Tag Archives: personality

Diversity within psychopathy

diversityMuch of medical science today is about further understanding disease, disorder, and treatment. By manipulating context, we hope to tease the unknowns out of the chaotic vacuum of human ignorance into the controlled environment of categorization and understanding. There is nothing more satisfying in research to draw a statistically probable connection between concept x and concept y. The mind revels in these successes and after years of research, shedding blood, sweat, and tears, it can feel like the beast has been tamed.

However, as is the nature of scientific knowledge, there are never absolutes, only probabilities. And so once we have our category, it soon becomes apparent that sub-categories are needed. In the world of psychology, humans are forever providing exceptions  to what we thought we knew (who would’ve thought that with billions of neurons and trillions of synapses, humans would ever throw continual curve balls?).

In psychopathy research, there have been some tremendous strides in identifying those with the disorder. The PCL-R and the CAPP are both powerful tools, but it is also important to remember that just as all people are different, the list of behaviors that make up these tests can be exhibited very differently, depending on the individual. This is partly why it takes a trained mental health expert, with a thorough understanding of the subject’s history, to determine whether or not the criteria is met.

Psychopathy, for many years now, is still being explored within different sub categories; along gender lines, within prison populations, in children and adolescents, and in those whose behavior never resulted in incarceration. The latter of this group have previously been termed ‘successful’ psychopaths, and researchers have pushed to see if there are any brain differences that could explain this phenomenon; for example, do psychopaths who have never been incarcerated have better impulse control? Does the way they express their ‘psychopathic’ behavior never quite fall foul of the law? Are they simply more intelligent and better at covering their criminal tracks?

Cleckley seems to recognize the problem of varying degrees of psychopathy in a variety of different individuals. In The Mask of Sanity, he lists six types of individual and attempts to explain how psychopathy manifests in all of them: These are psychopaths as business man, man of the world, gentleman, scientist, physician, and psychiatrist.* This list is clearly indicative of his time, and one has to wonder what the few pages on psychopath as customer service representative, rap star, or cable guy would look like. However, it is an interesting debate to see if there is anything remotely formulaic about how a psychopath’s career could influence and be influenced by all of the behaviors they are known to exhibit (in varying frequency), that is if they are a psychopath that can maintain a career for any length of time.

Psychopathy remains a very dynamic disorder, and there is clearly a profound amount of difference between those afflicted. There are many areas in the brain that have been implicated in the disorder, and it is when these areas have failed to develop that the disorder could start to make an appearance. One has to wonder that in the symphony of brain development, how much of x has to fail to develop, in light of the failures of y and z to reach maturation? What are the ratios in terms of tissue development and cellular activity that will increase the probability of psychopathic behavior to the point where the disorder is there to stay?

How much can psychopathy be parceled up, before it splits into independent diagnostic components?

 

*Despite having listed two female case studies, when theorizing Cleckley tends to default to psychopaths as male.

 

Boxing and domestic violence – Why boxing is not to blame

When the news breaks that a high-profile boxer has been involved in domestic violence, one of the immediate questions that springs to mind is whether the boxing, the actual training, has simply taught a fighter to be aggressive, whether in or out of the ring. Personally, I think this is highly unlikely, and you would have to find numerous examples of boxers that became more aggressive outside the ring, the longer they trained. Naturally, there is some quibbling to be had over what it is to be aggressive, but I think there are other better answers here.

Boxing is intimately linked with working class backgrounds and poverty. Many boxers have learned to fight as a means to earn some serious money and escape poverty. And make no mistake, for the few that have been able to succeed as professionals, many more have remained broke and had to find alternative or additional ways to earn a living. The connection between poverty and boxing is a phenomenal case study in itself, but here are three things that I think can at some point influence a boxer in their life if they have come out of this environment.

These three things are not unique to boxers, but I think they are factors when boxers have become aggressors in domestic violence.

1) As success increases and a boxer no longer worries about food, rent, clothing, and having the time to indulge in soul enriching activities, like hobbies, they will have very vivid memories of what it was like to have none of that security. This in itself is added motivation as they continue train and behave in ways so that they do not have to return to a desolate way of life. There is nothing inherently wrong with this drive, however if the boxer experiences something that they interpret to mean their current way of life is threatened, and they might have to return to what they fought so hard to escape, they could become irrationally reactionary. Their noble drive to succeed has become polluted by irrational thoughts, and could result in an aggressive outcome.

2) If a boxer has done well in the sport and managed to pull in some money and fame, it is possible they will develop an entitlement complex. They have had to work very hard to get where they are, and subsequently if anything is experienced that is perceived to threaten this status, it’s almost like a challenge to their identity and perception of self. When those things are challenged in this way, again, it is possible to react aggressively. I don’t think a sense of entitlement is necessarily bad, because we should feel good about ourselves if we have achieved a lot in life, but it again it’s when this is over-exaggerated and irrational that problems can result.

