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Are clinical “continuums” silly?

The narcissistic continuum?  The psychopathic continuum? The sociopath explained as being someone located at the apex of the narcissistic continuum?

Are clinical continuums silly? Maybe they are.

How “nice” are you? Well, maybe you’re somewhere on a continuum of “niceness.” At the apex, you are a super-nice individual; in the middle, sometimes very nice, sometimes less so; at the nadir, you are just an incredibly “un-nice” (or “mean”) person.

Hmmm. Wow. Somehow this doesn’t seem like a newsflash.

How sloppy are you? Well, couldn’t Robert Hare have developed clinically a “sloppiness” (versus a psychopathic) measure that places all of us somewhere on a “sloppiness” continuum.

With a score of 40, you are an incorrigibly sloppy individual, so sloppy that maybe society needs protection from you; with a score of 1-5, you are seriously, anally “neat,” so pathologically neat that society will DEFINITELY need protection from you.

The rest of us? We fall somewhere in-between, a fact that just doesn’t particularly astonish me.

Okay, I’m being somewhat facetious, but only somewhat. Because really, when you think about it, doesn’t every quality, literally every quality, encompass its own continuum? Aren’t we all, to say it again, on a continuum of EVERY quality there is to possess?

For instance, this article alone probably puts me pretty high up on the “annoying” continuum (and trust me, I can probably find a few others who might put me higher up on that continuum than I’d like to admit.)

Take the “intelligence” continuum—all of us, after all, fall somewhere between “dimwits” and “geniuses.” (If the self-testing IQ manuals mean anything, I fall somewhere on the this continuum beneath the orangutan and the llama.)

So a part of me (just a part) laughs when I hear that “sociopaths” are individuals way up on the narcissistic continuum. I could tell you, I think with some confidence, that “sociopaths” are individuals way up on the “dishonesty/deceptive” continuum. Or that sociopaths are seriously lagging on the “empathy/compassion” continuum. I think that would also be true.

We know that Al Gore invented the Internet. That places Al pretty high up on the “delusional” continuum. And Nancy Grace pretty much invented herself, which places her very high up on the “self-invention” continuum.

I’m going to bed soon, because I’m very tired; that must mean, at the moment, I’m way up on the “exhaustion” continuum.

Where are you on all of life’s hundreds of continuums?

To be “continuumed” in a future article.

(This article is copyrighted © 2012 by Steve Becker, LCSW.) 

Posted in: Steve Becker, LCSW

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37 Comments on "Are clinical “continuums” silly?"

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This reminds me of my parents using Reader’s Digest-type books to determine their ailments. Although they weren’t that bad, they could point to all sorts of conditions that existed.

It seemed so ludicrous to me because a body is a body with its various parts. Of course an ailment is going to affect something. Of course there are going to be things in common.

What can cause a person to have problems with their blood? Lots of things.

What can cause a person to have problems with their bones? Lots of things.

The liver is affected or the skin is affected and so it went.

Symptoms can also apply to many things – what causes problems with one’s sleep, vision, or energy? Lots of things.

Finding one thing that applies to a symptom does not a disgnosis make.

As for continuums, aren’t they more like bell-shaped curves and don’t these bell-shaped curves intersect?

I envision them as a 3D bell-shaped curve. Make a narrow slice one way, and you’ve got X. Make a narrow slice in a different direction, then you have Y, but because you’re slicing across the whole 3D shape, you will include some of the other things.

I prefer “spectrum” to “continuum” because knowing what I do about the color spectrum, it’s actually more like a 3D somewhat flattened sphere (ovoid) due to the limitations of the human eye. Color is entirely a subjective experience.

There are even different systems for measuring color.

One has three axes designated at L*a*b* or “L.a.b.s” for short. The top end of the vertical (L) gives you pure white. Move down vertically and you approach perfect black.

The center point where all three axes intersect is perfect gray.

Move anywhere in this ovoid and you’ll get various hues and shades with differences in intensity of saturations (tints.)

