Anxious Psychopath, Borderline Mask

Anxious Psychopath: Psychopaths are said to be fearless and sang-froid. Their pain tolerance is very high. Still, contrary to popular perceptions and psychiatric orthodoxy, some psychopaths are actually anxious and fearful. Their psychopathy is a defense against an underlying and all-pervasive anxiety, either hereditary, or brought on by early childhood abuse.

Psychopaths nurture and cultivate an image of themselves as free-spirited, daring, non-conformist geniuses who are grievously misunderstood and mistreated by Lilliputian society and its mindless cohorts.

This grandiose and romantic self-narrative legitimizes three classes of antisocial behaviors: defiance, passive-aggression (negativism), and reactance.

People with personality disorders who are high-functioning are very disconcerting: they compartmentalize their promiscuous, antisocial, addictive, sadistic, and defiant behaviors.

During the day, they are competent professionals, diligent students, pillars of the community, responsible citizens and fathers or mothers, loving husbands or wives, and thriving entrepreneurs.

Come evening, the mask drops, the drink and drugs are out, replete with dissolute reckless sex with virtual strangers, gambling, or any number of self-trashing and dysfunctional, even self-destructive behaviors.

What baffles scholars is that all these self-states are a part of the personality. There is no faking involved. The switching is abrupt but seamless. Dissociation is often involved, but never to the point of rupturing continuous autobiographical memory and core identity.

Cleckley called it the “Mask of Sanity”. It challenges everything we thought we knew about psychology.

Recklessness and fantasy are both clinical features of Borderline Personality Disorder (BPD). As a form of self-mutilation and self-trashing, Borderline women often place themselves in harm’s way with relative strangers and end up being defenseless and sexually assaulted.

Having been raped, they then use fantasy to defend against the trauma and resolve the cognitive dissonance (“I initiated it, I wanted the sex, he was attractive, I thought we could have a relationship”).

To prove the point, they may even meet and have sex with the attacker again.

Fantasy characterizes the Borderline’s intimate relationships as well. But her self-destructiveness, emotional dysregulation, and mood lability are such that she always sabotages what she has.

As reality intrudes on the fantasy (which the Borderline finds intolerable and anxiety inducing), she begins to devalue the partner and act out egregiously. The resulting deterioration in the quality of the bond justifies bouts of cheating on the partner and reckless self-trashing, on the way to a new man within the next fantasy.

Reactance in personality disorders often masquerades as “boundaries”. The psychopath’s defiance and contumaciousness, for example, can be easily mistaken that way.

True personal boundaries are endogenous and proactive. In other words, they are not triggered by the environment, they are immutable certainties and givens, emanating from a healthy and stable sense of self-worth. They are forms of internalized self-defense.

Fake boundaries are reactive to events and people, hair-triggered by them, are inconstant, and do not reflect any inner reality or processes. They are forms of externalized aggression.

ORIGINAL RESEARCH ARTICLE

Front. Psychol., 10 March 2016 |

Psychopaths Show Enhanced Amygdala Activation during Fear Conditioning

Douglas H. Schultz1*†, Nicholas L. Balderston1†, Arielle R. Baskin-Sommers2, Christine L. Larson1,3 and Fred J. Helmstetter1,3*

• 1Department of Psychology, University of Wisconsin–Milwaukee, Milwaukee, WI, USA

• 2Department of Psychology, Yale University, New Haven, CT, USA

• 3Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA

Primary psychopaths exhibited a pattern of activity in the dorsal and ventral ACC consistent with enhanced fear expression, while secondary psychopaths exhibited a pattern of activity in these regions consistent with fear inhibition. These results contradict the low-fear model of psychopathy and suggest that the low fear observed for psychopaths in previous studies may be specific to secondary psychopaths.

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