this person picked up the phone came to my office once spent the money to see me and if it's to come in and say I'm gonna give you this sort of mythological version and do I think sometimes clients do that absolutely absolutely and so then what's happening is probably nothing is changing at home because I'm working in good faith so at some point they're either gonna stop coming cuz saying nothing you're doing is helping me but but I have to say that it is important for me to honor their truth is I'm a humanistic therapist and I really miss my orientation be humanistic existential and a big part of that is that your is what matters to me and for some reason you're coming in here and saying this is your experience of this person and it's not my place to doubt that I just want to understand it that is so good I love a the permission to bring evidence as well call it to a therapist who's open for that you know why they do that though Kyle sometimes people bring that in because they've been doubted by everyone and there they feel like they're losing their grip on reality that's what gaslighting does to people it's a doubt it's a test your reality and it could be going on for 20 years and sometimes to them they've 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 rather heartbreaking gesture I am not kidding you I've had clients come into boxes of stuff and you know and I mean it's heartbreaking because I think god no one has been listening to this person and they literally feel like they're losing their grip on reality and not to me is devastating so I Jennifer comes in and she's irritated with her husband Paul because he's a sociopath and you tell her look the evidence would suggest that he's a sociopath but I would assume 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 charm particularly we see in psychopathy and narcissism they can often keep a lid on it long enough to get a ring on it okay sociopathy tends to be a bit more sloppy I'm not quite sure why people fall for that but they do some people just desperately want to get married and they're just sort of taking whatever person is in front of them they're like okay I guess I can work with this and sometimes is that sociopaths don't tend to be as successful as Psychopaths but if that person maybe brings enough practical characteristics they can live with they may be willing initially to overlook the rest so know this person these red flags were here from the jump going back to a conversation we had previously in this series about being mindful and being aware and conscious because when you're mindful aware and conscious you can hopefully see that Paul is characteristics that are maybe won't be good in a marriage yeah and but people are so easily go into denial and then get married thinking I'll get better well that's the biggest mistake a person can make any nothing's gonna get better once you're married if anything I put my good bet on things are probably gonna get a little worse yeah you know I'll quote my father who's not a therapist he said look it better be so good by the time you get married because it's only gonna I mean it's possible some things could get better with time you know but we I have to say that it is you're absolutely right and every single client I have ever worked with man or woman gay or straight you name it Amy culture they have said they owned it these signs were there all along and if anything they feel angry at themselves they feel ashamed and embarrassed humiliated why didn't I see this sooner and they'll own it family tradition they wanted to get married they wanted to be a parent they thought this person could take care of them they felt bad for them because that they had a bad childhood those are those the reasons they get all the way in and like we'll fix this it's almost like we'll get the house and it's like a fixer-upper what could the house and then we'll fix it yeah not a good idea I'll share a personal story I had a six-year relationship broke up in therapy about it we didn't break up in therapy but I'm in my therapists office reviewing the relationship and I brought something up that happened in our first few weeks of dating and that event occurred throughout our relationship and I told my therapist yeah but I didn't know it was happening you were in denial I wasn't in denial I saw it happen in the beginning he said that wasn't that's not gonna happen anymore and I just didn't know what was happening he wasn't I'll you know you just chose not to see him and I left his office angry because I go who are you to tell me that I'm gonna now you know but then after a few weeks I came back though you were right I was in denial I saw it all along I just chose to pretend like it wasn't or make rationalizations I mean the other pattern I see folks make is like he's having a bad day at work the kids are really noisy his father's been really sick I'm wait until we move by the new house I mean it never ends right any anyone can write those rationalizations and while those things may be true their causes of stress that kind of bad behavior is unacceptable emotional abuse is unacceptable any day of the week mmm perfect I want to stop it right there that was there was so many great takeaways and my big one was going to the therapist with evidence yeah I've never done that and I probably should have yeah I mean if I said but I warn folks that you know like before they show up to the therapists office bringing a bottle cap with five boxes of Records and they end up and they open their phone their therapist may say we you know I only want to hear about your reality they don't want the therapy to be punctured by outside realities like I said I respect how other therapists work given the nature of the populations I work with that I must say it sometimes elucidate something and it allows them to almost feel heard and it normalizes things for them because they'll sometimes say I have to show you this because otherwise I am I feel like no one could believe something this outlandish I say I believe you if this helps you by all means you know I'm just trying to give them a sense that I'm trying to help them feel sane and whole again yes by whatever path possible yes water what's the first sign someone needs to look at as if they think somebody they know is a psychopath I mean if you come to find out that they're breaking major rules moral codes ethical codes or laws now obviously on a first date a person doesn't I mean unless that they've got their like their I just broke the law bracelet around their ankle you know they're not going to I don't think that most people are gonna like put their rap sheet in front of you on a first date so you know but pay attention even to look at how they might handle rule-breaking in a relationship I don't know they might take something that doesn't belong to them if you're you know from a like I don't a place of business or a hotel or something it may feel like a small transgression but it'll be enough to make you uneasy they may share something that they did at work that feels like it's on the wrong side of shady you know there's enough of those little things start to accumulate and you know the danger is it like wow they're they're really slick like they're a hustle their player you know like you think you're in some sort of cool movie with them but it's not cool it's actually they're breaking rules and they're doing it over and over again and that might be a sign or a signal you know they just are it's and then may end up culminating in more and more stuff and you may find it out I think one of the most devastating things that people have said to me when they've been in relationships with Psychopaths is what they learned down the road they come to find out that this person had a history of incarceration that they may actually be married to someone else at the same time that they lied about their occupational history that they lied about a bills that went unpaid and which are now are ruining their credit you might go try to buy a house and find out oh they had two bankruptcies in their past or something so it's a it may be something you don't learn early on nowadays with Google you might be able to look into people Psychopaths have a tendency to use aliases they may not be who you think they are Wow does it look do a psychopath look different depending on the role they take in your life for example a significant other versa coworker verse absolutely you gotta remember a Psychopaths front game is the best game in town smooth glib charming intelligent articulate perfectly put together I mean you're you really need to know what you're looking at to be able to catch them in what they're doing so they're gonna be if they're trying to attract you as a new partner they're gonna bring their a-game if they're trying to impress somebody in the workplace they're gonna bring their a-game however if you're someone who's disposable or dispensable to them or someone they views you're in their service god help you is all I have