So, you could have a deep salmon pink or a light salmon orange.

The link below gives a visual of that.

http://www.docstoc.com/docs/1006629/LAB-COLOR-SCALE-CHART

When it comes to viewing color, lots of effort goes into viewing the color correctly…

1.) the background shade (a scientifically determined gray that needs to be renewed and refreshed periodically because it will subtly change with the environment,)
2.) the angle of the viewing board
3.) the ability of the viewer (there are stringent tests for testing color vision – and it isn’t the little book of circle and numbers that you may have encountered to test color blindness at some point in your life.)
4.) the length of time viewing the color – the rods and the cones in a person’s eyes react chemically and one’s perception of a color changes within seconds
5.) the substrate on which the color is presented
6.) the light spectrum under which the color is viewed, which is why when you buy something in a store, i.e., store lighting, it looks different when you get it outside, i.e., in the sun or at night with no sun, or in your home, i.e., incandescent or other types of bulbs.
7.) even the temperature and humidity of the room and the items very viewed impacts the results.

For the record, there is no such thing as “color memory.” You cannot remember a color. Take that swatch with you when you want to match something.

In an effort to take away the subjective factors, specialized computers were developed to “read” color, but even they have shortcomings. For instance, the human eye can see differences that the computer’s reader cannot.

There are mathematical formulas for determining color. If you really want to know what they are, check out the link below.

http://www.hunterlab.com/appnotes/an07_96a.pdf

I won’t touch what can happen with these machines that can impact their ability to read color. I will say that the very expensive models get calibrated with specialized, calibrated tiles of certain controlled colors-oh, never mind.

In the end, despite much effort to pin down a color as being a certain color, there are too many variables to say definitively.

However, they can get an excellent approximation.

And this is how I view these psychology scales.

In the end, they are subjective, there are many biases involved, people change according to their circumstances and the enironment, and there are so many other things possible of what could be presenting.

However, they also tend to be pretty good approximations.

Hmmm, there’s also the Masters and Johnson continuum! Personally, I have no argument with continuums, as long as they aren’t arbitrary, which you seem to imply here. I like continuums bc they have degrees of difference and the norm in the middle. That’s a better measure of things than those other psych tests that want you to answer to levels of ‘agreement”: a) likely b)more than likely c)the most likely that I have EVER agreed to anything in my whole life…
I think that’s the MMPI. I took it one time and the results had absolutely never even a hint of truth about my life, even factually.
The MMPI (Minn Multi-phasic Personality Inventory) test estimated that I’d never pass high-school (I graduated Grad school), nor would I likely have any friends!

Frontporchtalker – Glad to see you back!

About the continuum – this actually is the problem with the Hare PCL-R – The score at which someone becomes “a psychopath” seems totally arbitrary. Why does someone need a score of 30 to be a psychopath? Apparently a non-disordered person will score somewhere between 0-5. So if you have a score of 20, what are you? I wouldn’t want to be married to someone with score of 20, although maybe I was, since I never tried to rate my ex. Maybe I will – that will be an interesting exercise.

A problem with continuums is that the professionals don’t explain the nuances.

Your points are excellent, Donna, but I have never seen them addressed anywhere.

Sometimes I feel we are dealing with an archaic system of mental health professionals with god-like insights who, because of their degrees and titles, have some sort of mystical knowledge regarding “the continuums.”

It would make for a great movie title…

Now showing! The Continuum. Be mystified. Be confused. Sit in awe as others discern what is happening right before your eyes.

Oxy was right. Why do we need a diagnosis when we know that it hurts and is causing damage?

With my daughters health trials over the last two years – Scoliosis surgery and plates and screws for a broken ankle – I have watched doctors and nurses ask her to rate her pain on a scale of one to ten.

I always thought to myself – what good does that do ? Is 0 not too bad and 10 is mind bending – or does she need to say a 20 to let them know she was out of her mind with pain? Morphine wasn’t even touching it !!!

