Part two of the transcript of my interview with psychiatrist Donald Black, M.D., author of Bad Boys, Bad Men, on May 6, 2013, discussing anti-social personality disorder, sociopaths and psychopaths. He says there about 8.5 Million sociopaths in the USA-- about 4% of adults.

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I interviewed psychiatrist Donald Black, M.D., author of Bad Boys, Bad Men, on May 6, 2013, discussing anti-social personality disorder, sociopaths and psychopaths. He says there about 8.5 Million sociopaths in the USA-- about 4% of adults. 

  This is part two of a two part interview. Here is a link to the audio podcast. Links to other articles in the series, including part one of this interview.

Thanks to Don Caldarazzo   for doing the transcript.

 

John Wayne Gacy art by Wikipedia

Rob Kall:   OK.  Next: you mention in your books on a couple occasions use of marijuana as a sign, potentially, of anti-social personality; yet several states have now made it legal, and it's available for use as a medicine in a growing number of states.  Where does marijuana fit in with this?

Donald Black:   Well that's a good question, and let me correct that, in that anti-socials in general tend to abuse substances.  It could be marijuana, it could be methamphetamine, it could be cocaine, it could just be alcohol.  Alcohol is probably the most widely used substance of anti-socials, and I think it just reflects on their inability to delay gratification.  They tend to be into instant gratification, and drugs and alcohol can provide that.  If they are alcohol or drug addicted, their anti-social personality is worse, because they are dis-inhibited; they're more like to be impulsive, they're more likely to act out.  One of the thoughts about treating these people is that if they are drug addicted, you must get them off of drugs. 

Now, we have seen this tendency in the U.S. in various states to legalize medical marijuana or just decriminalize marijuana.  Whether or not that's a good thing or not I think society has to determine for itself.  I personally don't agree that states should be legalizing marijuana as a medical indication, because as a doctor I can tell you that there are no hard and fast medical indications, and certainly none that have been well studied.  But it's a question that society has to address for itself.  There's no specific connection with anti-social personality disorder.

Rob Kall:   OK.  Next question: I want to observe that your book tends to focus on people who are in lower portions of our culture, and I think you make it clear in your book that sociopathy can keep people stuck in a /

Donald Black:   Absolutely.

Rob Kall:   - cycle where they're impoverished, where they're dependent, where they're using theft and drug dealing to survive, /

Donald Black:   Yep.

Rob Kall:   -b ut my understanding is that there are also people who are higher functioning sociopaths.

Donald Black:   Absolutely.

Rob Kall:   I'm very interested in those people who don't get arrested, people who don't function in a violent way, but they do it in a way that perhaps hurts a lot more people.  What about wealthy people, what about powerful people, what about people who manage to navigate socially without being violent?  And I assume that you don't have to be violent to be a sociopath.  You could be a colluder.

Donald Black:   That's a wonderful question, and you're absolutely correct.  Not everyone who's anti-social is violent.  But there is this issue of low socioeconomic status: low income, low educational level, and all of those things are highly correlated with anti-social personality disorder.  Now, does low social status cause anti-social personality disorder?  No, but in fact people who are anti-social tend not to finish their education, they have unstable personal lives, they get divorced, have many relationships, they get fired from jobs.  So all of that reinforces low income positions. 

Now, there are some people who rise above that.  You'll find sociopaths at all levels of society.  There's no reason why people at even the upper ends of the income level can't be sociopaths, and in fact there probably are many, proportionately less than at the lower ends of the income spectrum.  For example, someone can grow up in a wealthy family, and despite their anti-social personality they get a good education, maybe through family connections get a good job so they have a decent income, and yet they are anti-social: regularly committing crimes (perhaps white-collar crimes and not violent crimes), abusing a spouse quietly at home so no one knows. 

But I do highlight these cases in my book - you know, the white-collar criminal.  And there are many that we read about in the news.  Now I'm not sure that Bernie Madoff is a typical sociopath.  His behavior is anti-social.  He certainly had plenty of money, access to the very upper levels of society, and yet what he did was commit a horrible financial crime that robbed many people of their life savings.  There are plenty of examples throughout history of just that sort of behavior.  Now, is he an anti-social?   I would say: probably technically not, because there's no evidence that he had this pattern of childhood misbehavior.

Rob Kall:   How would you know that, though?  This is not something that somebody would necessarily study; how do you know that he didn't torture animals, or was mean to people, or cheated in school ..

Donald Black:   That's a good point.  I don't know that; but there have been biographies written about him, and I've certainly read profiles of him, and I've never seen any journalist or biographer point out these things.  Whereas, for example, I mentioned Saddam Hussein earlier - who, again, was at the upper level of his society (because he is president for life, basically), and yet his history of misbehavior, including animal cruelty, is very well-documented.  So we do know that some people like that do have well-documented histories of childhood misbehavior.

