general information
Dissocial personality disorder (DID or DID) is also popularly called sociopathy or psychopathy. Doctors do not use such terms in their practice, at least not in medical research.
DID is included in the International Statistical Classification of Diseases and Related Health Problems, abbreviated ICD 10.
Most common among men. Perhaps this is due to the fact that representatives of the stronger half of humanity are more aggressive and impulsive. According to statistics, it is detected in 3% of men and only 1% of women.
That the behavior of sociopaths is antisocial is supported by evidence from prison services. It turns out that about 75% of the world's prisoners are people with DID.
But it is worth considering that not all dissocials are criminals. Most of them commit acts for which it is difficult, and sometimes impossible, to prove guilt. Or they are unacceptable in society, but are in no way punishable by law.
Most often it affects those who belong to disadvantaged sections of the population. Especially if they grew up in large families. And also city residents.
Basic information about the disease
Personality disorder of the dissocial type occurs more often in adolescence. The person does not experience feelings such as remorse, guilt or shame. Such traits get worse over time and persist throughout life. Timely treatment will help you return to a normal state of mind.
Such patients have an impaired ability to form any types of attachments. They cannot sincerely be friends, love and rejoice for a loved one. Patients with this diagnosis are convinced that their own needs come first and that all actions are legitimate. If necessary, they rudely violate the personal boundaries of other people and neglect their feelings.
In some cases, a psychiatric clinic is the only place where the patient can get help. The diagnosis is based on studying the medical history and talking with the patient. Treatment for dissocial personality disorder involves the use of medication and psychotherapy.
According to statistics, this pathology develops more often in men than in women. At risk are residents of large cities, representatives of low-income segments of the population, and children from large families. These people often believe that they have suffered a lot in life, and therefore consider others to be indebted to them for the hardships they have experienced.
Signs
To diagnose this disorder in yourself or a loved one, there must be at least three matches with these symptoms. But it is worth considering that individuals with DID are in very rare cases able to admit that they have dissociality.
Even if experts make a diagnosis, they are ready to challenge and deny it, no matter what evidence they are presented with. But you can check up on someone you know if you have doubts about their mental health.
So, the main signs:
Addiction
Prone to various kinds of addictions. That is, this disease is most often accompanied by alcoholism, drug addiction, food problems and other types of addiction.
Illegal groups
Such a person does not respect the law. He simply doesn’t respect him and doesn’t see the point in him. This is why he can commit illegal actions and end up in criminal groups.
Security breach
He doesn’t value his own life, much less someone else’s. This is why he neglects safety rules, takes risks and commits actions that give him a feeling of omnipotence and superiority over others.
A simple example is an aggressive driving style, which leads to emergency situations. By breaking the rules, such an individual feels satisfaction that he managed to overtake all road users, turning out to be the best driver and owner of the car.
Hypocrisy
As mentioned, completely incapable of feeling guilt or shame. Why does he almost constantly use lies to his advantage? Without thinking at all about the harm he causes to the people around him with his lies.
This refers to situations where a person forges documents, impersonates someone else, or manipulates using false information.
Irresponsibility
He strives to avoid responsibility, shifts his obligations and blame onto others, acts in purely personal interests and does not worry about loved ones. He cannot take care of his family, make friends and value any kind of relationship, remain faithful and devoted.
Low material income
It is not the main symptom, but quite often lack of money occurs due to constant job changes. Due to the above circumstances, he does not stay long in one company. And he changes jobs without any moral discomfort.
Aggressiveness
Hot temper, irritability and aggressiveness are almost the main character traits. They do not know how to cope with anger, which is why, without completely controlling themselves, they can cause physical damage, both to the health of people around them and to objects that are at hand. It is people with DID who usually turn out to be the instigators of fights, which is why they end up in prison.
Loneliness
Unable to form close relationships, sociopaths are most often lonely. Even if someone risks feeling affection for them, they will easily destroy the trust they have shown in them.
Only those who are accustomed to the role of victim and are able to remain in destructive relationships remain nearby. You can learn more about victimization by clicking on this link.
Violence
They commit both emotional and physical violence. They choose mainly those who cannot fight back, who are weaker than them. They can intimidate or even mock others, trying to gain a sense of power and superiority. Animals are often tortured and killed for fun and pleasure.
Unable to learn social interaction
Having disturbances in the emotional sphere, they do not draw appropriate conclusions after committing actions with negative consequences. Therefore, having avoided or even suffered punishment, they will continue to behave the same way in the future. The absence of guilt does not motivate the search for cause-and-effect relationships.