All you had to do was look at her during both events and by the tears in your own eyes you knew she was suffering intensely.

So when the N/S needs to be “rated ” – what’s important?

He ignores me but he doesn’t beat me

He cheats on me but comes home to me every day

I don’t really feel like he loves me- but he says he does

He doesn’t mean to waste our finances- just had bad ideas

Just this week my EX-NH went to his mother’s funeral without my daughter because she cannot stand his Skank G/F. My son tolerates her for the sake of seeing his dad.

It has been 5 days of pure agony for me watching my daughter be hurt. I tried talking N into splitting the two days of wake and funeral into one where Skank went and the other to be with his children. Didn’t happen – he wouldn’t hear of it.

I even left Skank a message that my daughter would not go if she went and how could a mother, woman hurt another child like this – inserting herself knowing it would hurt my child.

No – I didn’t expect her to react as a class act, back off and tell N to be with his kids – of course I didn’t. I just felt I needed to defend my child’s place in her own family.

So – Jerry Springer should have been there to film it all :

Wife #1 showed up with her daughter by her 2nd husband (I have no idea when she started talking to N again – never did the 22 years we were together) . And her two kids by N were there

Wife # 2 – ME – was not there – I took my daughter to the wake but sat in a parking lot down the street to avoid the circus.
So our 2 children were there together for an hour

Skank girlfriend was there …………

So what went on in N’s mind ? Perhaps – “Isn’t this wonderful how my life has come together. Ex 1 is here – and our 2 kids – ex 2 not here but who cares – my kids are here – Skank is here with her family and friends – all is good ”

And then the funeral day – my daughter could not go because the day required too much interaction – mass, the drive to the cemetary, repass meal – all with Skank next to her – she wanted no part of it.

I’ll bet NO ONE had the nerve to ask where she was . If they did – N likely answred – Oh – she is graduating this year and couldn’t miss school.

So how do we rate him – those of you who know my past – and even rate her ? What does it mean – there is devastation and disregard all over our lives .

Hi Donna! I missed all of you….

And, this is such an interesting conversation about Hare’s PCL-R, which I heard about on the news.

But, I want to also say this first, because I just can’t help myself! It’s not the size of the bell-curve that matters, but what you do with it!
When I was a student-teacher in Grad school, the university REQUIRED that we fail a certain percentage of students in Freshman English. The one exception being valuable football players. Thus, the Bell-curve was a 3-D slicing MRI: So many A’s, B’s, C’s (mostly), and so on. It was cut in stone.

Then, when I taught at the little Art’s College “that could,’
I used the Bell-curve, more-or-less to check my own bias when it came to grades. Of course, at the little Arts’ college where I taught for too many years the other prof’s gave mostly A’s and B’s.
The grade inflation was a way of life. It turned out to be my undoing, too. When a new provost arrived one day, she applied the “Antioch” model, which meant that those of us who taught courses that were too “hard” were forced out eventually. Oh well, 17 yrs with the Bell Curve. Interesting thoughts, G1S.

As long as I’m not being graded here, I am allowed to skip-around, right (as is my natural southern storyteller way)?

I heard the story about Hare’s PCL-R test, which measures psychopathology/sociopathy on a scale. The story was about an inmate who’d been denied parole, based upon his PCL-R scores. In an interview, Hare said that this test was never meant to be applied as a basis for parole.

Donna, could you explain a few more details about the PCL-R point system?

I was talking with a friend of mine, who is a psychologist. That’s her job–to give tests to inmates to determine whether or not they are “fit” to return to society. When I asked her about it she said: “Tests are used to give a snap-shot of that person….measured by similar responses of other psychopaths/sociopaths…”
Actually, it’s being used as a ‘means test’ for the state to cover its butt!
Here’s my problem with psych and neuropsych testing: are the tests really accurate in determining who will re-offend?
A female sociopath who took everything I had–and then some, used to brag that she scored like a ‘Nebraska housewife’ on the MMPI (also a personality test)…NORMAL.

