I write this column (using “he” throughout, for simplicity purposes) to suggest some useful ideas for vetting a prospective provider who does not come recommended through a reliable source (or through Donna Anderson’s growing new LoveFraud referral base).
How can you begin to assess a relatively unknown provider for his competence to address your experiences with a suspected sociopath specifically, exploiter in general, or otherwise personality-disturbed individual?
Let me start by suggesting that a provider who claims to be educated about sociopathy really isn’t if he lacks an equally fluent understanding of narcissistic and borderline personality disorder.
The reason I say this is that, under certain circumstances, all three disorders can look very much alike; but more importantly, if you are involved with someone who has any one of these disorders, you are at heightened risk of being personally violated and abused.
So, while they are distinct from each other (although common elements of narcissism and sociopathy remain intriguing), I’m suggesting that all three disorders greatly increase the probable, if not certain, occurrence of interpersonal violation.
In the course of this discussion, I’m going to assume that you may be involved with someone (or have been involved with someone) whom you suspect (or know) to be, for instance, sociopathic and/or abusive? Otherwise you wouldn’t be seeking assurances that a particular provider has knowledge and/or expertise of the disorder(s) in question.
I also make the assumption that LoveFraud members or visitors wanting to find a knowledgeable resource on sociopathy (who do not find assistance through Donna’s new referral resource) come with a nice advantage—by virtue of their involvement with LoveFraud, they are already extra knowledgeable on the subject. This equips them to be astute evaluators of a prospective resource.
So let’s get down to business.
You will need, no surprise, to ask questions; questions that can gauge the provider’s competency to appreciate the gravity of a situation in which a sociopathic (or some other exploitative dynamic) is, or has been, present.
And you will want good, expressive answers to your questions, not dismissive ones.
The first, vital task is to assess the provider’s receptivity to your interest in his clinical experience. This point needs emphasis: You are entitled to evaluate the provider’s clinical experience and expertise as it pertains to your circumstances.
I stress: You are completely, utterly entitled to assess the provider’s professional experience, skills, and interest on matters relevant to your personal circumstances and self-interest.
Remember, this is not about protecting the provider; it’s about protecting yourself.
As such, this speaks to a bigger issue: You are setting yourself up if you do not protect yourself, and so you protect yourself by owning your right to a completely respectful, receptive invitation to evaluate the provider’s scope of interest and competence with a given client population, or in a particular clinical area. Anything less than a genuine, undefensive invitation from the provider to proceed with your questions should immediately disqualify him from consideration.
So for instance, you might begin with something like, “You know, it’s very important to me, given my circumstances, to be working with someone I can feel confident has a really good knowledge of _________. Would you mind if I asked you several questions along those lines, for my own personal comfort?” (There are many ways to break the ice, this is just one example.)
Remember: A provider who fails, at this point, to invite you to proceed, undefensively, has disqualified himself. Thus, if he responds impatiently, arrogantly, angrily, curtly, condescendingly, as if offended or put-off, or in any other way inadequately, he is wrong for you. You must move on, because you deserve better.
Assuming you’ve gotten the proper encouragement to proceed, I offer below a list of questions (hardly comprehensive) which, depending on your circumstances, can elicit meaningful information. The idea (quite obviously) isn’t to ask all of these questions, but to pursue several that are most applicable to your situation.
This list is by no means complete; rather, it’s at best a starting point, if only to get your own wheels rolling to come up with even better questions! Note that some of the questions probe for knowledge, others for personal views and biases, and others for experience. The asterisked questions can sometimes elicit responses that will enable you to quickly eliminate potential resources.
· How familiar are you with sociopathy?
· How familiar are you with psychopathy?
· Do you distinguish sociopathy and psychopathy, or are we using these terms to mean the same thing?
· Do you distinguish antisocial personality disorder from sociopathy or psychopathy?
· How many cases have you worked involving sociopathy?
· Can I ask how you came to work with these individuals?
· What is your treatment philosophy regarding sociopathically disturbed individuals?
· I’m curious how you view sociopathy? I know that many people have different ideas about sociopaths. Can you tell me your view of what characterizes the sociopath?
· How do you distinguish, if at all, the sociopath from the narcissistic personality?
