Why Sociopathy is not a Personality Disorder

BMED report: Christopher Fisher, PhD
Mental Health, Neurofeedback

"Personality disorders are seen by professionals and researchers as an enduring pattern of inner experience and behavior that deviates markedly from the expectations of the culture of the individual who exhibits it. These patterns are inflexible and pervasive across many situations. The onset of the pattern can be traced back at least to the beginning of adulthood. To be diagnosed as a personality disorder, a behavioural pattern must cause significant distress or impairment in personal, social, and/or occupational situations."

Evidence suggests an effective treatment for anti-social personality disorder (AsPD) may be electroencephalography (QEEG). This guided neurofeedback "provides individually tailored neurotherapy sessions based on a patient’s unique EEG and comparisons to age appropriate, normative databases." Decide for yourself on conclusiveness of evidence. I'll return to opto-genetics and the general question of how brain firing patterns can be modified to treat brain disease later. 

What is sociopathy?

Most people agree, if they accept the term 'sociopathy" as meaningful, that it is, indeed, a persistent, pervasive, marked deviation of inner experience and behavior, and that it can be traced back at least to early adulthood. One consistent theme in sociopathy is a profound lack of emotional empathy as well as feelings of guilt and remorse. Due to their ability to imitate and their atypical or amoral stance, sociopaths may lie with ease.  Life is a game; their goal is to win. Self-identified sociopaths -- as a community -- endorse fundamentally different attitudes to life --  as well as views of themselves and others -- compared to neurotypicals. 

You won't find discussions of that in the DSM because it does not address sociopathy. Indeed it only addresses disorders -- not unusual or fundamentally atypical variants of personality. To get a view toward the variability of human experience seen through different eyes one has no choice but to step out of the DSM and look for a different way.  But first, I examine the final part of the definition of any personality disorder -- distress or impairment.  My argument demolishes the idea that sociopathy is a personality disorder.

Distress or Impairment of the Individual

To qualify as a PD, sociopathy or any other atypical variant of personality type must "cause significant distress or impairment in personal, social, and/or occupational situations."  The only reasonable take on this, if one considers sociopathy to be a personality disorder, is that the distress and impairment is viewed that way by all self-identified sociopaths, or those who would be reasonably labelled sociopaths once a good definition was accepted.  Many self-identified sociopaths do not regard themselves impaired or distressed in "in personal, social, and/or occupational situations."


Indeed for adults the only times the right to decide for oneself if one is impaired or not may be revoked is when individuals are

• incarcerated or otherwise part of the criminal justice system
• hospitalized for mental illness
• considered cognitively impaired 

Otherwise we are all free to decide if we are impaired or not. This right is an inseparable component of individual liberty in free, democratic societies.

High functioning sociopaths do not go to prison, can make sustainable plans for their future, regard their own safety and that of others, do not get in fights etc. Their own personal interest and intelligence motivates them to act 'pro-social' -- not because society says it is right or wrong. So a high functioning sociopath would not check off items 1,3,4,5 and 6 in the AsPD checklist at the end of this post and therefore would not qualify for this diagnosis. They would however likely check off items 2 and 7, but three out of seven criteria must be met to get this diagnosis.  That doesn't mean that items 2 and 7 are part of typical  human behavior! They are not. A similar argument can be made for all the other personality disorders in the DSM. For brevity I leave that for the reader to examine.

Distress or Impairment of Others

Sociopaths as a group tend to replace "social crimes" for acts that could lead to imprisonment. They are as a group more likely to manipulate people and to hurt with intent. The trauma resulting from the process of betrayal in intimate relationships can be hard to fathom, unless one has been through that experience. How a person reacts depends on individual resiliency and social support. Indeed there are many more web forums devoted to 'victims' or 'survivors' than to sociopaths or those in the so-called 'dark-triad' of personality. But anyone who has been wrung through that mill does not emerge unscathed.

