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To Dr Robert,

I don't know if it's sociopathy. I recently realised with a bit of a jolt that my worldview isn't everybody's worldview, and though I've known for a long time that I was different, I only just started to realise the extent of the difference. I'm 16, English, and everything I've described below has got stronger/more frequent/more intense in recent months. I would appreciate your honest opinion on my condition, because I have been as honest as I can be in writing this email. I will lie to anyone I speak to face-to-face, so pure words will probably be the only way I will ever find an answer.

I'm exceptionally paranoid, and I don't believe anything anybody tells me. I'm distrustful enough that I won't leave my possessions alone with my closest friend for even a minute, which the other day she told me really offends her - I didn't think it was at all unusual to be distrustful till she said that. The thing is, I don't believe anybody else because I lie so much myself, and I won't leave anything of mine alone because if anyone leaves their things alone with me then I go through and see if there's anything they'd hate to lose, or be inconvenienced to lose, or that I want, and I'll take it. I've always assumed everybody lies as much as me, and is as keen to steal as me, and so I treat everybody like their motives are the same as mine. Apparently, though, I'm wrong.

I remember my mother getting mad at me when I was a little kid because she caught me stealing from a friend's house. (I improved my technique after that.) I still take things, but never for any real reason: I like to do it, but as soon as I stop to think why? I get stuck. I think I just like upsetting people. I lie because I like the power that comes with knowing something the other person doesn't; I get a power kick knowing I've basically altered reality for them.

Also, right from being little I was confused about why people had these ideas about things being 'wrong' in their heads: surely it just stopped them doing things they'd want to do? I didn't understand, and I still don't, really. My friend is Catholic, and she has often complained of feeling guilt simply by association with my actions, which I've always just put down to her faith. But recently, other people have been expressing shock at the things I find funny (stealing things, hiding things, lying: generally making people upset). A girl called me 'cold and calculating' because I explained how to lie effectively. Someone else told me I have 'dead eyes' when I get angry; she said she was afraid of me. My mother called me a psychopath because after reading a report about a child murdering another child, I expressed sympathy for the killer, not the victim. Violence and pain in films and books makes me cringe, but if I meet it in real life I'm more likely to end up stifling a laugh. I'm not proud of any of this (though nor am I ashamed), I am not boasting; I am just trying to be honest.

I'm also usually furious. I feel sometimes I'm not even human, I'm just a cloud of fury in human shape. People make me furious: I usually start relationships by assuming people are pathetic (I honestly find people disgusting, sometimes to the point of nausea just thinking about interacting with a person), though sometimes I might respect a person a little if I get to know them; but generally speaking, people make me furious. Things people say make me furious, 'hmm' and 'oh really?' and anything meaningless makes me angry. If they have nothing to say, they should keep quiet. I'm cruelest to the people that make the most boring conversation.

But essentially, everything makes me furious, and I am always furious, even when I'm smiling (especially if I'm smiling). When I'm furious, I fantasise about hurting people very badly, and killing them, and how I'd do it and I can imagine every bit of it, and these fantasies are very intense and usually involuntary (not that I mind them). If I'm ever fully alone, I punch things and stab things and find things that hold sentimental value for others and attack them, and destroy things, and practise smiling in the mirror, and get 'feral'. It's the best word for it. I go wild on my own because I don't want to go wild around people; I stop myself savaging animate objects because I don't want to go to jail. (As a kid I was a daydreamer, but my daydreams were about my imaginary identical twin, who had an underground torture chamber where she did various things to various friends of mine that make American Psycho sound a bit like Bambi.) I also went through a phase when I was younger of strangling cats, but I was always interrupted before they died and so I would pretend I was just stroking them. (I think I've grown out of that now.) More recently I went through a phase where all I wanted in the world was to kill a baby. I work with young children, so it would have been easy; I was making plans, I was very excited about it. I don't know if I'd ever really have gone through with it, because I had to start applying to uni and I had a new fixation.

I realise that people will find what I have written above to be offensive, but I know that if I ever spoke to someone face-to-face about any of this, I would lie. This is my first experience of telling the truth about myself, because my whole life so far has been suppressing these facts. I want to make sure people realise I am just doing my best to level with you.

