Finding Out You're A Psychopath

Understanding that you are not like other people...

When I first started writing about psychopathy, I really had no intention of continuing to do so, but we’ll get to that in a minute. First, let’s talk about how that came to be. When I was younger, I mean in my teenage years, there was enough about me that prompted my parents to have me evaluated. No, that is not where the diagnosis came from. Actually, I have no idea what that evaluation found, and really it isn’t important. My brain wasn’t fully developed, which means that a good deal of my behavior at the time could be chalked up to me being a typical dumb teenager with an underdeveloped frontal lobe.

However, I certainly was different when I was a teenager. I was different when I was a child. I knew that I was different, and I knew that people around me did not react well to that difference. As that could stand in my way of getting things that I wanted, I learned to mimic those around me and to effectuate their way of thinking, in order to mask how I actually thought about the world.

Back to me as a teenager and young adult. I definitely crossed several legal lines when I was that age and had my fair share of involvement with law enforcement. By the time the last one of those events happened, I had reason to be interviewed by every level of law enforcement. Local, state, and then federal, and in the last one, it was significant enough that it would have been serious federal time. Fortunately, by that time, I also had a well-honed mask, and could cry at the drop of a hat convincingly, so the feds didn’t press charges. For those of you wondering, I am not interested in sharing what the charges were for. They are identifiable, and I don’t much have an interest in giving people the means with which to track me down. I don’t encourage the stalkers.

It was about that time that I met my Significant Other, who definitely changed how I view the world. He was a better observer than I was of people, and I began to ask him about why people did the things they did, how they thought, and how they experienced things. It made it more and more evident that I was different. Many of the things he had observed and knew I hadn’t sussed out because I had no frame of reference. None of it made any sense to me, and it was fairly obvious that I was further apart from the people around me than I thought.

Why though? What about me made my fundamental functioning in the brain so opposite of almost everyone around me. After a while, I decided it might be interesting to find out, so I looked up the guy that had done my previous evaluation. Interestingly, he remembered me and agreed to do another examination. After the first visit, he decided that he would involve other clinicians in this process, so long as I was okay with it. I agreed, though if I had to do it over again, I may not have.

A proper diagnostic workup for ASPD is detailed. They don’t just poke and prod your brain for five minutes and deem you a psychopath. If they do, good lord, find someone else and demand your money back. There is the first part of this, the money. If you are going to get evaluated for something like psychopathy, pretty much no insurance agency is paying for that. It is considered “untreatable”, so you are on your own. It is not cheap, and it certainly can be a bar from getting a proper diagnosis done. It’s easy to find someone that will have the proper license required, who will just take your money to tell you what you want to hear. That doesn’t make for a good diagnosis, however. It is just buying the alphabet. In that case the particular letters of A.S.P.D.

The next part is the time involved, and it is a lot. There are no short appointments for this, and every single one is going to make you never want to bother going to the next one. Why did I? Stubbornness, my Significant Other insisting, curiosity, probably a mixture of all of them. The first appointment was a “getting to know you” kind of thing. This is where he designed the process in his head and gave me a rough rundown of what it was going to look like. This was somewhat clever on his part because he made it seem very run of the mill. Nothing too extensive, it will be easy.

Nope. Lies. It was a slog. Every appointment involved personality testing. Usually, the same personality testing that I already did, yesterday, three days ago, last fracking week. Do you people not compare notes? I took the MMPI-2 three times in one week. I took it more than that, but the three times in a week was enough to make me consider bailing on the whole process. It takes forever.

Part of the motivation for the time suck is about seeing how I would respond. For the most part, I kept my mask on and responded with infinite patience. However, after clinician hopping, and eighteen hundred tests later, that was beginning to wane. The primary doctor, let’s call him Dr. Joe, was doing check-in appointments with me throughout this process to see what I thought about the progression. This whole thing was way more involved than the last time he had me in his sights while in my teenage years, and he surely knew that it was a lot of work. So, he asked me about it.

He asked me to describe my thoughts on the experience so far. He asked probing questions, explained some things, and basically kept me talking about it for about half an hour. Later he explained to me what it was that he was looking for during that time. Emotional language. He was looking to see if I would describe the process with anything involving my emotions. That didn’t occur to me as something to fill in. I suppose I could have, but I didn’t have the experience while masking to understand that most people would describe how they felt about the process, not just discuss the actual process itself.

One of the questions that I remember was him asking me about the MMPI-2, how many times I had taken it, and my thoughts about that. My response was not to convey emotion, but rather observation. “It’s long”. That was it. My lack of emotional description went into the notes and would make more sense to me later on.

One of the things about Dr. Joe, as opposed to several of the other clinicians that were involved, was that he acted towards me as an equal. This was not the case with several of the clinicians, and in fact, a couple of them were quite haughty for lack of a better word. There was one that had me sit in his office for forty-five minutes while he read my records. Likely, now that I look back on this, it was a part of the evaluation. To see my reaction to having to wait while he wasted time. Maybe, on the other hand, I am offering him way more credit than he deserves, and he was just a jerk. I have met plenty of those in my life, with all sorts of credentials.

After having me wait, melting into a chair, he had me do even more personality tests… yay. Followed by six or seven, what seemed like quite random questions, and that was it. He sent me off to the next stage. It was sort of like a video game. You finish a stage, and graduate to the next one, which in this case, was neurophysiological testing.

0/10 would not recommend.

