Exploring the Complexities of Antisocial Personality Disorder in Therapy

This case reflection delves into the intricate dynamics of working with a client diagnosed with antisocial personality disorder (ASPD), who self-identifies with the disorder and takes pride in it.

She openly acknowledges her lack of empathy, viewing any semblance of empathy as a mere manipulative tactic to achieve her desires. This perspective is compounded by her undisclosed motive of maintaining secrecy about her true nature. In addition to considering herself both narcissistic and antisocial, she distances herself from the concept of love, dismissing it as mere neediness, even in her closest relationships with her significant other.

In therapy, I am compelled to question what drives her perception of inadequacy in reciprocating love. Has she become so detached from her own humanity and emotions that acknowledging them feels uncomfortable? The possibility of recognizing her emotions might signify vulnerability or weakness, as she might perceive it. Yet, amidst this complexity, a crucial question arises: Why is she in treatment? What is her true motive for seeking therapy?

(c)2024 John Piedrahita