· What’s been your experience working with borderline personality disturbance?
· In your experience, what are similarities and differences between borderline, narcissistic and sociopathically disordered individuals?
· How much experience have you had working with abusive individuals?
· Can you tell me a little about the history of your interest, and experience working, with abusive personalities?
· *How effective and appropriate, in your experience, are anger management referrals for abusive personalities?
· How much interest, and experience, have you had working with victims of abuse?
· What is your view of what constitutes abuse in a relationship?
· What are your goals in working with someone who is in, or has been damaged by, an abusive relationship?
· *Are there circumstances where someone might be driven, legitimately, to abuse someone else?
· Do you mind if I ask you whose work or writings on abusive relationships and abusive personalities has most influenced your views?
· Do you mind if I ask you whose work on the subject of psychopathy (or sociopathy) has most influenced your ideas?
· *Are you familiar with Robert Hare’s work?
· *Have you successfully treated sociopaths?
· My partner, if you meet him, will tell you that I’m a sociopath”¦how will you know which of us, if either, is the sociopath?
· Are you familiar with any psychological instruments that assess for psychopathy, and if so, do you use them?
· *Under what conditions, if any, would you be hesitant to do couples therapy?
· What goals do you have, generally, when working with a borderline personality?
· What goals do you have, generally, when working with a narcissistic personality?
· What is your understanding of the central feature(s) of sociopathy?
· What is your understanding of the central feature(s) of the narcissist?
· Would you be willing to read something I’d give you if I felt it could help you understand the precidament/situation/personality I’m dealing with?
· When you believe you are dealing clinically with a sociopathic individual, what is your clinical goal?
The answers to your questions
As I’ve strongly suggested, the provider’s responses, first of all, should convey interest in, and respect for, your questions. Your first assessment, then, is less of the provider’s expertise and knowledge, than his or her attitude to your questions.
As a matter of fact, a primary purpose of your questions is to assess the attitude of the provider. In other words, if the provider isn’t temperamentally suited to appreciate the complexity of your concerns, he or she can have all the knowledge in the world and be pretty much worthless.
You’ll want honest answers. Genuine answers. Not pretenses to expertise where there isn’t any. You’ll want a provider who is willing to say, “That’s an interesting question. I might even need to think about that a bit more.”
I offer randomly some rough examples (from countless possibilities) of what might be deemed encouraging responses to some of these questions:
“To be honest, no”¦I haven’t worked with what I’d call a high volume of ________; but I do feel comfortable with my understanding of this clinical issue, and I’d like to be of help to you.”
“I consider myself to be clinically literate on this subject, but I’m happy to become even more enlightened and would welcome anything you have to share with me to get me up to speed.”
“I wouldn’t say that I have a particular interest working with _______, but I do like working with and helping those who have been victimized by ________(s).”
“I suppose I’d regard ______as a very central feature of _______. Also ______.”
“I don’t really make a distinction between antisocial personality and the sociopath? As a matter of fact, I wasn’t even aware of such a distinction? But I’m curious about that? Am I missing something?”
“I’ve worked a great deal with victims of abuse and enjoy working with this client population.”
“I’m not familiar with that issue, to be honest” (depending on the circumstances, this doesn’t necessarily have to be a disqualification).
“I can’t say that I’ve had great success working with narcissistic personalities”¦but I’ll work with anyone who voluntarily seeks my help genuinely.”
“I’m not sure if I satisfied you with my response?”
These hypothetical replies have in common a thoughtful, humble, curious quality. The confident provider will feel relaxed, undefensive, and unpressured to produce brilliant, comprehensive answers beyond his or her scope of expertise.
At the same time, you are looking for evidence of expertise that will leave you feeling comfortable that this is someone who can effectively, sensitively advocate for your interests.
Some responses, as noted, can quickly reveal a provider’s serious limitations.
For instance, the response to the question, Have you successfully treated any sociopaths?, “Yes”¦I’ve worked with many sociopaths and treated several very successfully,” is a great time-saver. You just say, “Thanks very much, I’ve really appreciated your time,” and then have a good laugh on your way out.
That’s because true sociopathy, as the LoveFraud community well knows, is a refractory
condition, unamenable to meaningful modification.
