Saturday, February 21, 2009

Anti-Social Personality Disorder from the perspective of an anti-social personality

I have been labeled "Anti-social Personality Disorder". Though, those who labeled me as such offered little, if any, information concerning the causes or treatment for this condition. (And that would be the Veterans Administration, or our government). So, it was left to me to interpret and assimilate the information that I could obtain through my own effort and with my own understanding.

I have cobbled together some clippings from around the web, added emphasis to certain assertions and interspersed my own commentary throughout. It shouldn't be too difficult to discern my own comments from the actual texts.

I have not given credit to the sources of this material because I do not have permission to reproduce their material. Why? Well, that's apparently what anti-social personalities do (as you will see in the following collection of web clippings). We have boundary issues. But I have a "teacher" who told me once that "information wants to be free". I kinda like that notion. Obviously, our keepers do not appreciate that philosophy.

So, on with the show...


Causes of personality disorder
Like other psychiatric illnesses, it is thought that personality disorders are caused by a number of factors. These include parental upbringing in childhood, personality, social development as well as genetic and biological factors.

Psychological causes
There is a body of research which shows that the vast majority of patients with personality disorders were abused as children. 75% of people diagnosed with borderline personality disorder have experienced physical or sexual abuse. Abuse can come in the form of physical, sexual or just not being parented properly.

Childhood is the time to learn to cope and manage intense emotional changes and this is one of the most important goals of parenthood. Children who are abused often do not learn these lessons, thus they are more likely to have difficulty regulating their emotions as adults.

What Causes Antisocial Personality Disorder?

The cause of antisocial personality disorder, or ASP, is unknown. Like many mental health issues, evidence points to inherited traits. But dysfunctional family life also increases the likelihood of ASP. So although ASP may have a hereditary basis, environmental factors contribute to its development.

The Theories

Researchers have their own ideas about ASP’s cause. One theory suggests that abnormalities in development of the nervous system may cause ASP. Abnormalities that suggest abnormal nervous system development include learning disorders, persistent bedwetting and hyperactivity.

A recent study showed that if mothers smoked during pregnancy, their offspring were at risk of developing antisocial behavior. This suggests that smoking brought about lowered oxygen levels with may have resulted in subtle brain injury to the fetus.

Yet another theory suggests that people with ASP require greater sensory input for normal brain function. Evidence that antisocials have low resting pulse rates and low skin conductance, and show decreased amplitude on certain brain measures supports this theory. Individuals with chronically low arousal may seek out potentially dangerous or risky situations to raise their arousal to more optimal levels to satisfy their craving for excitement.

Brain imaging studies have also suggested that abnormal brain function is a cause of antisocial behavior. Likewise, the neurotransmitter serotonin has been linked with impulsive and aggressive behavior. Both the temporal lobes and the prefrontal cortex help regulate mood and behavior. It could be that impulsive or poorly controlled behavior stems from a functional abnormality in serotonin levels or in these brain regions.

The Environment

Social and home environment also contributes to the development of antisocial behavior. Parents of troubled children frequently show a high level of antisocial behavior themselves. In one large study, the parents of delinquent boys were more often alcoholic or criminal, and their homes were frequently disrupted by divorce, separation or the absence of a parent.

In the case of foster care and adoption, depriving a young child of a significant emotional bond could damage his ability to form intimate and trusting relationships, which may explain why some adopted children are prone to develop ASP. As young children, they may be more likely to move from one caregiver to another before a final adoption, thereby failing to develop appropriate or sustaining emotional attachments to adult figures.

Erratic or inappropriate discipline and inadequate supervision have been linked to antisocial behavior in children. Involved parents tend to monitor their child’s behavior, setting rules and seeing that they are obeyed, checking on the child’s whereabouts, and steering them away from troubled playmates. Good supervision is less likely in broken homes because parents may not be available, and antisocial parents often lack the motivation to keep an eye on their children. The importance of parental supervision is also underscored when antisocials grow up in large families where each child gets proportionately less attention.

