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Dr John B
Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience:  PhD in Clinical Psychology, registered clinical psychologist.
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How common are sociopaths? How difficult is it to tell if someone

Resolved Question:

How common are sociopaths? How difficult is it to tell if someone is a sociopath?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr John B replied 2 years ago.

Hi,

True Sociopaths (Antisocial Personality Disorder) are very rare, estimated to be less than 1% of the population. It is actually quite difficult to diagnose APD even when you have specific training and experience in working with personality disorders and so recognizing one as a member of the public (I'm assuming you aren't trained in this area) is extremely difficult. I would be happy to discuss the diagnostic criteria in more detail if you like? If your inquiry relates to a specific person you could (as an alternative) tell me what it is your are seeing that has lead you to query the diagnosis?

Customer: replied 2 years ago.
Well, this person is very abusive, verbally and sometimes physically. As long as I do everything she says and agree with her on every point, we will get along just fine. If I disagree or suggest that what she is saying is not right, she loses it completely and tells me that's it, I'm done with you. Then a few days later, it's like the whole thing never happened. She has a very big need to control every situation and will lie to no end to prove she is right. She appears to have no concern about others rights or feelings. She is extremely self-righteous and thinks she is morally superior to everyone on the planet.
Expert:  Dr John B replied 2 years ago.

Ok, thanks for the extra information.

The problem with diagnosing personality disorders is that the criteria involve behaviors that non-PD people also exhibit at times. For example, the description you posted could very well describe a person with no Psychiatric Illness whatsoever. However, your description might also describe a person with a PD. Have you looked at the different diagnostic categories? There are a couple of other PD categories that could fit with the behavior you describe? Borderline PD is far more common than ASPD and I would query that category before ASPD. Would you like me to post a description of BPD?

Customer: replied 2 years ago.
Sure, that would be helpful. This person likes to tell me that a psychologist and a psychiatrist have told her that I am dangerously manipulative and that I am a bully. Would a Dr. ever say something like that without ever having met or talked with someone? This person is in conflict with everyone and her reactions to people who challenge her are over-the-top. She is also very paranoid and dramatic. She is the mother of my son and that is why she is still in my life, even though we are not a couple.
Expert:  Dr John B replied 2 years ago.

Ok, take a look at this description of BPD below and let me know if it seems like a fit. Also, I would think it unlikely a clinician would make that comment without having met you. Regardless, it's just hearsay.


BPD

 

The main feature of borderline personality disorder (BPD) is a pervasive pattern of instability in interpersonal relationships, self-image and emotions. People with borderline personality disorder are also usually very impulsive. This disorder occurs in most by early adulthood. The unstable pattern of interacting with others has persisted for years and is usually closely related to the person's self-image and early social interactions. The pattern ispresent in a variety of settings (e.g., not just at work or home) and often is accompanied by a similar lability (fluctuating back and forth, sometimes in a quick manner) in a person's emotions and feelings. Relationships and the person's emotion may often be characterized as being shallow. A person with this disorder will also often exhibit impulsive behaviors and
have a majority of the following symptoms:



  • Frantic efforts to avoid real or imagined
    abandonment




  • A pattern of unstable and intense interpersonal
    relationships characterized by alternating between extremes of idealization and
    devaluation




  • Identity disturbance, such as a significant and
    persistent unstable self-image or sense of self




  • Impulsivity in at least two areas that
    are potentially self-damaging (e.g., spending, sex, substance abuse, reckless
    driving, binge eating)




  • Recurrent suicidal behavior, gestures, or threats,
    or self-mutilating behavior




  • Emotional instability due to significant reactivity
    of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually
    lasting a few hours and only rarely more than a few days)




  • Chronic feelings of emptiness




  • Inappropriate, intense anger or difficulty
    controlling anger (e.g., frequent displays of temper, constant anger, recurrent
    physical fights)




  • Transient, stress-related paranoid thoughts or severe dissociative
    symptoms


Key Features in Detail



Frantic efforts to avoid real or imagined abandonment

The perception of impending separation or rejection, or the loss of external structure, can lead to profound changes in self-image, emotion, thinking and behavior. Someone with borderline personality disorder will be very sensitive to things happening around them in their environment. They experience intense abandonment fears and inappropriate anger, even when faced with a realistic separation or when there are unavoidable changes in plans. For instance, becoming very angry with someone for being a few minutes late or having to cancel a lunch date. People with borderline personality disorder may believe that this abandonment implies that they are "bad." These abandonment fears are related to an intolerance of being alone and a need to have other people with them. Their frantic efforts to avoid abandonment may include impulsive actions such as self-mutilating or suicidal behaviors.



Unstable and intense relationships

 

People with borderline personality disorder may idealize potential caregivers or lovers at the first or second meeting, demand to spend a lot of time together, and share the most intimate details early in a relationship. However, they may switch quickly from idealizing other people to devaluing them, feeling that the other person does not care enough, does not give enough, is not "there" enough. These individuals can empathize with and nurture other people, but only with the expectation that the other person will "be there" in return to meet their own needs on demand. These individuals are prone to sudden and dramatic shifts in their view of others, who may alternately be seen as beneficent supports or as cruelly punitive. Such shifts often reflect disillusionment with a caregiver whose nurturing qualities had been idealized or whose rejection or abandonment is expected.



Identity disturbance

There are sudden and dramatic shifts in self-image, characterized by shifting goals, values and vocational aspirations. There may be sudden changes in opinions and plans about career, sexual identity, values and types of friends. These individuals may suddenly change from the role of a needy supplicant for help to a righteous avenger of past mistreatment. Although they usually have a self-image that is based on being bad or evil, individuals with borderline personality disorder may at times have feelings that they do not exist at all. Such experiences usually occur in situations in which the individual feels a lack of a meaningful relationship, nurturing and support. These individuals may show worse performance in unstructured work or school situations.



Customer: replied 2 years ago.
What is the best way to deal with this kind of person?
Expert:  Dr John B replied 2 years ago.

If it is a case of BPD then I would recommend you take a look at http://www.amazon.com/Borderline-Personality-Disorder-Survival-Guide/dp/1572245077/ref=sr_1_1?s=books&ie=UTF8&qid=1322192153&sr=1-1 or http://www.amazon.com/Hate-You--Dont-Leave-Understanding-Personality/dp/0399536213/ref=sr_1_5?s=books&ie=UTF8&qid=1322192153&sr=1-5 . Both of these books will help you to manage how you interact with her.

As a very brief simple piece of advice I would suggest that you ensure that you are always consistent in your approach to her (whatever that may be). BPDs have a pathological fear of rejection and so if you alter from being nice to being unpleasant it can elicit dramatic reaction.

Dr John B, Psychologist
Category: Mental Health
Satisfied Customers: 557
Experience: PhD in Clinical Psychology, registered clinical psychologist.
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