"Psychological Matters" is Moving!

I have been making some changes!

First off, some of you may have noticed that this blog's name recently switched from "Living Life 2 the Fullest" to "Psychological Matters." Now the address will be changing. All future articles, including this Friday's will be found at  http://www.kerrykerrmcavoyphd.com/psychological_matters/.  

I have also been making some other modifications and additions this year. A few months ago I created a counseling website that features information about my counseling practice. It makes sense to host this blog on that site since they share a common theme.  So, going forward this blog will be hosted there.

As I have shared before, I have also been writing. Two years ago I published two paperback devotionals called Jesus, The Ultimate Therapist: Bringing Hope and Healing and Jesus, The Ultimate Therapist: Healing Without Limits. The Kindle ebook versions were made available last summer. 

Now, I am back at work on the third book in the series. This latest book is scheduled to be released early 2014 and will address how we experience God during difficult times. The tentative title is God, Where are You When I Need You? Exploring our Experience of God's Presence.

In light of this, I have just launched a author website! This site will provide information about the first two devotionals, upcoming books, release dates, and a new blog that will focus on spiritual reflections and insights.  

Thank you for all your great support here and I look forward to seeing you at my two new websites, Kerry Kerr McAvoy, PhD and Living Life 2 the Fullest! 

Please also "like" me on my Facebook page and follow me on Twitter (@KKMcAvoy).

Affective Mood Disorders: Impact and Causes of Depression

While listening to the radio on my drive home Tuesday, I heard the DJ pose this question, “If God would spontaneously heal just one illness or disease, which one would you pick?" A woman quickly called in. She said she would choose the illness of depression to be eradicated. She went on to explain that this condition is difficult to understand since it doesn't have any obvious outward symptoms. She shared that many people mistakenly think depression is a choice and can be conquered simply by thinking positively. As she spoke, she sounded discouraged and exhausted. I wondered if she was currently battling with the illness. The radio talk show host seemed surprised. I suspected he expected a more typical answer, like cancer or heart disease.

Depression, however, is a serious illness. It comes with catastrophic ramifications, such as higher rates of death, loss of productivity in the workplace, increased medical costs, marital stress, and a negative impact on family members, including children’s development. National Alliance on Mental Illness estimates that the workplace annually loses over $34 billion in direct and indirect costs. Suicide is currently the eleventh leading cause of death in the US. Depression has definite effects on our society.

As Tuesday’s radio caller mentioned, there is a common myth that people chose to be depressed. Depression, however, is not due to having a bad day. It isn't caused by being blue or moody and doesn't respond to positive thinking. It is a real medical condition with common occurring symptoms.

Although the etiology of depression is still not completely understood, several common causes have been found to play a role. A person’s biology, genetics, gender, age, health condition, history of traumatic events, current level of stress, and use of medication or illegal substances can have an impact. Women are more vulnerable to depression and are twice as likely as men to suffer with this condition. The elderly are also more at risk. Depression runs in families. Individuals with alcohol or substance abuse problems frequently struggle with depression. Those with chronic physical conditions have higher rates of depression. And, people with a history of child abuse seem to be more vulnerable to this illness.

I too was surprised by the answer to Tuesday’s radio host's question. But, I was very thankful that the brave caller was able to share her painful insights and her wish for universal healing of depression.

In the next article we will explore how depression strikes people at different times of life and in different ways by looking at the five main types of depression.

Affective Mood Disorders: Introduction

I am changing gears this year by beginning a long series of articles on Affective Mood Disorders. This psychiatric category covers a lot of ground and includes all types of depression and bipolar disorders.

This topic touches close to home for me since several members of my extended family have struggled with depression, particularly my father.

My father and grandmother

Dad was a hard-working farmer. He had a strong work ethic and put in long hours in the fields and barn. Dad, however, struggled with Major Depression, or possibly a type of Bipolar Disorder. Periodically he became moody. His outlook seemed dark, and he would made comments that indicated he entertained the idea of suicide. These bouts often lasted for months. I remember tentatively checking out what frame of mind he was in when he came in from working outside. Would he be warm and friendly? Or, emotionally remote and irritable? My quick assessment would shift how I approached him. Sometimes it seemed easier to leave him alone than to deal with his mood.

Dad wasn’t the only one in the family who experienced depression. My paternal grandmother (his mother) also struggled with it. Sometimes when I visited Grandma I would find her sitting in a dark house with all the lights off. She would seem discouraged. Depression usually made her pessimistic about life in general.

Affective Mood Disorders are unfortunately a common illness. According to the National Institute of Mental Health, approximately twenty-one million Americans, or about 9.5 percent of the US populations, ages 18 and older, have a mood disorder. The prevalence rate is higher for women than men.

