Psychotherapy

“I’m not bad, it’s just that they have drawn me like that.” The ex-therapist Patrick Gagne (Los Angeles, USA, 49 years old) paraphrases Jessica Rabbit—a cartoon character from Who Framed Roger Rabbit? (Robert Zemeckis, 1988)—when recounting his criminal activities, such as stealing Ringo Starr’s glasses, breaking into homes or taking other people’s cars for night getaways. This UCLA student and doctor in clinical psychology recognizes that she does not feel like others, it is difficult for her to empathize and she must make an effort to tell the truth. If feelings were colors, Gagne would only have the basic ones, such as sadness or joy, but not the complex ones, such as regret, guilt, jealousy, nor love in its conventional form, although she is married to the love of her life and has two children. With his memories, Sociopath (Planet)seeks to promote empathy towards those who suffer from psychopathic and antisocial disorders, although it warns that the term that gives it its title is outdated and is confused with antisocial personality disorder. In the US, it is associated with serial killers, while in Spain “psychopath” is more used. According to the writer and journalist Álex Grijelmo, “sociopath” carries in English the idea of ​​“misfit”, a nuance that does not exist in Spanish. But as some psychologists understand, labels only indicate one direction and the essential thing is to understand the person as a whole. The interview takes place by videoconference on January 20, just after the return to the Oval Office of a president with characteristics similar to those described in the book. Ask. How do you define sociopath? Answer. Sociopathy, psychopathy, and antisocial personality disorder (ASD) are related, but different. The term sociopath, which is no longer used clinically, is now included within psychopathy, which is divided into primary (biologically determined, lacking social emotions such as guilt and empathy) and secondary (caused by the environment, capable of learning social emotions). Sociopathy is associated with secondary psychopathy. APD is a broader diagnosis that can encompass both sociopathy and psychopathy, although not all people with APD are sociopaths or psychopaths. Q. It is so complex that diagnoses can vary depending on the therapist. R. The challenge lies in the etiquette. Words like “psychopath” and “sociopath” are highly stigmatized. I heard one therapist suggest reclassifying sociopathy as “low affect disorder” to reduce stigma and better address the behaviors. A common misunderstanding is that sociopaths and psychopaths cannot feel, but we experience basic emotions, such as happiness and fear. The challenge lies in social emotions, such as love, empathy and compassion, which are learned, not intrinsic. Q. What did your doctoral studies teach you about the connection between sociopathy and anxiety? R. Primary psychopaths cannot experience social emotions or anxiety, while secondary psychopaths or sociopaths do feel anxiety. Treating anxiety can help sociopaths learn social emotions. In my case, the anxiety came from fear of rejection due to my lack of emotion. As a child, I hid my true self to fit in, but once I accepted that I didn’t need to be like everyone else, the anxiety disappeared. Although I still feel apathy, I no longer force emotions, and it is important to be surrounded by empathetic people. As a therapist, I learned that understanding others, even just intellectually, is key. Humanity is diverse, and mutual understanding benefits everyone, regardless of emotional capacity. Q. As if having full access to emotions could magically solve everything… R. Look, from my perspective it doesn’t sound that great (laughs). Q. So does treating anxiety to address sociopathy offer hope? R. Absolutely, I wrote my book to show that there is light at the end of the tunnel. Sociopathy exists on a spectrum, with most cases being mild to moderate. Focusing only on the extremes ignores these milder forms, which could escalate to more severe cases. It’s like only recognizing stage 4 cancer, ignoring stages 1, 2 and 3; Something similar happens with psychopathy. In our society emotions are often heightened; I encourage more acceptance and less anger.” Q. His difficulties in feeling emotions have not implied lacking a moral code, like when he chose “not to hurt anyone.” R. Correct. I am often asked what stops me from murdering someone if I feel no guilt or remorse, and my answer is: I hurt people all I want, but that amount is zero. It seems crazy to me that people believe that guilt and shame are necessary to prevent harm or crime, implying that human beings would always want to harm without these emotions. It is a self-destructive argument. Q. Is there hypocrisy in a society where people without diagnoses of mental disorders do not have to justify their bad actions? R. People with psychopathic and antisocial disorders are criticized for lacking empathy, but most neurotypical people deny it to them. Empathy is often learned through parenting, and a child who struggles in this regard usually doesn’t get much of it either. It is hypocritical to expect psychopaths to show empathy when it is not extended to them. Q. He says feeling accepted is liberating, but accepting those who don’t follow social norms is rare. R. Historically, those who are different are not easily accepted. My emotional difficulties don’t mean my feelings don’t matter. Psychopathy, sociopathy, and APD are often labeled as aggressive disorders, but we should focus on behavior, not emotions. I challenge the idea that children who lack social emotions like guilt are “bad.” They should learn to experience these emotions in a way that works for them, which could prevent destructive coping mechanisms. “Antisocial or narcissistic personalities thrive in professions where emotion can be an obstacle, such as politics.” Q. Unwanted loneliness has been his greatest suffering, but despite the difficulty in making friends, he managed to do so. How did he get it? R. When I accepted my differences and acted authentically, I found people who accepted me for who I am. This is true for anyone: self-acceptance leads to finding … Read more