The Charismatic of Antisocial Personality Disorder

Those with antisocial personality disorder can initially appear charming (although this can seem superficial), and the perception of charisma and personal confidence may be used to engage in numerous sexual interactions, with relationships likely to be short-lived due to their callous or duplicitous behaviour.

It can be difficult to determine whether they are being truthful or lying, due to their manipulative tendencies. Those individuals engaged in more harmful or dangerous behavioural patterns can sometimes be called sociopaths or psychopaths.

Adults with antisocial personality disorder can have certain traits relating to an ongoing pervasive and inflexible pattern of behaviour that is relative stable over time and deviates from the norms of the person’s culture.

Manner

• Arrogance / cocky manner

Attitude

• Cynical view of the world

• Has a sense of superiority over others

• Sense of importance of own opinion

Lacks

• Consideration or respect for others

• Empathy

• Guilt when harm others

• Regret or remorse for their conduct

Disregards

• Right or wrong

• Safety

• Physical and emotional rights of others (and can violate those rights)

Actions

• Acting in a manner perceived as aggressive, hostile, violent or threatening to others

• Deceitful behaviours and telling lies to get what they want from others

• Engaging in actions to deliberately anger or upset others

• Interact harshly or with cruel indifference

• Irresponsible and difficulty or failing to consistently meet work, family or other responsibilities

• Problematic drug or alcohol use

• Use of deliberate charm, wit or persona to manipulate others for personal gain/ pleasure.

Childhood development and conduct disorders

Whilst antisocial personality disorder traits can emerge at any time, personality is recognised as forming during childhood. For adults with antisocial personality disorder, there is often a link to a past diagnosis of ‘conduct disorder’ (pre age 15). This coming from behaviours such as being dishonest and lying, aggressive and destructive behaviour and significant disregard or deliberate violations of rules.

Whether childhood ‘nature’ or ‘nurture’ is most influential here is debatable. Genes can predispose someone towards antisocial personality disorder. In the same way, a dysfunctional family upbringing, (such as abuse, violence and neglect, or family members with personality disorders) can lead to changes in the way the brain functions during brain development, potentially triggering the emergence of antisocial personality traits.

Diagnosis

A doctor or other healthcare provider may conduct a thorough mental health examination, which can include medical and family history, presenting thoughts and emotions, how they interact in significant relationships, their behaviours and potentially even seeking information for family and friends. During the diagnosis process, other personality disorders and psychiatric conditions (such as narcissistic personality disorder, schizophrenia or bipolar disorder) will be considered and ruled out before antisocial personality disorder is given as a diagnosis.

General treatment of antisocial personality disorder

In the first instance, people with antisocial personality disorder may not spontaneously engage in therapy; they can consider they don’t need nor would benefit from help.

For treatment to be effective, the individual will need to be willing to engage in therapeutic treatment. Where there are co-morbid conditions talk therapy and/or medications may be recommended.

Where an individual is already engaging in some form of therapy or treatment, a range of complementary and supportive options may be explored. In addition, clients may come to hypnotherapy after needing medical or psychological assistance with other symptoms, such as anger, depression or alcohol/drug misuse.

Hypnotherapy and treatment of antisocial personality disorder

The change process often begins with techniques from behavioural hypnotherapy. These techniques assist clients in recognizing unhelpful habitual responses and actions, allowing them to develop more beneficial behaviours. A significant benefit of hypnotherapy is the use of mental rehearsal and future pacing to practice new responses. This not only serves as an effective ecology check (will it work in the real world?) but also allows clients to practice in a safe environment. By the time they implement these changes in their daily lives, the new behaviours can already feel familiar.

Cognitive hypnotherapy enhances the progress made in behavioural therapy by addressing cognitive distortions and unhealthy beliefs. An added advantage is that clients can learn effective questioning strategies to tackle any future unhelpful thoughts. Specific cognitive-based methods, such as rational emotive behaviour therapy (REBT), acceptance and commitment therapy (ACT), and mindfulness, offer valuable strategies for managing challenging thoughts, feelings, and emotions.