I would assume that this is the most appropriate forum to post this in, and I hope that you all will be able to give me some useful information on this subject matter. If not, I hope that you can direct me to an area that will help me out. I had considered posting in the trauma forum, but I thought that it might be triggering for the vulnerable folk in there.

I had psych testing done 2 years ago and I had it done 10.5 months ago at the treatment center I'm at now (and almost finished with) and both times it came up with ASPD. I struggle with it having come up with this diagnosis. Because I both do and do not fit this diagnosis. I hope that I will be able to explain why in an accurate way. I've been trying to research on the internet to get accurate answers to my questions, but it's been difficult, and my therapists have avoided answering my questions, or give me conflicting answers. Some of them don't believe I fit the diagnosis, others believe I fit it to a T, and others avoid talking to me about it so I don't know where they stand.

Let me begin by saying that my current diagnosis is: Bipolar, BPD, ASPD, and EDNOS anorexic type.

I have experienced various forms of trauma for the majority of my life. My parents have always been inconsistent in their parenting styles and messages, emotionally and physically abusive. They taught me how to be anorexic. They took me to have plastic surgery when I was very young. When I was in 2nd grade SOMETHING happened to me. I don't know what, no one will tell me. That entire era is a giant block in my memory. I don't know if my mother knows or if she just won't tell me. She only says that for the whole year I came home from school crying every day and I would cry all night. From then on I experienced abuse in my adolescence and in early university.

Since I was younger, I've had these...thoughts and urges. I see violent images in my head all the time. I fantasize about it. I have sexual thoughts and urges that both terrify and excite me. When I was in elementary school a girl on the bus called me a ***** and I kicked her in the stomach so hard that I broke 2 of her ribs, and I remember feeling pure bliss, because I heard them break. I never got in trouble over it because I was so little (I'm very short), that the administrators assumed the girl was bullying me because she was 2 grades ahead of me. I've always gotten in to a lot of fights, but as I'm fighting and start to beat people, the bliss I feel over it starts to scare me so I stop. In high school a kid told me that I was weak, and I had 2 freshly sharpened pencils in my bag so I stabbed him in the arm with them, and again I felt happy over it. My senior year of high school I planned on killing my parents. I don't even know why. But I told my friend about it, and told my friend I was going to buy a gun and do it. I guess I told my friend because I was afraid of myself and what I felt I was capable of doing. So my friend called the cops and they came and searched my house believing I had a gun. My parents were afraid of me when they found out about what I wanted to do. I don't know if they still are scared of me, that was a long time ago now. I haven't been violent in a long time. I was never diagnosed with conduct disorder because my parents never believed in psychiatric treatment (I showed signs of depression and bipolar as a young child).

I just...struggle in my head a lot. I often feel evil. Because when I start to think about doing violent acts and the evil sexual things, I begin to feel so incredibly happy because of it. It's this massive high that I get off of it. When I'm driving down the street and a pedestrian starts to cross the street, I catch myself starting to speed up and I have to make myself stop.

But I guess this is where I get confused. It's not that I care about other people. I have difficulty empathizing with people in general. I empathize with friends and family when I'm "in the mood" to...if that makes any sense? I can be extremely empathetic when I want to. But I am terrified of what I feel I'm capable of doing. If I let the beast inside me come out...I feel I would do awful things. Evil things. And I struggle with that. Because it makes me so damn happy, but it scares me at the same time. This is something I've kept inside me my whole life and it has taken me up until I'm nearly turning 26 to mildly discuss with my therapist. Because I'm so terrified of it. And I don't know what to think about it.

So, I suppose...part of me doesn't feel it's a "true" ASPD diagnosis. Maybe it popped up because of the violent urges and stuff. But from what I've researched, ASPD people don't feel the way I do about those thoughts/urges (well they may/do feel happy, but they don't feel scared later), or maybe I'm misinformed about it. My therapist said that my thoughts and urges could be a developmental response to the trauma I've endured, but then my research said that there's a theory that ASPD can develop from trauma, so I'm confused on that also.

I understand if you all can't give me complete answers, but I was hoping that maybe someone could give me some perspective. Since, obviously, none of my therapists have ASPD...I suppose I thought asking people who have the diagnosis could give me a bit more clarity on the subject I guess? I have a massive science brain, so when I have a question...I just want a freaking answer...o.O

[Contrast]

It could be sadism in its classical form..

