I thought I’d depart from a more standard post and offer below some verbatim interactions I recently had with a client whom I’ve always suspected as having sociopathic tendencies.
I share these interactions (with comments) not for their excitement, because their subject matter is in fact extremely mundane; but rather for the sociopathic elements I believe they instructively contain.
My client, T, is a 35 year old male, with a “work history” of voyeuristic, sexually aggressive behavior towards females. My role with him is as a “consulting therapist” for a community agency. T is not psychotic, and has no reality testing impairment. He is a verbally quick, superficially engaging, extroverted individual.
My suspicions of his having sociopathic tendencies (whether or not he meets fuller criteria for sociopathy) derive from the kinds of interactions with (and experiences of) him that I share below.
I should also note that T has a fairly substantial job history that has been undermined by his predatory behaviors (especially at work) towards females. Presently, he has held down a part-time job for several months with an excellent company. However, he does not work with women at this job, which decreases his chances of acting-out.
Briefly setting the scene, I’ve been asked by agency staff to address their concerns that T may recently be non-medication compliant (I repeat, he does not have a psychotic history). T has assured multiple staff repeatedly that he’s been perfectly, uninterruptedly medication compliant.
I meet T today at the agency, where a staff party is unfolding on the first floor. We meet in the midst of this rather crowded, claustrophobic scene. Very quickly, almost immediately, he asks me if I’ll get him something to eat? Because I intend to get something to eat for myself, although I experience his request as rather presumptuous and aggressive, I agree.
However, as I’m making a plate for him with two small sandwiches, I am intercepted by a staff person who informs me that T is not to be eating the party food. She is already on to him, because she’s already explained this to him: It is a staff, not client, party. As other clients enter the agency they, too, will feel entitled to eat the food if he does.
This is a reasonable limit, and I understand it. As I note, prior to my arrival, she had already explained this to T. However, this didn’t deter T from asking me, instantly upon my arrival, to make him a plate. After all, by using me he could circumvent the limit.
“T” sees this staff person informing me of the situation, and when I return to him, I explain the situation. He is somewhat amused, and also a bit irritated by, this frustrating development.
A minute or so later, seeing that the plate I was making up for him remains untouched on the table, he suggests with remarkable audacity, “Why don’t you get the plate now? Nobody’s touched it. Nobody’s looking.”
I am used to this kind of reaction from him, nevertheless I venture, “Don’t you think that would be unethical, since we were just told again that you can’t eat the party food?”
He says, with absolute equanimity, “You can bring it upstairs…no one will know. You can have one sandwich and I can have the other.”
Striking here is, of course, the obvious manipulativeness, but also the utterly blithe, shameless presumptuousness.
I’ve written in a prior post of the “shameless audacity” of the sociopath; T has shameless audacity in his personality.
To clarify, T knows very well that his latest suggestion (that I lift his plate and bring it upstairs) flatly transgresses staff’s reasserted limit, the basis of which he fully understands (even if it inconveniences him).
And there is that disarmingly comfortable presumption of my complicity in his suggestion to circumvent a staff rule (no less knowing that I am among staff).
Now here, I make a confession: Because I am really hungry, I bring a plate of food upstairs with me, where he and I are to meet. And because I’m constitutionally unable to eat in front of someone who is also hungry while I eat, I offer T a sandwich from my plate, arguably totally enabling his latest manipulation.
Now what does he do, in response to my gesture?
He pulls out his wallet and says, “What do I owe you?”
Now this is gamesmanship. This is a highly insincere gesture. He has no intention to pay me anything, and he knows on some level how ludicrous this gesture is. More audacious is that he knows that I know how absurd and insincere his gesture is. Yet with no shame whatsoever he engages me in this absurd charade.
I say: T, are you playing games with me?
T (convincingly, still fingering his wallet): No, what do I owe you?
S: For what?
T: The food, man.
S: You’re playing games, T…knock it off.
T: Hey, I’m just asking.
S: I know you’re just asking, but it’s a game you’re playing.
No big deal. I’m not looking to be psychotherapeutic here, just confronting of his bullshit. He drops the subject abruptly, because he has as little interest in it as he did to pay me anything for the food.
It’s as if this shallow, false gesture of gratitude was, for him, a fleeting source of entertainment, or solution to his momentary boredom.
Now at this point I ask him about the meds.
S: So what’s up with the meds? I understand there’s some concern you’re not taking them.
T: I’m taking them.
S: You are?
S: So why’s the staff concerned about that?
T: I don’t know. I’m takin’ them.
S: Every day?
T: Yeah. Every day.
S: The bloodwork doesn’t show it. The meds don’t show up in the bloodwork.
T: I don’t know how to explain that.