Apparently, her charming, manipulative persona has worked well for her and her sociopathic cohorts. She is still using my identity, still commiting crimes. Her cohort, Diana, who served time for Identity theft, embezzelment, etc. charmed her way past the parole board.

Sorry, an aside here:
I know this is off-topic, but it turns out that bc Diana was a one-time ‘drug informant,’ she is now given free reign, by the police dept’s, to keep committing crimes. I guess it’s an unwritten law that the F.B.I. and police don’t prosecute ‘drug informants’ for later crimes…
True sociopaths are far beyond all PCL-R scores and Bell-curves! My psychologist friend says that often, while giving the PCL-R test for sociopathy/psychopathy, a true sociopath will scan the room for clues on how to manipulate her.

Here’s the part where I connect the dots (also the name of my novel, Dot-to-Dot) of Bell-curves and PCL-R (et al) psych tests: again, it’s not how high or how low you score, but how it’s used!

By definition, sociopaths/psychopaths are people without a conscience. Their brain waves don’t register on the morality/emotional scale. Their metier is manipulation!

(what does the new DSM-V call sociopaths/psychopaths these days—“morally-challenged?”)

Phew! I’m just hoping that some of that made sense!

P.S. Donna, would you mind if I put my Frontporchtalker essay back on this site? If you recall, it is a parody of ‘reality shows’ and the sociopaths who manipulate them called: “Desperate Meth-Lab Operators of Spokane County.”

Hi NewLife,
I was intrigued by your post also. I want to reread it, again and again…
There’s also the famous “Beck Test,” which supposedly measures depression. It goes something like this: How many days or weeks do you think about committing suicide? dah.

I don’t think the 30 is chosen arbitrarily… I think the 30 score represents the 1% percentile of the amoral-callous-selfish continuum, just like the IQ of 100 represents the 50% and the 130 IQ the 2.5%. Maybe the +20 score on Hare’s list makes for the 4% of psychopathic of the population?

What are you really annoyed about?

one/joy_step_at_a_time

…and then there is the Breck test…how many days a week do you need to shampoo to have bouncy, shiny hair.

I dunno, let’s ask EB, she has bouncy hair..

one/joy_step_at_a_time

LOL hens – i thought of her the moment i wrote it!

one/joy_step_at_a_time

hens, you ever break a toe?

no?

i know a few toes i would LIKE to break though…hehehehehe

slowly…..one at a time….

well I was waiting on a joke?…onestep did you break your toe?

one/joy_step_at_a_time

dupey – hehe.

hens, sorry no joke, and it was late so i had to go to bed. broke baby my toe about 4 weeks ago. All the bruising is down, but it’s still swollen and painful. just wanted to ask how long it took to heal. probably being impatient. doc had said it depended on how bad the fracture is.

Steve, I’m not sure in what vein you are aiming this article…while I agree with most of your articles there are some that give me a WTF? feeling and this is one of them. LOL Since I kind of seem at least to myself to sort of harp on the fact that I think that psychopaths/narcissists etc are on a continuum not just an “either/or” or “Is/ain’t” I kind of wondered if you might be laughing at me about it. LOL (I’m not offended, in fact, if that’s the case, then I’m feeling rather complimented!)

Of course everything can be rated on a continuum…and where are the arbritrary cut off points for things. 30+ a Psychopath, but 29 isn’t a psychopath. You can execute a man with an IQ of 76, but a man with an IQ of 75 is RETARDED and can’t be executed.

And what’s the difference in scores on IQ? How much difference does 1 point make? Well actually not a “tinker’s dam” (not very much) yet the decision to call someone MR and someone NOT MR has to be set at SOME POINT.

I’m 5’5″ but no one would call me TALL and actually for a while female I am about AVERAGE. (we will talk ONLY about height not weight now!) In the San people in Africa, I would be considered VERY TALL. In the Watusi I would be quite short.