There is more to the behavior of ASPD than wanting to watch people suffer whilst feeling euphoric during it. Technically; this whole explanation would not justify your (in)accurate diagnosis.

When I was diagnosed, the doc (who discontinued our sessions) knew on the first session I was your casual ASPD - a compulsive liar and a typical manipulator.. he even recommended that I don't see professionals in case they unintentionally teach me something that will help enhance my manipulation.

You claim you can be extremely empathetic when you want to,
you see, ASPD cannot do that; they don't have the capability of switching the ON button for empathy.

I think what you need to distinguish with your doc is whether the diagnosis was accurate or an accidental/careless misdiagnosis.

I'm not sure if this exists but maybe you could have: BPD w/ antisocial traits? I don't know.

Originally Posted by Contrast

It could be sadism in its classical form..

There is more to the behavior of ASPD than wanting to watch people suffer whilst feeling euphoric during it. Technically; this whole explanation would not justify your (in)accurate diagnosis.

When I was diagnosed, the doc (who discontinued our sessions) knew on the first session I was your casual ASPD - a compulsive liar and a typical manipulator.. he even recommended that I don't see professionals in case they unintentionally teach me something that will help enhance my manipulation.

You claim you can be extremely empathetic when you want to,
you see, ASPD cannot do that; they don't have the capability of switching the ON button for empathy.

I think what you need to distinguish with your doc is whether the diagnosis was accurate or an accidental/careless misdiagnosis.

I'm not sure if this exists but maybe you could have: BPD w/ antisocial traits? I don't know.

That's partially what I'm wondering. I'm highly manipulative and a liar, but those are also symptoms of BPD, so I don't necessarily attribute those to the popping up of ASPD for me. I asked one of my therapists why ASPD could have popped up for me on the testing and she was straight forward with me and said that it may be the mere fact of the thoughts and urges that I have. But then I have other treatment professionals that confuse me with their answers. I have had treatment professionals who have dropped me from their treatment rotation because of the way I behave. They say that I am "extremely charming" and can get what I want because of it. I am a skilled liar, and yet I just don't see the necessity in telling the truth sometimes especially if it will have reprecussions on my behalf. But as I said, this is also a symptom of BPD...and is also a symptom of my past drug addiction so it could be some left over behaviour from that?

I suppose it could be sadism. I'm just trying to gain clarity on the whole diagnosis in and of itself to find the answers. Since my empathy is so incredibly flaky and unreliable I feel so unsure about whether it's there or whether it's real. Sometimes it feels forced. Sometimes I feel annoyed that I'm trying to care, but don't. But few times I'm actually concerned and I'm like OH I CARE! But it feels so infrequent that when it's gone it feels like it was never there.

And I guess at the end of this all, more conflicting is that with my other dx's is that the fact that I'm so troubled about this must mean that the diagnosis is flawed...right?

Your ability to empathize isn't totally non-existent, but perhaps it's a resistance thanks to your BPD? I'm able to understand how a situation can upset someone but I'm not really reactive unless there's some sort of consequence/reward for my participation. Otherwise, I'm pretty much stoic. Any impulsive traits that resulted in your ASPD dx might also be Borderline, because there ARE subtypes to the personality disorders that result in a series of spectrums... One of those is Impulsive Borderline. Also, in the ICD, they specify two versions of Emotionally Unstable Personality Disorder -- Borderline & Impulsive. Which I assume are interchangeable.

Obviously I'm not the ASPD-police or any sort of dignified title as such! Though that would be pretty nifty... It's just worth looking into. Violent thoughts, manipulation, & lying are all too common human characteristics in my opinion. But as soon as you tell a psychologist what is really on your mind -- like they urge you to -- they are more than happy to put you in a category you may or may not belong in just because it makes them feel safer. Like they'll call heavily emotional patients "Borderline" when they are being non-compliant, regardless if it is the fault on the therapist's part.

I, however, can understand what you mean about the violent/sexual thoughts or urges. I'm also schizoaffective & I've really chalked those up to psychotic or intrusive thoughts. I'm not really violent to this day, though I have my moments. But the thoughts are still incredibly present. I was a really ridiculously violent kid though. Not sure if it was early signs of bipolar, antisocial behaviours, or trauma related. Or it could perhaps be all three? Regardless, you might also be a sadistic personality which could account for the intensity of those symptoms & their continued presence. But they don't give out that diagnosis anymore, so they might have thought it best to call you ASPD since they didn't have anything else to fit.

