Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
I am concerned about a friend's ex-husband-in-process. The individual in question overwhelmingly meets criteria for antisocial personality disorder and the often comorbid narcissistic PD. I am aware that prevalence rates are only between 3-4%, and PD's are very difficult to diagnose. However, his severe lack of empathy ability to form and/or maintain intimate relationships (friends, family, etc.), characterizing qualities of deceitfulness, manipulative behavior, and irresponsibility make him a textbook example of someone with APD (based off of DSM-V criteria). To clarify I am a psychology student. I understand that a lot of students tend to diagnose their friends, family, etc. due to the inevitable "medical student syndrome," but I do not recognize this as the case. His actions, and the consequences thereof, have had direct affects on his daily life and the lives of his wife and two children. For example, while seeing a marriage counselor each person was required to make an ordinal list of their priorities. Of 13 items on his list, "taking care of his wife and son" was #11. He has put a GPS tracking device on his ex-wife's car and is currently being prosecuted for it. He displays a charming personality to others only to reveal he hates them behind their back (and has lost dozens and dozens of friends this way), he has had several affairs, and told his wife to "get over it," when she brought it up in therapy (to which he described the counselor as a "b****" and "completely stupid/under-qualified," he swears loudly in front of his children, and even tells his 4-year old son that, "mommy's love for you is dying." He lies to his son and when their son confronts his mother, the father says "You can't believe a 4-year old. We know he lies." He left for 1 week on a "work trip" (which later was revealed to be an affair) one hour away from their home and refused to visit his pregnant wife with their infant son a few days after she had surgery. He is a compulsive liar. He lies on his resumes to get jobs and for the past 25-30 years (currently 50) he has never held a job for more than 1-2 years maximum (he just lost another job 2 weeks ago from which he was making over $100K). He has declared bankruptcy twice and is very likely to again by the end of this year, yet he is currently tens of thousands, if not over $100K in debt again (to which his parents say is "typical Richard" - not his real name). He has stolen money from his wife to pay off credit card debt, he spent the down payment when they tried to purchase a new house. The list goes on and on (and this is the tip of the iceberg and only things we know to be true). Like I said, they are currently going through a divorce, and have gone through family assessment. Is there any way for the court to mandate psychological therapy to show he is a possible threat and unstable? Or, is there any information that you could give me that may help with custody, therapy, things she should do, etc.?
Thank you so much for your reply. I appreciate the feedback, suggestions, resources, and encouragement.
She has spoken with her attorney regarding this matter. They have each been required to have a family assessment (mother alone, mother with children, father alone, father with children). She did mention to the court-assigned therapist she was concerned about his mental health (potential APD). Included in her interrogatories under a question regarding her opinion on the "mental health of spouse," is a complete, and detailed write-up of my highlighting and elaborating upon specific examples he meets under DSM-V criteria for APD. This is "Exhibit A" and will be presented in mediation and discovery. Her concern is that it will cost over $1.5K to do seek further assessment if mandated by the court, and may take until the end of the divorce process to get shipped out to be scored, sent back, etc. - so the effort may be more expensive and lengthy than what it's worth. Would it be worth it? Even if she gets the custody she deserves/is standard in MI (him seeing them every other weekend and the 20 mo. old not overnight - to which the court-assigned therapist strongly suggested), could a clinical diagnosis of APD drastically change this visitation to EXTREMELY limited circumstances even after the divorce process is over?
I did mentioned that she should see a therapist outside of the matter and fill her in 100% (to which she strongly agreed). Also, she does keep, as you suggested, detailed records of his abnormal behavior almost every day (because his significant abnormal behavior DOES constitute daily recording). She really is the best mother I know and is providing a very healthy, enriching, and stable environment for her children.
I apologize, I know my questions and responses are lengthy. One more question that you may or may not be able to answer: With the pending conviction of his misdemeanor, and a potential clinical diagnosis, but no actual physical violence, is there any way (other than him agreeing, which is next to impossible) he could be forced to leave the house and seen as a threat? I have gotten sound advice saying "No," and that, "the court doesn't like to kick people out of their homes," but would like your input. I just find it difficult to digest that our legal/justice system WAITS until someone gets physically hurt to take action.
Thank you again for your time.