The primary, erroneous assumption is that only two possibilities exist: either a person has one or more PDs or that person is within a normal spectrum. For instance, I quote Psychcentral: "You can read more about personality disorders or learn more about normal personality traits".[1]  

Three Alternatives not Two

The key point I am making is that only two alternatives are offered: 

• personality disorders
• normal personality traits

This proposition is presented as an unexamined fact almost everywhere on the web, and many of the traits of sociopathy are not included in 'normal'. Try a google search for yourself and see.

What if people exist -- who have a markedly different and anomalous personality structure, as well as habits, cognitions and emotional experiences in their relations to others as well as themselves -- but who do not fall into any PD category? 

If so, no wonder psychiatry has a great deal of difficulty with or even largely ignores sociopathy. In some sense it doesn't exist in medicine's collective thoughts as a fundamental variant that is neither disordered nor normal by any workable definition, because it is not included in the 'normal spectrum'. It has no where to exist.

However, it is also true that however one defines sociopaths in detail -- which I get to in following posts -- due to key aspects of their personality structure of which the main two are:

• absence of emotional empathy, remorse or guilt and second
• an anomalous relationship to morality 

-- such people are significantly more likely to fall into the PD category, end up in prison or cause harm to others than a neurotypical person.

But not all sociopaths do. There is much more to variations in personality than what is encompassed in models of disease. It's a fundamental error here. There are not two categories of personality; there are at least three.


Anti-Social Personality Disorder diagnostic:

For completeness I include the diagnostic criteria for AsPD. A pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by 3 or more of the following:

1. failure to conform to social norms with respect to lawful behaviours as indicated by repeatedly performing acts that are grounds for arrest
2. deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
3. impulsivity or failure to plan ahead
4. irritability and aggressiveness, as indicated by repeated physical fights or assaults
5. reckless disregard for safety of self and others
6. consistent irresponsibility, as indicated by repeated failure to sustain consistent work behaviour or honour financial obligations
7. lack of remorse. as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

Summary

Self-identified sociopaths as a community endorse a vastly different set of attitudes to life, motivations, and views of morality -- of themselves and others --- compared to neurotypicals. Individually they will have particular traits of one or more personality disorder but many do not qualify for a diagnosis because they are not distressed or impaired.

But you won't find discussions of that in the DSM. Addressing variability of human experience, given the facts on the ground of what is known about sociopathy, must allow for non-diseased, atypical variants of personality, which do not fall into a normal range, and have never been included in a definition of 'normal' personality.

Who is DoctorSciFi

Let me end by saying that I am not a sociopath nor someone diagnosed with a personality disorder.  I am not an advocate for socios or for people who have been victimized by them. My goal is to incrementally gain understanding of sociopathy and variability in human experience by participating in web forums including those blogs "Sites we Like" on the right. 

The views I present about sociopathy and personality types are based on analyses of series of texts presented by people who choose to anonymously share their attitudes to life and experiences on the public web.  I listen, I ask questions and review historical exchanges (sometimes a decade) in the community. The next step is to put a picture together of what I have gathered thus far.

My goal is to understand it better, not to claim that I know the answers when I have just started.  One makes steps forward, then perhaps revises as needed. 

To my readers, first off I want to say I appreciate your eyeing this. I can see how it can be annoying that I go back and edit previous posts.  That's how I was trained as a scientist though: work out -- as best you can -- ideas  and empirical observations into a roughly coherent picture, write it all down, seek comments, go back and read it myself, do some more research  -- and hope the picture clarifies, congeals, some details are added, some more general themes may be observed.  I would say you see the scientific process in action.  The more recent posts are the ones more likely to be edited.


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[1] Psychcentral is a wonderful resource for the mentally ill and for those who are or have been intimates either as family members, friends or partners. 

Combinations in the Alternative DSM-5 Model for Personality Disorders

Facets organized within Trait Domains:
DSM 5 Personality Disorder Map 

An alternative model for diagnosing personality disorders (PDs) appeared first in the DSM -5 section III, as an option to standard model, whose combinatorial death I described in the previous post. Here is the combinatorics of the alternative model.  The catastrophe tames in the right direction but the model still gives an absurdly large number of combinations that can lead to a PD diagnosis. 