[here today]

Originally Posted by Aanga

. . . I empathize with friends and family when I'm "in the mood" to...if that makes any sense? I can be extremely empathetic when I want to. But I am terrified of what I feel I'm capable of doing. If I let the beast inside me come out...I feel I would do awful things. Evil things. And I struggle with that. Because it makes me so damn happy, but it scares me at the same time. This is something I've kept inside me my whole life and it has taken me up until I'm nearly turning 26 to mildly discuss with my therapist. Because I'm so terrified of it. And I don't know what to think about it.

...I suppose I thought asking people who have the diagnosis could give me a bit more clarity on the subject I guess? I have a massive science brain, so when I have a question...I just want a freaking answer...o.O

Have you researched dissociation and the effects of trauma in general? I've never acted out my "evil side" very much -- but I understand the fear and the feeling that "I am evil". I don't feel that way currently, very much -- thanks to therapy. DX was DDNOS and PDNOS. Therapy for dissociation consists of bring that "part" into the therapy room and other such . . . you can find that online, too. I'm still working on the PDNOS -- not out of the woods yet but not giving up either.

There's lots of good info on the internet and books these days, so hopefully you can find the information you need to help yourself -- and maybe help your therapist help you, too? If the current one can't handle it, look for a specialist. I found a couple of them who could.

[Oxidopamine]

People with ASPD can feign empathy but cannot truly feel empathy. Unfortunately, the moment a therapist or psychiatrist reads ASPD as part of your diagnosis, they may be somewhat reluctant simply because there's a high possibility the treatment could improve manipulative abilities and they may not be able to accurately see through the masks the ASPD patient uses.

Many, or perhaps all, people with ASPD have violent or sexual urges, although they will not always act on them. The difference I see is you receive gratification and pleasure from the harm inflicted on others. In the DSM-III and DSM-III-R, such behaviour MAY fall under sadistic personality disorder (SPD). In the current version, ASPD was introduced but to avoid confusion, SPD was redefined as a paraphilia (sexual sadism). In other words, the criteria involves the gratification received has to be of a sexual nature, alongside any emotional gratification (which you described).

I'm not sure if you've come across Dr. Theodore Millon in your research but if not, he put forth the theory that each personality disorder has sub-types. Here is a link describing each sub-type. Keep in mind, he includes personality disorders from the the current version as well as older versions of the DSM.

Originally Posted by here today

Have you researched dissociation and the effects of trauma in general? I've never acted out my "evil side" very much -- but I understand the fear and the feeling that "I am evil". I don't feel that way currently, very much -- thanks to therapy. DX was DDNOS and PDNOS. Therapy for dissociation consists of bring that "part" into the therapy room and other such . . . you can find that online, too. I'm still working on the PDNOS -- not out of the woods yet but not giving up either.

There's lots of good info on the internet and books these days, so hopefully you can find the information you need to help yourself -- and maybe help your therapist help you, too? If the current one can't handle it, look for a specialist. I found a couple of them who could.

I used to work with a dissociative specialist due to some of my severe dissociative symptoms. One of my therapists thinks that these thoughts and urges I'm having is the manifestation of trauma and never having been able to talk about what happened to me and bottling it up. It's a theory, though. She also wants me to research the the BASK model of dissociation but the internet doesn't give much in depth information on it. My therapist at treatment is a trauma specialist and I'm hoping to continue with her after treatment. Finances will depend on it.

Originally Posted by here today

Have you researched dissociation and the effects of trauma in general? I've never acted out my "evil side" very much -- but I understand the fear and the feeling that "I am evil". I don't feel that way currently, very much -- thanks to therapy. DX was DDNOS and PDNOS. Therapy for dissociation consists of bring that "part" into the therapy room and other such . . . you can find that online, too. I'm still working on the PDNOS -- not out of the woods yet but not giving up either.

There's lots of good info on the internet and books these days, so hopefully you can find the information you need to help yourself -- and maybe help your therapist help you, too? If the current one can't handle it, look for a specialist. I found a couple of them who could.

Originally Posted by Oxidopamine

People with ASPD can feign empathy but cannot truly feel empathy. Unfortunately, the moment a therapist or psychiatrist reads ASPD as part of your diagnosis, they may be somewhat reluctant simply because there's a high possibility the treatment could improve manipulative abilities and they may not be able to accurately see through the masks the ASPD patient uses.

