Antisocial personality disorder is a type of particularly challenging disorder characterized by impulsive, irresponsible, and often criminal behavior.

The manipulation, deception, recklessness and the lack of empathy for the feelings of others are the most outstanding characteristics.

Antisocial personality disorder: example in a prison

In the 1990s, Spanish prisons suffered the blows and social destruction that unleashed in many families the era of debauchery and open bars in the 1980s, where Many young people fell forever trapped in the dense network of hard drugs.

It was around then when As a young psychotherapist I enthusiastically began my first steps in the Carabanchel men’s prison, Madrid I, where preventive prisoners and those convicted of various crimes arrived, many with an antisocial personality disorder. A serious mental health condition that affects the way a person thinks, perceives, feels, or relates to others.

At that time, the most frequent type of crime in 80% of the cases in that prison was robbery with violence intended to finance drug consumption or for crimes against public health (drug trafficking). And, although in the hive of the prison there were ETA prisoners – always grouped together and with a cardboard hanging from their necks with the inscription «political prisoner» appearing – mixed with bloodthirsty drug traffickers from the Nécora operation, and other types of criminals for major or minor crimes, None of those I interviewed, around 160 people, admitted to having committed any crime.

The inmates seemed not to know why they were imprisoned there and felt unfairly treated when it came to deserving such confinement.

There was only onelike a rare bird, who after making sure about the confidentiality of his confessions and the anonymity of his identity when participating in my doctoral thesis He revealed to me with complete naturalness that for him “stealing was a job.” and that he went out every night to see what he caught, that it was not his fault that people were gullible and forgot their things in the glove compartments and trunks of cars and that of the numerous causes that had brought him there – some still pending to «lower» the sentence, that is, with the trial still to be held and despite already serving a sentence for a few other accumulated sentences – he acknowledged that they were insignificant compared to the 240 robberies he estimated he had committed. He did not exhibit excessive resentment towards the police because he considered that, just as he did his job, they also did theirs. It was a game of skill, in short, perks of the job.

If at that time I had not had access to their judicial files and compared the manipulated and biased versions of the prisoners, it would seem that they had all been detained unjustly, that We lived in a tambourine country, full of laws designed to make life impossible for its citizens, a cruel and insensitive police, naïve or clumsy judges who were unable to clearly discern the lies that the lawyers wrapped around them. Everyone felt like victims of the hostile system and a cruel society that had inexorably pushed them to their situation.

Reality corroborated what scientific studies on antisocial personality disorder pointed out: They lack feelings of empathy, they exploit or violate the rights of others without remorse and prisons, Hospitals and mortuaries are full of their victims (Wedkond Ods, S., Papalia, D.,1992). They frustrate the judges who execute the laws, the dedicated social workers and educators, and their own parents from a very early age. These people seem unattainable by most means and, even as children, They do not seem to respond to the rewards and punishments that motivate others.

Antisocial personality disorder: first symptoms

According to the classification of the DSM-V, Diagnostic and Statistical Manual of Mental Disorders, which is the bible of Psychologists and Psychiatrists, Antisocial personality disorder is characterized by a pattern of irresponsible and antisocial behavior which begins in childhood or the first stage of adolescence and continues into adulthood.

Thus, it is very possible that typical signs such as:

• Lies
• Thefts
• Idleness
• Vandalism
• Fights
• Escape from home
• physical cruelty

Although will be reached adulthood where it manifests itself in all its crudeness due to the impossibility of leading a normal life and facing the responsibilities of adult life such as getting a stable and continuous job over time, facing financial obligations or acting as a responsible parent if applicable, etc.

In fact, in order to strictly apply this diagnostic category The person must have been at least 18 years of age and have a history of a conduct disorder since before the age of 15.

It is necessary to reach that minimum age because cWe consider that when we evaluate personality it must be consolidated, with “personality traits” already established predominants. It is only from then on that we begin to talk about the “structure” of the personality, made up of the cardinal psychological characteristics that will tend to remain stable over time and that can be exhibited in different scenarios. From that moment on, We talk about what to expect from a person in relation to how they will behave when interacting with others and in different contexts.

