Not Chris Brown, another one

I have been corresponding with one reader who (atypically) does not want to remain anonymous. The first i heard from Chris was this comment on a post:

I was diagnosed with ASPD (sociopathy) although I think it's more likely I have NPD (Narcissistic Personality Disorder). I've hurt a lot of people, but never intentionally (as with a plan), and always it's been due to feelings of powerlessness, fear or being taken advantage of. My emotional core is more comprised of feelings of inadequacy than of maliciousness. In fact, I care a lot about other people and do a lot of good things for my community. I also feel remorse and empathy. But at the same time I think in very selfish ways sometimes and have hurt a lot of people.

When I read the comment, I was struck with what an accurate and sympathetic description of a narcissist it was, or at least the narcissists I know well. Chris later emailed me about how he had been diagnosed as a sociopath after he punched his then girlfriend in a violent outburst, for which he served a year in jail. To read about his experience, check out ablessingindisguise.org. I replied:

Interesting blog. I particularly thought this post was interesting. Even before I read that post, though, I didn't think you were a sociopath. Before I read your self-assessment of NPD, I actually thought that maybe you might be on the autism spectrum, particularly because of your lack of conforming to social norms in odd ways, e.g. making eye contact with strangers and picking your nose. Those with sociopathy and NPD also have difficulties with social norms, but usually the big stuff, if that makes any sense -- stealing, lying, cheating. They (sociopaths at least) may also have difficulty with the smaller social norms at first because they don't have a natural instinct for them, but they are usually able to overcome those difficulties and be very adept socially, some say charming. I would look into asperger's and autism in addition to your research on personality disorders. The type of bursts of anger/rage you describe seem to be more typical of the sometimes violent symptoms of autism. I wrote about it here.

Unfortunately for you, if you were on the autism spectrum and the condition manifested itself as violence, I don't think there are very good treatments for it. If the violence is truly an uncontrollable impulse, then it seems like the only options available to you would be to condition the subconscious to react differently, perhaps via shock therapy? I assume you are already being treated for the basic anger management stuff, without much progress.

Cont.