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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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Is there any way to help a 26 year old adult man who lacks

Customer Question

Is there any way to help a 26 year old adult man who lacks empathy, is quite uncomfortable in social situations, prefers to have a job where he works alone, expresses eccentric thoughts quite vociferously, is essentially a "black whole" but has no understanding of his affect on others and is clueless about why he has been rejected by others for most of his life.
Submitted: 8 months ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 8 months ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I can help with this situation.

Elliott, LPCC, NCC :

What you describe sounds very much like some personality disorders, mainly Schizoid Personality DIsorder, with some other possible features.

Elliott, LPCC, NCC :

The diagnostic criteria for Schizoid Personality Disorder from the DSM-IV psychiatric diagnostic manual are as follows:

Elliott, LPCC, NCC :



Diagnostic Criteria for Schizoid Personality Disorder


A. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:



  • neither desires nor enjoys close relationships, including being part of a family

  • almost always chooses solitary activities

  • has little, if any, interest in having sexual experiences with another person

  • takes pleasure in few, if any, activities

  • lacks close friends or confidants other than first-degree relatives appears indifferent to the praise or criticism of others

  • shows emotional coldness, detachment, or flattened affectivity



B. Does not occur exclusively during the course of , a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects of a general medical condition.


Note: If criteria are met prior to the onset of Schizophrenia, add “Premorbid,” e.g., “Schizoid Personality Disorder (Premorbid).”


Associated features



  • Odd/Eccentric/Suspicious Personality

Elliott, LPCC, NCC :



This is not a psychotic disorder, but sometimes people with this disorder can develop a psychotic disorder (Schizophrenia or Delusional Disorder).

Elliott, LPCC, NCC :


Personality disorders are difficult to treat. Therapy is often based on helping the patient to realize the nature of his personality and teaching him how to make adaptations so as to cope with his perceptions and how they impinge on others.

Elliott, LPCC, NCC :

Positive results can be obtained, but all personality disorders are difficult, some more than others.

Elliott, LPCC, NCC :

He needs to be seen by a therapist who specializes in personality disorders. This takes a skilled and experienced clinician to make real progress.

Elliott, LPCC, NCC :

I would like to recommend three books that may be helpful to you to understand the process and thus help to choose an appropriate therapist.

Elliott, LPCC, NCC :

These are all linked to amazon.com but they can be obtained elsewhere as well.

Elliott, LPCC, NCC :


Theodore Millon is one of the world's foremost authorities on personality disorders. This book is expensive but is a main source book on the subject:

Elliott, LPCC, NCC :

Personality Disorders in Modern Life by Theodore Millon, Carrie M. Millon, Sarah Meagher and Seth Grossman


Elliott, LPCC, NCC :


Here is an excellent self-help book:

Elliott, LPCC, NCC :




and here is another informative and interesting book that may shed more light:

Elliott, LPCC, NCC :

Party of One: The Loners' Manifesto by Rufus, Annel

Elliott, LPCC, NCC :




There are other books, but these three will give you a well-rounded view, and the XXXXX XXXXX book might be useful if he were interested in following the steps of the workbook.

Elliott, LPCC, NCC :



I know that this has been an overwhelming experience. He can be helped, and he can live life on his own terms with which he is comfortable. It is all he knows at present.

Elliott, LPCC, NCC :


Gaining knowledge is the next step for you to try to help him adapt to the world on the best terms for him and others with whom he interacts.

Elliott, LPCC, NCC :


Do not expect a magical transformation. Medications will not help. This is a slow process in which he must be willingly involved.

Customer:

Definitely not a schizoid personality according to the DSM-IV. He has too much emotion and is very promiscuous. He is lacking in empathy, however, and it's true that he does not take pleasure in very many activities. Definitely a personality disorder - present throughout his life. He does not see himself as others see him and has no idea why his life has gone nowhere and why he has been rejected by those he thinks like him. After he loses his temper and then apologizes he cannot understand the damage that he has done and barely remembers the insults hurled in the heat of anger. Thanks for your answer - not sure there is much hope for him.

Elliott, LPCC, NCC :

Schizoids can have emotion.

Elliott, LPCC, NCC :

All of the criteria do not have to be satisfied. Only four of them.

Elliott, LPCC, NCC :

Was he ever abandoned or neglected when young, or was he bullied?

Customer:

His emotion is anger and blame. He does not understand the concept of really truly caring about someone else. Happy social situations are tortuous for him.

Customer:

He was never abandoned but he was bullied in the sense that he never really had friends.

Elliott, LPCC, NCC :

Does he have an big temper and a short fuse?

Customer:

Has been in one form of therapy or another since the age of 5. Very high IQ. Was just rejected again from a place where he thought "he was liked and cared about." Wondering if there is any way to help him before he ends up killing himself.

Customer:

rough day

Elliott, LPCC, NCC :

Sorry about your rough day.

Elliott, LPCC, NCC :

What about his temper?

Elliott, LPCC, NCC :

I am trying to get a comprehensive picture of him.

Elliott, LPCC, NCC :

He may have seen many therapists but they haven't helped him. I believe that he can be helped with the right therapist.

Elliott, LPCC, NCC :

While you are typing I am adding yet another question. Does he ever injure himself (cutting, etc.)?

Customer:

He lashes out when things do not go his way and his interpretation of situations is "off." I guess I am wondering if there is some program, somewhere, that can help someone like him see himself more clearly, LEARN empathy, and see what he does that sabotages his life. He makes people dislike him - gets fired from jobs by telling everyone how to do everything better etc etc - can't deal with authority. May just be hopeless.

Elliott, LPCC, NCC :

Do those triggering events include feeling abandoned or rejected in some manner?

Customer:

No, he has never injured himself. He did have a drug problem in college and became rather suicidal and asked to go to a wilderness program where he made tremendous strides. No drugs but no self awareness.

Customer:

Yes, he feels rejected all of the time but he argues with people all of the time. Only wants to have fun; not work. The more I write the more depressed I am getting.

Elliott, LPCC, NCC :

What kind of drug problem? Does he engage in other reckless behavior (overspending, reckless driving, binge eating, reckless sexual behavior)"

Customer:

He is handsome and can be witty and charming - temporarily.

Customer:

Cannot plan for the future, has no money, is sexually reckless - yes.

Customer:

I will take a look at those books.

Elliott, LPCC, NCC :

He also seems to have some elements of Borderline Personality Disorder. It is very possible to have elements of more than one personality disorder.

Elliott, LPCC, NCC :

I believe that they also feed each other.

Customer:

ok, thanks

Elliott, LPCC, NCC :

I would like to recommend 2 more books to you. I don't mean to burden you, but I think that this will give you the knowledge you need.

Customer:

ok

Customer:

reading is not the burden!

Elliott, LPCC, NCC :

Glad to hear that.

Elliott, LPCC, NCC :

One is a book by Randi Kreger who seems to know more about BPD than anyone., The other is a method of treatment workbook fo dialectical behavior therapy which will help him.,

Elliott, LPCC, NCC :



and

Elliott, LPCC, NCC :



I believe he has strong elements of both personality disorders, AND I believe that a Dialectical Behavior Therapist can help him.

Elliott, LPCC, NCC :

You must not give up.

Elliott, LPCC, NCC :

It has elements of Buddhist philosophy or is similar but is THE therapy of choice.

Customer:

Thank you.. Have to run! Thanks again

Elliott, LPCC, NCC :

God bless your family.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7662
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you

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