Antisocial personality disorder: how to recognize it

This is how antisocial personality disorder manifests itself in adults:

1. They break the rules without remorse

It is very difficult for them to internalize social norms, and carry out antisocial acts without any sense of remorse towards others, such as, for example: destruction of property, aggression, theft and illegal behavior. Which paves the way for them to be easily arrested or go to jail. When they are, they reaffirm their arguments over and over again to justify their actions.

I remember the case of a young man who told me coldly and lacking all empathy how he had almost certainly killed a man by robbing him without showing a hint of concern real for him, he was only anguished by his prison situation, how it could affect him judicially and the revenge of his relatives. He perceived the world as full of persecution and hostility toward him, fearing “an eye for an eye and a tooth for a tooth.”

2. They are aggressive and irritable people

Another characteristic is that when you interact with them you observe that they tend to be irritable and aggressive and It is very easy for them to get involved in physical fights.also at home, with one’s spouse or one’s own children.

3. They exhibit reckless behavior

Reckless behavior is common without worrying about their personal safety, as is evident when you are intoxicated or when they agree to race with speed bets.

4. They tend towards promiscuity

Sexual promiscuity is also very typical. and they find it very difficult to commit to monogamous relationships of more than a year.

Adolescence is a vital stage that they go through, frequently accompanied by the use of tobacco, alcohol or other drugs, and sexual relations that are unusual for their age group. And, the most frequent associated diagnoses are psychoactive substance use disorders.

Causes of antisocial personality disorder: innate or acquired?

Antisocial personality disorder affects men more than women with a ratio of 6 to 1.

It has not been determined with certainty Why do some people develop this disorder? but a combination of multitude of genetic and environmental factors such as:

1. Traumatic childhood experiences, full of situations of neglect and abuse.
2. Upbringings in difficult family circumstances.
3. Alcohol abuse by one or both parents.
4. Entrenched conflicts between parents with unstable and inconsistent upbringings.

As a consequence, social services are often involved in the care of the minor. And, these dramatic deficiencies and childhood difficulties carry them through the rest of the evolutionary stages in correctional facilities or juvenile centers in adolescence when they commit crimes and are arrested or in prison, as adults.

What is the treatment of antisocial personality disorder?

One of the most pronounced difficulties involved in the treatment of all personality disorders is that, given that personality is built from our childhood, throughout life and is consolidated over the years, People with a disorder do not see anything wrong with the way they act because “it has always been that way.” and they lack sufficient awareness that they have a problem. Which makes them reluctant to seek treatment and only come to therapy by court order.

Although antisocial personality disorder It is considered one of the most difficult disorders to treat and it was thought in the past that it lasted a lifetime, this is not always the case, and sometimes it can be controlled and treated.

The recommended treatment will depend on your circumstances, and age, criminal history, whether there is any associated problem such as alcohol or drug abuse, and also family and social support are taken into account.

In many cases, it is also necessary to resort to specific resources for substance abuse detoxification and social care.

On a psychological level This type of disorder is one of the least investigated. and much remains to be done but here are some of the therapeutic models applied that exhibit visible results after long periods of treatment.

A. MENTALIZING THERAPY

It is a type of psychotherapeutic approach that incorporates new developments and scientific advances to what has already been said by the psychoanalytic model. AND, consists of designing therapeutic interventions adapted to these specific disorders with the aim of promoting and developing the person’s ability to learn, recognize and understand the mental states of both oneself and others.

In Antisocial Personality Disorders It has been shown that the mentalizing capacity is very impaired. The results of neuropsychological studies support this observation by demonstrating poor functioning of the prefrontal area of ​​the brain, the most evolved and highly involved in adequately regulating our emotions and impulse control.

This model has demonstrated therapeutic efficacy in the emotional regulation of intense emotions: reduces anger, hostility and paranoia, the frequency of self-harm and suicide attempts, improves negative mood, general psychiatric symptoms, interpersonal problems and social adaptation (Peter Fonagy, 2016).

B. COGNITIVE BEHAVIORAL THERAPY

In general, it is used so that the person can gain greater understanding about their behavior and change maladaptive behavior patterns