The new model is based on five domains: negative affectivity, detachment, antagonism, disinhibition, and psychoticism. Twenty-five lower-order facets, or constellations of trait behaviors constitute the broader domains. Seven distinct diagnoses are defined by the same method as before, but with different numbers and types of listed traits.  

Combinations in the Alternative Model

One of the diagnoses, PD - trait specified, is a grab bag for all people who do not fit into one of the six primary diagnoses. Considering just the six gives a sum of 1100 PD phenotypes, ignoring specifiers that would only increase this number.  See the previous post for abbreviations. The diagnostic criteria add up to the following combinations:

• AsPD: At least 2 out of 4 AND at least 6 out of 7 others = 11*8 = 88
• Avoidant: At least 2 out of 4 AND at least 3 out of 4 others = 11*5 = 55
• BPD:  At least 2 out of 4 AND and at least 4 out of 7, one of which must be among 3 possibilities = 11*60 = 660
• NPD: At least 2 out of 4 AND 2 out of 2 = 11*1= 11
• Ob-COPD: at least 2 out of 4 AND at least 2 out of 3 = 11*4 = 44
• Schizotypal: at least 2 out of 4 AND at least 4 out of 6 = 11*22 = 242

If a person met the criteria for all six of these diseases, they could do so in 88*55*660*11*44*242 = 3.7*10^(11), or about four hundred billion ways. Adding up all possible ways to get a diagnosis of at least one of these disorders (which is entirely consistent with these these rules -- at least X out of Y, in this case at least one out of six) gives about 10^(12), or one trillion combinations of symptoms qualifying for a PD diagnosis.

Combinatorial Death

The alternative model is a great success compared to the standard approach! It brings down the number of possible combinations by about nine orders of magnitude. Still, one trillion combinations of supposedly clinically significant observable traits, for about one billion people who could encounter a psychiatrist in their life time, is overkill. Indeed one trillion is larger than the number of people who will live on earth for the next 3000 years. Using such a system with built in-runaway to define six diagnoses is absurd.

A reasonable conclusion is that the symptom list and criteria under which they line up together to signify disease is inadequate. The common notion that to delineate disease better, one should have more criteria rather than less is false. In fact the opposite is true, to avoid combinatorial catastrophe. 

Looking Forward

It's a long term project to examine on-going literature in the field and present a take on developing better diagnostic criteria and data structures for personality disorders -- to identify the appropriate axes that can parse human experience and the relationships to self and others more sharply. Perhaps a tree-like data structure is needed: just as genera branch into species -- specific traits could branch into others, implying a hierarchical structure. This could firmly tame combinatorial explosion. That's all speculative -- I look forward to seeing how this goes.

Some claim that a categorical model is ill-suited for personality disorders and Psychiatry should move to a continuous spectrum picture.  This is, however, not what I am saying. Instead, my point is that if one is to use a categorical model it must be more categorical than it is at present. The explosion of combinations arises from issues emanating from e.g. choices like 4 out of 7 AND 2 out of 4...  If a model instead stipulated for some disorder 5 out of 5 AND 0 out of 6, that would only leave one combination. 

Combinatorial Catastrophe in Psychiatry and Avogadro's Number

http://googology.wikia.com/wiki/Googology

In the 3rd century B.C. Archimedes developed a system of numbers extending up to 10^(8 × 10^(16)) in a work called Sand Reckoner. In this notation 10^2=100, 10^3=1000 ... so Archimedes big number is 1 followed by 8x10^(16) zeros, and 10^(16) is 1 followed by 16 zeros.

He is usually credited as being the first googologist -- a person who studies large numbers.  Large numbers like the googol -- equal to 10^(100) or 1 followed by 100 zeroes -- appear in parts of mathematics, but if big numbers crop up in psychiatric diagnoses then something has gone wrong, since for any practical purpose they may as well be considered infinite.  