I’ve heard it said that all narcissists are not psychopaths, but all psychopaths are narcissists….although my expereince has been that even among psychopaths some are more narcissistic than others. At least in my opinion.

Keith Kiehl said the AVERAGE PCL-R score for ALL convicts is 22. WOW! I’m like donna, I wouldn’t want to be married to an AVERAGE ex con. If you consider that there are about 2 million CURRENT inmates, 5 more million on parole, probation or whatever kind of supervision, then that’s a lot of folks with a scre of 22 ON AVERAGE….and then if you consider the ones that are OFF PAROLE, PROBATION ETC. and they as a group also have an average score of 22, that’s a bunch of badddddd actors in our society. Just in people who have been arrested and convicted of crimes. We know there are also lots of ones who have never been caught or convicted for crimes, too.

There isn’t any score on any test for me that is going to say good/bad person, and I’m like front porch talker, I don’t have much faith in the MMPI to assess what kind of person I am.

For me, the tests for people I want in my life, that I want to do business with, that I want to associate with, and that I want as my friends, is a basic test of honesty, compassion, empathy, kindness, and reciprocity. Anyone who fails any component of that test fails completely as far as I’m concerned.

Thanks for a chuckle, Steve. I needed one today!

……… you guys crack me up! You only have Bouncy hair on the days you wash your hair. UNLESS…..you use the WEN products, then you can have bouncy hair on day 2!
So what contiuum does that leave us on?

Nothing in life is black and white…..that IS what we all need to keep in mind. Toxic is toxic even if it’s just a ‘little bit’ toxic.

Hope your all well…….and know you’re in my thoughts.

Ebers…I miss ya.
Onesteprs…Sorry about baby your toe.
Oxers..your tall and above average in my book.

Hens, darling, I am actually the exact weight I should be, I am just a foot too short for my weight! LOL So I am back on my NUTRITIONAL PLAN (don’t say diet!) and back to walking and increasing exercise as my condition tolerates. Got another appointment with foot/ankle specialist doctor (doing the new dance “the doctor trot”—trotting from doctor to doctor! LOL) I cracked my internist up she hadn’t heard that one! I can’t believe she hadn’t heard it but I got to be the first to tell her!

I knew a doc that would write TAT at the top of some of his charts back when we hand wrote charts and it wasn’t an abreviation I knew and I asked him what it meant, he said “tired all the time” LOL That’s me lately since I”m deconditioned, but gonna get back in shape! May have to walk at 2 a.m. to avoid the heat but if that’s what it takes! Or go to Wal Mart and walk in the AC.

one/joy_step_at_a_time

so, on the bouncy hair continuum, eb sounds a bit….limp.

she needs to try Prell

hahahahahaha
i almost forgot Prell….

😛

Yea, Prell is good….and so is the equate generic brand….if I could just quit breakiing out in a hair wetting sweat with the least bit of exertion….God I am so tired of being SICK!!!!! Tired of being WEAK! Tired of watching DVDs over and over….tired of not getting things done that are time critical.

At least This is LIFE not psychopathic attack….I think I’ll go take a shower and get some bouncy hair on, maybe that will make me feel better. LOL

And yes, I’m whining…but I’m ENTITLED to whine cause it is just LIFE! AND I WANNA WHINE…CHEESE AND WHINE ANYONE? At least I’ll have bouncy hair for a little while.

🙂 Ox —-> let me know how the Prell works.
Yes, I am tired of all this too…just really tired of it…but I won’t give the psychopath the pleasure of me ending my life…nope…

I understand you because I don’t feel well either, Ox.
Right, at least this life is NOT a psychopathic attack or continued involvement with “IT” and all “ITS” ugliness.

You are entitled to whine, just like I have been.
Yes, I would like some cheese with my whine, please….
Say around six’ish??? 😛

xxoo Dupey

Yea, meet you at 6:00 for cheese and whine, …oops, c an’t have the cheese, it is too salty…how about Ezekiel Bread (NO sodium) sold at Kroger and is pretty good…only available around here frozen and $4 a loaf, but is great actually.