to say if you find yourself in a relationship with a psychopath or you believe that your husband or boyfriend let's say is a psychopath are there any questions you could ask them to maybe find out if you're right I would say that what you wanted use look for inconsistencies in their story and find out talk to people who know them now I'm not saying you need to go CSI on this and start this interrogation of everyone who's ever known them but try to see if there's continuity if the dates line up if their life story lines up if you know he might have said he went to college in one place and another person's like yeah when they graduated they were working at this job and you're like something's not adding up psychopaths often go out of their way to isolate their partner from other people who know their histories look for that pattern - why aren't you being introduced to anyone in the past they'll often say I was done wrong and I'll make up some dramatic story about how everyone did this to them so they have nothing to do with anyone from their past that's pretty rare that somebody would cut off everyone all friends all family all extended family it may be that they're on a fresh start path and they're sort of reinventing themselves and that you're in the in the you're in the eyeline of a grifter kind of person at this point so look for inconsistencies psych psychopathy is not a diagnosis of all time no but can someone have psychopathic tendencies but not be a psychopath you know I mean they're you then again you're splitting hairs you're splitting hairs because like because there's no diagonally if you have five psychopathic tendencies then you're a psychopath right you know the people who have like really are breaking rules in this consistent way and they're cold and they're and they fail to take responsibility and they're deceitful and they're manipulative and they're exploitative I mean these things tend to hang together it's very rare that a person exploits other people but then they're really sweet and they do bake sales and they run a Girl Scout troop like you're not going to tend to see those things kind of hanging out together these things cluster together so the more of them you have the more likely you are to dealing with somebody who is truly a psychopath I like the takeaway of looking for inconsistencies and this person and if you're in a relationship with them you do have the option to leave but if you have a co-worker for example you can't necessarily leave them so how do you adapt for working with a psychopath if you suspect you're working with a psychopath that you what you want to do is you really really really want to cover your bases remember HR is not going to help you unless you have documentation you can't walk into a try and say hey the person in the next cubicle is a psychopath they'll be like okay that's I watch the red circle of it you know so if you I mean I always tell people anytime you start on a new job you almost have to be kind of paranoid you start you save every email you make folders you get that stuff off the server you print it off like you knows all these steps that you really should engage in if you think you're working with a psychopath but you want to make sure you document things you want to avoid having meetings with them one-on-one you want to ensure that there's a third party present you want to ensure minutes are being taken of meetings you want to you know most times people scan minutes and 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 that you can trust but what you don't want to do is gossip about the psychopath because they're better than at that than you are they're already stabbing you in the back and numerous other places you can't see you know a way ahead of you they're gonna play this game better than you so you're best off playing a clean game yeah yeah then trying to beat them at their own game yeah really good advice what about for family members how do you tell how do you know if your mom yeah I mean that's incredibly painful cuz I got to tell you one thing I've seen in more than a few family systems is some people who won't refuse to believe it like I refuse to believe that we're just being dramatic and they'll say they're not a psychopath and so you'll have these families that also be schism didn't split like people will say I think you're exaggerating I think that you know they'll actually Gaslight the person who's making the accusation so it can be very painful if you come into the realization that one or god forbid both of your parents is a psychopath that's a very painful revelation but I gotta tell you you probably figured that out as a child psychopathic parents tend to be abusive neglectful manipulative one of the more famous Psychopaths out there is Bernie Madoff mm-hmm okay he's used as a classical example of a psychopath when you look and he was very wealthy and he raised his children up with tremendous comfort he certainly wasn't beating them with a stick or you know locking them in the basement or depriving them but there was a cruel edge to him and his kids would acknowledge that if you watch any retelling of that story there's well it's definitely not a comfortable relationship some people have high-functioning psychopathic parents a dad who's a CEO or a mom who's really really you know successful at whatever it is she's done and they'll report like having two parents the public person and this really cruel invalidating malevolent horrible person that would come home and they'd note the dichotomy how seamlessly their parent would go between those two worlds and so on and put through and put their child through unrealistic kinds of expectations so um people it's not like a person wakes up at 30 and says oh dad was a psychopath you know you know is there such thing as a self-aware psychopath you know the funny thing about Psychopaths is I don't even think they'd get mad if you call them Psychopaths because they don't care what anybody thinks of them so if you go up they'll laugh it off you wouldn't be like even a narcissist to get super defensive the Psychopaths like you want to call me a psychopath call me a psycho so that's how they respond but do they think hmm yeah I am a psychopath yeah I know they're not affected about by the evaluations or labels placed on them by other people what they don't like I know they're not affected by it but do they recognize that they are a psychopath maybe yeah maybe yeah they might in some cases they might and if anything it's like there's a there's a sadistic glee mmm-hmm you see what I'm saying like it's they may recognize it like how cool that I got like how cool like I'm a psychopath and I'm getting away with it or I'm a psychopath and look how much money I'm making or you know it's almost like if you I don't know it's like finding a bag of money on the street dropped by a armored truck and you're like no one's around and I'm picking this up and I'm walking down the street and I'm getting away with this like their whole life is about getting away with stuff so if anything that bath might even be like a badge of honor but I don't again I think they're impervious to the criticisms of other people that's where they're different than the narcissus the narcissus hates being criticized right the Psychopaths don't mind yes what are we talk what are we not talking about when it comes to identifying a psychopath that people need to know I think that with a psychopath it is it is really about looking for inconsistencies inconsistency in mood inconsistency in life history inconsistency in their stories the problem is we so want to believe when we meet someone new that their stories are real I've just met a supercool person that we we make the puzzle pieces fit even when they don't I tell people be a cynic when the dates don't line up recreate it listen Google's making some of this stuff possible - no I'm not I mean it's not like I want everyone to I said go out there and play like junior detective but if you're being isolated from anybody who knows anything about this person pay attention to that you know before you entirely by their their recreation of the events look for things that don't add up they have this huge job like they're so successful but they don't have enough money to get through the month but can you help me out this month like next month the big payouts gonna come come out I mean so I've got everything covered from then on in you know anything that feels like a hustle is probably a hustle we are seeing that there are certain there programs like for example prison transition programs and you know other programs working with more like incarcerated antisocial personality disordered groups that have found some utility in some forms of social skills training group therapies some 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 of how many psychologists does it take to change a lightbulb one but needs to want to change it's the same thing with antisocial personality disorder you know the person