ASPD - why do we torture ourselves?

[Psychobabbling]

Maybe I'm the only person to ever feel this way, ha, but like the title suggests, why do we make this our problem? ASPD vs. Antisocial behavior is one thing. But, we have a label, and no real treatment. Docs here pretty much just write (in sum) "Chronic high risk. Consequences should be managed through legal system." I don't think it takes a M.D. to reinforce not doing X so consequence of Y (jail, prison, etc) isn't suffered.

IED (i.e., Narcissistic Rage, ASPD, etc) has SSRIs, phenytoin and antipsychotics supposedly somewhere in there.

The only ASPD's I've seen even superficially motivated for treatment, are, court-mandated to said treatment.

I mean, that's great that they use primitive defenses and are rated more so on the extroversion side of things.

I don't intend to sound flippant, but what, really, are we to do. Why is this our problem? (This does not include ASPD with actual "axis I" (formerly known as) disorders).

---

Members don't see this ad.

 

[birchswing]

You should watch the movie Awakenings. Some people are curious about refractory disorders. If you can only do what someone else has already accomplished, then I think you are underestimating yourself.

 

[F0nzie]

ASPDers get depressed, manic, and psychotic like anybody else. What's annoying is when they are simply PD but misdiagnosed with Bipolar disorder. Now they're stuck with the mental health system and have access to an open playground that they can hijack.

 

[nitemagi]

Research the DSPD history in the UK.

 

[heyjack70]

There seem to be high functioning psychopaths who do fairly well given the right circumstances; eg salesman, blue collar laborer, executive, etc. This is the car salesman with no qualms selling you $250 floor mats (seriously, how do they think floor mats cost that much). They don't perceive or need treatment, probably. They just have little to no empathy and that's that. The lower functioning psychopaths are the ones who need help. These are the people who need cash, but instead of getting a commission sales job where they can BS their way to a good commission paycheck, they decide to rob a gas station for $500, get caught, and go to prison for 2 years because they used a gun in the robbery. These people need some guidance; their lack of empathy can be an asset they just don't realize it.

 

[Shikima]

ASPDers get depressed, manic, and psychotic like anybody else. What's annoying is when they are simply PD but misdiagnosed with Bipolar disorder. Now they're stuck with the mental health system and have access to an open playground that they can hijack.

I understand Mood d/o NOS pays the same as Bipolar disorder.

 

[st2205]

What I find ironic is that the general public is, by and large, rather skeptical and dismissive of psychiatry, but we have this problem with sociopaths that has been imposed on us by society and yet we seem to go along with it and embrace it out of fear of litigation. Every time someone is in the news for doing something "crazy" (i.e. something antisocial), the dialogue immediately turns to how they either lacked access to mental healthcare (as if they had something that we could have treated) or how they were under treated (and therefore we mismanaged them by not appropriately treating, managing and fixing their antisocial tendencies). So, we continue to take folks off the police's hands and hospitalize people with no other problem than Generalized Douchebag Disorder, recurrent, severe, with homicidal ideations because we're absolutely frightened that, since we're the last one to see them that it will therefore be our fault when they go out and kill someone. So load on the mood stabilizers, the antipsychotics and the benzos and, by all means, continue to tell society that we tried to help their problem and reinforce the idea that all their behaviors are a result of under-medication and under-polypharmacy.

 

[Shikima]

What I find ironic is that the general public is, by and large, rather skeptical and dismissive of psychiatry, but we have this problem with sociopaths that has been imposed on us by society and yet we seem to go along with it and embrace it out of fear of litigation. Every time someone is in the news for doing something "crazy" (i.e. something antisocial), the dialogue immediately turns to how they either lacked access to mental healthcare (as if they had something that we could have treated) or how they were under treated (and therefore we mismanaged them by not appropriately treating, managing and fixing their antisocial tendencies). So, we continue to take folks off the police's hands and hospitalize people with no other problem than Generalized Douchebag Disorder, recurrent, severe, with homicidal ideations because we're absolutely frightened that, since we're the last one to see them that it will therefore be our fault when they go out and kill someone. So load on the mood stabilizers, the antipsychotics and the benzos and, by all means, continue to tell society that we tried to help their problem and reinforce the idea that all their behaviors are a result of under-medication and under-polypharmacy.

Too bad people can't be forced into psychotherapy?

 

[F0nzie]

Too bad people can't be forced into psychotherapy?

The best treatment for antisocial is antisocial.

 

[smalltownpsych]

What I find ironic is that the general public is, by and large, rather skeptical and dismissive of psychiatry, but we have this problem with sociopaths that has been imposed on us by society and yet we seem to go along with it and embrace it out of fear of litigation. Every time someone is in the news for doing something "crazy" (i.e. something antisocial), the dialogue immediately turns to how they either lacked access to mental healthcare (as if they had something that we could have treated) or how they were under treated (and therefore we mismanaged them by not appropriately treating, managing and fixing their antisocial tendencies). So, we continue to take folks off the police's hands and hospitalize people with no other problem than Generalized Douchebag Disorder, recurrent, severe, with homicidal ideations because we're absolutely frightened that, since we're the last one to see them that it will therefore be our fault when they go out and kill someone. So load on the mood stabilizers, the antipsychotics and the benzos and, by all means, continue to tell society that we tried to help their problem and reinforce the idea that all their behaviors are a result of under-medication and under-polypharmacy.

GDD Love it. We (psychiatry and psychology) need to be clear that bad behavior is not a mental illness and that the vast majority of the people we treat are not doing bad things. Like I tell the ER docs, "Most of these people aren't my patients. My patients come to me to talk about their struggles and rarely show up here. These people don't have any problems, just ask them and they will tell you it's everyone elses fault." I love clearing people from the ED to go to jail. Not because I am cruel, but because the legal system is the best intervention for bad behavior. Also, like the detention officer told me, they have a rubber room in case the person needs extra containment.

Too bad people can't be forced into psychotherapy?

I can't do much with them either. The people that have to deal with their bad behavior benefit much more from psychotherapy.

 

[Doctor Bagel]

What I find ironic is that the general public is, by and large, rather skeptical and dismissive of psychiatry, but we have this problem with sociopaths that has been imposed on us by society and yet we seem to go along with it and embrace it out of fear of litigation. Every time someone is in the news for doing something "crazy" (i.e. something antisocial), the dialogue immediately turns to how they either lacked access to mental healthcare (as if they had something that we could have treated) or how they were under treated (and therefore we mismanaged them by not appropriately treating, managing and fixing their antisocial tendencies). So, we continue to take folks off the police's hands and hospitalize people with no other problem than Generalized Douchebag Disorder, recurrent, severe, with homicidal ideations because we're absolutely frightened that, since we're the last one to see them that it will therefore be our fault when they go out and kill someone. So load on the mood stabilizers, the antipsychotics and the benzos and, by all means, continue to tell society that we tried to help their problem and reinforce the idea that all their behaviors are a result of under-medication and under-polypharmacy.

And cynically we also want more funding, so we use things like Newtown to increase funding for mental illness while not mentioning the fact that lack of access to care was not an issue in that case and that honestly we have little to offer to prevent those types of tragedies anyway. All the way stigmatizing people with mental illness by playing into this association between criminal behavior and mental illness.

And don't get me started in talking about the VA and our attempts there to protect patients from facing any consequences for their behaviors. Want to stay in substance abuse treatment forever to avoid that jail sentence -- sure, why not!