Through the years there have been others in my extended family who have struggled with a mood disorder. This isn't unusual since Affective Mood Disorders also have a strong genetic component. Studies have shown that heritability (or in other words, one’s genetics) for this condition accounts for between 40 to 50 percent of all cases.

During the upcoming months I will discuss various types of mood disorder conditions, including Depression and its sub types  Bipolar Disorder Type 1 and 2, and Peri-natal Mood Disorders (formerly called Postpartum Depression). I will explore the many facets and aspects of these illnesses, such as, what are the symptoms of each? When is someone the most vulnerable to these conditions? And, what are the latest treatments?

The next article will kick off this series by starting out with a look at the various types of depression.

Antisocial Personality Disorder Resource List

This is the final article in the series looking at Antisocial Personality Disorder. I plan to start a new series discussing various aspects of Depression in January 2013. Hope everyone has a wonderful, happy holiday season!

Resource List

Snakes in Suits: When Psychopaths go to Work by Paul Babiak, PhD & Robert D. Hare, PhD (2006) HarperCollins Publishers

Not all individuals with Antisocial Personality Disorder (APD) are in prison, many are among us. They work and play alongside us. Babiak and Hare reveal the common ploys of psychopaths, especially in the corporate world. The authors provide detailed suggestions about how to screen for psychopaths in the interview process as well as how to protect the work environment from those whose main goals are to manipulate and exploit the workplace.

This is an outstanding book for those in the business world who would like to become more aware of the subtle warning signs of psychopaths.  

The Sociopath Next Door by Martha Stout, PhD (2005) Broadway Books

Stout does an outstanding job of describing everyday sociopathy. She uses case examples to describe commonplace APD, the role conscience plays in society, and the disruptive, destructive nature of this disorder. She explains how to identify the sociopaths among us and outlines specific ways to protect ourselves.

I highly recommend this book. It does not focus on the extreme violent end of the continuum of APD, but rather the everyday examples of this condition. This is an excellent read for anyone wanting to understand how to defend oneself against commonplace APD.

 The Anatomy of Evil by Michael H. Stone, MD (2009) Prometheus Books

Dr. Stone explores the concept of evil in this compelling book.  The first part of the book defines “evil” and what constitutes as such behavior.  Through a detailed analysis of more than 600 violent criminals he has developed a 22-level hierarchy of evil behavior that moves from justifiable homicide to psychopathic torture-murder. He then uses actual cases to discuss the impact of genetics, family dynamics, societal pressures, mental illness, and the abuse of mind-altering substance in order to help us understand what causes some people to commit heinous acts of violence.

I recommend this book to those who are trying to understand why/what motivates some people to perpetrate atrocities. However, due to its narrow focus on extremely violent criminals, it is not recommended for those who are looking for a more general exploration of Antisocial Personality Disorder. 

The Profiler: My Life Hunting Serial Killers & Psychopaths by Pat Brown (2010) Voice, Hyperion: New York

Pat Brown starts this book by describing how her real-life experiences with a killer lead her to become a criminal profiler. She then open actual case files to provide an up-close perspective of the forensic work involved in investigating crimes. This book provides a fascinating behind-the-scene exploration of profiling and is recommended to those who would like to understand how criminal profilers develop theories and insight into serial killers' behaviors. 

Bad Boys, Bad Men: Confronting Antisocial Personality Disorder by Donald W. Black, MD (1999) Oxford University Press

Black explains the history of the diagnosis Antisocial Personality Disorder. The information is peppered with plenty of fascinating case histories and examples. This is a very interesting book for those looking to understand the background and definition of this disorder.  It also reviews scientific thought about the disorder and various treatment options.

I am, however, reluctant to recommend Black’s Bad Boys since there are other more recent resources available.

Two books not reviewed, but worth a look–

Without Conscience: The Disturbing World of Psychopaths Among Us by Robert D. Hare, PhD (1993) The Guilford Press

Getting It Through My Thick Skull: Why I Stayed, What I Learned, and What Millions of People Involved with Sociopaths Need to Know by Mary Jo Buttafuoco (2009) Heath Communications, Inc.

Other Interesting Links–

The Psychopath in the Corner Office

The Psychopath’s Relationship Cycle: Idealize, Devalue and Discard

Ponerology 101: Snakes in Suits

Physical and Emotional Abuse On-line Support Group

Psychological Self-Defense: Protecting Oneself From Sociopaths

Photo courtesy of ©iStockphoto.com/hammondovi

Sociopaths are hazardous to everyone. This is a hard truth to accept, thus we downplay their ruthlessness and extreme self-interested behavior. We prefer to see sociopaths as misjudged or free-spirited. Let's use the character Neal Caffrey in White Collar as an example. We tend to ignore Neal’s deceptions, con jobs, and thefts, but rather focus on his good looks, sad past, quirky friends, and charming personality. He is simply misunderstood, instead of dangerous. His likeability reduces our internal sense of threat. This type of misdirection is commonly employed by sociopaths.