Here I'll show that the number of combinations of symptoms that can lead to a Personality Disorder (PD) diagnosis is about the same as the present estimate for the number of stars in the observable universe. Condensing this astronomical number into 10+1=11 possible labels is not only mind-bogging, but preposterous from a scientific point of view.  

The previous post showed how 256 distinct groups of symptoms arise in the standard categorical definition of Borderline Personality Disorder (BPD). As a shorthand I refer to this as 256 phenotypes of BPD.  

Combinations Leading to a Diagnosis of a Personality Disorder

The DSM 5 retained the 10 personality disorders (PDs) from the DSM IV. It also introduced an alternative hybrid model which I get to in the next post, but which unfortunately also suffers the same combinatorial catastrophe.

Each disorder is defined by the appearance of at least X traits out of Y possible ones, where the list of traits, Y, is specific to each disorder. Going through this list gives a sum of 1408 different symptom combinations leading to a diagnosis of a single PD:

• Paranoid PD: at least 4 out of 7 symptoms = 64 paranoid phenotypes [1]
• Schizoid PD: at least 4 out of 7 symptoms  = 64 schizoid phenotypes
• Schizotypal PD: at least 5 out of 9 = 256 schizotypal phenotypes
• Antisocial PD (AsPD): at least 3 out of 7 = 99 antisocial phenotypes
• Borderline PD: at least 5 out of 9 =256 borderline phenotypes
• Histrionic PD: at least 5 out of 8 = 93 histrionic phenotypes
• Narcissistic PD (NPD): at least 5 out of 9 = 256 narcissistic phenotypes
• Avoidant PD: at least 4 out of 7 = 64 avoidant phenotypes
• Dependent PD: at least 5 out of 8 = 93 dependent phenotypes
• Obsessive Compulsive PD: at least 4 out of 8 = 163 obsessive compulsive phenotypes

A symptom of one disorder may be similar to that of another; absence of remorse in AsPD resembles lack of empathy in NPD.  Although they could occur together in any person, they are not the same trait and were, in fact, written in such a way as to be distinct in most cases.

Meeting the Criteria for More than One PD

"The typical patient meeting criteria for a specific personality disorder frequently also meets criteria for other personality disorders. Similarly, other specified or unspecified personality disorder is often the correct (but mostly uninformative) diagnosis, in the sense that patients do not tend to present with patterns of symptoms that correspond with one and only one personality disorder." 

One arbitrary example, which points to the fundamental problem leading to large numbers and ambiguity of diagnoses, is that a person can meet the criteria for both NPD and BPD.  That person could have any one of 256x256=65,623 combinations of PD symptoms. It only gets worse.

There are 10!/(8!)(2!)= 45 ways of meeting criteria for two diagnoses, 120 different ways for three, 210 ways for four, and so on up to 9 for nine and one for all 10. Indeed individuals have been diagnosed  with more than 5 distinct PDs. But the principle is not the frequency that one finds distinct collections of symptoms, but the fact that such combinations are intrinsic to the definition of PDs, as a class of diseases in the DSM.  

Taking the case that a  person meets the criteria for all 10 PDs gives 64*64*256*99*256*93*256*64*93*163 =  6x10^(20) distinct groups of symptoms, or phenotypes that such a person could have.  This number is 6 followed by 20 zeros. It is not as big as Archimedes number, but it is astronomically  larger than common estimates for the number of species that have ever existed on earth, which is less than 10 billion -- or 1 followed by 10 zeros.

Combinatorial Explosion

Adding up all possibilities gives about 10^(21) distinct groups of symptoms that would meet the criteria of one or more PDs.  Note that this doesn't even take into account the 'Not Otherwise Specified', or other unspecified or specified categories -- as if 10^(21) distinct groups of supposedly diagnostic symptoms were not enough!