Regarding the Hare question: in cases where a provider claims to be experienced with the subject of sociopathy, I might find it dubious (although not necessarily instantly disqualifying) that he or she would have no knowledge of Robert Hare, who is such a notable figure in psychopathy research.
Similarly, the response to the question, Under what conditions would you be hesitant to do couples therapy?, “Umm”¦.I can’t really think of any?,” would suggest a potentially serious defect in the provider’s clinical knowledge and/or judgement. That’s because couples therapy is ill-advised under several circumstances, among them when serious abuse is occuring in a relationship, or when one or both partners is sociopathically oriented. (And naturally, non-genuine motivation to work on the relationship would be another contraindication.)
Further, a provider who suggests that, yes, a referral for anger management is probably the best intervention you can offer an abusive personality betrays a likely ignorance of the dynamics of the abuser, who has much more than merely an anger problem.
And it’s self-evident that a provider who can find a basis to justify abuse under any circumstance is probably confusing abuse with, perhaps, self-defense—a failure of understanding that ought to send you running for the hills.
Bear in mind there is no one right way to answer many of these questions; in many cases, there are multiple good (and good-enough) answers which also allow for differences in clinical approaches and orientations.
I offer below additional examples (also random, hypothetical) of the kinds of responses that might reflect a reassuring level of clinical expertise:
“What do I see as the central feature of sociopathy? I see the sociopath as someone who is extremely, chronically manipulative and deceptive. Someone who lacks empathy in a very gross way for the victims of his or her exploitation.”
“I see what you mean”¦.you can have a borderline personality disorder doing something, say, really vengeful that might look very sociopathic, but the motive for the aggression would be different. The borderline personality might be motivated by rage, panic, or desperation over, say, abandonment issues, whereas the sociopath? He or she may be movitated by”¦the impulse?”¦pure greed”¦or even the fun of it?”
“If I have good reason to believe I’m dealing with a sociopath, my main goal becomes evaluating his or her risk to others”¦depending, of course, on the circumstances of the referral and case.”
“If I’m working with someone with borderline personality, I’m looking to help that individual, among other things, learn how to better regulate his or her emotions, which may be very dysregulated and for that reason a source of much distress.”
“If I’m working with a narcissistic personality disorder, I’m looking, over time, to help that individual, if possible, examine his demands and expectations of others—his inflated sense of entitlement—more thoughtfully; and also examine the ways that he routinely handles, or mishandles, his disappointment in others.”
“When I’m working with abusive individuals my goal is to confront their excuses and rationalizations for their violating behaviors.”
“When I’m working with victims of abuse I may have several goals, including safety concerns; also exploring how the client finds herself in an abusive relationship, and the factors that make it difficult for her (or him) to leave that relationship.”
“How will I know which of you is the sociopath? I think in any clinical situation, you rely on a number of factors in formulating possible diagnoses, including your instincts, your experience of the individuals, the client’s history (as furnished by the client and others), other relevant, available, supporting documentation; and any adjunctive testing and evaluations that can narrow down, if necessary, a suspected diagnosis more accurately? And so there’s no guarantee that I’ll get it right, but I’m pretty confident of my chances.”
In sum, you’ll want assurances that the provider, at a minimum, can recognize the central aspects of sociopathy (or the disorder in question); he or she should appreciate the futility of pursuing treatment with the sociopath, especially in a private practice setting; but most importantly, the provider should be able to convey a good clinical grasp of, and history of work with, abusive personalities and their victims.
You will know, intuitively, whether the provider’s responses indicate an adequate level of thoughtfulness and knowledge.
And remember, your initial assessment doesn’t end when you choose to begin a working relationship with a particular provider, anymore than you cease evaluating the individual with whom you enter a personal relationship. Your evaluation should be ongoing, and your continued investment in the relationship, whether with a professional resource, or intimate partner, should be based on a continuing evaluation of him or her as worthy of your time and trust.
You can say at any point along the way, This person is not right for me. Just because I sized this person/provider up initially (with necessarily incomplete information) as worth my initial investment, doesn’t mean I can’t modify my assessment of him or her at any time, thanks to my making good use of additional, more complete information!
