But there are a lot of women with borderline
personality who also have anti-social traits or features, as you might refer to
it. For example, shoplifting, minor
crimes, lying, some domestic abuse, neglect of their children. And we see that in male anti-socials, that they
may have some borderline features, maybe they hurt themselves repeatedly by
cutting, or they have fears of being abandoned by some girlfriend or other
person they're in a relationship with.
So there's this overlap in some people.
I certainly see that in the prison system.
Rob Kall: Now I've
had a lot of contact with psychologists over the years - by running
conferences, presenting at meetings, and what have you - and I've met a number
of psychologists who say that they refuse to see borderline patients, because
they tend to let you get close to them, and then bite your face off.
Donald Black: Well,
there all also a group of psychiatrists and psychologists who say they're not
going to treat anti-socials. They don't
want anything to do with them. But in
terms of the borderline patients, I think that's unfortunate. I see and treat a lot of borderlines. I write about it, we've developed a treatment
program for borderline patients called "The Steps Program," and I can tell you:
most of them tend to improve, and if we follow them up years later after we
first see them, many of them no longer even fit the definition of borderline
personality because they've improved so much.
Rob Kall: That's
very hopeful.
Donald Black: It
is. So I think it's unfair, and in fact
wrong, for a group of mental health professionals to just write off a group of
patients. Now, I see this far more
commonly with anti-social personality disorder patients, where the doctor or
therapist says, "I'm not going to have anything to do with these people because
they're dangerous. Maybe they'll become
stalkers or they'll hurt me in some way.
And besides, we have no treatments anyway!"
But as I point out in my book, we just haven't
studied the treatments well enough, so we don't know that it's
untreatable. In fact, the same
phenomenon of improvement occurs in anti-socials as it does in borderline
patients. If you follow anti-socials
long enough, many of them will improve and no longer meet the definition for
anti-social personality disorder.
Rob Kall: All
right. We're going to come back to
that. This is the Rob Kall Bottom Up
Radio Show, WNJC 1360 AM out of Washington Township, reaching metro Philly and
South Jersey, sponsored by Opednews.com . I'm speaking with Donald W.
Black, MD. He's a Professor of
Psychiatry at the University of Iowa, and he's the author of Bad Boys, Bad
men: Confronting Anti-social Personality Disorder, also known as Sociopathy. Now, where does Psychopathy come in - and
psychopaths - to this conversation?
Donald Black: Well I'm
glad you asked that question because there is overlap between psychopathy and
sociopathy or anti-social personality.
Sociopathy and anti-social personality are really synonymous, and both
terms are commonly used, although "Anti-social Personality Disorder" is the official
term. Psychopathy is a variation, and I
look at it as "The severe end of the anti-social spectrum." Now what do I mean by that? Any disorder that Psychiatrists treat lies
along a continuum of severity from very mild to very severe. That's just how it is.
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