Number of Ways to be Diagnosed with BPD

In order to get a diagnosis of BPD, at least 5 of 9 criteria must be met leading to 256 unique combinations of symptoms. However such people may exhibit one or more symptoms of other personality disorders.  Adding up items up on the symptom list for the  remaining 9 PD's give 70 possible symptoms that a person with such a diagnosis may have.  This means in fact that there are 256x[2^(70)] = 3x10^(23) ways to have Borderline based on the criteria of the DSM IV and 5 themselves. This is almost the same as Avogadro's number for the number of constituent atoms or molecules in a mole of a substance.

If this isn't ridiculous, I don't know what is.  Advanced statistics are used in most published papers in psychiatry, to test for significance, correlation or uncertainty, for example.  A categorical system for diagnosing PDs has been around a long time, and with huge numbers like this staring one in the face, it's surprising not find published results about this combinatorial catastrophe in diagnosing PDs. It looks as if psychiatry does not take itself seriously.

One nice paper addressing this question focussed on bipolar disorders: Combinations of DSM-IV-TR Criteria Sets for Bipolar Disorders

Results: The number of possible combinations for the core episodes ranged from 163 for a manic episode to 37,001 for a mixed episode. When the full collection of specifiers that DSM-IV-TR applies to bipolar disorder was used, the number of combinations was over 5 billion. Conclusions: The precision of medical communication about bipolar disorder is called into question by the billions of different ways that the criteria for this diagnosis can be met. As DSM-V is developed, the possible combinations for each diagnostic criterion should be calculated, and the effect this number has on clinical communication should be considered.

At least 5 billion, or 5,000,000,000, for Bipolar Disorders is more than 10 orders of magnitude smaller [2] than 100,000,000,000,000,000,000,000, or 10^(23) possible ways to meet the diagnostic criteria for Borderline Personality Disorder.

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[1] Choosing at least 4 out of 7 symptoms gives 7!/[(4!)(3!)] + 7!/[(5!)(2!)] + 7!/[(6!)(1!)] + 1 =  64 combinations that qualify for a diagnosis.

[2] An order of magnitude corresponds to one factor of ten: for instance 50 is one order of magnitude larger than 5, the number 500 is two orders of magnitude larger than 5, etc.

Combinatorics and the Folly of Diagnostic Labels for Personality Disorders

by Randi Dellosa

This post has been edited since it's first incarnation. I view DSM Personality Disorder classification and labelling as conceptually grotesque -- not only inelegant but ugly, preposterous and unscientific. Here's why.

The DSM provides a classification system based on checking off items from a list. If the number checked is greater than X then the person has a specific Personality Disorder (PD) -- with significant ramifications for their life.

For instance, according to the National Institute of Mental Health, by "the DSM-IV)[1], to be diagnosed with Borderline Personality Disorder (BPD), a person must show an enduring pattern of behaviour that includes at least five of the following [nine] symptoms..." 

Combinatorics and BPD

So just by counting the number of combinations of having 5 or more distinct symptoms out of 9, there are 9!/(5!4!) + 9!/(6!3!) + 9!/(7!2!) + 9!/8! + 1 = 256 different phenotypes of BPD, with markedly different symptoms -- as required by the diagnostic criteria of the DSM itself. For those criteria to be meaningful, this implies that not only life experiences are different amongst the 256 phenotypes of BPD, but also ways of being, and of viewing one's self and others. Indeed this diversity is reflected in personal experiences of people with BPD I have run across in online forums. It is often a source of frustration and possibly confusion for people with this diagnosis.

Nor does the counting of combinations of symptoms take into account differences in their severity, as long it is over a qualitative threshold. Neither does it include co-morbidities (more than one PD diagnosis), which I get to in the next post. But all individuals fitting into this mould get the same label.

Other Personality Disorders

Both DSM-5 and -IV list ten different specific PDs, with the third most commonly used diagnosis being another one "Not Otherwise Specified". Some disorders overlap in symptoms with others, which leads to high levels of co-morbidity, and inconsistent diagnoses. 