I hope this offers some guidance for conceptualizing an approach to the evaluation of a relatively unknown prospective provider. I am glad to continue this discussion based on feedback.
(This article is copyrighted (c) 2009 by Steve Becker, LCSW.)
KH I also did not receive any professional help. But the reason I didn’t was because I was born to and raised by a psychopath. Once I became an adult I broke off contact with my mother. I found very few people, professionals or lay persons, who understood psychopaths and none that were willing to admit that a mother/woman could be a psychopath.
My work with domestic violence and then working in a maximum security prison with high risk inmates (mainly sex offenders) as well as working with survivors is where I got not only my own experience but experience in seeing just how different psychopaths are from your everyday criminal.
My work with sex offenders and survivors (especially clergy sexual abuse) also educated me to the fact that “safe” is often a comforting delusion I tell to myself. I had quite a few offenders comment on their favorite place and group of people to “prey” upon. And that place was at church/church schools, sunday schools, church camps, etc. Places that I had thought of as pretty safe.
This breaking of the trust, the shattering of the illusion of safety is something that I have found to have impacted some people very deeply.
I should say I did not receive any professional help in dealing with the psychopath in my life. I did receive help as a child for ADHD (of course it was not called that way back then) but even that stopped as I became a teen.
BloggerT,
You have quite a story. It makes me wonder about another thing: how many of us come from abusive backgrounds. Given what we’re reading, the percentage seems high.
You must have been trained in facilitative techniques to do that work. Me too. I’m certified in NLP and some lesser known approaches, have been through AA second-hand, went through a major study of codependency a couple of decades ago, and have been through three multi-year rounds of therapy. All of it played into my approach toward this.
On another thread someone wrote about obsessing on her S for a year, and then focusing on taking care of herself. That’s fast work, compared to me.
Blogger, it sounds like you work in a tough arena. I have a friend who worked with incent perpetrators for quite a while. I’ve sat in on one of these sessions (not hers) when I was researching an article. The facilitator was really confrontational. I could see he had to be to get through the denial, but it’s got to be hard work.
Most of us find ourselves “getting real” about the existance of bad people in our healing. It sounds like you’ve pretty much had that covered. Do you feel like you gained anything in getting over your S?
KH, your journey resonates.
I hadn’t written a journal in years, but started it again, just to keep track of things. Would go back a year, and see I was going through the same stuff a year later. The relationship was stuck in a loop that I couldnt break.
I knew I was not coping. I felt so desperate at times. And I mean DESPERATE.
I tried all sorts of things. I knew that I was way out of my depth, and needed to get a handle on things, but also felt overwhelmed.
It was the casual, almost dismissive, reaction of my psychologist friends that let me know that therapy would probably be more insulting than beneficial.
I read relationship books by the dozen. The first was ‘He’s just not that into you” ! I can laugh about that now !
I am a rather conservative person, but the agony of this anti-relationship led me to explore magick too. I even went for an ‘aura cleansing’.
I’d say it took me about 2 years of research and self-growth (at a hectic pace) before I had a proper grip on what was happening, and how it was happening. It took about another year of asserting my insights, and enforcing my new boundaries, before I felt whole again.
I used dreams. Art. Constant reading. I talked about it less and less to my friends, and I think they think I just moved on. I hadnt, but I would rather not talk about it than feel judged.
It has really been an all consuming task for over three years. It has dominated my life. I have really felt that I am dealing with a life threatening emergency, and everything else can wait.
KH – I think that I gained a few things from it. My mother tried to co-opt me as a young child and because of it I think I got an education in how to deal with manipulative people and how to spot them as well. I also think I gained something that I think spared me some of the pain and shock others have expressed. I learned very early on that the saying of don’t judge a book by its cover is so true. I also found that safety is often an illusion and the assumptions that people make about others can be very wrong. And yes growing up like this made me realize that anyone can be a “bad” person and those people are often the ones that appear to be “good”.
Sadly therapy is not always helpful for some folks and for some they are just not ready to hear the messages about their partner. I have had some be very receptive to hearing the message while I have had others become angry at hearing it. Another thing I have seen all to often is some who generalize and compare their experience to others and use this thinking to beat themselves up more.