A child who grows up in a disturbed home may enter the adult world emotionally injured. Without having developed strong bonds, he is self-absorbed and indifferent to others. The lack of consistent discipline results in little regard for rules and delayed gratification. He lacks appropriate role models and learns to use aggression to solve disputes. He fails to develop empathy and concern for those around him.

Antisocial children tend to choose similar children as playmates. This association pattern usually develops during the elementary school years, when peer group acceptance and the need to belong first become important. Aggressive children are the most likely to be rejected by their peers, and this rejection drives social outcasts to form bonds with one another. These relationships can encourage and reward aggression and other antisocial behavior. These associations may later lead to gang membership.

Child abuse also has been linked with antisocial behavior. People with ASP are more likely than others to have been abused as children. This is not surprising since many of them grow up with neglectful and sometimes violent antisocial parents. In many cases, abuse becomes a learned behavior that formerly abused adults perpetuate with their own children.

It has been argued that early abuse (such as vigorously shaking a child) is particularly harmful, because it can result in brain injury. Traumatic events can disrupt normal development of the central nervous system, a process that continues through the adolescent years. By triggering a release of hormones and other brain chemicals, stressful events could alter the pattern of normal development.

It is also suggested that feelings of real or perceived injustice by society in general have a profound impact on the development of Anti-Social Personality Disorder.

However, many resources for people regarding how to deal with people who have or may have this condition suggests that one should run like hell and avoid the subject at any and all costs! Just google it and find out for yourself.


How to Treat Antisocial Personality Disorder

An antisocial personality disorder is marked by behavior that seeks to challenge or violate the norms of society, especially by showing disrespect for the rights and privacy of others. (Even though society shows us all time and again that society itself is disrespectful of the rights and privacy of others. Society itself may indeed be the worst violator of all in this respect!) In fact, individuals with this affliction are often perceived as criminals, and may not receive proper treatment as a result. (Just label, brand, medicate and incarcerate them!) Through a specialized program of individualized psychotherapy and group therapy, you can effectively treat an antisocial personality disorder. (We just collectively reinforce the notion that these people should not and cannot be trusted and should be shunned and disregarded, if not incarcerated and forgotten.)


Instructions for treatment
Difficulty: Moderately Challenging
Things You’ll Need:

* Prescription medication
* Psychiatrist or psychologist
(And a stun gun!)

Step1
Determine if the more common symptoms of an antisocial personality disorder are present. These may include a lack of remorse for hurting the feelings or violating the rights of others, excessive patterns of irritability, recklessness, lying, deceitfulness and willingness to challenge and violate the norms of society on a regular basis. (As if the norms of society do not need to be challenged by anyone, ever!)
Step2
Obtain a proper diagnosis of an antisocial personality disorder from a qualified mental health professional, such as a psychiatrist or psychologist. Note that a diagnosis of an antisocial personality disorder may be more difficult than with other types of personality disorders, since the patient is seldom cooperative during the process and is also usually dishonest. (As if the medical community and society are always honest... yeah, right! So, if you don't get the diagnosis you are looking for, "Damaged Goods", just keep trying. You will find a fascist with the proper credentials who is ready, willing and able to provide you with the diagnosis you seek.)
Step3
Treat an antisocial personality disorder through the use of individualized psychotherapy in order to determine the causes of the disorder. Often a person who is diagnosed with an antisocial personality disorder is forced to do so under the aegis of a court or doctor, and will probably be very uncooperative at first. Motivating the individual by emphasizing the positive results they can obtain by being cooperative is usually the best strategy for the therapy. (This is also where one may find the stun gun useful!)
Step4
Consider using prescription medication to treat an antisocial personality disorder. (The stronger and more dangerous the medication, the better!) While there is no evidence to support that drug therapy can cure the disorder, it may be helpful to reduce or eliminate the mood swings that usually accompany more serious cases. (And to weaken the mind enough to make it more susceptible to mind control and reprogramming and reeducation.)
Step5
Use group therapy to treat an antisocial personality disorder. Take care to only include others that have the same types of personality disorder to reduce the chance of aggressive or even violent confrontations. Conversely, it is important to restrict the discussions so that criminal behaviors are not reinforced by the exchange of inappropriate information between members of the group.