has to need to want to change and you know you may or may not have it I have to be honest with you it's more of those slick glib charming almost if you want to call them white-collar Psychopaths that are you're gonna get absolutely we're there I mean I think there's absolutely no chance of change there I think actually in the in the criminal populations you may be able to do some level of job training social skills training meaning and purpose focus work and I actually would put my bet on the incarcerated population more than I would on the sort of the slick you know the slick sophisticated successful group of psychopaths quite frankly because there's almost no motivation for change they're getting rewarded for their behavior that's right they're there in their world they're killing they're killing it they're killing it and the world is telling them they're killing it too right yeah so maybe cured is the wrong word yeah could a and a person who is psychopathic could they at least get to a point where they're not breaking the rules I mean that's obviously the goal and that's that's the goal of you know rehabilitation after prison and you know that kind of thing is that there is no recidivism and we try to avoid recidivism is where we're trying to prevent a person from committing crimes again but you know criminal behavior or illegal behaviors just only one part of what we see an antisocial personality disorder we're also seeing violation of ethics or morality or social norms so for example somebody who is antisocial personality or psychopathy is very likely to cheat on a romantic partner if they have one they're going to probably keep doing that because it really are they're really almost immune to it any sense of morality and so that's not going to change which can make it very difficult to maintain any kind of trusting relationship with somebody like that so I think that some of the treatment targets may be in terms of illegal behavior they may be willing to bring some of that hustle if you will to a more legal behavior but even then you'll sort of see that their tendency is going to want to take moral and ethical shortcuts what does the treatment actually look like for these people you know a lot of it is again it's cognitive behavioral it's it's it's challenging their beliefs and changing them their beliefs and thoughts and a hope of changing their behavior that's really what you're trying to do right and so it's that's where you're sort of pushing back on their cognitions pushing back on their schemas on their sense of how the world works trying to enhance their sense of empathy you know to really help them focus on this is how people are being hurt especially if it's a kind of it's not like person on person crime like violent crime something that feels more remote that to help them sort of see that this is hurting somebody else and the people around them now in a person who's really a cold stone-cold psychopath they don't care so I don't care if I'm hurting someone it doesn't matter to me and so if that's the case what how are you gonna make change there if I don't think something I'm doing is wrong like if some if I'm somebody tells me tomorrow like it's wrong to turn off my bedroom light when I sleep oh my gut yeah why is that a problem that is that's a really good way to put that that's how far it is yeah what do you mean I gotta make a hundred million dollars yeah do it you know I'm gonna do it and no one's gonna stop me or it's a game again I'm gonna bring up the Bernie Madoff case because he's sort of like a real textbook kind of a psychopathic antisocial personality sort of person in some ways it's almost like it was gamesmanship to him at some point how much money does one person well it isn't that the price it's got to the truth yeah yeah that's all it was and it felt like that's what it was despite literally so many people's lives being destroyed by his decisions absolutely didn't even seem to it was the game was more important than the other people and that's what it is like they are players who really only care about the game so someone's watching this I doubt they're psychopathic no probably are in a relationship with somebody is nobody who are family members a family member or work with them or work with them yeah they are likely going to be advised to go seek therapy for themselves in that therapy session what do they ask the therapist because what I want what I want to have happen for them is that they don't have to go to five therapy sessions to figure out what is a psychopath and what all these things that you're educating them on and giving them the tools to ask the therapist so that maybe in the first session they can make a ton of a game it depends on the relationship of the psychopath is this your child is this your coworker is this your husband you know because obviously the nature of the relationship it's gonna have a lot of bearing on what you need to know for example if it's your child the question a lot of parents are gonna have is am I responsible for this will we'll go into the whole child thing in our next video right so let's assume that this is for a loved one so you mean like a part of romantic romantic partner is it possible he can change because he keeps telling me he will we have kids together can I expect that he's going to be a decent co-parent if we have kids should I be scared you know I keep giving him second chances but it never works out why not you know is it possible he'll change those are the kinds of questions you're gonna you know that somebody should probably ask and you know by and large if that person has any expertise whatsoever in psychopathy or antisocial personality they're going to be able to give you some straight answers on that like I said these people are not made for long-term intimate relationships they're not and what if somebody's a what what if somebody's in the position where their partner makes all the money they have nothing in common scenario and they have five kids what and they come to a therapist and they say you're telling me he's not gonna change and you're telling me to leave be for all these reasons there just won't tell her to leave I wouldn't tell her okay then but they're saying this is gonna be really tough and that person says I want to stay in the relationship now what's your response to that then I'll say look at the history of what it's been like so far that's how it's going to keep being okay he has not been listening to you he's not going to start he has been cheating on you he's going to continue he's been disrespecting you that's gonna keep going like everything you're seeing I said at least you already have the roadmap expect nothing you expect nothing do you help them with coping strategies things like continuing if they can continue stay in therapy group therapy I do ensure that people women in particular who are relationships with men who have antisocial personality disorder or psychopathy have access to domestic violence resources 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 online communities you know and I do want to tell med circle listeners the guidance we're giving right now is not meant to be to serve a person who is in a violent relationship if you are in a relationship where you or other children or other dependent adults in your environment are in danger you must seek help immediately you must seek domestic violence services law enforcement and keep in mind if you're researching those resources online on a computer make sure you clear out your cache every time because it's not unusual in those relationships for a partner to go through and search everything you've searched it's that level of control so I mean I do want listeners to understand that what we're talking about it's situations where it has not escalated to violence financial abuse things that are putting you at abject risk that this this is not a substitute for the guidance somebody needs in that kind of a situation and it can go there and in with Psychopaths not uncommon is creating an exit strategy for the relationship every part of it is a part of it now unfortunately this is where you start exactly getting sometimes 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 attorneys they'll be able to charm the custody evaluators I have seen these things go really really badly for people people losing custody of their children people getting limited custody sometimes the psychopathic parent wants custody of that child not because they're interested in the child but to stick it to the other parent which is not good for anyone in this situation so I do tell people you need a plan you need a strategy you need supports and after all that it still may not go your way and I wish I could give people like a really sugar-coated version of this but people say well the judge is gonna see right through him not necessarily well I'm glad you're not giving a sugar-coated notion because what we're doing here is giving the reality the reality of mental health and