Why would a therapist voluntarily see an aware psychopath?

I am a fairly young psychopath.

I went to a therapist about 3 years ago after experiencing a major narcissistic injury with a love interest. I had been mind******* a long string of girls, and along came one that mind****** me.

I did not realize it was a narcissistic injury at the time, I had heard the word "narcissist" many times and even joked about being one, but I had no idea what it meant. I had also (like anyone else) heard "psychopath" many times and had no grasp of the term, especially how it would apply to me.

At that point, I don't think I would've even identified myself as a psychopath even if you sat and read all the diagnostic criteria that I clearly matched.

I had a lot of disposable income and free time in this period, so I began to see her twice a week. Just a few sessions in, she asked if I would take a personality test. She administered the MMPI.

The results, among other things showed both antisocial and borderline tendencies. She would not give me the results (though I paid for the test myself), but offered to give me a report of her interpretation of the results.

I wasn't ready to discuss this, I didn't think it was important because I failed to see it as a problem.

For some time we talked about this girl, then other issues which seemed to be deeper (ex. going from a surface level discussion of why this particular girl had affected me, to going into why I had never had a healthy romantic relationship in 15 years of dating, to my issues with Mother).

Once I recognized the issue as being more about the girl wounding my ego than about me actually caring about her, it kind of ameliorated the pain. I also didn't feel the need to explore the parental issues, or much of anything else. Life was good once the narcissistic wound was patched.

So I dropped out of therapy for quite some times- though I did begin to study ASPD, which led me to the study of psychopathy. I identified very strongly with numerous things I was finding in the more traditional literature like Cleckley, Hare, etc. I also found a lot in common with the "pop psychology" sites like Sociopathworld and a few other independent blogs written by people who claim to be socio/psychopaths.

Of particular note was Cleckley's description of psychopaths who have spoken clinically and fluently about the condition, yet seem to have no emotion associated with the diagnosis, and no subsequent desire to change.

I began to go back to therapy intermittently to discuss concepts or topics when I would get stuck in my research and needed a fresh and experienced perspective.

Throughout the last few years she has described me in terms of "thrill-seeking", "impulsive", "grandiose", and "criminogenic." After exploring these concepts in private study, I've found them to be quite applicable to my life.

Everything I have ever read about psychopathy says that there is no known treatment, psychopaths cannot change, and therapy only makes them worse by allowing them to explore their cognitive, empathic, and emotional deficiencies... leading to a fine tuning of their manipulations and masks.

The therapist knew what I was far before I did, yet she continue to see me.

There was even a session where she kicked me out of her office and terminated a session early. I can't remember exactly what I was talking about that her offended her so deeply, I think it was a pretty vile misogynistic rant but can't say for sure.

In the last few sessions, I have questioned her as to why she would continue to see me. She refuses to say that I am a psychopath, and deflects when I make subtle inferences.

In the most honest exchange we've had about this, she told me that she treated me despite my "antisocial tendencies" because I wasn't violent and that her goal was to help me "grow" and sublimate my desires. The other times she was clearly evasive and I let it go because I honestly get a lot of stimulation from some of the sessions and don't wish to end them.

We have discussed sublimation, ego strength, and the need to temper my narcissism and grandiosity, as strategies for me to achieve more of my own happiness. She claims to have seen growth in me over the last few years. I don't view it as growth - I view it as awareness.

Where before I saw random unexplained impulses and irrational self-defeating behaviors at conflict with my stated goals, I now see patterns. I always knew I was different, now I just know how.

I enjoy my relationship with her, and I understand its limits. I have always been respectful of the boundaries, and kept my games within the confines of the session.