Understanding borderline personality disorder

'I wish I had never been diagnosed with BPD. With another diagnosis yet similar behaviour I was treated so differently. Possibly the most painful part of this illness (I will call it that) is the discrimination. And the only reason for this is the diagnosis, not the way I feel, behave or speak, because that was the same before.'

Borderline personality disorder (BPD) is a controversial diagnosis. This information aims to help people to understand when the diagnosis might be given and its consequences.

What is borderline personality disorder?

BPD is one of many personality disorders listed in the manuals used by clinicians when they are giving someone a psychiatric diagnosis. The word 'personality' refers to the ongoing pattern of thoughts, feelings and behaviour that makes us who we are.

A personality disorder may be diagnosed when it's felt that several areas of someone's personality are causing them or others problems in everyday life. This diagnosis is very controversial, because it implies that someone's whole personality is flawed - rather than just one aspect of them. Some psychiatrists argue that it's impossible to treat someone's personality and that it's wrong to apply medical terms and treatments to a personality. This means it's usually the symptoms of BPD that are treated, rather than the disorder as a whole.

BPD is sometimes referred to as Emotionally Unstable Personality Disorder. Some argue that the term 'borderline' is misleading. Originally, the term was applied to people who seemed to be on the border of being given a diagnosis of schizophrenia. However, now BPD is seen as distinct from schizophrenia diagnoses, the 'borderline' aspect is seen to express being on the border of psychosis. If someone has a psychosis, it means they have beliefs or experiences not shared by others. Those diagnosed with BPD may have these at times of stress.

BPD is thought to affect about two per cent of the general population. It’s been estimated that three-quarters of those given this diagnosis are women. It's a condition that isn't usually diagnosed until adulthood, because the personality is seen as still developing until then.

Because of the controversy surrounding this diagnosis, services are often not readily available.

How would a clinician make this diagnosis?

There are no biochemical or physical tests to tell whether someone does or doesn't have BPD. (In other words, it is much like the terms, "nigger, cracker, honky, spic, wasp, poor white trash, or asshole", just to name a few stereotypes ). The UK and Europe use slightly different criteria and ‘number of symptoms present’ to diagnose BPD, compared to the USA. But on the whole, if five or six of the symptoms below are present for a year or more, the diagnosis of BPD is given. Note: anyone can experience any of these symptoms occasionally, but with BPD the experience is much more intense and prolonged. (It may be pertinent here that the 'victim' of this stereotype could simply be hyper-aware of the injustice of "societal norms".)

* Self-harm (for example, cutting yourself) or repeated attempts or expressions of the desire to commit suicide. This behaviour can only be counted as one of the criteria for diagnosis; it can't be counted again as demonstrating any of the other symptoms.
* Frantic efforts to avoid being alone, due to an intense fear of being abandoned. Others may not see this fear as justified, but you may go to great lengths to avoid being alone. For example, you may say that you will harm someone if they leave. (Or, perhaps, the inverse: attempting at all costs to be left the fuck alone.)
* A pattern of unstable and intense relationships. Feelings often alternating between idolising the other person and then thinking they are really awful. (Or, perhaps simply viewing most everyone as hypocritical, maniacal, deceptive, injurious pricks.)
* A very uncertain, shaky self-image or sense of self. You may feel good whilst you feel loved by someone you think is wonderful. If you later see them as bad, your own sense of self could be affected. You may also have doubts about your sexual identity. (Or, perhaps you have simply come to the realization that few, if any, truly know what love and compassion is and therefor have no confidence in your own ability to do so as there are no 'teachers' from which to learn healthy relationships from!)
* Two or more areas of your life where your behaviour could cause you harm and be seen as impulsive. Examples would be: spending money extravagantly and having huge debts, having unprotected sex, abusing drugs or alcohol, driving without due care, or binge-eating. You may do these things because you're trying to deal with awful feelings of pain or emptiness.
* You may have moods that are very difficult to come out of. For example, you may go through long periods (usually lasting a few hours...or a few years ) of extreme irritability, restlessness, unhappiness or anxiety.
* Terrible feelings of emptiness. (...realizing that society itself is quite empty...)
* Anger that's inappropriate, intense or difficult to control. You may lose your temper a great deal, experience constant anger or be involved in physical fights. You may feel particularly angry when you think you're being criticized. Anger is often a very difficult feeling for people to acknowledge and deal with, but may cause particular problems in the life of someone diagnosed with BPD.

