Monday 23 March 2020

Is My Sister a Psychopath?

From a woman in the U.S.: I have seen a lot of disturbing behaviors from my older sister who is now 40. I only started suspecting recently that something is not right with her and childish bullying or cruel behaviors has escalated with age instead of her growing out of them.

Today I remembered an incident when we were kids where she deliberately caused injury to another kid in a way that really bothered me at the time (I was about 6). We were playing a game where one of our cousins was blind folded. My sister deliberately removed a section from a tall plastic slide that we were playing on and lured our blindfolded cousin onto the slide so that he fell through the gap. I was worried when I realized what was going to happen and my sister was gleeful.

When our oldest cousin got angry that my sister injured his brother, my sister claimed to have been treated unfairly and justified her behavior. Similar incidents occurred over the years and as an adult my sister is still prone to cruel and inappropriate behaviors that she knows will hurt or injure people she dislikes. Any attempt to address her actions make her claim to be a mistreated victim. People tend to see these incidents as one time occurrences and fail to see the pattern so she keeps getting forgiven and maintaining a positive social image.

Is this a kind of psychopathy and can someone who is extremely sensitive to their own feelings but has no empathy for others be a psychopath?

I can’t make a diagnosis on the basis of a letter of course. But the behaviors you report are consistent with antisocial personality disorder (ASPD). Psychopath is not an official diagnostic category in the DSM-5, the Diagnostic and Statistical Manual of Mental Disorders that is used by mental health professionals. None the less, “psychopath” is commonly used as a term to describe people who have little empathy for others. ASPD is found in .2% – 3% of the population.

I’m struck by the fact that she’s been behaving so inappropriately towards others since she was very young. A person with ASPD has a long history of manipulating, exploiting, and hurting others. They don’t take responsibility for their hurtful actions and show little remorse or guilt when called to account. They have little regard for the rights of others. Often they try to shift the blame for the negative consequences of their behavior on someone else.

They can do quite well meeting people in a social situation, but they have difficulty maintaining friendships over time due to their thoughtlessness. Employment is often unstable due to their irresponsibility, impulsivity, and inability to work collaboratively with others. Family members who have had to repeatedly deal with their negative, even at times violent behavior, find them hard to deal with.

It is confusing to others that the same person who can be callous and thoughtless can also be quite charming. Your sister is probably often “forgiven” by others who don’t see her very often so haven’t been subjected to the pattern of abuse.

Unfortunately, people with APD aren’t likely to seek help from a mental health professional on their own. From their point of view, everything is someone else’s fault. They feel justified in conning and hurting others because they believe that everyone is out for themselves. They can’t acknowledge that their beliefs about others and their behavior is not usual or normal. For that reason, it probably won’t be helpful for you to suggest to your sister that she see a therapist.

Regardless of label, your challenge is to decide what you will accept as the terms of your relationship with your sister. You do not have to tolerate hurtful behavior. You are under no obligation to continue a visit if she is unkind. When provoked by her, do your best not to fall into the trap of being as unkind to her as she is to others. Simply calmly state that what she is saying is unacceptable and leave the situation as gracefully as you can. You will feel best about yourself if you can hang on to your own integrity in spite of your sister’s provocations.

I wish you well.
Dr. Marie



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