Men and Mental Health toughness

I am a man (CIS gender: assigned male at birth ). When I was in my twenties, I rejected my parent’s wish for me (the son) to take over the family business. My sister did instead. She was one of the few female business owners in the fruit machine service industry. Seven years ago, I decided to become a Grumpy Old Man and joined the local GOM group. We meet every week at the pub. We talk about football, cars and how machines work but we also share our private feelings, sometimes we reveal our vulnerability. Imagine I have a diagnosis of being a psychopath (I don’t). If I shared this with the GOM group, what would be the reaction ? Is this Mental Health stigma or an understandable fear of me being dangerous ? 

How do you feel about the following statement ? “Living with psychopathy can be incredibly difficult, both for the person afflicted and their loved ones”. A “sociopath” or “psychopath.” in popular culture, both words are often used to refer to someone who doesn’t seem to care about right or wrong, tends to manipulate others, or has a hard time understanding other people’s feelings.

I attended a Seeds talk at the Old Fire Station, Carlisle on the 14th October to hear Dr Laura William speak about the psychology of psychopaths. The venue was fully booked. She presented some thought provoking information: 90% of psychopaths are male, few psychopaths are criminals ending up  in prison.  4% of leaders in corporate companies have psychopathy. 

Several times, the audience asked why 90% ? They wanted to know what is it about men that makes some men psychopathic but not women ? Laura could not answer the question even though she is a clinical psychologist, worked in Scotland’s prisons and a specialist in relational trauma therapy. I do not know why either, but one person in the audience suggested it could be explained by the social pressures of societal “toxic masculinity”. This article unpacks psychopathy and personality disorder, explores what is it like to live with such a condition of sociopath and explores men and Mental Health toughness.

Psychopathy is not a diagnosis but a set of 20 traits. When clinically assessing someone in prison, Laura would use the Hare PCL-R rating tool. This helps her in deciding who should be detained or released, or who should undergo what kind of treatment. Traits included are; superficial charm, pathological lying, lack of guilt and empathy, parasitic lifestyle, impulsivity, irresponsibility and many short-term marital relationships

The (American) DSM 5 Antisocial personality disorder (ASPD) is on a spectrum, ranging in severity from occasional bad behaviour to repeatedly breaking the law and committing serious crimes. The other label clinicians use for ASPD is Sociopath. The first 1952 version of the DSM, labeled this disorder as sociopathic personality disturbance. Psychopaths are considered to have a severe form of antisocial personality disorder. Only one third of people with ASPD meet the criteria for psychopathy. In England, the ICD classification is used: Dissocial personality disorder (DPD).

A Mental Health professional can only diagnose a person with ASPD or DPD  if they are over the age of 18 years because their personality is still developing until this age. Laura says the cut off point for a fully developed brain is 26 years. Conduct disorder is a mental health condition that occurs in children and adolescents. Many antisocial symptoms are diagnosed in conduct disorder. Two behaviours warning signs are setting fires and animal cruelty.

I would like to explore what is a sociopath (ASPD)  and what is life like when living with such a condition. I recommend you read Dr Martha Stout’s book “the sociopath next door” which I have used to illustrate what life is like.

Imagine throughout your life, you have absolutely no conscience : no feeling of guilt or concern for the wellbeing of any strangers whom you meet and share their company. What about those close to you ? It’s the same, but this time you hide it from your work colleagues. You are charming and engaging with your friends even though you are at times, selfish and act without morals (principles of right and wrong). Your family have no idea of the real you.

You are really skilled at pretending. You make it appear that something is the case when in fact it is not. The feeling of being responsible is foreign and unknown to you. Feeling conscience free is effortless. You believe you can do anything at all, whatever your chosen career. You tell premeditated lies. You take advantage of your employees for personal gain. You manipulate and bully people who are under your thumb. Making people jump is your way to feel raw power, which is thrilling, in the absence of  any concern for others.

Now imagine the other end of the spectrum: you have no interest in power or  in controlling and coercing others. Your live your life with minimal effort and without a conscience. You only enjoy simple pleasures of food and TV. You survive with handouts from friends and family. Despite your freeloading lifestyle of taking advantage of other people’s generosity without giving anything in return, you never feel embarrassed or shame. Friends may privately gossip you are an underachiever in life, lazy at the core. Unlike you, they live their lives by their moral compass. Their ability to judge what is right and wrong and act accordingly. About 4% of any population have a diagnosable ASPD. That’s almost 1 in 25 people. It is often undiagnosed and untreated: “psychiatry’s forgotten disorder”. 

A stereotype of men is: men sort their problems alone, act tough and don’t show their feelings. Men are naturally aggressive. Men like to fight by boxing. To achieve world boxing champion status is admired and respected by men, globally. Toxic masculinity involves cultural pressures for men to behave in a certain way:

  1. Anti-Femininity – Men reject any and all feminine traits, including most emotion, accepting help, and domesticity.  
  2. Power – Men are worthy only if they have money, power, status, and influence.  .
  3. Toughness – Men are strong, aggressive, and emotionally hardened. 

A way of thinking that’s associated with masculinity is physical toughness. It is “toxic” in part to the promotion of violence, “boys will be boys”. Toughness can be a ruthless work management style but also at home: sexual assault and domestic violence. 

Male sociopathy can be counter intuitive: men can be charming, behaving in a friendly way. In coercion and controlling relationships “love bombing” usually happens in the initial stage of stealing a women’s personally identity. You pretend to be fascinated by her. Compliments and praise are showered over her. They want to get to the real you but shut away her opportunity to discover his “empty core” identity.   Sociopaths have little depth to the emotions they feel. Affectionate feelings are surface shallow. It’s like a hollowness. A bouncing tennis ball with stale air inside. Try to scrape the surface charm off, there is nothing underneath. Marriages end up being a “one way loveless relationship”. 