Related difficulties
DID is often accompanied by depression and post-traumatic stress. Sometimes schizophrenia and chronic mania are present. This is what sometimes prevents a correct diagnosis from being made in a timely manner.
Damaging someone else's property
They get pleasure from damaging things that belong to other people. Some have a passion for arson.
Again, this gives a feeling of power and superiority. And also the pleasure of having managed to ruin not only the object, but also the mood and emotional balance of its owner. This is a challenge to society, with the help of which psychopaths demonstrate their disobedience to the rules and norms accepted in society.
Charm
To have influence and power over other people, sociopaths often try to use their charm and charisma. This allows them to become leaders of any groups and organizations, ranging from workers to criminals.
Reactionary foundations of disorganization of actions
There are certain types of reactions characteristic of children with a disorganized manner of action.
For younger children these are:
- protest. Occurs when there is increased imposition of something, or restriction of activity. Active protest is manifested by aggression, rudeness, and damage to property. Passive - hostility, deliberate silence, suicide attempts, starvation, running away from home. Physiological signs – enuresis, digestive disorders, hacking cough;
- refusal is a reaction to dissatisfaction with the sense of security and communication in very young children. Manifestations: lack of activity, desire to communicate, lack of emotion. No response. There is no desire for gaming activities. Everything is not interesting, they are not able to enjoy sweets or favorite toys;
- imitation - imitating the negative traits of authority figures. Children adopt bad habits and antisocial activities;
- compensation - the child compensates for the failures of one activity with the achievements of another. Failures in educational activities are compensated by hooliganism and theft. Fears and timidity are replaced by bullying other children, extreme car and motorcycle riding.
Reactions in teenagers:
- emancipation - resistance to the rules established by adults, rejection of help, disregard for advice and tips;
- grouping - the creation of antisocial groups;
- hobbies - aimed at satisfying interest in a specific activity. Excitement is satisfied by card or other games for money, leadership - by situations of leadership (gangster group). But even if hobbies are positive (sports, art, beauty), they can also destroy acceptable rules of action. They are provoked by refusal to attend school, carrying out illegal acts, making inappropriate acquaintances, ignoring relatives, and committing life-threatening acts.
Myths
Such a person is easy to recognize
Not so. Modern cinema only contributes to the incorrect perception of information. In films, sociopaths are easily recognizable and instantly arouse suspicion and rejection.
But in reality things are different. In addition, people with this disease usually have a lot of other related problems that complicate the diagnostic process for specialists. What then can we say about people who do not encounter DID in their practice and life in general?
Treatment only worsens the person's condition
There are a number of experts who are inclined to this opinion. But treatment can only interfere if the methods are chosen incorrectly, or if they are outdated and require complete abandonment.
In principle, harm can be caused by any disease, both mental and physical, if you have sufficiently scanty information about the disease itself and how to combat it. Agree, a simple and insignificant wound can endanger a person’s life if a dirty plantain leaf is applied to it.
Hypnosis in the treatment of DID is only necessary to access memories
An individual with psychopathy has impaired communication, both with other people and between his own dissociative parts.
It is for these purposes that hypnosis is used. To improve communication. And not to restore lost memories. In addition, according to the latest data, a person under hypnosis can describe any events very colorfully.
So colorful that there is no doubt about their reality. But in vain. Because patients often talk about things that have never actually happened in their lives. The imagination works so actively at such a moment that it is impossible to determine where is fiction and where is the truth.
Conduct disorder in children
A distinctive feature of conduct disorder in childhood is the inability to control and plan one’s own actions, as well as interact with other people in accordance with accepted norms and rules. Increased aggression, irritability, lack of discipline and desire to obey elders, pugnacity, cruelty, theft appear, and often the child begins to lie.
To establish a diagnosis, specialists carry out a number of psychodiagnostic measures and also talk with the child, drawing up the most competent and complete history. Treatment development is carried out through therapeutic techniques in an individual or group setting.
Types
Psychologist Eric Berne has identified several types of people with dissocial disorder.
- Passive. Such individuals are passive in protesting against social norms. That’s why some of them are still carried out, trying to avoid punishment. Without experiencing pangs of conscience, they can commit actions whose guilt is difficult to prove. But you are afraid to go directly against the system. Passive-aggressive, manipulative and provoke others into conflict. After which they look flawless, presenting their victim as a tyrant.
- Active. It is these people who have absolutely no restrictions in the internal structure of their personality. They lead a criminal lifestyle, so their behavior is not only deviant, but also delinquent. After therapy, they can demonstrate decency and adherence to moral standards, but this is only for others. The internal picture of the world does not change at all, so whenever possible they return to their previous actions.