Yet I'm bothered by the question of why an experienced psychologist would continue to see a psychopath, both before and after I gained or expressed awareness. It seems these are the possibilities:

• Despite my criminal history, behavior, personality, and MMPI results, she does not believe I'm actually a psychopath.
• She is just using me for the money (she isn't cheap and I'm self-paying).
• She believes I have developed rather than inherited psychopathy, and can change. She agrees that I will never be "good" or "moral" and doesn't attack my view that these are just meaningless constructs; yet has commented that I do appear to have a conscience though I have "lacunae in the conscience."
• She is a very intelligent, controlled psychopath who feels confident in her ability to influence me. (I can only dream of having the opportunity lay bare someone's psyche and direct their deepest thoughts.)
• She is sexually attracted. (I discount this theory largely because I believe she is a lesbian; also, I have watched her body language when I describe sex with attractive younger women and the response is not there. Typically with me, if a girl who feels initial attraction, competition and sexual social proof turns her on even more.)

So why should it even matter? If I'm getting value out of the sessions and she's getting paid, who cares right? At the end of the day, I'm prepared to move forward with that mindset. However, we are getting into some fairly significant things at this point, we have worked from surface to depth. The meat. It is important for me to be as aware of her true motivations as possible, when going into deeper waters.

As for her impression of my motives, who can really say? I usually come to the sessions open and ready to learn. Sometimes defiant but always willing to at least listen to what she is saying. I do have a deep hunger for the truth about myself, even if the truth is something others would consider unbearable. I believe she feels that I am increasingly aware that my personality structure is a problem and has hindered me in life, and that I wish to attain the most satisfaction and pleasure I can... even if it means making some changes.

Thanks for your thoughtful responses.

Perhaps she is willing to treat you simply because you are a human being who is wanting some form of help from her? You're making an assumption that she has an ulterior motive in seeing you when that might not be the case.

It would be wrong of her (or anyone else) to discriminate against you due to having a disorder. I know that a lot of psychologists, pyschiatrists and therapists do discriminate against various disorders, but that doesn't make it right. It sounds like the therapist you have been seeing is a good human being who doesn't agree with discrimination. (Well, she sounds like a good human being just on the brief information you've shared.)

You could also try asking her why she sees you. You might think she's lying but at least you would have some form of a response from her - which will likely be fairly truthful to some degree.

It sounds to me like it DOES matter though, to you. And the fact that it bothers you makes it a legitimate topic for therapy IMHO. I agree with Panda -- can you ask the therapist again? Maybe even go over your list of possibilities with her? Of the possibilities that you've laid out, #1 and #3 seem the most likely to me. Clearly, you're curious about yourself and willing to learn.

Have you also researched the limitations of the MMPI and DSM diagnostic categories? I think that they can be helpful but some people think they are part of the problem for people with. . . well, what are currently called PD's.

Yes, and we have also discussed at length the idea that personality disorders occur on a spectrum rather than "you have it/you don't." Just like the PCL-R is not a true/false proposition (as an aside, I've self-scored PCL-R ranging from 28-32, she refuses to administer it to me herself).

She is negative toward the DSM and has said several times that it is more a formality and a tool for standardization than an accurate representation of how disorders work in the real world.

It does matter to me in the sense that I hate being manipulated or being kept in the dark (yes, this is simply a projection of what I do to others). I want to know what someone is truly thinking at all times.

In poker, you rarely play just your hand. You play against what you perceive the opponent's hand to be. In this way, your cards (and the factor of luck) matter far less than for others.

I am getting value out most of the sessions, so I wouldn't stop seeing her even if she came right out and said "I don't believe you will ever change but I need the money," for example. But I would want to know that was the primary motivation.

It's difficult for me to grasp why she would want to help me in the traditional sense. I can grasp why she would want to control me, manipulate me, use me for money, or "keep an eye" on me. (She works in some capacities with local law enforcement. I'm not a violent person but I am criminal minded and have serious felony convictions.)

FWIW -

From my OP it isn't clear what made the focus on therapy shift from superficial topics to much deeper, personality related discussions. Long story short, I experienced a massive financial loss over the last year. This led to a reduction in my lifestyle, loss of prestige, altered perception by others, etc. Basically, a lot of my supply evaporated.