Periods of paranoia or feeling unreal when under (constantly socially imposed) stress. This might be accompanied by an almost complete lack of physical sensation. At difficult times, you may experience yourself as having more than one personality or feel you are in a trance-like state. (Or, you may just feel like another turd floating in a cesspool).

As a result of confusion about your personal identity and a terror of being left alone (or not) , you may find yourself clinging to very damaging relationships (or taking pot shots at the fucks who won't leave you alone) . Many people who meet the criteria for BPD also meet the criteria for histrionic, narcissistic or antisocial personality disorder. (I guess that is a fancy way of saying that I feel like, as obviously damaged as I may be, I am the only one who seems to see how fucked up everyone is....)

Unfortunately, those diagnosed with BPD have a greater risk of committing suicide than the general population. Most studies suggest between eight and ten per cent of those diagnosed with BPD commit suicide. If you are diagnosed with BPD, it's important to know where to turn to if you are feeling suicidal.

Whilst some people may see themselves in the symptoms of BPD and feel relieved to have a label (numb nutted fucks) to apply to the problems they experience, others may be devastated at the idea that their personality is disordered. It's worth remembering that aspects of almost any type of personality can be found within the pages of the diagnostic manuals. What matters is that you get the help you feel you need.

What if they've made a mistake in my diagnosis?

Strictly speaking, a medical diagnosis can only be given by somebody who has been medically trained - usually a GP or psychiatrist. However, because the term 'borderline' comes from psychoanalytic thinking, you may have this term applied to you by someone who has not been medically trained. There is a recognised and very worrying danger of mistaken diagnosis. Mental health professionals sometimes fall into the trap of applying it to people they have difficulties dealing with, perhaps because of a conflict of personalities. Within the NHS, you are entitled to ask for a second opinion, although this doesn't necessarily mean that your request will be granted.

If you feel your GP or psychiatrist has misunderstood you, and you are having problems getting the help you need, you may find an advocate useful. (But then, who advocates for sociopaths?)

Will I get better?

It's often thought that personality problems are too deep-seated to be treatable. But this is contradicted by evidence that symptoms may get better as people get older. Some research suggests that after 10 to 15 years, or so, between 50 to 75 per cent of those diagnosed with BPD no longer display enough of the symptoms to meet the criteria for the diagnosis.

Recent research suggests that talking treatments and medication can reduce the behaviour problems associated with the problem. Day-care programmes may also be useful. (The idea that society itself is screwed up from the ground up never ever enters into the equation.)


What causes borderline personality disorder?

The causes of BPD are still not clear and research is still continuing.

Often, those diagnosed with BPD turn out to have had very traumatic experiences in childhood. You may have experienced the early loss of a parent, or be a survivor of childhood sexual or physical abuse . You may have been neglected as a child. Such difficult life events are very common in those diagnosed with BPD. The problems associated with BPD may become much worse following a stressful experience, for example, the loss of a loved one or an established routine, such as a job. (And here you have it, folks! The vague admission that society itself and the treatment inflicted upon the subject is actually responsible for the condition!)

An American psychiatrist, Dr Leland Heller, believes that BPD is a 'neurological illness', probably a form of epilepsy, and that it can be managed with appropriate medication and talking treatments.

There is a school of thought that suggests that some people may be genetically predisposed towards BPD, and that if those people are exposed to negative nurturing in childhood, they are more likely to develop symptoms.

What sort of treatment can I get?

Talking treatments (Reprogramming and Reeducation)
Psychotherapy is a relatively long-term talking treatment that aims to find the roots of present feelings and behaviour in your childhood. The relationship you have with the therapist is seen as an important reflection of your past and present relationships. Exploring this relationship can help to break unhelpful patterns of behaviour. The in-depth nature of psychotherapy can make it particularly appropriate for those diagnosed with BPD.

Some forms of counselling are quite similar to psychotherapy. Psychodynamic counselling, for example, places great emphasis on childhood experience.