Causes
It usually appears during puberty, that is, adolescence. At least, it is during these years of life that it is possible to diagnose the presence of sociopathy. Since in childhood, an antisocial style of behavior is most often an inability to realize the cause-and-effect relationship between one’s actions and consequences. For this reason, parents bear responsibility for the child's crimes.
At the moment, there is no exact data on what provokes the development of psychopathy, but there are theories from experts that are the most likely:
- Heredity. It is not uncommon for such a disease to occur in several generations in the same family. Especially on the paternal side.
- Educational mistakes. If parents did not take an active part in raising children, or they themselves were an example of antisocial behavior. Which the child could adopt without knowing a different, healthier model of perceiving the surrounding reality and interacting with it.
- Traumatic brain injuries.
- Severe stress. The effect of stress on the human body is sometimes so serious that the psyche loses its stability and undergoes changes. Unfortunately, destructive.
What is meant by dissociative (conversion) personality disorder?
For a complete understanding, it is useful to explain the concepts of conversion and dissociation. The process of transformation in which a very burdensome and unacceptable affect is transformed into a symptom, often physical, is called conversion. The term "dissociative" can be understood as separate, indicating the loss of continuity of personality, that is, their components such as emotions, thinking, perception, etc.
Dissociative are those elements of consciousness that have been displaced, but are still active, constantly affecting the human psyche without realizing it. This content is isolated, divorced from consciousness and is reflected in the behavior and actions of a person.
There are several dissociative (conversion) disorders, the common characteristic of which is a discrepancy or complete loss of connection between memories of past experiences, self-awareness, feelings and limitations or inability to control body movements.
Conversion disorders are relatively rare, affecting women rather than men. Their origin most often falls between 15 and 30 years. They arise in response to some serious trauma, experience of harm, injustice, unresolved conflict (interpersonal and internal) or unmet need.
In addition, they can also appear due to dissatisfaction with life, inability to realize themselves, lack of attention, and love from both parents and partners. It depends on the disposition and structure of the personality, on how it copes with and processes such external influences.
Genetic talents, temperament and personality maturity of a person play an important role. Thus, it can be said that a combination of biological, psychological and social factors is behind the development of conversion disorders.
The person copes with traumatic experiences through a reversal disorder. He pushes this experience into his unconscious so that it can no longer bother him in consciousness, causing unpleasant or even unbearable feelings. This process is called primary profit. Then comes secondary gain, through which the patient manipulates other people through his illness.
It is important to note that all this is done unconsciously. He sees the benefit in the fact that the disease will attract the attention and care of others to him.
People with a hysterical personality type are most likely to develop conversion disorder. In short, this personality type manifests itself in very strong emotional experiences that are superficial. This is an attempt to attract attention to themselves by mood swings, eternal dissatisfaction, excessive concern for their appearance, to which they attach great importance.
Moreover, they also manipulate other people to make everything conform to their ideas, and if this is not the case, they make everything up in their imagination. With these above-mentioned manifestations, they attract attention to themselves and thus hide their uncertainty.
What not to do
Sometimes it happens that a person with a dissocial disorder turns out to be a close relative, with whom it is quite difficult to completely stop communicating. What then should be done, how to protect yourself and the rest of the family from its effects?
- Give up the illusion that he will understand how wrong he is behaving and will correct himself. Even if he has gone through a long stage of therapy, you should not relax. Credit of trust is not at all an option for such a case. Be careful and careful. This means that you should not trust him with your life, finances, and so on.
- Stop blaming and proving him wrong. Maintain your mental balance, because, trying to reach his consciousness, you will simply encounter powerlessness. Which is better to admit right away. More valuable to yourself. No arguments can evoke pity, sympathy or repentance in him. And after the inevitable conflict in such cases, you will find yourself the injured party. Because in addition to defeat, you will appear in his and not only his eyes as a tyrant, hysterical, and so on.
- Showing emotions in the hope of appealing to his sensuality and conscience will also turn out to be a waste of time and effort. Besides, showing your weak, vulnerable places will only please the sociopath. Realizing that he caused pain, suffering and other unpleasant experiences, he will feel satisfaction rather than guilt.
- Threats are also meaningless. They can provoke an attack of aggression, during which you will suffer due to his inability to control himself. In such a game, the dissocial clearly has superiority.
- Give up trying to appeal to his rationality by trying to organize conversations about good and evil, morality and morality. He doesn’t understand such judgments, not because he’s stupid, but because it doesn’t matter.
What to do in case of threats
If you are threatened and you understand that violence is inevitable, be sure to contact law enforcement. There is no point in risking your own life, especially if threats have previously been translated into reality. He has access to weapons, or even just periodically shares delusional obsessions about harming others.