Rob Kall:   Well, let's talk about this a  minute, because I'm very interested in this upper echelon sociopathy, and so I'm curious: assuming that somebody comes from a family that has wealth and the power to erase some of the records, the power to influence schools so that a kid can transfer to another school, have the records excised, or what have you, what are some of the ways, the kind of useful behaviors that would be detectable or to be looked for in people who are in the upper class?

Donald Black:   You've made a good point.  I mean, how could you tell, especially if they're being protected by their parents?  One of the cases I highlight in my book was: a guy named Alex Kelly came from a wealthy Connecticut family, escaped rape charges, fled to Europe, and eventually came back and was convicted and incarcerated.  But his family was sending him money in Europe, pretending that they didn't know where he was.  He had a full history of misbehaviors, and yet the family was covering up.  I think that's one of the things that we see in a lot of these wealthy families who have someone they would probably refer to as a "Black Sheep Member": they cover up.  They have the money to do that.  They have the influence.  Now, other cases that I highlighted are -

Rob Kall:   (interjecting)  But wait, wait.  What are some examples of the kinds of things that they cover up?

Donald Black:   Well, in Kelly's case, getting high-price lawyers to represent him.  I don't remember enough details about his specific case, but another case I mentioned was William Kennedy Smith, who was arrested for rape; and we know how wealthy and influential his family is.  They stood behind him, obtained high-price lawyers, etc.  This is a pattern that you see in these families.  I suppose families at the other end of the income spectrum might do exactly the same thing, but they don't have the resources.

Rob Kall:   So what you might see (indirectly) is somebody who changed schools multiple times.

Donald Black:   Yes; changing schools or getting lawyers to cover up for them if they're accused of committing a crime.

Rob Kall:   Well that's what they might do, but you probably wouldn't see that if you were trying to research them - their lawyers that covered them up. (laughs) Right?

Donald Black:   No, no, I think you're right.  One of the things that you probably would see is changing school districts - or quitting one college, starting up another.  And then if you start digging behind that, you'd see what some of the motivations underlying that were.

Rob Kall:   Another angle I want to look at this with is, what about -- we have a whole new world with the internet, and there's a lot of talk about "trolls" and anonymous behaviors.  What about sociopaths and anti-social behaviors online?  Can you talk about that a bit?

Donald Black:   You know, that's really a wonderful question.  I can't really address that because I don't know a lot about it.  But I did mention in the book, and I talked about it, and there are other cases too, of hackers.  There was a hacker, well-known (I think this was in the 90s), a guy named named Keven Mitnick, clearly a bright guy.  He was arrested for hacking and has a whole host of problems relating to that, ends up in prison -- I'm not sure what he's doing now.  He's long since been released.  But you see this repeatedly with some of these bright -- I guess you could refer them to as computer nerds -- who are very interested in hacking, and get into trouble because of that. 

But you can commit all kinds of criminal acts on the internet, from finding underage sex partners, to hacking into people's bank accounts, to hacking into government bank accounts.  So there's all manner of crimes that could be committed, and some of those might be considered these white-collar crimes, because you would basically have a perpetrator who is educated, smart, has access to computers, and so forth.

Rob Kall:   Let's try to extrapolate a little bit.  When you're in the world dealing with people and you encounter somebody, you never know if they're a sociopath or not, and it's not like they're going to suddenly beat you up, necessarily.

Donald Black:   Right.

Rob Kall:   It may be  that you're working with them.

Donald Black:   That's true.

Rob Kall:   Let's say you work with somebody who is a sociopath.  What kind of patterns of behavior would you expect?  What kind of feelings would you have that might be in response to somebody who is a sociopath?  Because maybe that is interesting all by itself, and maybe it might also apply to online behavior, too.

Donald Black:   Well you're absolutely correct, and there is a book on the market that gets into that, and it's called Snakes in Suits.  They're essentially the white-collar criminal, and say your co-worker is essentially a snake.  But I think for just an ordinary work situation, let's say your co-worker is absent a lot - so a lot of absenteeism; or the person lies frequently, so you ask them about being absent or away, and they concoct lies that maybe later are exposed; or there are are petty arguments that develop, or disputes, or even fights in the workplace.  This is how it probably manifests most often, and it's probably not all that apparent or dramatic in most situations. 

