At the Backend of the Sylvian Fissure, Female Psychopathy, Mice and Men

Someone recently asked for my credentials and I found myself amused by that. It was the first time in my life that I felt no desire to have them known. It wasn't that I wanted to conceal them, but rather that I had no personal need to be acknowledged through them.

I soaked that up for a good moment, always thrilled to find salvation wherever it is--a new and unexpected freedom, a reprieve from the grind, respite from the relentless sun...

I hadn't even imagined such a thing existed, or that I needed it, or that it would feel so fine. Those little moments were 30 years in the making. I was surprised at my delight.

I laughed a little from that sense of relief and my absolute delight in it, but it seemed, I suppose, that I laughed off the request of the woman who had prompted it. Gathering up myself again, I suggested a silly thing and waited to see if she had a sense of humor: I could send you my resume. After a brief sputter for which I felt a twinge of guilt,she said flatly, dysphorically and pitifully: that would be great.

A thought went rumbling through on the tail end of that: It has always interested me to watch a cat play with what she thinks is a mouse.

And, quickly a train came pulling mental cars in a really fun few minutes where you have no choice but to sit and watch, eager for some good graffiti from up north.

It has always interested me to watch a cat play with what she thinks is a mouse.

Getting On Board After 30 years of it in one form or fashion,I'm still fascinated by the deeper, more 'abnormal' psychiatric issues--psychosis, personality disorders, trauma, emergencies. I suppose had I been an MD or RN, I would have liked the med-surg ER. An ex-near-boyfriend psychologist in-house colleague would say we're sending so and so over so you can install an ego. That level of work, but also extreme dangerousness, too.

Back to the Fishbowl I know I've mentioned the fishbowl psych ER, with goon squad stationed around before, but I keep going back there. How fantastic to know the spacing of chairs so that a lunge can be intercepted. You have to have a conversation if you can. Under any circumstances. Then, you have to wait for the privilege to be revoked by natural consequence...

That's the beauty of the no-life-time insurance cap and accountability to the litigious demographix in which one makes a distinction between the merely rich and the affluent.

Things go differently in the state nuthouse. You don't have to converse if it's too much trouble.

What a Woman Has to Do with It I have been off and on nostalgic for the power and control junkies since retirement. They were the hardest to detach from in the end; it required a clinical trauma bond exit strategy that has been slow in the execution and rather complex... I liked having a conversation if I could and making a relationship if I could. It was often like a really, really fine game of chess--so streamlined and without props. Well, maybe a cup of coffee and a dim bulb in a table lamp...

Those were the best moments. The worst were something very different, of course. The worst moments were still games, but ones you never heard of and so didn't know the rules until you were already in play.

You have to keep up or die in even the mortal combat of exhibition-only push hands with them.

The way you die without any evidence of combat or injury. That way.

The way of female psychopaths with their particular Sylvian fissures.

Personally, I've never found the garden variety female psychopath too frightening to work with. They're either overly concerned with a social facade, unable to manage cold detachment or very amenable to being understood. That's not a list of their characteristics so much as my own skewed and spontaneous sampling and how my clinical style works out.

The Woman, Mice and Men I've had the occasion here and there recently to consider a woman with a rather relentless power and control agenda. I dare say even in her best moments, it is in play--whether premeditated (it often is) or unconscious. However, another dynamic has revealed itself: she seems to over-estimate either her own psychopathic ability or her own intelligence.

Happily, lots of psychopaths do this.

I think of it this way: she's found the Sylvian fissure through chronic psychic masturbation and deep neediness for parenting, even though she is very long in the tooth by now.

Being older helps her some. It has given her intrapsychic chops--long hours of psychobabbling around in her own 'process'. Consequently,she's fiddled with the thermostat in there, straddling the hemi-crevasse at the fissure and is surprised that even a thing exists. Crawling around back, she has actually managed to breech the fuse box to the right temporoparietal junction.

Then, there is the use of auto-eroticism in various forms. Her anatomical tinkering, plus religious going here and there to services rendered by all sorts of providers, has inflated her grandiosity.

She feels powerful when sexually stimulated, for example, and psychic masturbation stimulates and soothes her, too.

All of this is supplemented with picking up housewifey (in the dullest, most classically sexist sense) self-help books to parrot. In short she's a collector of manipulative tactics, still unable to cope straight on effectively, but managing a passable shell with a social facade.

Of course I am speaking of the garden variety female antisocial. The petty thug we might call her male counterparts. The maneuvers of these women bode ill-fatedly for their lovers, but is only a mild irritant for acquaintances.

The problem with lovers is that they are stewed in oxytocin and have let go of the drop floor button. They see no reason to dispose of her completely until, as they say, they do.