A boxer is going to be challenged to keep those two things under control throughout their professional career, and they can be made worse by a number of reasons. If a boxer is surrounded by the wrong people, people that have a strong influence over the boxer, such as saying things akin to, “They don’t respect what you’ve been through,” “They want you to return to the ghetto,” “They think you’ve got where you are through luck and there simply wasn’t a decent opponent to take you out.” This is why, throughout the course of a boxers life, they need to be surrounded by good people. I would wager that many are, but a few are not.

3) The experience of poverty, hardship, and violence can have a profound impact on a child. It’s worth noting that a child’s brain is still developing, all the way through birth and up until the age of 25. Key areas of development, though, are taking place before puberty. Extreme stress, abuse, and trauma can have an impact on the brain’s development, and could even result in such things as stress disorders and personality disorders. How a child deals with or reacts to stress could easily be a result of how the child’s brain has developed and how they learned to respond. Stress and personality disorders are connected with violent behavior, but there is no formula for determining if they’ll develop or not. There is no equation – Poverty Aspect 1 + Poverty Aspect 2 in the presence of Poverty Condition 3 = Stress Disorder 5. Still, they are very real possibilities when a child has come out of this background. Stress disorders can result in impulse control problems, increasing the likelihood of violent outbursts, and personality disorders can result in planned violence for personal gain. Of the two, reactionary aggression is far more common.

These three “explanations” are only theories, and I would love to see more research on them, especially stress disorders. Learning violence, experiencing violence, and being unable to control aggressive impulses as a child, can easily lead to the cycle of violence, and it’s a hard cycle to break. However, I would like to stress again here, these things are not unique to boxers.

The Disciplining Effect of Boxing

I would like to take some time here to explain why boxing can actually help control aggression.

There have been numerous instances where joining a boxing gym has literally helped to keep kids off the street and out of gangs. This has the immediate affect of preventing children from being exposed to criminal violence.

Much of our behavior is determined by responding to cues – a none stop stream of cues that we interpret (on some level) and respond accordingly. When training in a gym, especially for long periods of time, the sight and presence of pads, bags, and ring, eventually start to mean this is the time for boxing/fighting. When pads are held up for you in the gym, now is the time to box. When you’re in the ring, with your gloves, and a referee, now is the time to box. As trivial as this sounds, boxers become taught to “do it” in the gym or the ring. These cues become reinforced by the fact that the gym is safer, it’s a controlled environment, and other people are (should be) looking out for you. Indeed, after a while, when a trained boxer enters a gym, just the sight and sounds are enough to get them loosening off and rearing to go. Having these alternate cues, I think, is likely to decrease the chance of throwing punches to other cues, because these other cues mean “now is not the time to box.” I think this can help keep boxers out of violent provocations outside of the gym. It’s not absolute, but it helps.

Gyms can also have a humbling affect on boxers. They become aware early on that there are others in the gym that can best them (to put it bluntly, there’s always someone who can whup your ass). As this is the case, it helps them to develop respect, which is then reciprocated. Without the support and respect of their peers, their own training is not likely to progress very far.

In the infinitely complex quagmire of human behavior, there will always be exceptions to these things, but this is why I think boxing has probably helped to reduce aggressive outcomes outside the ring, rather than encourage them. To be sure, there are people that have been beaten by boxers (Mayweather as the highest profile example), and I do not want to undermine the plight of the victim. There is no excuse for domestic violence, and I still maintain that (ideally) boxers should have a greater self awareness of the damage they can cause, which is perhaps why they should be held to a higher standard.

Domestic violence is an abhorrent endemic social problem that impacts far too many people on a daily basis. If boxing was somehow removed from the equation, the numbers would not drop. We need increased awareness, better education, better assistance, better justice, and a push for social reform to make domestic violence a thing of the past.

Asthmatic Personality

asthma lungsI’ve had asthma ever since I was a child, and fortunately as I entered my adult years the severity of its onsets have reduced. Most people know that asthma results in a shortness of breath, but there are two things happening that result in this: Firstly, your bronchioles fill up with mucus, which means that less air can pass through, and secondly, the bronchioles themselves are narrowing, which has the same result. It’s like a double whammy of suffocation, and as you’re struggling to pull air in for extended periods of time, the muscles all around your chest begin to fatigue and ache. Imagine breathing through one of those narrow red straw-like coffee stirrers for five minutes, and you’ll be able to recreate the feelings surrounding the onset of an asthma attack.

Even though there is no cure for asthma, fortunately there are some very effective drugs that can immediately open your bronchioles. I’m sure you’re familiar with a friend who carries a little blue inhaler in their pocket or purse, although I bet you’ve never really seen them use it (I’m personally a bit embarrassed to use it in front of people). Typically, there are two types of inhaler. One that prevents the onset of asthma (a preventer), and one that relieves the symptoms of asthma (a reliever). With a combination of these treatments, most people can stop asthma from interfering with their lives.

So, what has asthma got to do with personality?