Cognitive behaviour therapy is a more short-term treatment that aims to tackle practical, everyday difficulties with problem-solving techniques. It works towards identifying negative thinking patterns and replacing them with more positive ones.

New therapies have been developed which combine elements of cognitive therapy and psychotherapy. Dialectical behaviour therapy (DBT) and cognitive analytical therapy (CAT), have been found to be particularly useful for people diagnosed with BPD.

People often have high expectations when they enter a talking treatment. It's worth bearing in mind that therapists aren't miracle-workers and that change can take time. If you find it painful to be separated from others, you might want to think about how you will manage breaks in the therapy early on. You could ask when the breaks will occur so that you can look at how you will cope beforehand. There may be times when you think your therapist is wonderful and times when you may hate him or her. It may help you to express these feelings, so that you can look at them together. If you are interested in pursuing a talking treatment, you could talk to your GP about seeing someone through the NHS, or getting treatment subsidised.

Therapeutic communities
The NHS runs some inpatient therapeutic communities that specialise in treating clients with personality disorders. In a therapeutic community, staff and residents share responsibility for tasks and decisions. If you decide to go to into a therapeutic community, you will need to be prepared to talk about your life with others before the group decides whether to give you a place. This can be hard, especially if it's the first time you have talked in front of a group in this way.

Once part of the community, you would be encouraged to talk about your feelings about others' behaviour in group discussions. (I rarely have difficulty in this area, myself. It is just that others find my feelings disturbing and unsettling. Usually, they feel this way because they have conflicts about admitting their own responsibilities regarding their participation in societal dysfunction!) This may seem difficult at first but it can be very beneficial. It may give you the opportunity to see how others react to you and what you say. You can then think about what you like and what you want to change about yourself. Some, but not all communities may offer you individual therapy and, possibly, medication. (Ah, the omnipotent potential of mind altering substances to modify perceptions regarding the shortcomings with the root of the problem: wrongs committed by family and society.)

Alternative therapies
There are a whole range of alternative therapies, which some people find useful, from acupuncture to yoga. (Finally, something that actually makes sense!)

What about medicationt? (The panacea o all of life's problems!)

Antidepressants
Research has found low levels of the chemical serotonin in people diagnosed with BPD who have committed impulsive acts of violence. Some of the antidepressants work to increase levels of serotonin.

Antipsychotics
Antipsychotics (also referred to as major tranquillisers) may be prescribed to help with feelings of unreality or paranoia. They should be prescribed with caution, as they can have distressing side effects, especially in long-term use.

What happens if I can't cope?

In response to demand from mental health service users, crisis services have been developed in some areas. In these services, the emphasis is on talking treatments and informal support. A crisis service may be somewhere safe to stay, or an out-of-hours telephone helpline. ("I called suicide prevention and they put me on hold", Rodney Dangerfield.)

Hospital
At times of great distress, you may feel you need to be somewhere safe. This could mean going into hospital. It can be upsetting to be around others who are in pain, however, and you may feel a lack of privacy and support. Service-user or patient groups based in the hospital can be useful and supportive.

Most admissions are voluntary. However, if you are regarded as a danger to yourself or to others, but you don't wish to go, you may be admitted compulsorily under the Mental Health Act 1983.

Guidelines on treatment
The National Institute for Mental Health in England (NIMHE) and the Department of Health (DoH) have recently issued guidelines with the aim of enabling people with a personality disorder to get appropriate clinical care and management from specialist mental health services. The guidelines, titled Personality disorder: no longer a diagnosis of exclusion, can be found on the Internet (it is best to type the title into your search engine, as the document appears in several places). NICE (The National Institute for Health and Clinical Excellence) will also be publishing clinical guidance on the treatment of BPD - due to be published by the end of 2008.

What should family and friends do?

It's important not to see someone purely in terms of their diagnosis. People with BPD can have very low self-esteem, and it can help them enormously if you can emphasise the positive parts of their personality.

It can be extremely difficult caring for someone with BPD. They may try very hard to control you, because they feel so out of control of themselves. There may be periods when they refuse to talk to you or when they rage at you. This can be very painful and may make you feel powerless.