In this state I was able to slowly accept that there were negative patterns and my own reckless behavior was to blame. Cleckey's observation that psychopaths engage in spectacular and protracted social and spiritual suicide, really hit home. I identified a deep seated tendency (even satisfaction) at my own self-destruction as well as a dark glee at the destruction of others.

So, against that backdrop my interest in therapy resumed, and I started discussing issues related to the core of my personality rather than superficial distractions like strippers, gambling, drugs, etc. that took up the sessions before.

My understanding is that most will not treat Cluster B disordered patients, especially borderlines and psychopaths, outside of institutional settings.

Everything I've read about "psycho/sociopaths in therapy" indicates that it makes them more aware of their deficiencies. In an emotionally normal person, this could lead to a desire toward positive change.

Psychopaths are said to use the knowledge to "get worse." Blend better, manipulate better, deceive better, etc.

I have. See OP.

We can discuss me as an "antisocial person" or "person with antisocial characteristics/tendencies" but she becomes clearly evasive when I bring up the term psychopath(y). I get the sense that this is an unspoken boundary and a kind of willful ignorance on her part.

I think she is afraid of "enabling" me by applying such a label.

I'm not sure I understand. Is it that you do not understand why anybody would experience a sense of accomplishment (and joy sometimes, even) in helping somebody else? Or is it that you don't understand why she would want to help YOU?

Let me suggest that, since you have been talking about the core of your personality with your T, that THAT is where changes might possibly take place. And probably neither of you can know, in advance, what those changes might be.

I have experienced changes during my therapy for PDNOS. Sometimes it's been like the landscape under my feet is changing. Very disorienting. But more solid now, so OK.

The latter.

I'm not sure you understand the nature of the psychopathic personality, which basically just destroys and even seeks to be destroyed. I seek to understand things so I can undermine or master them, not so I can experience them more fully.

The general consensus is that making a psychopath more aware of his deficits means you've created someone both more cautious and more refined in his manipulations. In a "normal" person, making them aware of the deficits makes them want to fix them in a way that reconnects them to others.

A psychopath will use the same knowledge in a way that allows him to take advantage of others.

I think it is going to be difficult for me to use what I'm learning for anything other than a selfish motive. The idea of "healing" and being like "everyone else" seems so difficult and foreign. I like the sound of it sometimes, it's romantic to think I could change the very core of who I am. Yet I look at the cold indifference of this universe and fear giving up a unique power that helps me survive in a world where the best of people often get the worst of the deal.

I'm not familiar with that one, but I can definitely tell you that this whole process of (real) introspection has been disconcerting. Currently I'm examining issues like why I engage in self-defeating behavior that negates my goals (money/power/sex basically), it's strange going from a thought process like "I have a gift [the PD] and would never give it up" to "Why am I hurting myself?"

I completely agree with this!

Maybe it's one of the aforementioned scenarios. Maybe she has a messiah-complex big enough to feed a third world country. But looking to anonymous strangers for the certainty you seek is futile. In my situation?

I'm not a psychopath because I don't legally qualify — despite my self-report scores on internet tests. But I've been diagnosed ASPD/NPD with Schizoid traits. And my therapist finds me amusing! But her main goal is to help me help myself, essentially. I'm smart. And clearly could have avoided the pitfalls that landed me there in the first place. She knows she can't change me; but we've made a bit of progress. Impulsivity is my main maladaptive trait, while everything else is all but neatly wrapped tight. I feel... More in control of my faculties.

Whichever the case, best of luck! If you don't need it, then I'll save it all for myself lol.

ok so I didn't read your entire thing cos it was long winded and I got bored but the thing is it's certain kinds of therapy that make a physcopath or anti-social worse and better at manipulating- not all kinds, if this person knew you were one then she wouldn't be using traditional therapies unless she is weird/crazy/a bad therapist who wanted to make you worse and see the result in which case she shouldn't have her jo. Or she could just be ignorant and not very good as a therapist. Here's a question for you, why do you care why? I don't mean that in a nasty way or whatever but I am curious.