the reality on this topic is what you it is just described and let's not move away from reality because it makes us feel good in the moment right let's lean into it so we can work within the realms of what's real and make as of the best decisions as we possibly can yeah and I think you've given a lot of our viewers actionable steps to take absolutely but you have to I mean these these relationships can become dangerous yeah you know and it's also listen I'll tell you this if a person's psychopathic or antisocial personality partner is really high functioning they are like the head of a company or some sort of like really high up in a political structure or something like that the world may not believe them yeah and that's me that's even more horrifying and in fact women who have who are more wealthy are often 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 some people may be watching now and scratching their head and say how did the person not see this how did they get in in the first place listen and you know a lot of flash a lot of sizzle everyone around you saying oh my god she's so generous he's so nice oh my god he's he's taken oh he's flying all of us on this great vacation or you know he's taking care of you or he's actually you know let's say you have a child he's offering to take care of the child - that all looks really good to the world and a lot of people don't stop under those circumstances to ask the right questions well that's a really good takeaway for people who knows somebody who's in a relationship with a psychopath - make sure you ask him check yeah yeah and when I sat down with Kevin Hines who survived a what normally would be fatal jump off the Golden Gate Bridge he really drove home the point of checking in with people asking how are you but meaning it not the oh hi there how are you good that's what surface that was never listening to that we're really going hey you're in a relationship with this person but how is it how you feeling yeah relationship with people don't often like to pull back that curtain I don't know whether it's because they don't want to know the answer or whether they feel like they're prying that it feels impertinent or something like that especially if you I mean I think even if you don't know someone well it's okay that you've met them how are you like it's a good it's a good relationship I think people are often like what why would you even ask me that I think it's it's an interesting question because if it's a great relationship and it's healthy you'd say I'm so fortunate like it's a really really happy relationship at a minimum it would make anyone stop and think dr. Ramani explained why first a child cannot be diagnosed as a cycle because it's it is a it is a pattern a diagnostic kind of a label that's saved for people over the age of 18 antisocial personality disorder is not diagnosed until somebody is over 18 but in children we can look for patterns that really conform to delinquency mm-hmm these can be milder patterns like truancy cheating on school assignments to more severe ones like physically or sexually assaulting peers it could be things like torturing animals I'm setting fires all of these behaviors you know if you have I think three or more these kinds of behaviors they qualify a child to be diagnosed with something called conduct disorder now these kids typically get handled through school and juvenile justice systems they may be placed in special school settings they may be sent to sort of special boarding school settings if the family has the money sadly some of them may end up in juvenile detention settings as well where say where we know they're grouped in with other kids doing these things so sometimes they actually learn more criminality in those settings so if you're noticing these patterns in a child they're bullying any of those things you want to act Swift leads early early and early and intensively I think part of the reason this is always so tricky is that sometimes it's kids being kids is that childhood in all those childhood fights that's just kids being kids that's boys being boys and that's often uses in a defense of something that people could get ahead of but it's also not that simple you might in nowadays we have a new issue to look at with kids and that's their online activity you may not have a kid who's going to school and making trouble there but what you might have is a child who's really getting into some dark online spaces whether through social media or even websites and and sort of social networks that aren't that is commonly used you want to watch their video game play while their research associating violent video game play or video game play and violent behavior is equivocal at best there's really we're not seeing consistent patterns there is your child locked up in a room all day playing those video games by themselves are they socially isolated how do they treat their siblings are they interactive at family gatherings or are they distant and remote so you there's a lot of places you can witness this child and there's a lot of ways it's not just the acting out some of it is also that extreme social withdrawal you're their parent they don't get cyber security you get to go through their stuff and that's a good thing yes it is a good thing but if you're at the position as a parent where you feel like your kid is exhibiting some of these signs and symptoms be happy that at least they're not 18 so that you you might be able to get that you can take control yeah and a lot of parents listen a lot of these kids are more savvy electronic spaces than their parents are that's it so they're able to you know really bury things and you know there might be on websites and extreme websites that parents don't even know exists so it's getting more and sometimes more and more challenging to monitor all of these kinds of situations where kids could be going down some really perilous places at that point you can really only engage in early intervention like I said in part through the schools and part through people who have this as a specialization and at that point hope for the best I talked to so many of our viewers and so it helps me to learn what helps them and one of the things that they've shared with me is that when they're watching videos like this and you just you just look at if they're isolating if they interact with people have family functions and you went through this list go back in this video play those responses again that dr. Romani just gave and write down those questions and over the next week two weeks a month write down what you're observing because we get so caught up and getting the kids to school getting to word packing lunches we miss the parenting we do we don't always pay attention no and so if you write that down and you actually take the time to look and write up yeah then you can take something to a therapist and say this is what I've been observing right so we have some track record here and we start to expedite the process of therapy so that they get as much yeah correct information as possible and one thing that's also tricky Kyle is and you and as a parent I can understand this is some parents just are in a place of denial they don't want to even let themselves go they're like it's terrifying to think not only could something be wrong but your child potentially could be dangerous to other people and parents think well maybe it'll be different in the new school maybe it'll be different next year this is a thing you know maybe maybe this is a phase exactly maybe it is but better that you do 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 this it's hard if the child is oppositional enough even getting them into a mental health practitioner may get you nowhere but I think for parents to at least know that you gave it a shot the more resources you throw at something early the more likely you are to have a good outcome yes what do you wish more parents would be doing you know I think I would I wish more parents would be willing to have emotional conversations with their kids early I have to say that we're having a real crisis of emotional expression in our culture and I think sadly it's concentrated in men and boys where we're not giving them permission to talk about their feelings we view vulnerability as weakness we view talking about feelings as weakness we feminized it and that's opposed to make it weak too and I think a lot of some of the bubble ups we see in men are just an inability to talk about their feelings their fears their Ang's their vulnerabilities and I think sometimes parents are even afraid to go there to open those Pandora's boxes and with technology kids have become sort of almost like they're speaking we're talking two different languages in a household and it's just to give permission to those conversations and you know and I think parents often feel they have to give solutions to their kids sometimes all you need to do is let them talk let them talk and listen I listen I have to