Dangerous personality disorders

Initially, upon entering the field of psychology, I was interested in becoming a forensic psychologist/profiler, in order to understand the causes of aberrant criminal behaviour.

This did not happen, but I never lost my interest in this subject. I recently became aware of the television series about the murder of the iconic Italian fashion designer, Gianni Versace, which occurred in 1997.

It is reported that his murderer, 27-year-old Andrew Cunanan, was a serial killer and had antisocial personality disorder (APD).

APD describes an ingrained pattern of behaviour in which individuals consistently disregard and violate the rights of others around them.

The disorder is best understood within the context of the broader category of personality disorders.

A personality disorder is an enduring pattern of personal experience and behaviour that deviates noticeably from the expectations of the individual’s culture, is pervasive and inflexible, has an onset in adolescence or early adulthood, is stable over time, and leads to personal distress or impairment.

The symptoms of antisocial personality disorder can vary in severity. The more shocking, harmful, or dangerous behaviour patterns are referred to as sociopathic or psychopathic. There has been much debate as to the distinction between the two descriptions. Sociopathy is chiefly characterised as something severely impaired with one’s conscience; psychopathy is characterised as a complete lack of conscience regarding others. Some professionals describe people with this constellation of symptoms as “stone cold” to the rights of others.

People with this behaviour may seem charming on the surface, but they are likely to be irritable and aggressive as well as irresponsible. Due to their manipulative tendencies, it is difficult to tell whether they are lying or telling the truth.

The diagnosis of APD is not given to individuals under the age of 18 but only if there is a history of some symptoms of conduct disorder before the age of 15.

Symptoms

According to the DSM-5 (Psychiatric illnesses diagnostic manual), features of antisocial personality disorder include:

Violation of the physical or emotional rights of others

Lack of stability in job and home life

Irritability and aggression

Lack of remorse

Consistent irresponsibility

Recklessness, impulsivity, deceitfulness

A childhood diagnosis (or symptoms consistent with) conduct disorder.

Causes

While the exact causes of the disorder are unknown, sociopathy is believed to be a product of childhood trauma and abuse but may also have a genetic component.

Sociopathy appears to be mostly learned rather than innate. Sociopaths are capable of forming an emotional connection with others but only to certain individuals such as a family member or friend and only in certain circumstances.

Sociopathy centres around a deep-seated hostility or resentment towards family, culture, the world, destiny, fate, God, reality, and indeed, towards life itself. But the antisocial personality is highly proficient at masking this underlying and largely unconscious hostility and hatred. They are masterful actors, having honed and practised their skills since early childhood.

Like the person with narcissistic personality disorder (NPD), they have learned to conceal their deeply wounded true selves. What the world sees is a carefully constructed and meticulously cultivated and maintained false self, behind which the raging, wounded, depressed true self hides. This is why some offenders seen by forensic psychologists or psychiatrists seem so unperturbed about their malevolent deeds and the disastrous negative consequences.

It is precisely what makes them such charming, charismatic and diabolically convincing con artists, manipulators and liars. And, in some cases, cold-blooded killers.

The primary difference between narcissistic and antisocial personality disorder is always one of degree.

Pathological narcissism often includes antisocial tendencies. APD typically expresses narcissistic tendencies.

There is a very fine, sometimes imperceptible line dividing NPD and APD. The sociopath lives on the far side of this line, having bitterly turned against society, repeatedly and often impulsively engaging in illegal activity resulting in multiple arrests, lying, manipulating, conning, deceiving, and aggressive, vindictive and violent behaviour aimed at undoing or repaying a hurt (past/present).

The narcissist, however, is usually better adapted; functions at a higher level; is often financially and socially more successful; skirts the law more skilfully, typically avoiding detection; chooses to work within the system, outwardly accepting rather than rejecting society, yet still playing by his or her own self-serving and rebellious rules; unceasingly seeks admiration and stimulation, and may be no less vindictive and persistent, albeit sometimes more subtle, in getting even for the smallest perceived slights.

The complex hybrid “psychopathic narcissist”, however, is capable of committing evil subtly and concealing it behind a sophisticated veneer of lies, distractions, denial, evasions, obfuscation, bullying, intimidation, manipulation, gaslighting, and disinformation.

APD is one of the most difficult personality disorders to treat. Individuals rarely seek treatment on their own and may initiate therapy only when mandated by a court.

But even highly trained and experienced forensic psychologists and psychiatrists are sometimes taken in and conned by these imposing individuals, some of whom can fool a polygraph examination.

Many manage to consistently outwit the law, deceive their spouses, con their family and friends, and they can be very successful, rising to the pinnacles of power, celebrity and wealth. But in most cases, even these clever criminals eventually slip up or get too cocky, resulting in detection and prosecution. But, tragically, for most – and particularly for those upon whom they have inflicted suffering – that is a little too late.

Carin-Lee Masters is a clinical psychologist. Write to her at helpmecarin@inl.co.za or send a WhatsApp message or SMS to 082 264 7774.