She is doing her job.

That was flip.
I used to work with sexual offenders. It is important for us to learn about people with disorders that harm others (emotionally or physically, or both), and to do what can be done to decrease the behaviors that harm others, and to increase behaviors that are socially useful. Now and then, this happens.
Many professionals used to think "you can't change a Borderline"/any PD/...now we have DBT, CBT, other strategies --- and we know better than to lock those people up and take away their responsibility for their behaviors/to 'control' them externally.
Sometimes people have to be controlled externally. The hope is to be able to change this. To learn how to motivate change for the good of the person and those they come in contact with.
The decision to make changes, to take that risk, is yours alone.

Winter I can understand people working with thieves, hookers, (even though I have no respect for them myself), fraudsters and even murderers but the one thing I can't is pedo's/rapists- worst pieces of dog turd in the world and I think there is only one solution once someone has commited a sex crime- a bullet- no second chance for those sick, not human things.

I read every post in this thread, but my initial thoughts haven't changed.

The op is just slightly paranoid--curious about the motives of another person, because they can't fathom why they would do something like this. It's a consequence of thinking very differently from other people; you can't take their perspective without listing the possible reasons for their behavior, then deducing through reason which is most likely.

I do the same thing. There are certain logical bridges we cannot cross, people like you and I. Like a cat that enjoys taking baths, or Tom Cruise playing Austin Powers, it makes no f***ing sense, and so we obsess, and try to covertly and innocently elicit a satisfactory response from someone else that understands the [normal] behavior in question, without alienating ourselves, ultimately for some tangible benefit down the road.

The simple and most likely answer why she continued or continues to treat you, is because she is not like you. She is a different kind of human.

You know it's funny, I've had my suspicions that I may have ASPD, but never sought to enter therapy for fear I would be diagnosed. I only recently began therapy, but I still try not to let her know the true extent of what I feel. Much like yourself though, I have always felt that the way other people treat each other and the way in which they almost effortlessly build relationships was alien and foreign, as another poster so eloquently described. However, the reason I began therapy was because firstly I wanted to know why the world doesn't make sense to me, and secondly I don't ever want to feel like I have felt, where my urges, violent urges, have almost manifested themselves. One could say these are but a byproduct of my upbringing and environment as I was raised in a crime ridden neighborhood with the usual driveby shootings, armed robberies at grocery stores in broad daylight, home invasions etc. I mean I used to be able to keep these feelings of stress and intense hatred for everyone under control while I was in contact sports as a kid, but I found that as soon as I stopped the urges to hurt others began to build and build until they eventually came out most often as fights at school for what I look back now on as the stupidest and most insignificant things. I don't know maybe it was where i grew up, maybe it was that i was tormented as a child both at school and at home. Either way, i have noticed that while hurting people through my words also tends ease this 'stress', I can't say that there is anything to me like when I've hurt people physically. It's weird though, sometimes I am ashamed of these feelings whereas other times I feel that they are an inevitable part of my character now which cannot be separated, only controlled or suppressed.

Regardless, when I have communicated these things to my therapist I've have seen her grow more and more apprehensive towards me as our sessions go on. I sense on one hand that she is almost afraid to be in the same room with me, while on the other I sense that she dislikes me but only doesn't display it more prominently as she thinks I might strike her or assault her (though I never would). Overall she is put off by the way I talk so freely and comfortably about violence and how I don't really think much of it anymore. It's almost comical how I can see the horror in her face as I tell her things about myself and I know she's connecting it to some b.s she learned in her classes.

However, in the same way that I have thought that I may be a sociopath because of these things I have described, I also think I may not be because sometimes I want to change (or at least I tell myself I do). I also tend to hate myself just as much as I hate others. It is because of this that I have wanted to kill myself, that is until the other part of me pulls me back by saying that there is nothing to be ashamed of.