It's probably just quiet problems.  You notice that there's something not quite right about your co-worker.  They're away a lot, or they don't do the work that's assigned to them, and maybe you end up having to do more work because they're not doing it, and yet they produce all kinds of excuses which are probably just lies.  This would accumulate over time, and eventually they'd get fired or reassigned, or maybe they'd just quit because they think they're being taken advantage of.  So those are typical of the sorts of things that you might see in the workplace.

Rob Kall:   How about really smart sociopaths?  I have a feeling that they all think that they're really smart, but what about high IQ ones and high-functioning ones who are working as administrators, managers, even CEOs.  What would they look like?  How would you detect potential sociopathic behavior among high-level, high-functioning people?

Donald Black:   Well that's an excellent question, and I'm not sure exactly how to answer that, other that perhaps they engage in behavior that's sleazy or criminal, and if they're caught engaging in some criminal [act].  Let's say someone in high finance who developed some illegal investment scheme, and then they lie about it, and they cover up.  But at that level, they probably have lawyers and others, and layers of protection.  I mean, we certainly see this sort of thing: sometimes it's exposed and the person gets caught, other times, not.  But it's a problem, because how do you identify it and call it for what it is?

Rob Kall:   Sounds like something that ought to be researched.  It probably could be costing our society billions of dollars.

Donald Black:   I think there's no question about that.

Rob Kall:   But like you said there's no research.  Why do you think that is, that there's no research?  I mean, literally one study on sociopaths!  Considering how many studies there must have been on bipolar disorder, and schizophrenia, and other disorders with similar occurrences of 4.5% of the population, it is bizarre and crazy and inexplicable why there is so little research!

Donald Black:   I agree, and I don't understand this.  There's a government website called Reporter , and it lists all of the research grants funded by the federal government.  This is run by the National Institutes of Health, so it's the NIH website.  And you can enter into their search box keywords like "Anti-social," or even "Psychopath," or "Sociopath," or "Personality Disorder,"  and I did that as I was rewriting my book last summer, and I put these facts in the book.  But there were like five research grants in which the term "Anti-social Personality" appeared in the title; and I thought, this is wrong.  If you do that with "Schizophrenia," you literally get hundreds (if not thousands) of hits, whereas "Anti-social," almost nothing.  Psychopathy was a little bit more, but not much.  It's clearly underrepresented in the research field.  It's like no one cares about it, and yet it is this common and highly problematic disorder.

Rob Kall:   I would imagine it would be extremely difficult to identify and collect a collection of subjects who were corporate CEOs who were also sociopaths.

Donald Black:   Well, I don't think it would be that difficult.  For example, a researcher named Adrian Raine who studies anti-social personality disorder, I was at dinner with him once, and I said, "Well, how do you recruit these people?  Because you don't put an ad in the paper saying you want anti-socials!"  He said, "Well, what we do is we go to temporary work agencies, and just ask if we can interview all the people seeking work.  A very high percentage actually meet criteria for anti-social personality disorder, and they're just being recruited for a study that look s at brain function, so they don't know necessarily that they're being recruited because they have anti-social personality disorder."  That's the sort of strategy that you would use.  Ideally you could go into prisons, because the have such a high prevalence of anti-social personality.  But the government has /

Rob Kall:   (interjecting) But what you just described, you're really only going to be getting the ones who are the low functioning ones, the ones who aren't getting caught.

Donald Black:   That's true.  So you'd have to get people at the other end of the income spectrum.  You'd have to use some clever recruiting tool; and I'm not quite sure what that would be, but you couldn't just say, "I want people who have hurt their spouses, or lied in the workplace, or been arrested," or things of that nature, because no one would volunteer.

Rob Kall:   That's right.  All right, a couple more questions.  What about leaders?  What about a leader who just sends out orders to kill people without any laws or any judges getting involved?  Does that make somebody a sociopath?

Donald Black:   That person could be, and certainly around the world there have been a lot of dictators who essentially do that.  They order the murder or elimination of large groups of - Stalin killed millions, had millions killed, Mao had millions killed, either directly or indirectly because of their policies.  Are these people anti-social?  It's hard to tell, but most of them,probably not.  They're just in power, maybe they're highly narcissistic, maybe they're inherently bad people, or even evil people (we talked about that word earlier,) but I'm not sure they fit the definition of anti-social personality disorder.  It's certainly bad behavior, something that you and I can't endorse, but unfortunately it happens all the time.  We see it all the time around the world.

Rob Kall:   You just brought up "narcissistic."  I had asked about related disorders before, and you didn't really cover that one.  What's the story with narcissism and narcissistic?

Donald Black:   Well narcissistic people are extremely self-centered and entitled.  That is, they believe that everyone owes them a living, basically, and they deserve it.  So this strong sense of entitlement.  You see that in a lot of leaders and people in various industries; I think you see that a lot in the financial world, for example.  People who just have this strong sense that they deserve it all, they're better than other people, they're smarter than other people. 