Many, or perhaps all, people with ASPD have violent or sexual urges, although they will not always act on them. The difference I see is you receive gratification and pleasure from the harm inflicted on others. In the DSM-III and DSM-III-R, such behaviour MAY fall under sadistic personality disorder (SPD). In the current version, ASPD was introduced but to avoid confusion, SPD was redefined as a paraphilia (sexual sadism). In other words, the criteria involves the gratification received has to be of a sexual nature, alongside any emotional gratification (which you described).

I'm not sure if you've come across Dr. Theodore Millon in your research but if not, he put forth the theory that each personality disorder has sub-types. Here is a link describing each sub-type. Keep in mind, he includes personality disorders from the the current version as well as older versions of the DSM.

So, if I understand correct, ASPD completely lack empathy? That was one part that I needed clarity on. Because when I was reading diagnostic criteria "lack of empathy" could be interpreted as "no empathy" or "severely low empathy". I only qualify as one, but I didn't know which one qualified as ASPD.

And secondly, ASPD people don't derive pleasure from their violent acts, they just merely do them or think them?

Thank you for the reference, that is greatly helpful.

[here today]

I was very freaked out sometimes when I felt a twinge of happiness or satisfaction at the thought of someone I loved feeling hurt. Very freaky. But it now feels like it was more related to the dissociated hurt and vengeful feelings I had in the relationship with that person. I didn't know I felt vengeful, I didn't know (couldn't acknowledge) I felt hurt. Once that came to consciousness I felt "better". Well, very, very hurt but not the other, freaky stuff.

Well, "severely low empathy" could also qualify. But a common characteristic for antisocials on the milder end of the spectrum is that what little emotion exists is incredibly fleeting. Up to & including rage. I can't even hold a grudge. I have as little regard for the joy of the people around me as I do their pain.

Which I suppose could answer your other question... I have hurt people in the process of other activities. But their pain was never a motivator. As I said, I'm no expert or professional; but there are plentiful explanations for your symptoms of stunted affect, manipulation, lying, & enjoying others' pain that have already been explored in your diagnostic workup. It is stupid of them to add another dx even though the symptoms are already right there.

[Oxidopamine]

Originally Posted by Aanga

So, if I understand correct, ASPD completely lack empathy? That was one part that I needed clarity on. Because when I was reading diagnostic criteria "lack of empathy" could be interpreted as "no empathy" or "severely low empathy". I only qualify as one, but I didn't know which one qualified as ASPD.

To be more accurate, the DSM refers to a, "lack of remorse", in order to make a distinction (albeit arguably a semantic distinction) with lack of empathy being reserved for psychopathy. To me, it's confusing because it implies someone can be empathetic while having no remorse. Practically speaking though, the DSM criteria implies a lack of empathy and remorse. It's impossible for clinicians to measure the exact amount of empathy or remorse someone has, so, "lack" can either mean the clinician estimates there is absolutely none or severely low.

Originally Posted by Aanga

And secondly, ASPD people don't derive pleasure from their violent acts, they just merely do them or think them?

It depends on the exact circumstance, however, deriving pleasure isn't a motivator because it's either extremely low or non-existent. The violent acts may be done for other reasons, such as wanting something when the person refuses to provide.

Originally Posted by Shayatanica

Well, "severely low empathy" could also qualify. But a common characteristic for antisocials on the milder end of the spectrum is that what little emotion exists is incredibly fleeting. Up to & including rage. I can't even hold a grudge. I have as little regard for the joy of the people around me as I do their pain.

Which I suppose could answer your other question... I have hurt people in the process of other activities. But their pain was never a motivator. As I said, I'm no expert or professional; but there are plentiful explanations for your symptoms of stunted affect, manipulation, lying, & enjoying others' pain that have already been explored in your diagnostic workup. It is stupid of them to add another dx even though the symptoms are already right there.

Thank you so much. This has been greatly helpful.

Originally Posted by Oxidopamine

To be more accurate, the DSM refers to a, "lack of remorse", in order to make a distinction (albeit arguably a semantic distinction) with lack of empathy being reserved for psychopathy. To me, it's confusing because it implies someone can be empathetic while having no remorse. Practically speaking though, the DSM criteria implies a lack of empathy and remorse. It's impossible for clinicians to measure the exact amount of empathy or remorse someone has, so, "lack" can either mean the clinician estimates there is absolutely none or severely low.


It depends on the exact circumstance, however, deriving pleasure isn't a motivator because it's either extremely low or non-existent. The violent acts may be done for other reasons, such as wanting something when the person refuses to provide.

Thank you so much, this has been greatly helpful