My mother used to think I was autistic because I failed to understand when I was being offensive. I also didn't get sarcasm. I still think she must just be very quick to take offence, but she was that concerned she was ready to take me to a child psychiatrist. When I'm laughing and talking to people, I stop to think, and I could be doing anything and I'd feel the same. It doesn't matter who it is, what they're saying, I could be doing algebra and I'd care the same. Someone I hardly know told me they'd never seen me less than cheerful, but I thought about it and I don't remember ever having feeling cheerful in my life. I just pretend, for other people's benefit. In fact, the more furious I am and the more intense my fantasies are becoming, the more cheerful I will act, to make especially sure that what is happening inside my head stays hidden. I don't think I'd care if I never saw any of my friends again.

I don't know, basically. I know there's something up, but I don't know to what extent labeling it would help. I decided last year the ultimate challenge would be to lie well enough to fool a psychiatrist, famously unfoolable, so I set out to describe the symptoms of psychosis and convinced my local mental health services I had suffered a psychotic break in the past. It turned out that I was going to be stuck into therapy and I would have had to decide on something I wanted to change about myself, and there's nothing I want to change, so I recovered very fast from my 'trauma' and never went. I don't want to change. I am happy to be this way, but I want to feel in some way that I fit in, somewhere. It's lonely to feel like no one else is my equal, and it's lonely to know there's no one I can nostalgically discuss childhood cat-throttling with who will find it as funny as I do.

Please tell me, do I sound like a sociopath? And if I am, if that is how I was born, can I tell anyone and not have them find me a monster? I don't believe it's my fault that the inside of my head wants to kill someone, but then I suppose everyone who ever killed found a way of abdicating responsibility from themselves. I wouldn't kill, because I'm too realistic to think I'd get away with it; I'm just using that as the most extreme example of what I think people would find alienating about me if they knew it. I don't mind not understanding friendship and all that, because what you've never had you can't miss (I was born without a sense of smell and I don't have a huge desire to develop one of those, either), but I just want a person to know the truth and not find it awful. Is this ever going to happen?

Sorry, Dr Saltzman. It seems to me like instead of asking a single coherent question, I have made you the person to whom I've told the truth. So I guess another question is, do you find me awful? I'm afraid your answer will be my testing of the waters. I admire you for your honesty, because it's ruthless, and it strikes me that such honesty can be just as hurtful as any bunch of lies; so please tell me honestly.

Yours,

Mary.







ask dr-robert





Hello, Mary--

Good letter. As I have written elsewhere, a diagnosis of psychopathy (or sociopathy as it is sometimes called) did not depend at all on behavior, but only on one single criterion: Is the person capable of feeling guilty or not? If the answer were yes, that person was not psychopathic regardless of any hurtful or destructive acts he or she might have committed or fantasized committing. This is important to understand because a fairly recent, and, in my view, wildly infelicitous decision by the American Psychological Association (APA) to rewrite the Diagnostic and Statistical Manual (DSM) by dropping any reference to psychopathy in favor of a new diagnostic category, Antisocial Personality Disorder, has garbled this issue by moving the emphasis away from psychology (guilty feelings, lack of empathy, etc.), focusing attention instead on actions: "...a pervasive pattern of disregard for, and violation of, the rights of others" . . . "Failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest."



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In other words, the APA decided to pinpoint behavioral traits, which may be identical even in two persons of completely different psychological makeup, instead of focusing properly on the emotional makeup of the person in question. Obviously this moves the focus away from treatment and onto law enforcement instead. I consider this an ominous change, and blame the APA greatly for gutting the old and very useful diagnosis of psychopathy.





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That said, let me get to your questions. First, judging from your self-description, I would say you are psychopathic. Naturally, without meeting you face-to-face and speaking with you at length, I cannot be certain of that diagnosis, but many of your statements seem to meet the criteria which I (APA be damned!) continue to use in my understanding of human behavior and the psychology which lies beneath it. In general, you lack guilt, you have trouble understanding other people's guilty feelings, you have learned to feign or fake emotions so that others will not see the real you, and you are entirely self-centered, caring not one whit for anyone or anything besides yourself. These are, in my experience, classic symptoms of psychopathy, made poetic in Behind Blue Eyes, by the rock band, The Who:






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No one knows what it's like

To be the bad man

To be the sad man

Behind blue eyes

And no one knows

What it's like to be hated

To be fated to telling only lies


[Chorus:]

But my dreams they aren't as empty

As my conscience seems to be

I have hours, only lonely

My love is vengeance

That's never free


No one knows what its like

To feel these feelings

Like i do, and i blame you!