I think the worst combination is probably the combination of narcissistic tendencies and anti-social traits, because those people commit bad acts and they thin that they can get away with anything.  So I think a lot of bad world leaders have a combination of those traits.  Whether or not they meet criteria for anti-social personality disorder is almost beside the point; that combination is truly bad because it allows people to commit heinous acts and get away with it, and it doesn't offend their sense of what's right and what's wrong.

Rob Kall:   So that takes me to the next place: what about politicians? (laughs) It sure seems to me like there are some of them out there that don't care about other people, that they sell out to lobbyists, and they create bills that are strictly for their own interests, or just their donors interests?  Where do they - ?

Donald Black:   I can't disagree with that.  I think the term "Narcissism" probably applies more than "Sociopath."  I think they just feel that they are better than others, they deserve more; and I think frankly a lot of them lack courage, that they're unable to make decisions that represent the views of their people, and instead they choose to represent the views of those who are paying for their campaigns.

Rob Kall:   Moving from politicians, how about terrorists?  What about these Tsarnaev brothers?  What's your take on what happened in Boston?  Is this a case of sociopathy?  What do you think?

Donald Black:   Again, that's -- I'm not sure because I don't know about their early life.  The older brother seems to have been in trouble periodically; he certainly was accused of domestic violence, in terms of one of his girlfriends before he got married.  The younger one, based on what I was reading in the New York Times just yesterday, seemed to be fairly normal, had friends, was not felt to be unusual or to stand out from other people, and I think in his case he's probably responding to the influence of an older brother whom he admired, and perhaps he was caught up in some sick version of the Islam religion. 

And the older brother, you know, maybe he was responding to distorted religious views as well, but it's hard to know.  It's like, I mentioned Osama bin Laden earlier, who arguably did not meet criteria for anti-social personality disorder.  Certainly he was messianic in a sense, because he was regarded as a kind of religious leader to a lot of people, certainly very narcissistic, committed horrible antisocial acts that probably technically did not meet the criteria for sociopathy.

Rob Kall:   And the biggest criteria that is difficult to find is -- youth.  Engaging in behavior in youth.

Donald Black:   Yes, because it's considered a lifelong disorder, so you have to have this pattern of misbehavior established very early in life.  So how these terrorists and people like that fit in is hard to know.  They're almost a special category that really defies traditional diagnostic practices.

Rob Kall:   What are some of the early examples?  What do young people, teens or children, do that is predictive or them turning into sociopaths?

Donald Black:   Well, getting into trouble with their parents and teachers, lying frequently, fighting in the schoolyard, vandalizing a local cemetery, hurting animals or small children, engaging in early sex acts that others aren't. All of these things, the behaviors escalating over time to fit their age and opportunity.  So it's people that /

Rob Kall:   (interjecting) Would cruelty or bullying be an indication?

Donald Black:   Oh absolutely.  Yeah.  Bullying others, that's an anti-social act.  A lot of these bullies we read about in the papers, they're probably, if they're old enough, we'd probably call them an anti-social personality, or sociopath.  If they're younger, we'd probably use the term "Conduct Disorder."

Rob Kall:  OK.  What about this fascination in America with guns?  We've got three or four million members of the NRA.  That's not even half of the number of the sociopaths in the country.  I'm fine with somebody who want to go out and hunt and bag a deer or a squirrel or something like that, but is there a level, an extremity, a degree where gun ownership becomes an obsession that could verge on sociopathic ?

Donald Black:   I'm not sure I even want to go there, because there's no association between gun ownership and sociopathy as far as I know.   Guns, unfortunately, are considered as American as apple pie anymore, and if the NRA has it's way even more guns would be out there.  What we do know is, if homes where guns are kept, you're more likely to see accidental shootings, murders, and suicides in those homes than if the guns were not present.  And that's the elephant in the room that people aren't willing to talk about: that if guns are present, you're more likely to have these bad events occur than if the guns are not present.  And whether you lock them up or not almost doesn't seem to make any difference; if they're in the home, they can be used for these bad things.

Rob Kall:   Final question: How do we deal with people who are anti-social personalities or sociopaths if we encounter them, if we work with them?

Donald Black:   Well, if you know that they're anti-social -- (laughs) one of the things that I say almost in jest in the book but actually has some practical application is: keep a distance from these people, because they can only cause you grief.  Now as a doctor, I interact regularly with people who are anti-social.  Much of my work is on an inpatient unit.  I see these people with some regularity.  I tell our residents in training that we don't have much to offer them on an inpatient basis, and we shouldn't keep them around very long.  The longer you keep them on an inpatient unit, the more disruptive they can become in terms of requesting special privileges or requesting new medications, and they can become very disruptive.  But in your personal life, if you know a relative has one of thees disorders, or maybe your husband, or a son -

Rob Kall:   Co-worker?

