Psychiatry & Psychology--General/Anti social


I have long been worried sick about potentially having anti-social personality disorder. I obsessively read about it online and worry that I see myself in the symptoms and would fit the DSM criteria. I have been known to be impulsive, irresponsible, disregarding other people, and can and have been manipulative at times. My question is, how does this diagnosis actually work? Surely people can fit these qualifications and not be a sociopath, or am I wrong? Also, it seems so subjective. What kind of irresponsibility? I am a huge procrastinator and can be very irresponsible but I remain a college student and do fairly well at times. I used to have strong emotions and empathy but the past years I've been consumed with constant worry and fear that I don't anymore. I've even manipulated people for fun with friends, which makes me not feel emotional guilt but makes me despise myself.  I love impulsive adventure but have cut down a lot since I got sober two years ago. I've successfully gotten sober because the embarrassment and worry became too much.

Now the issue is that I feel very much sociopathic, however my therapist and former therapist refuse to diagnose me wth ASPD! I don't understand that. I can point to the three or four (three being qualification) for ASPD and say "yes that's me!" But they never diagnose me as such and say that I wouldn't be worried about it if I really was ASPD. I'm so confused and feel so evil. Now my officially diagnoses stand at OCD and anxiety. Should I trust my therapists? Do you think they're being honest and trustworthy by not diagnosing me? How would I know? I find it so hard to put this worry to rest.

Is ASPD perhaps over diagnosed in some cases? To me it seems like the 3 check criteria could very much describe someone who is very much not evil.  I work with homeless people and have met some with ASPD diagnoses and never got the evil vibe from them. I used to also try to act narcissistic and "evil" when I was an edgy teenager to try to act tough and defensive against my depression and OCD. This is the time when I would manipulate people and stuff for fun. This is driving me mad, I don't want to be this diagnosis that people act like is the scum of the earth, but it seems I would fit a diagnosis easily which I think my therapists just are trying not to accept the truth.

What advice should I take?

Hi, thanks for your questions. You asked,

Surely people can fit these qualifications and not be a sociopath, or am I wrong?
---- the problem with laypeople trying to use diagnostic criteria is that they don't have sufficient information to understand the adjectives and adverbs being used. Another problem is that laypeople don't understand the purpose of diagnosis. They think that a diagnosis is an accurate description of 'who they are". I never give patients their diagnosis, because people are unique, not a label.

What kind of irresponsibility?
---- mostly criminal in nature

Should I trust my therapists?
--- if you have to ask that question, that means you do not trust them, and that this is an issue that has not been resolved. You should discuss it with them and get your lack of trust cleared up.

Do you think they're being honest and trustworthy by not diagnosing me?
--- I think you are saying that they have not diagnosed you with ASPD, because you said they gave you 2 other diagnoses. I would say that you are focusing on an irrelevant question. That is, of course, the purpose of anxiety/OCD - to prevent you from dealing with your real problems. So you spend all your time wondering about your diagnosis, even though that is meaningless, and you don't work on your real problems.

How would I know?
--- the better question is - who care what label they put on you? You are not a label - you are a living human being, with your own set of strengths and weaknesses. Why not work on improving your life?

Is ASPD perhaps over diagnosed in some cases?
---- yes, especially in prisons.

What advice should I take?
--- be your own guru. Learn to live and love. Be happy where you are and who you are.

Psychiatry & Psychology--General

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Bruce Borkosky, Psy.D.


any related to psychology, especially related to forensic psychology


15 years as a licensed psychologist, 15 years in private practice. My practice began primarily doing individual and group psychotherapy, is now devoted to assessments, but I occasionally do take on clients in therapy.

American Psychological Association

B.A. psychology, B.A., music, Ohio Wesleyan U., 1978 MCS, computer science, University of Dayton, 1984 MA, psychology, Miami Inst. of Psychology, 1991 Psy.D., psychology, Miami Inst. of Psychology, 1993 post doctoral training in Neuropsychology, Fielding Institute, 1995-1997

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