catch myself on that all the time I happen to have a very long commute to school for my daughter that I used to try to say well let's fix it and I had it took me a while to say I'm gonna let her talk I'm gonna let her talk and talk and talk and not try to bring a solution to it every time and which is hard when you're psychologists well I I find that funny that it's hard I would think it'd be so easy for you to just listen you are it's like because it's your kid kid you wanna write and I think many parents even well-intentioned are you know it's time that like you said you come home you're making dinner you're running around you're doing homework this whole sort of like let's just sort of claim under the covers and have an emotional conversation when does that happen good time make the time you just cause a light bulb to go off in my head i I've seared in our depression series with dr. sue Varma that at nine years old I was diagnosed with clinical depression and completely suicidal was put on Prozac and I shared more of my depression story throughout that but during or throughout my life but during that time I remember I have episodes of like I would say panic or anxiety or just really emotional outbursts and I would end up in my room in bed and I would be just wishing wishing that my mom would come in and talk to me I wouldn't I wouldn't go he would the classic red no I would never go that's such an important and I was there oh gosh I hopefully and when I would hear that knock on that door that door open it was just like relief yeah because I go she's going to let me talk now yeah and it was such a I didn't realize it that until you just said that of letting them talk yep give me that outlet to be like here's what I'm feeling here yeah cuz for whatever reason I couldn't manage it health and a healthy well I I think we as parents it's not art we don't wait for our child to come get us we do have to be we have to be the early warning mechanisms we have to check in in our children that balance will shift one day that won't forever be our responsibility but it really is about paying attention and again it's something I've been rueful about myself as a parent very busy and there been times I wanted to give advice when all she needed was an ear you know and I guess we learned and we evolve and we keep trying to get it right mm-hmm if a parent does take their kid to a therapist and they are diagnosed with I always forget that in conduct disorder conduct disorder what are the chances with the right intervention that this kid will not develop psychopathic tendencies as an adult you know my knowledge based in Syria isn't good enough for me to give you a specific probability I would be uncomfortable doing that because this is such a high stakes game let me put it this way your mistakes are much much better if you do take them to a therapist than if you don't yes you're improving your odds you know the I think a lot it's a lot of it's going to depend on that the child's pattern of behavior the environments they find themselves in the resources to help the child there will be other adjunctive programs around that child for example there are some programs that use things like martial arts and and and those kinds of like physical kinds of programs to actually channel some of the strong feelings these kids have into the discipline of martial arts so you'll see some of those kinds of programs somebody I know works on those kinds of programs with gang affiliated youth so there's different kinds of innovative programs out there that meet kids where they are at using art using music using physicality that you want to use as many of these resources as possible to give that child a chance to express themselves where they may not be able to find the words they may be able to find another outlet give us a few tips for parents on that on those initial therapy visits with that child you know when you bring a child in for therapy initially now while different therapists who work with kids under 18 work differently most of them Stalin's we're gonna want to meet with the parents once and sit with you because many times a child won't be able to relate their own developmental history like were there any birth complications and their milestones or all of that so let me the parents to do that and then you'll have to work out with the therapist sort of how you're going to communicate about it with the child who's well into adolescence that child might want a private space and then you agree with the therapist on when she will contact you or he will contact you if the child is in danger if there's symptomatology they're concerned about you want to make sure that the adolescent feels fine with that with the younger children it's less of an issue that tends to be more of an open book and more open conversation you as a parent should ask some questions on how they work you know with your child and what kinds of things that they're going to be expecting a child will they expect your child to do anything between sessions so I think that it ends up becoming collaborative I also have to say Cuyler can be useful families to enter family therapy where everybody's in the room mom dad or whoever the caregivers Dino whether it's to caregivers whether it's a single parent siblings and the child because these are these tend to be systemic issues I think there's a real risk of sort of labeling that one child is the problem child which that child is probably already experiencing that sense of identity within the family especially if there are other siblings are playing by the rules and they're not that by having family therapy there could be a chance for everyone to kind of get a little bit more aware of the dynamics but it's early intervention it's regular intervention it's multimodal intervention meaning we're using different techniques to help them out it's monitoring and then it's leap of faith the stakes are never higher when it comes to a child yeah I agree and what are we not telling parents about psychopathic tendencies and their kids that we need to be telling 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 film kind of sequence it's an area where there are some specialists who are doing work in this area it is hard because there's so many moving parts here listen for the child who's coming from a really abusive deprived violent home I'm not so sure that they're going to be watching this if the parents are abusing them I don't know that they're watching videos to figure out how to help their kid so those kids are likely potentially to have poorer outcomes to got custody of the kid or something he's now trying yeah but in that kind of scenario exactly now that the child has a consistent caregiver to that family family member or someone else who may have stepped in in this child's life regular intervention and that child may be really different and have their arms curved you know they're gonna do that they're gonna Stonewall and they're a child and you're going to keep trying to find that way to get in to them and that's why therapists use all kinds of techniques even playing games with a child I mean the child people therapist II work with children very very creative and very gifted it's very difficult work to do and there are people out there who specialize in this and there are also experts who sort of cross that line between sort of the justice system and psychology who sort of are working you know know about the cutting edge programs for young people who are vulnerable to ongoing series a developing criminal behavior or who are you engaging in it one i I want to thank you first for sharing that because this is hopefully and I believe will change the path of so many I hope so I I don't think that people understand and I think for me especially on a day I'm you know clinically working with clients is the devastation that's wrought when somebody abuses a child yeah for me it is a it is a it's a passion it's it's a it's a fight it's an absolute there's something about it that the sheer innocence of a child that they place their trust in the adults around them and that trust is betrayed that ramification is lifelong it is self doubt it is sometimes self harm it can be mental illness on the bright side yes we often can see resilience and growth and empathy and lots of other things and we can also see darker patterns like psychopathy and sociopathy but I I think that we I cannot stress enough how important it is to safe guard our children they are our children or not your children are my children they are our children these are the people who will be taking care of the world as we get older and our complete disregard sometimes to the welfare of children is concerning for me this is why I want people to listen to this and really get that sense that pay attention to the kids around you pay close attention because for many folks I've worked with over the years even students I've talked to if one person one person had listened to them and paid attention to them