I just did a cholesterol killer breakfast this afternoon, though, french toast with duck eggs, half and half, fried in real butter and with REAL maple syrup (not that shiat you get at the store) and no sodium….won’t do that very often but once in a while as a treat is good for us all. It was a day I needed something special and I did it for me. For my son D who needed something special. But that’s lunch and supper for today Tomorrow is back to the low fat meat, skim milk, and no salt spices. Enjoy!

Ox,
Why dont you live life on the edge and turn your thermostat down to at least 80 degrees, mine is on 72. Hey you cant take all that money with ya so mite as well be comfy and cool.
I was sick the past few months and it feels so good to feel good. Again. So I relate with tired of being sick and tired, hope you get better soon. And yap being sick is not as bad as being under the spell of a sicko.

I am a half hour late for whine and cheese, Ox…oops…sorry about mentioning the cheese, I cut it out of my life too. Never did care for it much, actually…

Yum: your breakfast sounds so wonderful!
Makes me so jealous just hearing about it.

Have a nice night, Ox…

Dupey

hens: i live life on the edge every time i drink a glass of milk. Every time I eat a french fry or some other awful fast food. Bluck!

I am so happy you are feeling better, Henry.
You are definitely right about that: being sick is not as bad as being under that horrid toxic spell of a ‘sick-o’.

(((hugs hens)))

Dupey

I too prefer spectrum vs. continuum. I’ve given up at this point. As far as I’m concerned, a Cluster B PD is a no go. I’ve racked my brains re: is he an N, a milignant N, a psychopath and so I just say Cluster B.

I’d like to make a comment on how much I hate holidays. They just remind me of all the holidays I spent alone with the Cluster B in my life without so much as a phone call. And then they make me kick myself for wasting so much time. So I guess my stupidity is somewhere on a continuum or it’s a spectrum disorder on my part.

kathy – I prefer saying I was ignorant, I didnt know what was going on. But thanks to my Life Lesson I am only stupid if I allow it to happen to me again. Some holidays are ruff with or without the spath involment. It really isnt that important if we diagnose them as a this or that, whats important is we educate ourselves about personality disorders in general. And learn how to set boundaries and be aware of user’s and jerks.

users, jerks, psychopaths and sociopaths…

THEY are the ignorant ones.
You are right, though, hens: our ‘lesson’ has shown us to never be stupid by allowing it to ever happen again. No holidays are ruff without the spath, around here. In fact, they are more peaceful.

Boundaries are like the most important thing we can do for ourselves.

Yah, I am still here, posting over and over again, hens, in a state of shock…don’t really know why…

Yea, Hens I turned on the ac today…it was 97+ out side. I did get my first ripe tomato yesterday, over a month earlier than usual. The grasshoppers have eaten all my potted plants and the ground is parched dry. If we don’t get rain soon, it will be a total DISASTER! Pastures are parched and eaten to the ground. They could have baled the hay directly behind the mower it was so dry. Humidity is low though so that’s good I guess for how it “feels” but not good for the plants and soil. Just dries it out faster.

Watering every day, even my trees are suffering already.

I killed the 3 drakes, gonna make some salt free gumbo. the 3 hens are still laying 3 eggs a day…son D has high cholesterol we found out, so he is on meds for that now so I will have to quit making him eat 2-3 eggs a day! LOL

I’m feeling better, but not up to much work, but did accomplish a bit today. Glad you are feeling better. You are right bein sick sucks, but not as bad as being with a sicko.

Ox. We have had a really wet spring, it’s raining now. As compared to last spring and summer it has really been nice.

Dupey…You have to find your way through this. I know it’s hard and you have to deal with his stalking and harassing. I hope you can find some peace of mind soon.

I think there are continuums.

I don’t think so.

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