In movies, novels and TV dramas, men historically have been associated  with murderers and serial killers. People who break the law: robbers, fights that cause serious harm. Men are depicted as villains: the psychopath. The lead actor acts without any moral purpose. 

In real life, people without a conscience are largely invisible to us. Why ? Maybe the reason is that everyday decisions we all make both at home and at work are driven by our conscience. It sits there inside of us, automatically influencing what we do. It is there like the way you breath. Break that bond with conscience and you feel intense guilt. It hurts. 

Go back to ancient times. The spiritual distinction between good and evil was the absence of a conscience. Freud removed conscience from god with his creation of the “superego”, an internalised “authority figure” that controls the base instincts of your “id”. But the superego is not the same as your conscience. It is better explained as the anchor that tethers us to our desires to care for others. 

Men do care for others. It is for many men, a duty to provide for their family. An essential component of their job description in life. What does my life mean ? To love and cherish a special partner, to be a loving dad and be there to act as a role model for my young impressionable kids. So children grow up with a strong moral conscience and do good. But the demands of work can sabotage this “man wish”. A moral dilemma: work long and hard, earn money to provide a good comfortable family life or earn less so I can spend more time with my partner and kids. 

Men are represented by the media as having an innate ability to win. They have a right to dominate and within reason, bend others to their way of thinking. Men are under pressure to earn and be wealthy. Is that really true ? What about men who are sensitive caring and skilled in empathetic conversations ? 

Anthony Joshua, nicknamed AJ, twice heavyweight champion boxer, AJ was recently interviewed “head to head” by BBC Louis Theroux. It was clear from their conversation and Louis’s probing questions that AJ  is a sensitive, softly spoken man. When listening to Lous’s challenging questions. SJ responded with humour and empathy. “you lost 3 of your last 5 fights, how do you feel now ?”. AJ responded by asking Louis “are you any different from 5 years ago ?”  He clearly possesses deep empathy. In the ring, it is a different matter. AJ is promoted as a “knock out machine”,” there to fight and win. Losing is not an option. Anger is the dominant emotion that gets “knock out” results.

I recently watched the movie “Big George Forman”. There were times when I was  I was close to tears. Born into the family for poverty, George experienced a tough life. To succeed he wanted himself, to be tough and fight. He discovered boxing was a way to make money and achieve respect. To win George needed to feel hate towards his opponent, until he lost to Muhammed Ali in “Rumble in the Jungle”.  It destroyed George’s self-esteem. Losing your toughness image can trigger poor Mental Health. Then he discovered spiritual faith, everything changed. Foreman became an ordained Christian minister. That change was a concern for others “the boxer with a conscience”. In 1994 at age 45 won the unified WBA, IBF championship titles. The reason to re-fight, was to finance community youth boxing services for those who were at risk of being violent to others.

Foreman and Joshua are tough men but they are not sociopaths. People with a diagnosable ASPD, typically think they have done nothing wrong. Or they will try to convince you that accept they did wrong but underneath this is a lie. We feel it is true because we assume everyone who has committed a bad act will naturally feel the full negative weight of being responsible. If you have little or no conscience then your view of the world, your frame of reference, is your way of being in the world: the assumption is that you are superior to everyone else. 

You feel excited when someone with ASPD says to you “let’s go and see the Rolling Stones, I have tickets for this week’s London show”. If you feel unchained from your conscience, then it is easy to make another feel their lives are filled excitement rather than with living and complying with boring social rules that we all have to obey.

The most important sign to be alert to is: don’t pay attention to what they say but what they do. A second important warning sign is not looking out for someone acting sinister but be alert when you are being targeted for you to feel pity. So why is pity, people with ASPD crave for from you ? 

Feeling pity means you feel compassion but watching from a distance. A safe emotional distance, means their real self remains hidden. If you were empathetic, that means you feeling what they don’t feel. You may sense the empty hole of conscience. Pity protects a person with ASPD, so you become vulnerable and defenseless. Imagine a woman who is physically abused by her husband, who seeks pity but falsely emotionally communicating he cannot control himself “please forgive me”. 

Robert Hare the creator of the psychopathy checklist believes that modern society support certain traits of psychopathy such as impulsivity, irresponsibility and lack of remorse. Men are being encouraged by society to uphold individualism as a core value which in Hare’s opinion, is providing the opportunity to disguise and hide anti-social behaviour.

Throughout my life I have chosen not to step “into the ring” and act tough. I have tried to develop my empathy skills to understand what others may be experiencing in their lives. I see myself as a mixture of socially constructed masculine and feminine qualities. At GOM gatherings, I have no desire to impress others of how wonderful I am, to gain admiration. 

Laura is a trauma therapist, her key message that night was psychopathy (and sociopathy) was like a potter at the wheel. Some aspects of psychopathy is hereditary and biological, like the clay, it remains throughout life, but just as the potter moulds the clay into a pot, your life experiences and with personal effort, some aspects can improve. Understanding and accepting early traumatic conflict turns the key to open the door of positive change.

But what if you are a loving partner or a child of a sociopath ? Here is Donald Black’s of “Bad boys, bad men” advice: Accept the diagnosis, urge treatment, be firm with children, protect yourself from abuse, consider your motives, recognise it’s not your fault. 

Like coercive and controlling relationships, consider the risks and benefits of staying, but if the risks of leaving outweigh the benefits, leaving permanently is the safest option. But that is, for many, so hard. 

  • Written by Chris Graham

*thought expressed are authors own and not that of the organisation