You may find that the person panics and perhaps reacts very angrily when you want to leave or to go somewhere. They may beg you to stay, or hurl words of abuse. It can help if you focus on how they are feeling, rather than trying to argue them out of their fears.

(Or, as in my case, they may want you to stay the fuck away from them!)

Looking after yourself
It's very important to look after yourself and to remember that you need time to yourself, if you are to care for others. If you are experiencing problems - for example, if the person calls you many times a day at work - it's vital to set down some boundaries. It might be important to decide how often you will be available. This can be hard to stick to, especially if you are being threatened, and you may need to enlist other people's help. Offer to help draw up a list of numbers the person could call when they feel afraid.

A person diagnosed with BPD may feel that they have no control over their feelings; they may blame you for everything. (Even though, as we have seen above, society in general is a guilty for the condition as anyone else, namely the victim of the condition.) Make sure you have someone you can turn to, to help you look at what is happening and make sure you don't take the blame for absolutely everything. Nobody deserves to be abused. There are organisations that can help you talk about the situation and make decisions about what you're going to do. You may need support in the form of a self-help group or some kind of talking treatment.

In an emergency
If you feel that the person you care for is a serious danger to themselves or others, you might need to think about the last resort of compulsory admission to hospital. The 'nearest relative' as defined under the Mental Health Act 1983 can request a Mental Health Assessment from a social worker specially trained in mental health law. The social worker would decide, with the help of medical advice, what the treatment options should be and whether the person needs to be detained.(See, the victim of the original abuse becomes the victim of societal labeling, forced sedation and incarceration... for a condition which is the result of misdeeds of society in the first place!)



In spite of the generally accepted facts (as far as facts can be interpreted about a pseudo illness with no scientific test with which to diagnose it), that genetics and social dysfunction experienced by the victim are the primary triggers or instigators, it is the victim him or her self who bears the stigma, responsibility, and social ostracization that being assigned the label inevitably brings.

My point is simply this:
Perhaps some of us members of the "Tin Foil Hat" Society are not that terribly far off from the mark. If you have read this far into this diatribe, you may be interested in further reading. You could visit
http://members.iimetro.com.au/~hubbca/psychopolitics.htm
or
http://www.geocities.com/Heartland/7006/psychopolitics.html
(no affiliation) or simply google psychopolitics. The whole idea is not necessarily "communist" in nature, though fingers are pointed squarely at communism. I believe, however, that it is more of a totalitarian conspiracy. And if you wish to look for the roots to totalitarianism, one must inevitably consider fascism (in all it guises), the International Monetary Fund, the World Bank, and, of course, capitalism (read in its broadest sense as "greed").

Free societies are not threatened by free thinking. And they generally embrace debate and differences of opinion. This, however, cannot be said of greed, and its many guises. As is the case with virtually all philosophies, religions, and forms of government, socialism and communism have been hijacked by greed for money and or power. And this comes back to the false premise that anyone is any more deserving of consideration and/or privilege that any other.

I am only aware of a handful of people to ever existed whom I might consider "special". And they generally shun that distinction. Any who believe that they are special are living in a fantasy world. Yet, I am a nut just the same.

So, if one reads any of my words and continues to wish to apply a stereotypical, judgmental, hypocritical, and discriminatory term with which they may feel more at ease while dismissing me, might I suggest that you take a good long look into the mirror. That inclination is merely your own insecurity and irresponsibility in perpetrating these fallacious, derogatory and highly suspect tendencies to deflect fault and to actively or passively participate in social injustice. And your joining in with this travesty will make me not one whit of difference, as you would merely be "jumping on the bandwagon". And as I am sure that your mother asked you, if everyone else jumped off a bridge, would you as well?

Recall the saying:
"When they came to get the Jews I said nothing, when they came to get the Pole,. when they came to get the homosexuals, the teachers, the intellectuals, the gypsies, I said nothing.
When they came to get me I realized, I was the only one left."

In other words, YOU are next on their list of "acceptable casualties" in their class war. Now, don't say you haven't been warned. Please return your head to the "sand hole" position now. Thank you.