We all have characteristics of personality disorders. It is the extremes that cause the personality characteristics to be a pathological problem. I have characteristics of Obsessive Compulsive Personality Disorder from the DSM-IV aka Anankastic Personality Disorder ICD-10, but not enough for a diagnosis. Many very successful people have these characteristics and it is very common among critical care nurses. In fact these characteristics are seen as an asset in many professions. Many of these characteristics are also common in people with autistic spectrum disorders, so probably most of these characteristics are related to the Aspergers. One must have all the criteria for a diagnosis and it needs to be severe enough to cause dysfunction in the life of the patient. In other words if it is not causing problems who cares.

There has been a great deal of discussion about Sarah Palin having Narcissistic Personality Disorder. Personality disorders overlap a great deal and often two are diagnosed at the same time which share characteristics, narcissism is one of those. They are mainly a tool for communicating a set of characteristics. It gives practitioners a generalized picture of a particular patient’s issues. Some practitioners have a favorite one they over diagnose and some personality disorders are used inappropriately as labels by some rather uneducated practitioners. Also take note that the World Health Organization’s ICD-10(International Statistical Classification of Diseases and Related Health Problems) which gives diagnostic criteria for medical problems in the area of mental health disorders does not even include Narcisisstic Personality Disorder. That tickled my brain and set me to thinking.

The United States has very slowly integrated the ICD into our healthcare system. Narcissism is one of the symptoms commonly seen in what we commonly call sociopaths or psychopaths. It is of course the most glaringly obvious symptom next to the constant lies. In the US we have the DSM-IV for psychiatric diagnosis which much of the world does not use, preferring the ICD. Over the years they have negotiated and gotten more similar, but still large differences remain. This could be a symptom of the U.S.’s own Narcissistic Disorder as a society. In fact having an autistic spectrum disorder myself and knowing the problems the definition of it in the DSM-IV has caused many people leads me to use the ICD-10 when I do my psychiatric research, even though their description of Aspergers contains some misleading information. The DSM-IV has prevented understanding and proper diagnosis of autism spectrum disorders through it’s inaccuracies in this country. The DSM V will hopefully be much better. Autism is not a mental illness, it is a neurological disorder, although autistics do often have problems with depression and anxiety.

Let’s compare the two descriptions from the different systems. There is an interesting difference which says something about the United States.

DSM-IV-TR Diagnostic Criteria for Antisocial Personality Disorder (301.7)
A. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:
failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
impulsivity or failure to plan ahead
irritability and aggressiveness, as indicated by repeated physical fights or assaults
reckless disregard for safety of self or others
consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
B. The individual is at least age 18 years.
C. There is evidence of conduct disorder with onset before age 15 years.
D. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or a manic episode.

Contrast this with the World Health Organization’s ICD-10 criteria for the same disorder by a different name. The WHO’s ICD takes the element of being arrested for illegal actions and physical assaults from the picture. Notice the ICD uses generalized violations of the rules of society while the DSM describes particular illegal type behaviors, specifically naming them. This slants the disorder to not include the white collar or socialized sociopaths. I find this fascinating. Just who is influencing the American Psychiatric Association? The ICD includes violence in their criteria, but since only three of their criteria are necessary it may not be in the picture at all, in other words violence is not a requirement of the diagnosis.

There are socialized sociopaths and in the United States who do not get arrested for crimes. They are accepted and have been normalized into our society. They are often found in leadership positions. We find them as politicians, CEOs, and as heads of government agencies. Drug companies, insurance companies, health care companies, and government leaders(who may be sociopaths themselves),  use them to control others or make money and they cause a great deal of harm. These companies often lobby our legislators to make sure their deviant behaviors remain legal or if illegal they are not punished. They may lie about a drug which causes people to die or become addicted, but they just get fined a little, none of them go to jail.

There are corporations who lobby to make sure people who commit low level crimes are punished harshly because they make money off of them. Both the company executives that do this and the legislators who write laws for them harm those who commit low level crimes, thereby harming society, yet do not care. The evidence that socialized sociopaths are accepted as a norm in our society is the lack of laws against much of their behavior and the lack of prosecution against atrocities they have committee against society. President Bush and his regime went so far as to cause the deaths and torture of innocent people through lies used to circumvent the laws of our country and the world. They do this because they have no conscience and believe their own twisted agendas outweigh the needs of other people. So far they have not been prosecuted.  While most workplace bullies are not sociopaths, the ones who cause the most damage to others are. I should know. There are no laws against their behavior. The lack of recognizing the presence of large numbers of sociopaths in high level positons in business and government in this country I believe is one of our biggest downfalls. Unless we learn as a society to recognize them and keep them out of important leadership roles our country will be destroyed by them.

F60.2 Dissocial (Antisocial) Personality Disorder
World Health Organization ICD-10
Personality disorder, usually coming to attention because of a gross disparity between behaviour and the prevailing social norms, and characterized by at least 3 of the following:
a. callous unconcern for the feelings of others;
b. gross and persistent attitude of irresponsibility and disregard for social norms, rules and obligations;
c. incapacity to maintain enduring relationships, though having no difficulty in establishing them;
d. very low tolerance to frustration and a low threshold for discharge of aggression, including violence;
e. incapacity to experience guilt and to profit from experience, particularly punishment;
f. marked proneness to blame others, or to offer plausible rationalizations, for the behaviour that has brought the patient into conflict with society.
There may also be persistent irritability as an associated feature. Conduct disorder during childhood and adolescence, though not invariably present, may further support the diagnosis.
amoral, antisocial, asocial, psychopathic, and sociopathic personality (disorder)
conduct disorders
emotionally unstable personality disorder

Add sociopathy to the psychological makeup of the evangelical right which is facilitated by the harsh punishment the followers are taught by their leader James Dobson and they are basically breeding sociopaths. There is much controversy about sociopaths and psychopaths. Some say they are the same thing and some say psychopaths have genetic tendencies to antisocial behavior. If a child is born with genetic tendencies to antisocial behavior and they are in an environment of abuse/neglect or have bad role models, etc. their problems will be compounded. They need extra help to decrease the effects of their genetics. Many parents do not recognize they have a child with tendencies to sociopathy of course. It is normal for children to make up stories and lie to their parents sometimes after all.

What I am saying is this tendency for sociopathic traits in many evangelical leaders is coming from the parental practices being taught the evangelical right. These people like Sarah Palin are being created on purpose. They are being raised to be evangelical sociopaths or as I call like to call them, Sociopaths for Jesus. Their harsh and incongruent method of punishment has been said to cause sadomasochistic tendencies by Max Blumenthal and others, but they are speaking of the average person who probably does not have genetics which make them predisposed to sociopath behavior. I have no knowledge of parenting practices of Palin’s family of origin. Most people would not understand the psychology behind this and would trust a psychologist who is with an organization  called, Focus On The Family. to tell them the right thing to do. James Dobson has a radio show which legitimizes him further.  Sociopaths have come from very good families where parents have gone to great lengths to help their child, but I suspect this is not so in this case due to the severe case of denial her parents seem to have about her. We know abuse and neglect can have an impact on development, but the things that are missing from our childhoods can have a large impact as well. All of us are born narcissistic and our development helps us learn we are not the center of the universe. Sociopaths can benefit from psychological treatment, but rarely seek help because they usually feel there is nothing wrong with them.

I am not a doctor nor have I played one on television, but I am an Aspie Nurse.


1 comment:

morb320 said...

Sad to say, but I see many of the qualities you discuss in a lot of politicians and CEOs, and their behavior has been normalized and is accepted by some members of our society. I doubt if they'll be seeking professional help because they see nothing wrong with their behavior.