What are the indicators that we are dealing with someone dangerous?

The best resources for this information are found in Martha Stout’s The Sociopath Next Door and Babiak and Hare’s Snakes in Suits: When Psychopaths go to Work. I have pulled out several tips from these outstanding books for the benefit of this article.

According to Martha Stout, the best interpersonal warning signal of a sociopath is when this individual appeals to our sense of pity. She calls this move the “pity play.” Sociopath uses our sympathy rather than our fear to manipulate and deceive us.  She goes on to say, “when deciding whom to trust, bear in mind that the combination of consistently bad or egregiously inadequate behavior with frequent plays for your pity is as close to a warning mark on a conscienceless person's forehead as you will ever be given.” (p. 109)

How can we protect ourselves from sociopaths?

First, we must learn to trust our gut. If something seems off kilter or wrong about an individual, even if this person has impressive credentials, then suspect a problem and be on guard.

Second, we need to know ourselves. What are our psychological needs and weaknesses? Sociopaths are experts at identifying our psychological vulnerabilities or “hot buttons” and use them against us. If we look for approval from others, then they will make sure to build us up so that they can manipulate us. Becoming more aware of our insecurities will help to alert us when they are being used against us.

Third, we need to suspect the excessive use of flattery and to watch out for flowery phrases, inconsistencies, distortions, bad logics, or outright lies. Sociopaths often implore such tactics to sound impressive and to create a smoke screen. It is helpful to be clear about what we are trying to express during key conversations in order to avoid being misled or deceived.

Fourth, once someone has lied three times, including broken promises or neglected responsibilities, we should suspect this person’s integrity and get out of the relationship as quickly as possible.

And finally, if we suspect someone may be a sociopath, we should not try to outsmart or to redeem this person. As harsh as this seems, some people are dangerous and should be avoided.

The next article will be a list of resources on this topic and will be the final one in this series on Antisocial Personality Disorder.

Current Television Show Sociopaths:

White Collar - (Neal Caffrey)

Dexter - (Dexter Morgan)

Revenge - (Emily Thorne, Conrad Grayson, Victoria Grayson)

Falling Skies - (Pope)

Persons of Interest - (aka Root/Caroline Turing)

References:

The Sociopath Next Door by Martha Stout, PhD (2005) Broadway Books

Snakes in Suits: When Psychopaths go to Work by Paul Babiak, PhD & Robert D. Hare, PhD (2006) HarperCollins Publishers

Patsies, Pawns, Patrons, and Police: Understanding Sociopathic Relationship Roles

At least one time in our lives each of us will make the mistake of trusting someone who doesn’t deserve it.  Especially when we consider the statistics that one out of every twenty-five people in the world are individuals with APD (sociopaths). In the best-case scenario, this betrayal only inconvenienced us, but more often we will have been conned, cheated, or abused. How do we recognize and avoid relationships with sociopaths?

To protect ourselves, it is important to understand sociopaths’ motivation for developing relationships. Their reasons are not the same as ours! Lacking a conscience, they are unable to form emotional attachments and are disinterested in developing a bond with others.  Instead, they are thrill seekers, and use relationships to achieve this goal.

In pursuit of their next big emotional charge, sociopaths tend to cast others into three main roles: “pawns, patrons, or police.”

“Pawns” are individuals with little or no social or political power who can be manipulated to advance the sociopath’s agenda. Just as in a chess game, they are easily used and quickly discarded. For example, serial rapists are often married men; their family conveniently provides them the screen of “normalcy,” thus helping them to avoid suspicion.

“Patrons,” on the other hand, have considerable social or political power. They usually occupy high places at the office or in the community. Through the use of charm, they are wooed and won over. The sociopath uses them either to protect himself from accusations or to betray them as he navigates himself toward his end game. 

Finally, there are the “police.” These are individuals who could get in the way of the sociopath’s agenda and must be neutralized.

To make this picture clearer, let’s use a current ABC’s show, Revenge, to understand these roles. (This program seems to celebrate the Antisocial Personality Disorder!) There are three main sociopathic characters: Emily Thorne, Victoria Grayson, and her husband, Conrad Grayson. For the sake of this article, let’s focus on Emily and her relationships.

Emily’s “pawns” are (the fake) Amanda Clarke and occasionally Jack Porter. Neither have useful social connections or power in this rich Hampton community, but both are used as alibis or fall guys as Emily takes her revenge.