This is a long involved process that apparently has a point, but also takes three days, and at the time cost almost $4000.00. If you ever have the option, I would go ahead and skip it. Unless you really really really need it. Then, you do you, but don’t expect it to be fun.

After all my hopscotch of doctors appointments, then it came time for the final meeting with Dr. Joe, or at least it was supposed to be, we’ll get back to that later. I get there, and he has this little grin that he’s trying to hide. He probably would have been successful with anyone else, but I have been observing microexpressions since I was really young. To me, it was very obvious. He had a stack of paperwork next to him and began with the pleasantries.

He wanted to make sure that I understood how extensively they had evaluated me. I’m thinking, “Dude, I know that. I was there. I also wrote the checks. Anyway, go on Captain Obvious.”

He talked about how all the tests had a purpose and explained to me why they were administered multiple times. You see, if they give you the same, very long, personality inventory, multiple times, they find out if you are trying to cheat the test, or if you are taking it honestly. My guess is that this works in two ways.

1. Memory. Unless you have an excellent memory, you are not going to remember how you answered number two hundred and eleven on a five hundred and sixty-seven item true and false test. Also, they ask the same questions several times on the test but worded differently. They want to see how you consistently answer.

2. Annoyance. If you have taken the stupid thing six times already, at an hour and a half a pop, you are going to be more inclined to answer honestly just to get it over with.

That’s my guess anyway. Actually, no, the first one is right, the second one is my guess.

Dr. Joe has been talking to me for a while at this point, and he is reiterating a bunch of things I already know. He isn’t padding the time of the appointment, I already paid for it, so what is he doing? He’s trying to get me to the point that I can hear the word “psychopath” without immediately assuming that I have wasted all this time and money with a crazy person. He picked up the stack of paperwork and leans over to hand it to me while telling me that everyone agreed with the diagnosis. It’s rare apparently, which made me wonder how they have jobs if that’s the case.

He gave me the technical diagnosis first. ASPD. Uh-huh, and? What does that mean? “It means that you’re a psychopath,” and he continued….

“Hold up doc, back up. What now? Psychopath, like serial killer? I know I have done some things that aren’t the best, but I haven’t killed anyone, nor do I care to.”

While I’m thinking this, he’s still talking and trying to get me to look at this paperwork that he passed to me. He’s pointing at information about the brain, and blah blah blah, and it’s way over my head. I have no idea what he’s getting at until he says, “Would you be willing to get your brain scanned?”

“I guess?” This made him happy, and it was about this point I realized that this was not just an evaluation for me, but he was having a grand old time with it. I guess I was the first psychopath that he had ever diagnosed, and the reason that he remembered me from when I was younger is that he felt like there was something bigger going on.

All right, off to the lovely fMRI scan. We did a few of them, and they show you emotive words and pictures, waiting to see if your brain lights up like a Christmas tree. Alas for them, no Christmas tree. I didn’t respond to emotive words or pictures. It was official in the neuroscientists’ eyes, I had a brain consistent with what psychopaths demonstrate. However, a brain scan can never diagnose psychopathy. The imaging technology isn’t there yet. They can only look at it and say, this is consistent with what we have seen previously, or this is not consistent with what we have seen previously. We also did a SPECT scan which is the only one that I still have around somewhere. SPECT scans are weird. Sit in the dark for half an hour, then do the scan. They found that I had basically nothing happening in my frontal lobes. Another exciting discovery… I guess.

My SPECT showed;

Decreased diffuse and focal thalamo-limbic perfusion

Decreased left and right inferior orbital prefrontal cortex perfusion

Flattening of the prefrontal cortex pole

Decreased posterior medial cerebellar perfusion

I have no idea what the neuroscientists at the time thought about that because I knew nothing about the brain, but in conversations with a neuroscientist on Quora, he stated this:

What you describe in the SPECT scan is what I might have expected (especially given newer insights into the role of the cerebellum, as classically it had been thought to relate to balance and fine movement, with white matter connections to areas of the brain containing information about vision, eye position, the state of the semicircular canals, the position of the body in space, and procedural memory in the basal ganglia), but “Flattening of the prefrontal cortex pole” is an anatomical diagnosis, and I would not feel comfortable making it from SPECT alone, so I’ll bet they merged yours with high resolution CT of the same slice of the brain, so they could see the anatomy better. I had mentioned that previously, and it is pretty standard in animals and humans now.

You would think that after all of that I would be interested in psychopathy, and being psychopathic. Nope, and wrong. I didn’t care. It crossed my mind occasionally, but for the most part, it was a nonfactor in my life.

However.

However, the word kept popping up. It’s in movies, TV shows, books, news reports, the word is used as a pejorative when what a person means to say is that, another person is an assh*le. One day I decided to google it, and an answer on Quora popped up.

What are some things that still aren't covered about psychopaths?

I had never seen Quora before and poked around in their category for psychopathy and psychopaths. Wow, the nonsense that I found there. It was unreal. That is what prompted my first answer. However, it was not meant to be something that I was going to embark on a mission of correcting the narrative, but the more I dug into it, the more studies I read, the more I understood, the more I saw the broken system that was defining what people believed about psychopathy, the more I wrote.

In my next post, I will cover why I still write, and where this is going. However, that is how my diagnosis came about. As I mentioned, I wouldn’t do it again. It was expensive, it was tedious, and it gave me a label that can cause me problems if a deep background check is ever run on me.

It was interesting, but I am not certain the cost-benefit analysis was in my favor on this one.