I can relate to some of this, except I grew up in a very low crime area (with the occasional spousal murder or drunk driving death). I also feel less stressed after shouting at and berating someone. Avoiding conflict actually seems to take a greater toll on me.

While I was in inpatient last time, I had hoped to discuss psychopathy and personality disorders, but I decided to wait until I could get a 4 hour eval instead. I noticed the psychiatrist I had in there seemed uncertain what to make of what I was telling her. I mentioned as a kid in school I had a really strong urge to blind this one kid next to me and bash his head on the floor in front of everyone. Normally people running their mouth off didn't get to me, but he pushed a button somewhere, and I ended up hitting him. It hurt me more not to attack him. I also mentioned to her that I've felt an urge to victimize people since I was pretty young. After that, our sessions became much shorter, and she would meet with me around people, or in her office, while she sat close to the door. I think she picked up on my fidgeting and saw it as nervous body language, which sometimes precedes premeditated violence. A schizophrenic man saw my fidgeting once and asked me not to kill him, so maybe I am making the people around me uneasy.

I've thought about suicide a lot, but I always decide that if I want to die, I won't be the one to kill myself, and that I probably wouldn't want to die if I've reached the point that I may be killed, so it never becomes more than a thought. I self harmed quite a bit as a kid. After I turned 18, I cut really deep through the fat and muscle on my arm and nearly hit bone. I later realized I was acting out on myself an unrealized urge to dissect something. I'm not sure if that's better or worse than killing animals.

Even though I've tried to laugh it off and dismiss it, I can't deny that the fact that my therapist sees me the way she does in reality has helped me solidify the possibility that I may in fact be a monster. Though I still also recognize that under similar circumstances most people would have done as I have. There is nothing exceptional or fascinating about the way I am or the way I treat people. And although sociopathy and psychopathy have been heavily romanticized and idealized in the media, if I do indeed 'suffer' from such conditions, I would equate it more to a punishment than some kind of gift of genius and charm as is the cliché. I don't enjoy the fact that my therapist regularly glances at the door, nor do I appriciate when she has made statements that I suppose were supposed to console me like, "well at least you didn't do ___". That is, her attitude is yes you are a piece of ****, but at least you aren't that much a piece of ****. I also noticed that she won't enter a room first and insists on following behind me into her office, which although it doesn't bother me, I do notice. I don't know though, maybe it's a mixture of the things I've told her as well as the fact as I am muscular and am very much larger? Either way I don't really understand her apprehension as I have never had urges towards sexual violence, but just feel a strong need to hurt people. It's like I may be 'cruel' but even I have things that I think are wrong.

Sometimes therapists have a lot of confidence and think they can fix anyone.

I definitely agree, jimi.

As far as anyone feeling victimized by their therapists making them feel like a "monster" or unworthy of treatment? Either [a] you already have low self-esteem & are harbouring these feelings: no one can make you think something you don't already believe. Or [b] you're somehow bringing it upon yourself. Either through negligence by finding someone better or by using threats/manipulation & thereby making things difficult.

They don't have to understand you — a lot of them simply can't. Are you able to understand the mystifyingly stupid things most humans do regularly? But they are obligated to be supportive. Up to & until they cannot perform their duties as a mental health provider.

That's just my two cents, as a patient & a psych student.

*by NOT finding someone better

Hah. Can't edit my posts on this ****ing thing.

Understatement of the year. However, insofar as therapist making clients feel a certain way I would offer that many times other people are not aware of how overt they are about the way they feel, and/or do not recognize how prominent such behaviors can be. You or I may be able to emphasize sincerity even when false, but that doesn't mean everyone can.

Oh and do excuse my use of the term 'monster' as it didn't feel as painfully cliché when I wrote it..

Iiiiiiiii may have overlooked that factor... I really do get absent-minded, as far as the way other people function is concerned! Hah

Lmao, figures. I was just making my point, because I hear that complaint in excess with cluster B disorders in general.

What does it mean to 'legally qualify as a psychopath'?

Hi does anyone one how which is the best treatment for mental disorders.