As psychopaths go, such a woman's psychopathic career seems to be a mediocre one, with very little promise in sight because her Achilles Heel is 3-fold:

1. She has very little self-control. Her limbic self is still wide open. No one among all those providers has successfully installed an ego. Consequently, there is insufficient detachment and this cripples her efforts. For example, she misses social cues that, if properly used, could make her more efficiently dangerous.

2.Too much labor is required to maintain her self-absorption. It isn't an uninterrupted flow. She's not graceful with it and it drains her to hide it. For example, she has to manage impulses almost everywhere she goes and is exhausted by it. 3. Her cognitive facility is not so sharp that she is dangerous at large. She is not intellectually gifted, for example, and she is poorly educated.

We shall be grateful for all that.

Some things are just mercy gifts to humanity.

Where Diagnostics Meet the Road There's a good deal of confusion out there about what psychopathy is. It is often equated, for example, with the more well known Antisocial Personality Disorder, or APD.

There are associations, but not quite what many think.

Here is the formula:

All psychopaths have APD.

Not all people with APD are psychopathic

Going back to our case subject for illustrative purposes... She appears to have been served a combo platter on the old school Axis 2--antisocial, histrionic, borderline and narcissistic characteristics. Of course, this cluster of traits is often exactly that: a cluster. It's not rare at all among the psychiatric population.

It is dreaded, but it is not all that rare.

and while all of those constructs are useful descriptors of pertinent strategies, the limbic connections she must manage undermine her psychopathic aspirations routinely. This is due in large part to the fact that she is the type of psychopathic practitioner that doesn't want to be found out.

The result, of course, is a great swath of damage when she has the opportunity to bring a victim to close range and inside her hunting ground., but overall, since she doesn't detach easily enough to cut her losses, move on, and hone her skills, very little cost to society.

That's all more mercy falling like rain, but makes for little seaworthiness in her self-chosen life goals.

You might want to know what the life goals are. I have to say we haven't discussed them,but

There are several brands of self-determinationists in the psycho-therapy world at large. Basically, you support the patient's chosen goals and honor the right for all patients to determine the trajectories of their own lives.You see the dilemma already. When the patient's goal is satiation, perhaps we can hang in. When the taste is for human spirit, then what do we do?

The classic psychopath guns for satiation as a prime directive. We can only hope that our denial has a kernel of truth or two in it.

Perhaps psychopaths are rare. Perhaps we have insulated ourselves enough to evade the targeting of the few out there. To feel safe, we have to play those odds.

But there are glitches in that plan. There are also holes in our research and even more anectdotally, basic misunderstandings. Perhaps.

One of the most touted is that female psychopaths just don't get caught as easily and so we misinterpret that to mean that there aren't many.

However, and you'll see my bias now, there are various possibilities about why we don't catch them and drag them into prison as often as we do their male counterparts. This would suggest that they are either smarter than male psychopaths or we are more stupid than we need to be when they're around.

I vote for a little of number one and a whole lot of number two.

Part of our delusion and denial is that women and men psychopaths are basically the same. What if they aren't? What if we don't find so many women who are like the men? What if we discard the real female psychopaths when we find them because they do not meet our gender neutral diagnostic criteria?

Also, whoever said that a psychopath has to commit crimes to quality for membership?

Ironically, too, she is not very educated, but has learned to parrot spiritual principles and to whack away at others with assertiveness and other 'skills' picked up here and there. She seems to think that reading a few books about love languages or the like is helpful. She is the victim of new age hodge podge and clinicians who have not been perceptive enough to diagnose her correctly. Consequently, she balloons iatrogenically into an infantilized grandiosity and insists that her feelings have to be heard and processed. All of that is fine, of course, except she cannot heed other social cues or access empathy. It is really a sad sideshow of what modern psychotherapy can produce after countless hours and many dollars.

It is really an ethical problem for people in the profession--akin to the problems of surgeons who continue to operate on the surgically addicted. According to Hart and Hare (1996), all individuals who have been diagnosed with psychopathy will also have APD but not all individuals suffering from APD will be diagnosed with psychopathy. In short, the psychopathic diagnosis reflects a more severe disorder than APD. "The variety and severity of criminal acts performed by these women, as well as their capacity for cold-blooded violence, are similar to those committed by their male counterparts" (p. 102). Research suggests that young women who later become psychopaths may look different than young men who later present the same disorder. Specifically, Verona (2006) found that young women who later develop the disorder show a more relational form of aggression characterized by jealousy, self-harm, manipulation, and verbal aggression. Other research has examined the importance of relational aggression among females, suggesting that women may display aggression differently than their male counterparts. Crick and Grotpeter (1996) studied relational aggression, also known as covert aggression, which is a type of aggression in which harm is caused by damaging someone's relationships or social status—and it’s different from the type of aggression (typically, physical) that males show each other. Relational aggression tends to be more subtle and manipulative.