Wednesday, August 15, 2007

Mini review. The sociopath next door

This mini review is the first in a series that I would call 301.7—terrorism @ home. In Europe the Seventies brought IRA, ETA, RAF, and BR and with them terrorism in our immediate environment. In the USA, 30 years later, after 11 September 2001, we also have to deal personally with terrorism. As a society, we have entities like military strategists, politicians, covert agencies, and historians to study the phenomenon; and we have institutions like the Secret Service, police, and army to deal with it.

Informally, we label the agents of terrorism with terms like sociopaths and psychopaths. However, for the past 60 or so years (actually, since Cleckley wrote The Mask of Sanity in 1941) these terms have been associated by the medical profession with an actual disease. The medical name of this disease is antisocial personality disorder and it is described in section 301.7 on page 706 in the Diagnostic and Statistical Manual of Mental Disorders IV of the American Psychiatric Association.

It turns out that antisocial personality disorder, or APD for short, is a quite common disease—4% of the population are affected by it. For comparison, here in California, according to the Centers for Disease Control and prevention, the "alarmingly high" colorectal cancer incidence rate is 0.045%. Therefore APD has pandemic proportions and you should be aware of it, because you might have to deal with a sociopath living next door.

A good starting point is Dr. Martha Stout's book The sociopath next door. Dr. Stout has served on the Harvard Medical School for 25 years and is also in private practice, specializing in the victims of sociopaths. The book is easy to read and gives you an overview of the disease and some guidance on how to recognize and deal with APD sufferers.

Diagnosing and treating a disease is complex and requires a trained physician. For example, if you checked out section 301.7 above, you will have noticed that page 705 is all about when the symptoms are not those of APD, and the diagnostic criteria requires you to have some anamnesis prior to age 15 of the diseased.

If you think your friend has a heart attack, you do not take out your Swiss Army knife and perform a bypass on him; similarly, if you think you are the victim of a sociopath, seek immediate help from your family doctor, who can then refer you to a specialist. With this caveat, Dr. Stout teaches you some symptoms of this disease, namely

  1. failure to conform to social norms
  2. deceitfulness, manipulativeness
  3. impulsivity, failure to plan ahead
  4. irritability, aggressiveness
  5. reckless disregard for the safety of self or others
  6. consistent irresponsibility
  7. lack of remorse after having hurt, mistreated, or stolen from another person

But she teaches you also that there is little you can do, other than avoid any contact with sociopaths. In fact she elaborates on these 13 rules for dealing with sociopaths in everyday life:

  1. the first rule involves the bitter pill of accepting that some people literally have no conscience
  2. in a contest between your instincts and what is implied by the role a person has taken on—educator, doctor, leader, animal lover, humanist, parent—go with your instincts
  3. when considering a new relationship of any kind, practice the Rule of Threes regarding the claims and promises a person makes, and the responsibilities he or she has. Make the Rule of Threes your policy
  4. question authority
  5. suspect flattery
  6. if necessary, redefine your concept of respect
  7. do not join the game
  8. the best way to protect yourself from a sociopath is to avoid him, to refuse any kind of contact or communication
  9. question your tendency to pity too easily
  10. do not try to redeem the unredeemable
  11. never agree, out of pity or for any other reason, to help a sociopath conceal his or her true character
  12. defend your psyche
  13. living well is the best revenge

So far I have not told you what this disease is. Dr. Stout explains that we have 7 senses. You know about about the first 5. The 6th is intuition and the 7th is conscience. A person with APD is a person completely lacking the 7th sense. Like some people are born blind, some persons are born without a conscience. Because the incidence is so high—1 in 25, like for color blindness—you sooner or later will have to deal with a sufferer, although at first sight it is not obvious.

Like color blindness, APD is a genetic disease. Comparing monozygotic with dizygotic twins, scientists researching the Texas Adoption Project have estimated that APD is 54% inherited, the rest being acquired. Worse than many color blind people not being aware of their disease, the sociopaths cannot be aware of their disease because they do not have the conscience that is necessary to detect a conscience.

If you recall the research published early 2003 about Genghis Khan's propagating his APD-carrying genes to some 16 million men living between Afghanistan and northeastern China—almost one in every 200 men alive—you would expect this disease to be prevalent in Central Asia.

This is not so, because of the acquired component, which in this case should be qualified as "demonically nurtured." In fact, the Asian cultures focus on the relation among people, therefore sociopaths tend to be outcast or even executed, like the Inuit do with the kunlangeta, as they call the sociopaths. In America's Judeo-Christian culture of individualism, instead, many traits of sociopathy are praised and reinforced, such as impulsivity, irresponsibility, and lack of remorse.

In conclusion, right here is where you can become the victim of a sociopath. If you live here, slowly and carefully reading Dr. Stout's book is a must.