Antisocial personality is often confused with a personality structure that is unsociable and withdrawn, but it has nothing to do with this definition. In summary, antisocial personality is a personality type that manifests itself by not following the rules and not having any remorse, and has problems in moral judgments.
As with other personalities, we can talk about a wide range of personality traits for antisocial personality, from personality traits to personality disorders. Like other personalities, psychopathy can be seen in a wide range of different doses. The 'disorder', which is at the extreme end of this spectrum, is clearly stated in DSM-5 with criteria under the name antisocial personality disorder (American Psychiatric Association, trans. Köroğlu E., 2014, p. 331). Accordingly, we know that for a diagnosis of antisocial personality disorder, at least three characteristics must be seen in a person. If the person shows fewer than the five characteristics mentioned, we can talk about antisocial personality structure instead of antisocial personality disorder. What is important here, as in all other pathologies, is the intensity, severity, in other words, the 'dose' that occurs in the person. As we know, personalities; It lies on a spectrum from trait to disorder, what is important is where the person is on this spectrum.
Antisocial personality, such as repetitive behavior aimed at receiving punishment, using others, being action-oriented, aggressive behavior, irresponsibility, lack of empathy. may have distinctive features. It is known that individuals with antisocial personality enjoy harsher and more challenging experiences, cannot express their emotions, and prefer to act rather than talk, other than enjoying music, art, love and nature, as many people love and enjoy. They cannot control their impulses and often behave irregularly. It is known that people who are identified as having conduct problems/disorders during childhood and adolescence are diagnosed as antisocial personalities in adulthood. It is also known that it is three times more common in men than women in society.
As we know, biopsychosocial reasons are effective in personality formation. There is a biological reason for antisocial personality, especially as shown by studies such as twin and hormone studies. These have been frequently emphasized. As can be expected, the past stories of antisocial people are surrounded by traumas. From an object relations perspective; There may be inconsistent family behaviors, sadistic parental behaviors, stories of parents using substances, excessive pampering and excessive discipline imbalance or emotionally deprived parents, parents who did not limit the child's limitless displays of power, and family stories that rewarded antisocial behavior and abused in various ways. In addition, antisocial personality did not experience a healthy secure attachment process in infancy and childhood. As can be understood, they could not experience a secure attachment process and therefore antisocial personalities could not receive sufficient love. In addition, it can be predicted that those with severe antisocial personality may have more severe traumas in their stories.
When we look at the defense mechanisms, the first thing that should be in our minds is that the superego of the antisocial personality does not work well. For this reason, his preferred defenses are; Mechanisms such as acting out, omnipotent control, dissociation, and projective identification are mentioned. In particular, the mechanism of acting out is so intense that they often respond by acting out in times of stress or anxiety.
It is known that the psychopathic person has an unconscious feeling of envy and shows this with his behavior. In other words, they show behavior aimed at destroying the things they envy and attract. He may show hostile attitudes when he realizes that he lacks some things that others enjoy. This interpretation is a very descriptive explanation that illuminates the inner world of antisocial personality.
Family dynamics in the formation of psychopathy have been mentioned in detail above. The message given to antisocial personality since childhood; These are traumatic messages such as not being loved, being a problematic person, not being responsible for the child's actions, or 'even if you do bad things, you are too worthless to be given attention'. Therefore, in conclusion; An intellectual belief that ensuring one's self-worth and self-respect and coping with the inner feeling of envy is only possible through action-oriented, irregular behavior. may occur. From this perspective, it can be understood how there is a frightening sense of envy behind psychopathic behaviors that lead to tortured murder.
It will be important to remember that antisocial personality can be confused with other personalities and to differentiate accordingly. Personalities that can often be confused with antisocial personality; Narcissistic personality may be paranoid personality. As is known, there is a connection between narcissistic personality and psychopathy. Since both personalities tend to be too 'entitled', they cannot empathize and hurt others. However, narcissistic personality distinguishes itself from psychopathy through idealization and devaluation defenses. In addition, it should be known that narcissistic personality does not show criminal tendencies and aggression as in antisocial personality. In psychopathy, there are ruthless behavioral patterns, criminal behavior and lack of remorse, as well as omnipotent control.
Antisocial personality's application for therapy may be rare, like some other personalities (narcissistic personality). The encounter of the antisocial personality with the clinician may be more likely for a reporting situation in court proceedings. Transference and countertransference issues are inevitable when faced with antisocial personality. As it is known, transference refers to the client establishing a bond between someone from his past life and the therapist and maintaining the relationship accordingly. Countertransference means that the therapist establishes a bond between the client and someone from his own past and behaves accordingly in the process.
From this perspective, as can be expected, transference and countertransference issues will be important. Some sources mention the issue of transference, and as expected, the antisocial personality is reflected in the therapist; It will reflect his own inner aggression, anger and action orientation. From a countertransference perspective, the therapist will judge the antisocial personality morally and will probably dislike the antisocial personality at all. The therapist working with antisocial personality may often experience experiences such as anger, fear, judgment, disdain or distancing.
When planning the treatment process of antisocial personality, first of all, the 'personality' that I mentioned before The 'density' evaluation part will be important. The evaluation of antisocial personality, which is a much more important and sensitive issue than the evaluation processes of other personalities, is very important for the treatment plan. Another issue that should be taken into consideration when working with antisocial personality is to plan a therapy process that is not flexible, in short, disciplined, with certain boundaries and rules, for this personality group that does not have boundaries and rules in the therapy and treatment process. In addition to the discipline and structured techniques often emphasized, the other theme that the therapist is recommended to adopt for antisocial personality is the issue of honesty. Of course, the issue of honesty here does not mean that the therapist reveals himself to the antisocial person. The honesty that the therapist must have means that he stands behind what he says, is realistic and disciplined. Although it may be difficult when working with antisocial personality, the therapist's goal is, in short, to develop a superego in the patient. For this, throughout the therapy, the therapist will need to regulate the client's reactions in a non-punitive, 'healthy' parent manner. At the same time, it is important and necessary for the therapist, in his role as a healthy parent, to reconsider transference situations in a useful way during the therapy process. In summary, as in many personalities, the issue of transference will depend on which important childhood character the therapist refers to, such as mother or father. Therefore, the therapist will need to know his own backyard well in terms of countertransference. As can be seen, transference and countertransference issues have a very different importance for antisocial personality.
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