when they were children things could have turned out quite differently yes you mentioned in previous videos that people know once they become an adult if their parent has an antisocial personality disorder they may not know the label for it but it mean the odds are if they had a psychopathic parent or a sociopathic parent or you know antisocial personality patient I mean your parents I should say they would have either had a parent who it'd be end in the family that would have been very common like disappeared or who physically harmed them either themselves or their mother or you know other people in the family or who might have gone to jail you know for really committing some sort of heinous crime so something there's going to be some sort of ringer they just may not know what it's called but they'll know I don't know yeah it's not subtle it's not subtle how many of these how many of these kids who are now adults have relationships with their parents who are a psychopathic or sociopath you know it depends it you know it really depends on the nature of the parents transgressions obviously somebody abandoned the child some people out of curiosity as an adult may circle back and want to try to have a relationship with that parent if they were horribly abused by that parent they they often won't but you know listen it's amazing how many people who had abusive parents still stay in the game with their parents I don't know maybe it's just it's almost like a loop they get stuck in still trying to think they can win them over or something would change their behavior so some do certainly many don't because of the parents transgressions are either so awful or just pull them out of the child's life and never to come back again well I think out of all the categories children and parents are the most difficult because I do have the choice even though it might be very difficult to leave a partner I do have a choice to quit my job if my boss is a has antisocial personality disorder but I can't go get a new biological mother no I can't go have I guess I could have another kid but I still got the one that I have yeah well I mean if you're talking about it being your parent can you quit a parent sure you're right you can you're right you know I mean I think that the heartbreak I see in folks is when they realize their parent just did a bad job they were neglectful they were abusive they just were not they should not have been a parent bottom line yeah that awareness is devastating because you're right you do only get one set of parents now and they may not always be biological parents call sometimes adoptive parents come into the scene in that person's life and that's that's the only parent they know it may be a slightly more it could be a more complex than you know dynamic if that adoptive parent abuse I'm making them wonder because this have gone a different way but ultimately it's the the sense of loss of I don't I was I feel like I feel like I've been robbed I could have had a healthy parents relationship which is such an important relationship not only for a child obviously critically important for a child but also even in adulthood person feels something's been stolen from them however I think then that's getting caught up in somebody being given a job they probably weren't good at which is namely your parent some people who are good at this actually seek out mentoring figures and other adults it may be a grandparent it could be an aunt or an uncle it could be some other trusted adult in the family system or it could even be a mentor they meet along the way in as a university at the university of high school what you know in the job that they find someone who becomes that fathering or mothering figure to them and they have that relationship there's still a yearning gosh darnit I only wish this had been my the parent I had been born to life doesn't always look the way we want it to you know and and by fighting say this is my parent needs to be right and fighting a fighting for something that's completely futile that you're never going to get that feels like a waste of time so I want to break this into two categories the first category for the people who are in the position where look I go to Thanksgiving every year and I see my my parent and I have to know how to deal with them and the second one is for the people who say you know what I've moved on from them I've separated but I do need to recover from that's good and perhaps both people need to read yeah so let's start with the first one what do you tell the people who still want or feel like they need to have a relationship with their parent you know when people feel like they need that then I say to them you gotta manage your expectations you got to get realistic about this they're never gonna be a cheerleader they may be downright jealous of you they may try to undermine you they may try to take money or resource from you they may try to manipulate you because these are all the things they've already done so they're not gonna stop yeah so can you go instead of waiting for something you're waiting for that I love you that may never come or that I'm proud of you that may never come and so you're waiting for something that may not arrive that can be heartbreaking but if you can say listen I want to know the I like the idea that I have a parent out there somewhere and I know they're always going to get it wrong if you can get down with that and really manage your expectations then go ahead have your relationship with them but to keep being surprised that they're acting badly after a lifetime of acting badly that that's that it's actually feels illogical you know it's easy illogical because it's a matter of the heart but you have to be realistic about the expectations you bring into this situation that is first of all so simple mm-hmm my favorite things are the simple ones though because they're often underrated and the most powerful it yes you this has been going on your entire life just because you're an adult now and can point out what it is doesn't mean it's now going to be different nope and if you could just let it go put it down realize this is the depth the hand you were dealt yeah and just like Anika see you know sometimes you're gonna have to fold the hand and say I'm done playing this I'm good you know you you say let it go and meet for me for me it translates to forgive and puree that jaggon I'm gonna I want to hear all about that response because my definition of forgiveness is giving up hope that the past could have been any different it doesn't mean I say what you did was okay it was terrible but I'm going to give up the idea that my childhood could have gone any differently because it couldn't no I mean that's fair I I actually what you're describing I tend to use the word acceptance except I use the word acceptance I forgiveness to me is a this happened and I no longer resent you for it mm-hmm there are not many people I know who reached that bar like I forgive people who might cancel dinner plans mm-hmm I can live with that I don't know that I would forgive someone who fundamentally betrayed my trust depends it depends but yeah we could have a whole conversation about the only of you know it's about forgiveness here's the problem with forgiveness okay when we hand it over to another person we expect them to treasure it and to treat it as the the really almost divine gift that it is which is thank you so much for this because it feels almost like absolution right I'm gonna honor this and I'm gonna get it right and I am so sorry for the hurt I caused you thank you thank you for thank you for seeing through to this better part of me and they make real change that's an example of forgiveness working out hmm but where forgiveness can be devastating is when you go out of your way to forgive someone and they turn around and they do it right back to you again which they would do which they would do yeah for me forgiveness is not even about that for me it's all about okay it's me really taking a moment with myself to go you know what that is okay I'm either gonna dwell on this and get angry and you know ruminate on it or I'm gonna go and you're okay with them of doing it again if I'm not okay with it but I I accept that that's their behavior okay accept accept yeah that's why I can't I've made the choice to have them in my life right and I have to know what's coming because so if you forgive them because forgiveness to me is very much a and many people argue what you do philosophically forgiveness is an act to the self okay it's for the self so I can but to me that's letting go like I can say let go of something when you let go of something it doesn't necessarily mean you've let go of the resentment does that make sense like I thought this go I'm gonna tell you though it's changed this relationship yeah that's not forgiveness forgiveness is really kind of like a bit of a little bit more of a reset now if you read Desmond Tutu's work on this and you know that he was Nobel