Donald Black:   Co-worker.  If they're in your family I would encourage them to at least get counseling for the trouble that they have in getting along with other people.  Maybe they can benefit from anger management.  Some people may benefit from medication, particularly if they suffer depression or some kind of anxiety disorder.  If they have a substance abuse problem they should be encouraged to get treatment for that.  So those are things that family members can do.  But in the worst cases, the best thing to do is create distance from that sociopathic relative. 

Rob Kall:   And what about if you work with somebody who is like that?

Donald Black:   Well - you're more limited.  But you could always go to HR and ask for reassignment, or if you have knowledge of their misbehavior, report that.  But you're probably more limited because of rights that people have in the workplace that may actually keep them in the workplace than outside the workplace.

Rob Kall:   OK.  What if a sociopath is intentionally making your life miserable?  Does that happen much?

Donald Black:   It can - for example, a stalker: some who's stalking you and making threats.  That's criminal behavior, it should be reported to the authorities.  And in the worst cases, perhaps, someone needs to get a "No Contact Order" - although with some anti-socials, it might just make them more angry.

Rob Kall:   I see.  Sounds like our culture really has not dealt with the reality and phenomenon of the sociopath in anywhere near close to a way that is competent or comprehensive.

Donald Black:   I totally agree.  I think our society needs to address it, I think the leaders at our research institutions need to address it, and they're not.  I think by writing this book, and talking about this condition and bringing attention to it - that helps, but we need more than just talk.

Rob Kall:   I'm sorry, a last question.  What about in other cultures?  What about in indigenous tribal cultures?  Have you ever looked at that, the phenomenon in different cultures, and particularly tribes, things like that?

Donald Black:   That's an excellent question, and I can address it this way: anti-social personality disorder has been looked at in various countries around the world, various societies.  Wherever people have looked for it, they've found it.  I don't know that anyone has specifically looked at, say, indigenous cultures or very primitive cultures, but my guess is that you'd find it there too.  I think it's in our genes.  Wherever it's been looked at, it's present in a certain percent of the population, and I think it's just part of human society wherever humans are found.

Rob Kall:   OK.  It's been a great interview.  Thank you so much.  This is the Rob Kall Bottom Up Radio Show, WNJC 1360 AM.  I've been speaking of Donald W. Black MD, author of Bad Boys, Bad Men: Confronting Anti-social Personality Disorder.  Thank you.

Donald Black:   Yes, thank you.

Authors Bio:

Rob Kall is an award winning journalist, inventor, software architect,
connector and visionary. His work and his writing have been featured in the New York Times, the Wall Street Journal, CNN, ABC, the HuffingtonPost, Success, Discover and other media.

Check out his platform at RobKall.com

He is the author of The Bottom-up Revolution; Mastering the Emerging World of Connectivity

He's given talks and workshops to Fortune
500 execs and national medical and psychological organizations, and pioneered
first-of-their-kind conferences in Positive Psychology, Brain Science and
Story. He hosts some of the world's smartest, most interesting and powerful
people on his Bottom Up Radio Show,
and founded and publishes one of the top Google- ranked progressive news and
opinion sites, OpEdNews.com

more detailed bio:

Rob Kall has spent his adult life as an awakener and empowerer-- first in the field of biofeedback, inventing products, developing software and a music recording label, MuPsych, within the company he founded in 1978-- Futurehealth, and founding, organizing and running 3 conferences: Winter Brain, on Neurofeedback and consciousness, Optimal Functioning and Positive Psychology (a pioneer in the field of Positive Psychology, first presenting workshops on it in 1985) and Storycon Summit Meeting on the Art Science and Application of Story-- each the first of their kind. Then, when he found the process of raising people's consciousness and empowering them to take more control of their lives one person at a time was too slow, he founded Opednews.com-- which has been the top search result on Google for the terms liberal news and progressive opinion for several years. Rob began his Bottom-up Radio show, broadcast on WNJC 1360 AM to Metro Philly, also available on iTunes, covering the transition of our culture, business and world from predominantly Top-down (hierarchical, centralized, authoritarian, patriarchal, big) to bottom-up (egalitarian, local, interdependent, grassroots, archetypal feminine and small.) Recent long-term projects include a book, Bottom-up-- The Connection Revolution, debillionairizing the planet and the Psychopathy Defense and Optimization Project.

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