I have also learned that every psychopath I have ever interacted with may have some things in common with other psychopaths but they are also unique unto themselves (along the lines of signature as a profiler would call it) and so are the survivors.
Grant,
I thought I was alone, and maybe crazy to be doing what I was doing. Hearing that you did the same thing, and that you talk about it in the same way … I don’t know, it’s a really interesting piece of information.
I’ve probably been hearing this all along, but I was so stuck in my idea that I’d invented some wheel, that I wasn’t grasping it. Have we all done something like the same thing — been in so much pain that we partially withdrew from life to get over it, went through a massive reevaluation and growth process, and come out of it changed? Stronger and more independent, but maybe a little regretful about lost innocence and trust.
As I write this, I think that maybe this is just a description of any healing process after a trauma. And maybe my perspective is skewed by being on this site, where so many people are successfully going through it. I know that people always don’t go through this kind of trauma processing successfully, or maybe not as completely.
I know that I haven’t in the past. I’ve stumbled through a couple of things, like the death of my husband when I was younger and basically resolved that. But there were other things affecting my life that I never really got beyond superficial philosophizing and submerged anger.
I used this experience with the sociopath to process through a lot of old trauma stuff that was warping my perceptions and my emotional life. It was like a big whack on the side of the head, telling me it was time to recover.
I think you used it the same way. I think there is evidence here that other people used it like that. Maybe it’s just built into the recovery process for those of us who have older, underlying abuse issues. Or maybe people like that are more likely to be unprotected when it comes to dealing with sociopaths. And in processing this experience, we come to face how that history relates to this experience, and do it all at one fell swoop.
It would be interesting to run a research project on those two questions. Whether we have an abuse background. And whether this healing process is also addressing the PSTD or whatever you want to call it from that background.
You know, I’ve felt for a long time that the meaning of the sociopath in my life wasn’t just a bad experience with a bad person. When I was healing, I got to the point where I viewed him as an avatar, a symbol of something. I didn’t know if he was an avatar for my father, or for some large issue I had (like abandonment), or for a chronic emotional dynamic inside me that shaped my life. Whatever it was, it was more than him.
Toward the end of the recovery process, I began to consider the idea that I’d manifested him to help me obtain something I really wanted. I got what I thought I wanted, which was a smart, funny writer who would help me after I helped him. Except that story didn’t play out as planned, and I got what I really wanted, which was to become the focused and disciplined and self-interested person who could actually really achieve this stuff on my own.
The experience taught me what was wrong with me (in spades!), gave me a model for how a writer behaves if he’s serious about doing it (I could edit out the childish values), and gave me the motivation (pain) to “rebalance” my character. It even gave me fair warning of what I was going to have to lose to grow up in this way — a lot of the romantic, trusting, accommodating wishful thinking that was cluttering my life with not particularly helpful commitments and dependencies.
Yes, it was painful. But how painful is it to discover the hard way that you’ve been doing it wrong, that the oldest survival strategies you’ve got are working against you. How much resistance does that kind of information have to get through?
Well, I’d better get back to work. Thank you for what you write.
Hello KH:
You talk relationships that had “a lot of the romantic, trusting, accommodating wishful thinking.” I’ve seen the polarity in myself between “I’ll do it myself; I know how and I’ll get it done faster” and “Life is a team sport — we have to be able to trust others and work in community to get the big things done.” I was moving out of years of “just doing it myself” (having had my trust breached in the past) and acknowledging that what I wanted to do I just could not do alone. So I trusted.
Right now I’m looking from the outside at a businessman who may be making many of the mistakes I made: trusting “clowns to the left of me, jokers to the right . . . ” to quote the Steelers Wheel song. In his mix, I see his trusted right-hand guy on the spot who is looking more and more like an N who gets something out of delaying every project and inserting himself into things he knows nothing about. Malicious? I don’t have my finger on that part yet, but I haven’t ruled it out.
I understand the drawing inward. I’ve had to do that throughout most of my life. I’ve even wondered if the big lesson from the S/P was NEVER trust ANYONE, and ALWAYS GO IT ALONE! I’m sure we’ve all wrestled with that one. I also know that as humans we are social animals and we need community to thrive. Dilemmas. How to think outside the paradox?