And there isn’t the remotest sense of accountability, of his feeling the remotest discomfort or anxiety to be faced with this suspicious, if not incriminating, evidence. He has reassured staff that he’s been taking his meds, and now he reassures me. He doesn’t find this bloodwork issue embarrassing, or puzzling; it’s more just a nuisance to be told about it.
T: I take ’em every day I work.
S: You said you take them every day.
T: I do.
S: Every day you work?
T: Yeah. I take ’em every day I work.
S: You work every day?
T; No …not on Saturday and Sunday.
S: So you don’t take them every day.
T: Yeah, but I take ’em every day I work.
There is real glibness, and slipperiness here; also the brazen attitude that this incoherent, logic/reasoning should satisfy me.
S: You said you took them everyday, and now you’re telling me you take them only during the week, meaning 5 days, not 7.
Bald-faced lying exposed; yet again, neither embarrassment, nor the sense of anything to account for. He has used confusing, diversionary language as a strategy for evading responsibility. But even when the strategy has failed (very obviously), even when he’s been patently exposed for his prevaricating, he acts like he hasn’t been exposed for anything.
The blitheness is so striking, so comfortable, that it makes you doubt yourself—i.e., perhaps I didn’t expose him for anything?
S: So how does your not taking the meds on the weekends constitute your taking them every day?
T: I said I take them every day I work.
S: You’re saying that now, T, but you didn’t say that initially, and you haven’t been telling staff that.
T: Whatever, I’ll take ’em.
He’s annoyed now, not embarrassed. This is inconvenient for him. He’s not ashamed, but irritated. His attitude is something like, “So what. Okay…you got me…congratulations…who cares?”
T: I take the meds to keep me on the up and up at work.
S: Up and up? What do you mean?
T: Yeah…to make sure I’m like…exercising good judgement.
S: You don’t need that good judgment on the weekends?
T: I’m fine on the weekends. I take ’em every day, like I said, to make sure I’m good to go at work.
S: Uh huh…but we’ve already established you don’t take them every day…you haven’t been taking them on the weekends.
T: Yeah, I get you. Whatever. Okay.
There is a continued manipulation of the facts, a continued effort to blur the distinction between “every day” (7 days/week) and “weekdays” (5 days/week). It remains striking that T conveys an absence of shame…not suppressed shame…but an absence of shame. There is a difference between someone who, when caught lying, responds with suppressed shame versus no shame. T has no shame.
S: So you’re telling me you’ll start taking them seven days a week…that’s something I and the staff can trust?
T (apathetically): Yeah.
S: Uh huh…okay….and you’re okay if I report this to the staff? The truth about your medication situation? And your intentions going forward?
T: Whatever…yeah…why would I care?
About now, the conversation shifts, when T abruptly raises the question of why we have to keep meeting weekly? This is a question he raises repeatedly—and, I think, manipulatively, passive-aggressively, and maybe somewhat impulsively—every week or other week, despite our having addressed it many times.
T: So…what do you think? You think we need to keep meeting?
This signals also his desire to drop the medication issue, as it bored and inconvenienced him.
S: You ask me this pretty much every week, and I pretty much tell you the same thing.
T: Yeah, but what do you think? I’m doing pretty well, right? No problems with women lately…I’m holding down my job. Why do we have to keep meeting?
S: We meet, T, every week, because it’s the expectation of the program that we do. You know this very clearly. The program expects its clients to meet every week with a therapist…even if just for a check-in.
T: Yeah, but what’s the point? I’m doing fine. Maybe we can cut it back to once every other week?
He is manipulating…cajoling. He wants what he wants.
S: It’s funny, but you’d think that you come out to see me, instead of my coming to see you. I drive 30 minutes to come here, to see you…sometimes for just a few minutes…you walk two blocks, I drive 30 minutes…who’s making the sacrifice? What’s the skin off your back?
T: I hear ya…I’m just saying I don’t see the point of meeting. You’ve said yourself I’m doing well.
S: You are doing well. You’re holding down this job, which everyone applauds you for….you’re basically doing real well. Then again, the reason we started meeting in the spring was about your failing to own some of your behaviors…like the female issue. We were meeting about your failure to take responsibility for your actions. And now, with this medication situation, it’s still more of that…your lying, or only telling half-truths…this is the latest thing…your not being honest and responsible about your meds.
T: Look, I don’t care if we keep meeting…I’ve got no problem with you. I just don’t think I need it. It’s a waste of time.
No interest whatsoever in the larger points I made. He blithely dismisses them, and then superficially, emptily affirms his willingness to cooperate. But he will ask again, soon, maybe next week, about our cutting our meetings.
As I warned, these are mundane interactions. But mundane interactions can be full of interesting, diagnostically suggestive clues. In these instances, T deploys, rather characteristically, some verbal gymnastics and attitudes that, I think, lend strength to (rather than weaken) my hypothesis that he is sociopathically inclined.
(This article is copyrighted (c) 2008 by Steve Becker, LCSW.)