No one bites back as hard

On their anger

None of my pain and woe

Can show through






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Second, this is not your fault. I am quite certain that psychopathy has a strong genetic component. I have felt this way for many years, based partly on my interviews with hundreds of penitentiary inmates, and also on my individual analytic work with psychopathic patients, but the results of a 2004 study by Dr. Essi Viding, make this practically a certainly. In this study, almost 4000 pairs of seven year old twins were examined. Teacher ratings for antisocial behavior and psychopathic tendencies (i.e. lack of empathy and remorse) were used to classify the twins. Those who were in the top 10 percent of the sample for antisocial behavior were separated into two groups, those with and those without psychopathic tendencies. Following analysis, the results showed that, in children with psychopathic tendencies, antisocial behavior was strongly inherited. In contrast, the antisocial behavior of children who did not have psychopathic tendencies was mainly influenced by environmental factors. In other words, a bad-acting child can be produced by a bad environment, but a true psychopath, such as yourself, someone, that is, who lacks all remorse and has no compassion, is born that way, and should not be blamed anymore than one should be blamed for the color of his skin, or the color of her eyes.





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I am certain to get many letters, as I always do when writing about psychopathy, criticizing me for pardoning or coddling psychopaths instead of condemning them and commiserating instead with their victims. These letters are both mistaken (as Dr. Viding's study demonstrates), and boring in their stupidity (especially the ones from self-proclaimed "Christians" who I would have thought should be much more forgiving, as Jesus, their hero, is said to have been), so I probably will not read them anyway.

So, yes, Mary, you are correct in feeling that many people would find your desire to kill monstrous, and might be even more put off by the fact that you refrain from killing only because you fear the consequences to yourself, not due to any compassion or fellow feeling for your imagined victims. Nevertheless, there are people who would understand (many of them, I guess, would be members of my profession), and who might even be willing and able to help you make a more positive adjustment to the tendencies with which you were born. Personally, I do not find you "awful," as you asked. In fact, I feel a bit sorry for you because love and compassion seem to me to be the truest and happiest feelings a human being can experience, and these, apparently, are denied to you. So, rather than reject you, I would help you if I could, and perhaps my work on this reply will be helpful to you, if only a little bit.

By the way, I do not agree that fooling a psychiatrist (or psychologist) would constitute the "ultimate challenge." In my approach to this work, I would rather be fooled at first than be too suspicious at first, thereby foreclosing what might have been a fruitful communication. Yes, I am always skeptical, but never to the fullest, and so a clever liar can fool me—but, hopefully, not for long. For more on this, take a look at this discussion on a blog called "SociopathWorld" of my reply to another letter from a possibly psychopathic father about therapy for his psychopathic child.

Thanks for writing, Mary, and be well.







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To Dr Robert,

Thank you for your reply - that was incredibly fast! I truly appreciate your understanding; though like you say, I doubt many people could be so compassionate towards me if I didn't return the favour. I also feel that I am high-functioning enough, outwardly respectable enough, that if I ever tried to tell somebody any of what I told you they wouldn't take me seriously, which only adds to the pressure to keep hidden.

This afternoon I found myself in a conversation about how much one of my friends is loved by her boyfriend. It was bizarre.. Over the last year, my friends have all got suddenly into romance, and love, and boyfriends, and I've always assumed they're just pretending when they talk about how 'in love' they are, that they're faking it to fit in. This afternoon, I just couldn't understand anything they said, because I can't imagine a situation where you could care for another person that way. And I had another moment realising that, no, it's only me who thinks like this. These moments of realisation are throwing my whole perception of the world off-kilter; I thought I understood people and I keep getting more and more evidence to the contrary.

Do you think you could forward me some of those critical emails, when you receive them? Like I said, I wanted to test the waters, and I guess finding out how strangers react to the truth about me is the best way of finding out how a person I know would react to the same. I want to understand how people would see me (seeing as how it's turned out I don't understand anything anyway). I would be very grateful if you were able to do that.

Thanks again,

Mary

PS. Behind Blue Eyes used to be my favourite song, when I was about eleven. I'd never actually registered the lyrics, though, beyond the chorus: clearly my spooky subconscious was at work there. . .




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