BloggerT,
It sounds like you got smart very early in life.
I know we’re not cookie-cutter people. The older I get, the more I recognize the importance of early influences in my life is shaping my values, and the way I think and learn. I’ve spent my whole life as a professional communicator, one way or another, and I learn over and over again that just because we speak English, doesn’t mean we speak the same language.
But I’m also an information analyst. I look for patterns, and the patterns that seem to be emerging from this group are really interesting.
It sounds like you have a lot of personal knowledge about sociopaths. You talk about similarities and differences. Not many of us have had that kind of exposure in a controlled setting. I’m sitting here wishing I could spend time with you and hear what you’ve seen and what you think about it. If you have the time and inclination, I think you could write an article that would interest us all a lot.
KH
Ive overcome a lot of difficult things in my life, taken some major risks, and won, and lost. I thought I was pretty tough. But this, this shook me to my foundations.
I can trace a thread of development through my life, and see how it led up to this. I also feel that I willed him into existance at times, because he fit my mental image of a soulmate like a glove.
I used to feel that what he did caused me to grow so much, that he was a really big influence on my life. And I HATED that. I dont want him to be able to take even the smallest grain of credit for any of my growth, because his intentions were never honourable.
So now I feel that I have grown IN SPITE OF him, not because of. It has been important, psychologically, to achieve this alone.
Im disillusioned, and empowered, at the same time. I am, all things considered, a better peson. Nonethless, Id rather die than go down that road again. It was just too painful.
Am very sensitised to disrespect now. I tend to see a lot more of it, because I have felt so much of it.
The last hurdle seems to be to continue on this path of growth, now that the original impetus (the N) is gone. I am still defining my growth RELATIVE TO this situation. Hence my presence here.
I think it was Tood (CRS!) that mentioned a “study”—I think the study here on LF was completed last month about the VICTIMS and the commonalities WE have. Of course the 75 victims that were studied by Liane and Sandra for their book.
My WAG (Wild A$$ Guess) is that there is in many cases, where we saw/experienced AND ignored the abuse or rationalized it away, that there is a background of some kind of abuse in earlier life (childhood) Maybe not the “beat-you-and-starve-you” kind of “abuse” but maybe the more subtle abuse of emotionally over-controlling by our parents, or abandonment, etc all the way up to the “beating and starving” abuse.
“The same sun that hardens the clay, melts the wax” so the same conditions will have different effects on the person, depending on their “inner material.”
Just as the Ps have a predisposition geneticly, I think there also might be a predisposetion toward “victim-hood”–wouldn’t that be a nice research problem?
Why do some children even being horribly abused mentally and physically come out NON-victims, NON-abusers?
Why do some abused children come out ABUSERS?
Why do some abused children come out VICTIMS?
Why do some children who have (apparently NOT been abused) come out ABUSERS? I don’t think my P son was ever abused, yet he is the ULTIMATE abuser because he is willing and anxious even to KILL victims (anyone who crosses him).
As the genetic link becomes more and more apparent for the Ps, I am guessing the “victim genes” will be found somewhere in there too.
While how we perceive and handle physical pain was always thought to be socializing, they have now determined that it is to a greater extent GENETIC. There are two genes, a wimp gene and a stoic gene. If you get two of the wimp genes, you preceive pain much more intensely, and if you get two stoic genes you perceive that pain is not so bad, and if you get one of each, you are in the mid range. As a health care professional I had known there were different levels of perceiving pain in patients, but this answers WHY and HOW.
All very interesting. Years ago at Ft. Roots, VA hospital a researcher bred two races of dogs, starting with the same litter, breeding the timid ones to the timid ones, and aggressive to aggressive, and within 20 years he had two groups of dogs, one very “psychopathic” and one group very much the “victims” who would “belly crawl” in the sight of an aggressive dog. Could that be US? I feel sometimes like I have “belly crawled” like a fawning dog, seeking for approval from the more aggressive pack members, until it was time to either lay down and let them kill me, or ‘RUN FOR THE HILLS” and I chose to run and heal and no longer crawl on my belly like a reptile, but stand up and walk upright like a self respecting human.