Hello again, to answer your last question first, you would have to check with her attorney or call the police department in her jurisdiction and ask what has to happen in order to get a restraining order. She can get a restraining order on her own and does not need to court's approval if her situation meets the standards. They vary depending on where you live. No one can really predict what might happen if he is assessed and diagnosed with APD and I certainly understand the cost concerns, but I believe that she needs to do everything she can to protect her children in order to be at peace with herself. I do believe that the court would not turn a blind eye to such a severe diagnosis and that supervised visitation would be in order. Divorces are hard enough without dealing with someone with such mental health problems. I certainly hope things go well for her, Eleanor
Some recent developments have updated the situation at hand, and have raised further questions. The court consulting psychologist that assessed my friend and her ex-husband-in-process released her write-up. Everything in her write-up, I felt was very accurate (based off of a 45 minute individual session with each person, and the session with their kids). The following is a brief synopsis (again, names have been changed)
Lindsay: Stated the reasons for divorce were lying to her and to kids, cheating, hiding money, poor financial history (bankruptcy, spending sprees, etc.) not being involved in kids' lives, trust, etc.
She revealed all of the documentation and letters from doctors stating she had been the one to take them to appts. She has a stable career, provides the kids with an enriching, loving, and stable environment.
During her session with the kids she played, encouraged and was attentive to both (son and daughter). When the psychologist asked that she leave the room to speak to her 4-year-old son alone, she said "I will be right back," and her son did not want to see her leave.
Richard: Denies all accusations of having an affair, and accuses that Lindsay had an affair for the past 3 years (hence GPS tracking device), said that she is an alcoholic (even though he was initially hospitalized for alcoholism back in April, but later had his personal physician to change it to pancreatic complications for insurance purposes). He said he tried to make the marriage work, and still loves Lindsay and did everything in his power over the years to make marriage work. He even said they sleep in the same bed (which is not true). States that Lindsay is verbally abusive (even though he swears at her in front of the children). It was also revealed that he was seeing a psychologist prior to his hospitalization in April. That psychologist stated that Richard revealed his wife to be an alcoholic narcissist. BOTH psychologists stated that Richard has narcissistic characteristics.
With his session with the children, he played well with them. However, when asked to leave the room, he kissed and hugged his son excessively-"like he was leaving for a long trip, and [his son] showed no separation anxiety, like he did with Lindsay."
The court-assigned psychologist granted 100% custody (every other weekend for Richard) to Lindsay based off of Richard's unstable work life, poor decision-making skills, pending criminal charges, and the responsibility and stability Lindsay can provide for the kids. She also recommended that Richard seek counseling for a year, and provided resources to do so. Furthermore, she recommended they reevaluate Richard's conditions after 6 months to amend any necessary custody changes.
What sickens Lindsay and I further, is the fact that he wrote a very, very graphic and hostile letter to the court-psychologist about Lindsay's "affair", and her mental instability. The psychologist dismissed this letter completely-she realized it carried no weight whatsoever. What's more, the psychologist Richard was seeing since April, noted he does have narcissistic characteristics, but does have empathy and is insightful. As briefly stated in my initial question to, it is clear Richard does, in fact, possess a clear lack of empathy (actually a dangerous lack thereof-especially concerning the kids. He leaves the kids in the driveway in their car seats while he goes in the house, leaves their gas stove burner on, does not feed them dinner until 2 hours past normal, doesn't give their daughter naps, etc. etc.). Of course, as we know, individuals with PD's do not recognize a problem, will never reveal they have a problem, nor the truth about significant situations. A misdiagnosis, or none at all, is usually the result by a clinician.
My question/concern: Is there any way I can directly, ethically, and/or legally talk to either psychologist about his condition? If there is and I do so, should I wait until after the divorce is final and before Richard's 6 month evaluation? Richard's psychologist refused to comply to testify if needed. If I personally made an appointment with either psychologist to reveal my concerns about their situation (with Lindsay's consent, of course), could I do so ethically? What CAN I do?
Again, I apologize if this is a bit verbose. I feel the background information is necessary.
Thank you for your time.
I agree that the court-ordered psychologist is doing her job well. If I decide to meet with her, would she be obligated to tell the court, testify, or tell Richard that I met with her? I understand there are confidentiality laws in place, but will I have to agree to a HIPAA release? If she does recommend that the court mandate psychological care for Richard after our meeting, for my protection (from him, actually) will my name and relationship to Lindsay be revealed to them? I am just afraid that this could backfire and be seen in bad taste for Lindsay and reduce custody for her. I suspect that outcome is not very likely, but I would not want to do anything to worsen the situation. Furthermore, should I wait until the divorce is actually final to meet with her-prior to Richards 6-month evaluation?
I believe you are right. I will take your advice and not intervene. If I do, at all, it would be after the divorce is final, but like you mentioned, he could do himself in. Thank you very much. It does help immensely.