I will show the absurd folly driven by combinatorial explosion in the number of phenotypes the DSM defines for Personality Disorders as a class, if one takes its categorical system seriously to determine whether or not an individual has one or more PDs in the next post too. It is a catastrophe involving astronomical numbers of symptom combinations or phenotypes within the class of Personality Disorders. It is the death of any categorical system based on factorials with numbers up to 10 or so.

The standard, prevailing methods for diagnosing other PDs also use a checklist algorithm. Hence people with such diagnoses also have not only vastly different symptoms from others with the same diagnosis, but also vastly different experiences, ways of being, interacting as social beings, and attitudes to life.

Harms Obscuring Beauty

The oversimplification of not taking into account the variance or variability of people with the same diagnosis, leads to widespread cultural misunderstanding and type casting. It is hard to see how it does any good. Due to the astronomical numbers involved (as I show in the next post), either psychiatry's categorical diagnostic system groups people together based on the wrong criteria, or they cannot really be grouped at all.

In the context of psychiatry's labelling and our cultural use of these labels, individual experience gets swallowed by a hungry, munching monster, turning everything except the most undigestible parts into mush. I find it more than sad; indeed I see beauty in these varieties of human experience, beyond and within each label -- the variety itself is intriguing, and fascinating. It is part of what makes us human. 

To give one example of the harm of type casting, I quote at the end of this post a recent exchange on sociopathworld.  This type of situation is faced by people with BPD on a regular basis.

Online Research Ethics

Regarding my journey into anthropology of online voices, I have decided for now to stick to wholly anonymous posts -- those that lack even a pseudonym. The question of privacy of online texts on the public internet is not the same as individual privacy. It takes into account the connection, if any, between a text and an individual person.  

For instance Michael Thelwall writes "A simple but strong argument for researching published information on the public web without consent is that the object investigated is the publication and not the person."

To be conservative, online comments posted anonymously have no connection to an individual, by any reasonable measure, and can be treated as any other publicly available text: newspapers, blogs, research papers, wikipedia etc. This is a prevailing norm in the still unsettled area of online research ethics.

How labels harm -- an online excerpt

Anonymous writing to another poster: ... could you answer a few questions about borderline's for me? I recommended the book about Hitler called "The Psychopathic God." Are Borderlines:

• A) Purposefully self sabotaging. Do they LIKE to set themselves up for failure?
• B) They are extremely contradictory. It's ALL or NOTHING.
• C) They can display "many faces," in over the course of a few minutes. Almost as though demon possessed. Look at the hundreds of "faces" "good" mother Casey Anthony expressed in the 1,000's of photographs taken of her.
• D) They play sex games involving poop. I don't know WHY, but that has been a noted trait.

I don't know whether this is true in your case, and you've said you worked in a mental hospital setting. The hospital TA's are sadistic and often w orse than the patients, but you said you had a "responsible" interactive position as an "intake nurse." Is it so? You've held it together pretty good for a Borderline. Any explanations?

DoctorSciFi: Anon, regarding your post:

• All your questions are ill posed. They are not even wrong. To be diagnosed with BPD one needs at least 5 distinct symptoms out of 9 possible ones to be checked off. 
• By combinatorics this means there are 256 different types of BPD [even disregarding the actual severity of each symptom over a threshold]. Each person will have some symptoms and NOT have others, as demanded by the classification system itself.
• Just because a person has a high degree of one symptom does not demand they have any other particular symptom at all. That is a requirement of the classification system itself.
• So any question like Are Borderlines:"A) Purposefully self sabotaging. Do they LIKE to set themselves up for failure?" misses the point entirely.
• Assuming for the sake of argument that A) fits into one of the 9 possible symptoms, it is not true that "borderlines are A)". Some are and some aren't.

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[1] The current edition, the DSM-5, retains the nine main symptoms of BPD with slightly different wording.

Online Anthropology: Borderline Voices and the Self

One of my favourite voices

I'll return to Hacking the Mind in subsequent posts. It leans heavily on neuroscience and technology, which lack the depth we tack to individual experiences of consciousness.

