Am I Raising a Psychopath?

My first job out of teaching college, where I trained to become a special education teacher, was in a middle school classroom for students who were considered Emotionally Disturbed/Behaviorally Disturbed. I loved the job and stayed for five years before moving to my next teaching challenge. In those five years, I had some incredible students, and some incredible scary students. I had one girl who wanted to cut the fetus out of another student’s body with a pair of scissors. I stood between her and the pregnant student until help arrived - quickly thank goodness! I taught one male student for a while until he impaled his grandmother to the floor of their home with a screwdriver and was incarcerated. When I put a call out on social media for help with this article, my inbox immediately started alerting me to new messages.

“Paul was thirteen years old when he was sent to the psych ward for the first time,” shared a mother, anonymously. “I walked on eggshells around him for years. My husband, to this day, has not accepted the disorder. We have disagreements about Paul all the time. I tell my husband to let me handle him on my terms. Paul has never really had a relationship with his father.”

A different father, who will remain anonymous, shared, “My daughter was three when we first started to see that she was very different from other children. Not just different, bad different. Manipulative and unremorseful. She lied, stole property from others.”

“She was caught in the neighbor’s yard with a big knife. She’d caught some of their koi fish and had cut them open to see their insides and watch them die. She was in second grade,” anonymous teacher. “She started several fires and hurt the family pets. It was so strange because she appeared calm and quiet at school. We paid close attention to who talked with her to see if she had enemies. None. Friends? None. Children didn’t outwardly dislike her, just kept their distance, like they knew something wasn’t quite right.”

All contributors wished to remain anonymous, but were very eager to talk to me about their various experiences. Mental health isn’t the taboo topic it once was, but openly talking about children as sociopaths or

psychopaths just feels wrong. In fact, neither term is used anymore as both are considered outdated. The new term, according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition, or DSM 5, has grouped psychopath and sociopath under one umbrella diagnosis of Antisocial Personality Disorder, or APD, under the heading of Personality Disorders. According to the American Psychiatric Association (APA), Personality Disorders are long-term patterns of behavior and internal experiences that differ from society’s norms. Because personalities are nearly unchanging over time, a diagnosis of APD implies that the condition cannot be helped. However, children’s brains are still developing and therefore APD cannot be officially diagnosed until age eighteen.

“In children, the terms ‘callous-unemotional traits’ sometimes with ‘with limited prosocial emotions’ are used,” according to Dr. Paul Frick with the Department of Psychology at Louisiana State University. “In both the DSM 5th Edition, published by the APA in 2013 and the International Classification of Disease 11th Edition published by the World Health Organization, a child who shows serious conduct problems can be diagnosed with Conduct Disorder with Limited Prosocial Emotions if their behavior problems are accompanied by at least two of the following features with most people and in most settings (not just occasionally or in certain situations): lack of remorse or guilt, callous-lack of empathy, a lack of concern about educational or occupational performance, and shallow emotions.”

Signs and Symptoms

Dr. Frick went on to share, ”The first thing that should alert parents, is if their child is getting into trouble (such as not following rules) and hurting other people either directly by fighting and/or bullying, or by stealing or damaging others’ things.” Additional red flags for Conduct Disorder include the child using a weapon against others or animals, setting fires, stealing, and running away from home. Children may lie to intentionally deceive others, act impulsively, disregard social norms, display erratic or dramatic behaviors, and engage in illegal or promiscuous behaviors.

The additional specifier, “with limited prosocial emotions,” includes at least two of the following traits over a twelve month period: lack of guilt or remorse (not feeling sorry after harming others or does not care about breaking rules); callous - lack of empathy (disregards the feelings of others’, may be considered cold or uncaring); unconcerned about performance (shows no concern about problematic performance in important activities, may even blame others for their own poor performance); and shallow or deficient affect (emotions appear insincere or superficial, or emotions are used to manipulate others for personal gain).

Hope for Families

For the Child

“Parents can seek a psychological evaluation to determine if these problems are due to the above traits or due to other factors, such as the child being impulsive or having trouble controlling their anger because the child is frustrated with school,” shared Dr. Frick. “Such evaluations can be done by licensed psychologists and we offer those services through the Psychological Services Center at LSU. It is important that parents seek help for these behaviors early, because the treatments are very effective for young children but get less effective as the child gets older and enters adolescence.”

Although there are no medications to specifically treat conduct disorders, medications for anxiety, depression, impulsivity, and mood-stabilizers can help control some of the symptoms. Additionally, physicians suggest regular exercise, meditation, or yoga to help manage symptoms of stress and anxiety.

Finally, limit screen time. A 2013 study by Robertson and colleagues found that the risk of developing aggressive personality traits, experiencing negative emotions, and developing antisocial personality disorder (APD) increased with the amount of unrestricted tv time the person was allowed as a youth.

For the Parents

Take a deep breath and read all you can to arm yourself with knowledge about Conduct Disorder. First, know that unless you are either an extremely neglectful or brutally controlling parent, you didn’t cause it. Second, children are still developing both cognitively and emotionally and early interventions can be very beneficial, so seek an evaluation. Third, join a support group ASAP to share your experiences and avoid isolation. Having a child who displays the traits of Conduct Disorder is extremely stressful and can be burdensome on relationships. Having a support group of parents in the same boat can be extremely helpful. Consider reaching out to NAMI, the National Alliance for the Mentally Ill, an organization for parents of children with mental illness. NAMI has several Louisiana chapters with group meetups and discussions.

Take the physician's’ advice and make sure that you are able to meditate, exercise, or destress with yoga or journaling, which can help with processing thoughts and emotions. Spend “time-in” with your child and rely more heavily on positive rewards for prosocial behaviors than punishments for negative behaviors.

Finally, take heart that there is hope. Paul’s mom shared, “As far as seeing how I was a parent during that point in his life, I felt like I let him down. It was the hardest time of my life. But, to this day, he and I have the strongest relationship that any mother and child could have. He went to counselling. We attended family counselling. [After counselling] if either one of us sees our faults, we can identify them. We let things calm down, apologize to each other, then talk about it. We are close, he and his sister are very close, and he has gone on to have very meaningful relationships.”

As far as my former students go, the ones from the middle school class for troubled teens, some of them are incarcerated for arson, theft, or assault. But, I choose to focus on the happier endings. Many of my former students are now supportive, loving parents. I have been invited to graduations, weddings, gender reveal parties, and other celebrations of life. These now-grown adults are gainfully employed, living independently, and contributing to the world in a positive way. Ultimately, it is hard to say who exactly is to credit for these individuals’ successes, but I know one thing for sure, hope does exist.

Published in Baton Rouge Parents Magazine.