If you feel the influence of a dissocial person, enlist the support of loved ones and go for a consultation with a psychologist. In therapy, you can discover your own boundaries and ways to protect them. Develop a style of behavior that will help maintain integrity and ensure safety.
Diagnostics of DRL
Making a diagnosis is possible only after collecting anamnesis and personal conversation with the patient. During the dialogue, the specialist asks what emotions a person experiences in specific situations. If he says that he does not have positive feelings towards others, that moral standards are an empty phrase for him, there is a reason to carry out further diagnostic measures. They will allow you to confirm the original version. An experienced psychiatrist can easily recognize lies when the patient tries to create an impression of himself as a positive member of society. Disguise will not help him “hide” in front of a specialist.
Treatment
Psychopathy is quite a difficult task for specialists. Those who truly suffer from this disease do not seek help. They are satisfied with the chosen way of life, its perception. They do not believe that they are sick; on the contrary, they think that the people around them are not intelligent and strong enough. Especially compared to them.
Therefore, they become patients mainly not of their own free will. The initiators of treatment are usually representatives of law enforcement agencies. Less commonly, teachers, employers, family members.
They independently turn to psychiatrists and psychotherapists because of feelings of anxiety that arise for no reason. Or, if it seems that life is passing you by, there is no motivation, etc.
The effectiveness of treatment is usually low, due to the fact that they do not know how to establish emotional connections with others, in particular with specialists. They do not trust, are unable to receive or provide support or sympathy.
Self-help groups have a beneficial effect on their change. Only if it is possible to gather a number of people with DID who have recognized the presence of the disease and are trying to cope with it.
Also important is the figure of the leader, who is able to withstand tension, provocations and is able to cope and recognize the manipulations of the participants in a timely manner.
Drug therapy is often used to reduce the symptoms of the disease. The same anxiety, irritability, which leads to rage.
Dissociative amnesia
This is partial or complete memory loss that is associated with a traumatic stressful experience, such as childhood abuse or maltreatment, a car accident, trauma, criminal acts, or suicidal behavior. Thus, the person forgets what he cannot process.
Memory loss refers to memories of events, it does not include abilities and skills. The extent of memory loss may change over time. The person does not know that he has a gap in his memory. This disorder was common during the war due to the extreme stress experienced by soldiers in combat.
To diagnose dissociative amnesia, it is important to exclude an organic brain disorder, intoxication, or excessive fatigue. Unlike dementia, memory is reversible in dissociative amnesia. It is also important to distinguish this disorder from simple feigning amnesia for various reasons.
Dissociative fugue
This disorder is rare and occurs again in response to severe stress, mainly as a result of trauma experienced in war or various disasters. This manifests itself in an emotional attitude towards a place and a constant return to it.
A dissociative fugue can last for several hours or even weeks. During the entire period, this person has amnesia, and he does not remember who he really is. He's pretending to be someone else. In most cases, a person “wakes up” on his own and does not know where he is and why. Travel may occur when epilepsy is diagnosed, but the person shows signs of unusual behavior, such as urinating in public.
Dissociative stupor
Stupor can be described as general rigidity and immobility. A person lacks free movement and reaction to light, noise, and touch. Speech is fragmentary, or he does not speak at all. However, eye movements, posture and breathing indicate that he is conscious. This disorder is more common in women.
To diagnose dissociative stupor, it is important to rule out a physical or mental cause. It is necessary to identify a clear stressful event that affected the person shortly before the disorder occurred, or that the person is still being affected by it. It is important to distinguish dissociative stupor from catatonic stupor, which is preceded by schizophrenic symptoms and behavior. It is also important to distinguish dissociative stupor from depressive and manic stupor, which begins slowly and gradually.
Trance
A trance state can be defined as an altered consciousness that can be compared to a hypnotic state. It is usually caused by a strong emotional experience, often associated with religious rituals and ceremonies (for example, the lata state in Malaysia) or with meditation or holotropic breathwork.
Dissociative trances involve only those states that are unwanted, so the person's goal is not to cause these states through his own efforts. Manifestations include numbness, immobility, crying, screaming, loss of balance, etc. Memory is preserved during the trance; fragmentary amnesia rarely occurs. The trance occurs suddenly and subsides spontaneously. There are no delusions or hallucinations.
State of obsession
A possessed person acts as if he is being controlled by a stranger, a spirit, or a supernatural force. He often engages in sexual or aggressive religious sessions. His movements are limited and repetitive. Amnesia for the entire period of possession.