In the context of personality types, my view is that the hardest nut to crack is the experience and expression of 'self'. I am not referring to textbook, jargon-filled definitions of self one runs across in psychiatry, psychology, or philosophy... though. (If you know of salient references, please let me know.) 

1. Anthropology of online voices 

Instead, this is a pedestrian approach: look at what people write online about their experiences as atypical neurological beings. Some of these voices are eloquent, compelling and fascinating. One example is the book 'The Buddha and the Borderline', which is a personal account of perhaps the most complex and fascinating disorder. Borderline disorder often, but not always, manifests as an experience of 'fragmented self'.

Since each person is their own unique being, it's important not to put to much emphasis on any one voice. It's also important not to come at this with too many preconceptions. Indeed psychiatry is a mess when it comes to personality disorders.  Many people, who should know, agree. Unsurprisingly successful treatment is rare, with certain exceptions including Dialectical Behavior Therapy (DBT).

Much to my appreciation and respect, a number of online voices speak eloquently, and with candour, about their sense of self and how that plays out in their lives. Anthropology means to look across many voices to find both the commonalities and differences.  Form your own impressions. Join in with comments and questions.

2. How this project can work

My aim is to create an anthropology of online voices from communities engaging different personality types to offer glimpses into how radically different these experiences of consciousness and life are --  letting others speak in their own voice, organizing into themes, without hopefully too much bias. I hope my fellow travellers find their way here to offer their voices in the comments section. That would be the best result I could hope for, or start your own blog too!

There is always the possibility of deception, especially in personality disorders. Indeed Munchausen by Internet is an accepted phenomenon. Even if a description is false, it still has meaning to the person who wrote it, otherwise they would not bother.  I take it for granted that some quotes excerpted here as part of thematic discussions now and in the future will be fake.

On the other hand, how well do we really know ourselves? Don't some of us deceive ourselves about who we are --  a few times in life when it mattered?

3. Voice of a Borderline self

Skybuzz
SEP 06, 2014

For most Borderlines, the ones I have met in DBT, and also on line, the striking similarity is a personality that never formed. Another definition of this could be ‘fragmentation’- a puzzle of a human being's mind that was never ‘put together’.

That’s the ‘lack of self’. For me this has been devastating- no real career goals, no sense of identity in who am and what I do. In my ‘recovery’ from BPD , I am beginning to see a sense of self, my interests, talents and true abilities. Many borderlines never actualize who and what they are, which leads to the anger, negative thoughts, rage- cutting and ultimately suicide.

A poignant post. I'd like to understand this fragmentation better -- an unintegrated, fractured self for some people with borderline disorder-- a fluid self for a psychopath. How do these self senses differ and how, if at all, are they similar?

4. About myself

I'm not a mental health expert, and am not equipped to give advice. I read a great deal, and will link to any authoritative article I can find to verify claims. Please join in with comments if you have some other articles or information you want to contribute, or you think I have got something wrong, or you want to share your voice.

Hacking the Mind (Part 2): A Sense of Self

Having read this far you might wonder if people really will be walking around with electrical and optical circuits embedded in their brain.  Those circuits would be connected to an implanted computer and power source, to modify thoughts and to change behaviour based on pre-conscious signals. 

This idea may seem far fetched and a bit creepy. It pushes boundaries of what we think a self is, a ponderous subject I will move to in subsequent posts.  It is also one aspect linking optogenetics and thought-stopping, in my mind, to personality disorders.  I only mention it briefly here.

3. Self Sense in Sociopaths

It's well-accepted that sociopaths maintain a more fluid sense of self than neuro-typicals. The sense of self in people with borderline personality disorder is also atypical. 

Individual descriptions of self-identity, self-respect, and  a self itself vary widely. There is no one size fits all answer.  For example, one can find lengthy discussions on internet forums about theses senses of self, some claiming indeed no sense of self as is commonly understood.  Look, for instance, in the comments section of ME Thomas blog sociopathworld.com, particularly in a "viewpoints" posting. (This requires hitting the 'load more' button at least four times to see all the comments, or you can take my word for it.) 