The “patrons” are Ashley Davenport, Nolan Ross, and Daniel Grayson. Emily initially used her friendship with Ashley to gain access to the Grayson family and then regularly takes advantage of Nolan’s wealth, computer acumen, and social access to reap havoc on the Graysons and their friends. And of course, Daniel Grayson, the son of Conrad and Victoria, is used to gain even greater access to the Graysons’ secrets and as a weapon to hurt the Grayson family.

The “police” vary from episode to episode. Sometimes it is the legal authorities, other times it is outside sources that threaten to upset Emily’s plans of revenge.

There is one more role in the sociopath’s world, the “patsy.” This is another name for victim. This person may have previously been a pawn or a patron who now is of no further benefit to the sociopath, or this individual could be the target. Unfortunately, one becomes a patsy when the game is finished. At this point the sociopath has played out his moves and has moved on.  Meanwhile, this person has been deceived, betrayed, cheated, blamed, used, ridiculed, abused, or in the worst-case scenario, killed. 

How does one avoid becoming a sociopath’s patsy? The next article will identify useful strategies to protect oneself from a sociopath.

Antisocial Personality Disorder: Characteristics and Development of APD

At the beginning of my professional career I came across a fascinating book called, The Stranger Beside Me (1989), by Ann Rule. It was a biographical work about Ted Bundy and his killing spree across the United States during the 1970’s. Ms. Rule personally knew Bundy. She briefly worked alongside him at a Hotline Crisis Center. He was a brilliant, attractive man who majored in psychology and went on to obtain a law degree. He would often feign physical injury, such as a injured arm, to lure women to a private location where he could physically overpower them. Before Bundy’s execution in 1989, he confessed to thirty homicides. Published estimates of the actual number of murders committed by Bundy, however, ran as high as 100 women.

Ted Bundy is just one infamous serial killer. There have been many others who have grabbed the public’s attention as far back as Jack the Ripper. More recent examples include Kenneth Bianchi, John Wayne Gacy, and Jeffrey Dalmer.  How are such monsters created?

Most serial killers can be diagnosed with APD, but most individuals with APD do not become serial killers. Bundy and his ilk are an extreme example of APD. The DSM-IV-TR lists the main criterion as “a pervasive pattern of disregard and violation of the rights of others occurring since age 15.” Behaviors that qualify include: repeatedly committing unlawful acts; a failure to conform to societal norms; a practice of deception, either by regular lying, use of aliases, or conning others for personal gain; displaying aggression and chronic irritability; a reckless disregard of the safety of others; being consistently irresponsible; and a lack of remorse for one’s behaviors.

How does this disorder come about?

Theories vary about the origins of APD. What is known is that suffering individuals often come from troubled homes. Parents are more often alcoholics or criminals. Divorce rates are higher with parental absences or separation. People with APD often have experienced repeated early emotional losses, causing problems with their ability to attach to others.

Neurological abnormalities are also present in those with APD.  Certain brain measurements indicate a chronic low arousal level, possibly causing a need for greater sensory input. Thrill-seeking behaviors and risky situations could be understood as efforts to address this condition.

There are also strong genetic indications. Identical twins are 50% more likely to share this disorder than fraternal twins. It has also been found that those with APD are more likely to have fathers with criminal history, suggesting a familial pattern.

Ted Bundy was born at a home for unwed mothers and raised by his grandparents. He was told that his grandparents were his parent and his mother was his older sister. Although Bundy spoke warmly about his grandparents, other family members described his grandfather as a tyrannical bully and a bigot, who flew into violent rages. Bundy was an odd child. He struggled to fit in with his peers. His criminal behavior started in his adolescence when his stole skiing equipment and forged lift tickets to purse his passion of snow skiing. Some speculate he may have killed his first victim at the early age of 14.

What is particularly disturbing about APD is that most of us have hard time recognizing it in others. How did thirty women fail to see Ted Bundy was extremely dangerous? Unfortunately the characteristics that make APD perilous also create an exciting or sexy allure about these individuals. They are often charismatic and seem larger than life. They live on the edge. We find them charming, and their shocking behaviors titillate us. Like a deadly Venus Flytrap, we are drawn to them to our own peril.

In the next article we are examine how to recognize APD in our midst and briefly describe how to protect ourselves from those with this condition.

For more information about Ann Rule's work, please visit: 

http://www.trutv.com/library/crime/serial_killers/notorious/ann_rule//3.html

Ted Bundy:

http://en.wikipedia.org/wiki/Ted_Bundy

The Stranger Beside Me:

http://www.amazon.com/Stranger-Beside-Me-Ann-Rule/dp/1416559590