Prize winner from South Africa if you read his work he gives a much more nuance to take on forgiveness and actually his work as some of my favorite work I'm forgiveness because he really does say like yeah this has changed the DNA of this relationship from there's no getting past that but I mean I think we're talking about that you know so we're circling around that drain of forgiveness letting go and acceptance but people use the word acceptance but they don't really mean it they'll say I accept this what do you mean you just did that to me again Michael slow down sister you just said that you accepted that yeah you know I don't really mean it well then they didn't accept it and you didn't forgive it you know so be clear on the terms and listen some people you might really transgress on them and they may truly forgive it and they'll be okay and you're gonna do it again and you're gonna do it again and that's not what most people have signed up for yeah and sometimes when people feel like I've given you this divine gift of my forgiveness and you keep abusing it that feels like outer devastation to people in your practice do you find that your patients talk about their parents a lot number one number one it's like the stereotype of Freud and I know what we don't start there we start on what brought them in which can be marital problems work problems low self-esteem problems with their weight anything but it's current this others by rarely produce a person come and say I'd like to unearth the damage under weight at the hands of my 35 years at some point though especially since my work is in people who are trying to be survivors of narcissistic psychopathic or other sort of toxic relationships if you will I need to understand where their precedent came from why do they think enduring this is okay and many time we get many times we get some of those answers in their childhoods that's why we explore there I am NOT a I'm not a psycho analytically trained or a psychedelic dynamically oriented therapists but I do very much believe that when we look at 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 what they were rewarded for and what they weren't rewarded for or if they were rewarded at all we learn what they learned about love and what a relationship looks like we learned if they've had a history of trauma we get a lot from understanding those early relationships yeah I think that's really wonderful for people to hear because hopefully they have or will take the step to go into therapy and not be afraid to talk about the truth yeah when it comes to their parents yeah I have found in my personal experience going to therapy that I often protected yeah my parents to the therapist he would ask me a question point-blank and I would paint it so that my parents looked better than maybe they actually were and I found myself doing that and then of course we discuss 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 people feel they're being disloyal it's something that goes back to childhood you know children feel incredibly loyal to their parents and so even as adults we hold on to some of that and and coming out about them you know so there's some of its self protective in therapy doesn't need to because therapist is probably never gonna meet your parents your parents might even be dead you know and people still feel that it's deeply disloyal so it's a it's an interesting space for people how protective they can even be of their abusers yeah you know when they talk about those histories down the road I think I know the answer to this but do you find that people who were raised parents or a parent with antisocial personality disorder end up in a relationship with somebody who is perhaps in an antisocial people who witness abusive relationships as children there is there's a risk that they may enter those relationships it's some level violence got normalized at some at some level they think that might be all they deserve likely where there was domestic violence there was also at a minimum verbal abuse of those children if not also physical abuse so it's a it's a sense of devaluation that's why I was saying I get so angry when I hear that children were exposed to early traumatizing environments because it changes their worldview and more importantly their view of themselves and then ultimately the choices that they make now that again I always want to stress to listeners if you came from a family of origin where there was antisocial personality or psychopathy and there was abuse are you doomed to repeat those cycles no no no a lot of this is awareness yes that you actually go out of your way you get therapy you're very mindful and aware it's when you're not aware it's when you are in denial that you're at risk of making those kinds of errors yes but it's it's the awareness followed by the action it's the awareness and then going to therapy it's the awareness and seeking out this education it's the awareness and talking with the friends getting the support system that action is so critical but it's also the awareness and being mindful and you know and list allowing yourself when a signal is given to you it's only useful if you're willing to heat it isn't that the truth that is the truth when I say that one more time when a signal is given to you yeah and there's lots of them there's lots of them it's only useful if you heed that signal yes and when a lot of people realize like there was that signal and I chose to overlook it for any number of reasons had they stepped and walked away then so much better yeah I've done that all of us me many other times yeah I actually last night was telling my friend I said when this thing been in my relationship I should have just called it but I didn't you know but Kyle here's where I'm gonna be kind to you and everyone listening to myself is that there's a point at which sometimes if we walk away too soon we then get forever sort of hamstrung by the H of regrets regret did I step away too soon I mean we all what I want is for people to feel that they can take that moment taking the information and the experiences around them trust their feelings and when it starts feeling uncomfortable that they can give themselves permission to either communicate about it or walk away with the least damage possible if you did walk away at that first signal you might have spent the rest of your life wondering well was I too much of a cut and run guy like did I not give this a full chance versus I saw this thing through and if anything I stated the funeral way too long this body was buried in the food and wine were gone and now we're standing yeah you are and I I do take some bit of uh I feel good about that knowing that well at least I know I know I know there's no and you know my my goal is to get people away from like obsessing over those lingering doubts like this doesn't feel good pay attention to those signals seek out help communicate some and if when you communicate with a partner for example you're getting very strange pushback or you're getting a lot of projection or they're blaming you yeah it's already hard to go to work every day yeah but you mentioned in an earlier series that anywhere between about four or five percent to 21 percent of major corporations have a CEO yeah yeah yeah so what is someone to do you know I mean I think that it really comes down to how close you are to that psychopathic leader that psychopathic leader maybe running the whole show now that's not going to make it easy because the culture sort of trickles from the top down right so a really psychopathic boss can make for a really toxic culture where there's lots of backstabbing and subterfuge and lying and deceit and people throwing each other under the bus and so it can be a really oxic workplace when it's somebody at the top you may not have day-to-day contact with the person at the top of the ship but you may have you know contact with people in the middle who are still impacted by that kind of company culture in terms of what you are to do in the long term it's not something you can do much about I mean certainly we've seen in the last few years more and more reports of the real dangers of abusive workplaces and what people have endured in those settings and honestly how many people said when I even did say something I wasn't believed or I was told by people don't say anything because that person's protected because they're making too much money for this company right there's a reality there it just say you're in this sort of David and Goliath battle you're not gonna win yeah you're really not and I wish I could sit here and say no really and and you can go to HR and you can get an attorney and it's all can that be a happy ending it may very well not be and by the time this whole story plays out you may be so shredded psychologically but it mate the battle may not be worth it so it's really about choosing your battles and being very realistic about how it's all gonna turn out but all of that said you know when you are in