If one agrees that personality disorders exist together with less extreme neurological forms, which I call personality types -- those who are not disordered but differ in fundamental ways from the typical case, it goes without saying that such types would not only perceive others in vastly different ways, as objects for instance, but also themselves.

4. Neural implants, thought-stopping and information theory

People are already living with neural, or brain implants to treat conditions like Parkinson's, depression and other neurological defects. As well, research in brain-computer chip interfaces takes place at institutions globally, and is part of the growing dominance of neuroscience as a funding target for governments.

To do thought-stopping, one has to decode the pre-conscious signals in the brain. This problem is not so different than being able to predict epileptic seizures. 

Seizure prediction has for decades been a collaborative effort between doctors and scientists using information theory to decode the brain's activity patterns. This is not to say that seizures are a 'thought', but both are a cascade of signals sent around the brain, so the decoding/prediction problems are not so different in that respect.

More than a decade ago, Kreuz and others developed a set of techniques to validate prediction algorithms, which could enable countermeasures to be taken in advance of the seizure. Those methods, based on information theory, are just as applicable to the EEG time series studied in the past, as they would be for any other set of data from the brain.

For the technorati:

"Measure profile surrogates: A method to validate the performance of epileptic seizure prediction algorithms" 

Information theory is one of the most beautiful and useful inventions ever made.

Hacking the Mind (Part 2): Are decisions really free?

The first part of 'Hacking the Mind' introduced optogenetics as a proven means to alter behavior in animals, at the flick of a switch.  This post goes a step further: stopping thoughts before they happen. 

In optogenetics, the shift (for instance, from cowering in a corner to exploring) occurs at the time scale we experience consciousness -- in the range of tens of milliseconds to seconds -- not microseconds and not minutes. 

It's roughly the same frames per second (fps) in movies, like the video clip at the above -- a TED talk by Jim Fallon, "Exploring the Mind of a Serial Killer".[1] I'll get to the connection between optogenetics and serial killers at the end of Part 2. It's a winding tour through a brave new world, where technology wires computers and brains together.

1. Thought-stopping technology (TST)

The behavioural levers in optogenetics are pinpoint laser beams carried by fiberoptic threads, painlessly placed into certain regions of the brain that have been genetically engineered to respond to light by producing electrical signals. Optogenetics has been widely tested in mammals like rodents and will likely be widely tested in humans too one day.  

But what if it was possible to stop thoughts or urges, such as an irresistible craving for cigarettes, before the subject is  aware of the thought or feeling? "Searching for the 'Free-Will' Neuron", an article that appeared in a recent issue of Technology Review, shows how this could happen in the not too distant future.  I will be discussing this article in more depth addressing specific questions in this and following posts.

The formation of a particular 'thought' creates distinct signals in the brain, a "pre-conscious" signal, before the subject consciously thinks it.  That time delay sets a lower limit on the marching pace of consciousness. It's easiest to think of consciousness as an observer of brain processes, so there has to be a delay.  Indeed such delays have been experimentally measured.  Interrupt  that pre-conscious brain activity, at the right times and in the right places, and the subject would never know the thought they were going to have, or that it had been erased.

2. What's up next

The number of questions this technology opens up is mind-boggling, from curative or healing (think of compulsive or addictive impulsive cravings) to profoundly dystopian, to everything in between.  

Some of you will probably be able to think of more futuristic outcomes than I. The implications for philosophy are beyond my ability to adequately address, so I'll stick mostly with the former. Any comments along those lines are appreciated, to widen the discussion.  I look forward to reading your thoughts!

In the next posts, I'll explore some of these questions and also highlight the way thought-stopping technology in real time can work.





[1]  Some neuronal processes run faster than others, or are refreshed more often, but tens of milliseconds to seconds is the pace consciousness marches by.