Asthma, like any other lifelong ailments, becomes a part of your life – indeed, a part of you. In order to treat the symptoms of asthma, a sufferer must always be aware of how frequently they need to take their inhalers, and make sure to keep them near their person at all times. In fact, as a sufferer, I can tell you that if I leave the house without my inhaler I suddenly feel fearful and nervous. Sometimes I even feel like my chest is getting tight when it isn’t. In order to deal with these irrational feelings, I have deliberately left my inhaler at home, but only during times when I am not straying too far and I can easily get back if I need to. This increases my experiences of being without my inhaler that always transpire with no asthmatic occurrences, and I feel like the deathly-necessity of carrying it all the time is diminished.

As you can see, there is a habitual routine that asthma sufferers have to be mindful of all the time. If this routine is interrupted, such as forgetting the inhaler, emotions like panic and fear, and even the psychosomatic feeling of becoming short of breath can result. Over the years, all of this will have an impact on your personality.

The asthma attack itself is synonymous with feelings of desperation. When you can’t breath, with each contraction of your chest muscles and diaphragm, you are desperately trying to pull the much needed air into your lungs, but you can’t. The duration of an asthma attack is laced with frustration, fear, and desperation. You are anxiously waiting for your chest to open up and pull that much needed oxygen in. It is no wonder that asthma sufferers develop such an obsessive and paranoid relationship with their inhalers – anything to avoid having to go through an attack again. If the attack is bad enough, I would even call it a traumatic event, and we know how our lives and our behavior can be shaped by trauma.

I have even found that if I start to become tight, and I am engaged in a particular activity, I will try to finish the activity before I take my inhaler. In this sense, having a puff of my ‘reliever’ becomes the reward for finishing. If I start an activity, particularly if it is a chore such as doing the dishes, I do not want my asthma to mean I have to stop, go find my inhaler, take a puff, and then resume washing the dishes. Instead, I rush to finish the dishes so that by the time I can breath again I can associate the feelings of relief with the feelings of having accomplished the task. The only trouble is, if the asthma starts to get bad, I delay taking my inhaler as the asthma worsens, and could even end up making myself bad. But during the times that I am asthmatic, my inhaler has trained me to finish chores!

I have also become defiant with periods of chest tightness. I can remember a number of times during my school days that I did not want to let my asthma interfere with doing what the other children were doing. If I started to become tight, and taking my inhaler wasn’t an option without stopping the activity (such as playing or running), I would just deal with the feelings in my chest for as long as I could ignore them. I didn’t want to be the outsider. I didn’t want asthma being the reason that I couldn’t play and compete with everybody else.  I’m sure that these experiences are partly responsible for the aspect of my personality that ignores, even condemns, those who tell me I can’t do something.

If I did have to stop playing, and with asthma you don’t really have a choice in the matter, I started to become impatient with my condition, and I would start to get mad at myself for having such a ‘crappy’ body. I am happy to say that my self-loathing never resulted in anything clinical, and it vanished along with my adolescence. Nevertheless, the remnants of asthma-induced frustration in my ‘developmental’ years still shaped my brain and my personality.

If anyone has any thoughts on this, I would love to hear from you.

Revisions to Antisocial Personality Disorder (APD) for the DSM V

The DSM-V development website lists a number of proposed revisions for personality disorders from how they initially appeared in the DSM IV. Part of the problem with the DSM IV was that people with a personality disorder were frequently diagnosed with two or more, and as individuals only have one personality the need to recognize a singular personality as dynamic has been recognized.

For more information on how the classification of personality disorders will be different in the DSM V, click here.

The proposed revision of APD does not include recognizing Conduct Disorder (CD) before the age of 15, even though many studies have shown that CD in the pre-pubescent years is a good indicator of APD in adulthood. Although, the revision still includes the need to be 18 or over to have a diagnosis of APD.

For more information on the proposed classification of APD in the DSM V, which should be published in May of 2013, please click here.

Psychopathy as one personality disorder?

In a recent Science Daily article, Dr. Skeem of the University of California, Irvine, was quoted – “Psychopathy has long been assumed to be a single personality disorder. However, there is increasing evidence that it is a confluence of several different personality traits.” While it is true that within the last ten years there have been many neurological studies elucidating structural abnormalities in the brains of psychopaths (particularly the OFC, VMPFC, amygdala, hippocampus, and corpus callosum, as well as white matter damage in the uncinate fasciculus), it seems a very antiquated view that psychopathy is one disorder with an underlying etiology that is carved in stone. Hare’s checklist for psychopathy (PCL-R) includes a multidimensional analysis of those exhibiting antisocial behaviors, and the ICD-10 and DSM IV (while not in strict agreement) make it apparent that there are many facets to psychopathy, and this is no longer a new phenomenon.

I think both the public and the scientific community are in love with the term “psychopath” and both seek to claim and shamelessly manipulate the term for their own ends. Whenever another line is drawn or a statistically significant difference rears its ugly head, the flags go down and the term itself  gains another meaning in its pock-marked face.

Dr. Skeem’s article “Psychopathic Personality: Bridging the Gap Between Scientific Evidence and Public Policy” is a very compelling read and does help to dispel many of the myths about psychopathy.