these workplaces where maybe some in your direct report somebody you report to directly is a is a psychopath the key again it's something I've talked about in other med circle videos is document document document because as I said if you do decide to go down the you know the path of talking to HR they're only going to be able to work with documentation a lot of people don't like to hear this but it's it's a realistic piece of feedback is that sometimes you simply can't win in those workplaces either you'd be willing to take on the litigation and really I tip my hat to your courage and also I'm rooting for you to succeed at it some people don't have the resources the patience the time they may not be some industries it would just sort of end up if it doesn't go the way you hope you may never be able to work in that industry again so it can be a really really painful sort of a decision to pursue it sometimes easiest thing is to find a new position but for some people that's hard because that psychopathic supervisor or boss may not give them a good recommendation to go into the into the sunset with so you really may end up being hurt by this time spent with this psychopathic boss so you know it can be quite bleak depending on the situation what does a psychopathic boss look like they're very toxic they tend to lie I think 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 play people against each other they thrive under division they like it when there's lots of infighting because it tends to do it tends to benefit them they can be quite abusive that yelling screaming hostility yelling things that you would think would get them into legal or at least you know HR trouble but it doesn't they tend to take credit for stuff that they're not responsible for they steal other people's ideas they are they have inhumane demands on their workers they show absolutely no empathy to them they're punitive they'd hire fire with you know with almost frivolously yeah they would they abuse their underlings they maybe inappropriate with the people they work with sexually or otherwise so it's it's a bad scene it's a bad scene and there's no way as an employee to manage them I don't first of all they have power over you in this system now like I said in the best telling of the story you save all your information you have the smoking gun you show up at HR that there's somebody above this person in the pecking order and they say we don't care how much profit they make for us we run a clean workplace we're going to get rid of them and we're going to give you a promotion I wish that's how the story goes it so often isn't and many people will report the processes that they were made to go through to turn you know to sort of drop a dime if you will a really you know come come clean - how horrible a psychopathic supervisor a boss was its reach Ramat izing and like this isn't even worth it anymore and so it can break a person and it's your work it's your livelihood and because a psychopathic boss is usually very good at their job tend to be making money on terms of being sick whatever the outcome is yeah yeah whatever that looks like right I forgot about that so of course the company is going to they don't reward true they don't want it to be true right because this person is really willing to do sometimes the dark and dastardly things you need to do to succeed in certain sectors and so it's a and and they'll try to argue like listen my management techniques are being misinterpreted you know one person's intimidation is another person sort of I don't know hard driving kind of supervisor mm-hmm if somebody decides that they don't want to pursue action with HR and they don't want to leave their job what advice do you give them number one you've got to take care of you it can be you know you you'll be horribly depressed on Sunday nights when you know you face another day at that workplace it is important that you seek out therapy therapy is a confidential space keep that in mind I do let people know though if you are gonna pursue civil litigation they will try to get your therapists records so just you know keep be open with your therapist that this is a possibility to like I mean I'm just preparing people for the worst case scenarios and really psychopathic bosses and workplaces they're going to go in and try to do a smear campaign on you so you have to be prepared for all those things but get the help you need you know build 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 underlings may actually unite against their you know against their single enemy if you will common enemy and sometimes they they end up either going off and starting their own startups or creating creative problem solving solutions like creating their own community independent of the psychopathic boss like they unite and provide each other soup and of course the Psychopaths boss feels well yeah because I am their boss like I made yeah I'm a visionary leader or he may get really harren or she may get really paranoid why is everyone uniting against me but either way you might be able to find you might be able to find support another rank-and-file people you work with you may not even be rank-and-file I mean I've worked people with people who are at an executive level and it's the person at the next executive level that's causing them misery right so it's no I mean even you know it can be at the top of the top top it could be down 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 slowly slowly start working on that exit strategy these kinds of experiences are what have led some people to actually pursue new career paths go back to school do things that they never thought of like move to another country like some people just viewed as the wake-up call it isn't for some people it's utter devastation they may have worked for decades to establish themselves in a career to simply watch it get stolen from them by one boss mmm well if it's not your boss it could be your coworker yeah what advice do you have when dealing with a co-worker which is a different dynamic it's a same with a co-worker it's actually in some ways it can be strangely a little more problematic because you know you're almost a little less protected at least when it's from the top down you can show more negative effects on your job like if you get a demotion or something you can you can probably plead your case better but when it's a co-worker they may be impeding your progress in your career again by stealing your ideas by creating alliances with co-workers and turning them against you by spreading lies about you in the workplace it's really easy to try to get in the gutter around this stuff for example to complain on in social media I have a psychopathic boss I have a psychopathic co-worker never go there that kind of stuff is a big no-no we're HR is concerned and then they'll have grounds to dismiss you you're just hurting yourself some people are just so desperately situations they want to put the cry for help out there to their community social media is not private it's public it's a public space so you have to be very judicious about how you try to get that support from other people social media is not the way talk to friends to talk to a therapist document document document document make sure you have everything covered all your eyes dotted all your t's crossed a psychopathic coworker could be finding your vulnerability your [ __ ] in the armor and use that against you so you need to make sure that you're as sewn up as possible I understand that excellent advice and thank you again for walking our viewers through how they can deal with people in their life who may have an antisocial personality disorder in all aspects subscribe below and remember this video just scratched the surface for more in depth videos on mental health topics go to med circle comm and join for free [Music]

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Views: 2,577,683

Rating: 4.8102865 out of 5

Keywords: psychopath, psychopathy, sociopath, psychology, mental health, antisocial personality disorder, mental illness, what is a psychopath, personality disorder, sociopathy, signs of a psychopath, psychopaths, psycho, psychopath vs sociopath, are you a psychopath, narcissism, psychopathic, serial killer, narcissist, psychopath test, education, signs, disorder, personality, criminal, sociopath vs psychopath, ramani durvasula, antisocial, brain, medcircle, mental, psychologist, aspd, interview, psychiatry, video

Id: gpjYtAB9i2w

Length: 143min 39sec (8619 seconds)

Published: Wed Feb 05 2020

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[u/LouieCapone]

99% of CEO’s are unimpressive failures. Anyone can fire the janitorial staff and delay safety repairs for a couple years and then point at the savings as increased revenue deserving of a bonus.

Essentially they’re just saying psychopaths excel at mediocrity and unoriginality.

[u/I-Am-the-Cold]

Person with autism wants to work in foodservice. "Oh no, we can't have that!"