 Okay, so today we're talking about antisocial personality disorder and its treatment. So why don't you give me a brief outline about what antisocial personality disorder actually is? Well, it's called a personality disorder, which means that it's about your whole personality, which is things like the way you act, the way you feel, the way you think about other people and your relationships with other people. And it's antisocial in that it's against other people, the social being other people. So it's sort of a personality disorder where you're constantly at war with other people, with your surroundings generally. So you see other people as your enemy and you see yourself as someone who has to form alliances and break alliances and conquer territory and you can either be victorious or meet defeat and your whole life is basically a fight of some sort. So that's what I think the core of antisocial personality disorder is. So the issue of control is very big. So it's not just someone being socially withdrawn then, it's not the common term antisocial, it's a little bit different. It's absolutely not about being withdrawn and shy, that's a completely different type of person. So how do people with antisocial personality disorder experience the world? It's obviously different from how other people experience it. Well, as Morden was telling, they see the world as a place that needs to be conquered or is full of potential enemies that they need to be quickly gaining control over. So it's very much a hierarchy and it's a big power struggle. So they're not at peace with the world as such but if you're with them and support them, they will be at peace with you. So the world is not a friendly place, it's really survival of the fittest you could say. So you think that feels quite isolating for them then? You think they feel isolated from the rest of the world? In many ways yes, I think especially as people grow older and they experience that they have been in a lot of conflicts with other people and they have destroyed their own relationships repeatedly. So they lose more and more people and they end up sitting very much alone and they also begin to learn that it's their own actions that cause all these rifts. Whereas when a person is young, what they tend to think is that it's someone else's fault. So that's another part of what we call the externalization of blame. It's someone else's fault if something goes wrong, if there's a conflict, it's the other person's fault. If I don't get the job, it's because the manager was jubid. It's never because I didn't perform well. So that's that kind of thinking too. And do they feel normal then in the sense, do they feel that they are different from other people? Do they think everyone else experiences the world in the same way that they experience it? I think that many don't want to feel normal. There are in many ways special and needs to be recognized as special. Needs to be shown proper respect. The respect can be very important to them and it's more important that there's your respect that they need to respect others. But I also think that when you encounter them as young, they have already experienced some of them social isolation because of their anger and pulsivity. So they maybe have a hard time getting friends. They can have had a hard upbringing. So in some ways they can have actually been marginalized. And that's also why they might look for peer groups where their anger, their impulsivity is more respected and acknowledged. They actually appreciate it. So I think some sense of isolation can occur at a very early age. But maybe it's not so reflected, it's more a feeling of that people don't understand me. So fuck them. People that they tend to associate with, do they also have anti-social personality disorder? Or some sort of personality disorder at the same extent? Yes, especially they all have anti-social behavior because they will need to find people that they can sort of say, cooperate with, that they can form these alliances with. They can be partners in crime or they can do two drugs together. So there will be this sort of attraction to like-minded people for that reason alone. But also because other people will reject them and having been rejected and being angry, what do you do to find someone you can be with? People usually seek like company. And sometimes people with anti-social personality disorder are labeled as maybe psychopaths or psychos. And do they see themselves in that way as well? Some do, absolutely. And some take pride in it. I begin to describe that it's an appreciated trade. And psychopathy is of course this big monster in our big myth in society about the evil person. It's really just a description of a way of relating and of a way of handling emotions. Maybe we should also add that you can have people with this personality disorder who are very high functioning. So sometimes we talk about we meet them a very often. They have comorbid drug problems, alcohol problems and lots of other problems. But there are also people who are doing very well in the business world and make a lot of money. So you can be well adjusted and I don't think they would label themselves. Maybe they would as psychopaths. Some would and some would probably label themselves as very good leaders. So I think it also depends very much on the person what label they want. But the thing is that they want to pick the label. So it's maybe sometimes quite hard to identify someone with anti-social personality disorder. If they are so high up in businesses or if they are quite good leaders and they may be just quite charismatic. So it may be quite hard to actually identify when someone isn't just charismatic when there may be just something a bit more. That's a very interesting question. How do you assess personality disorders and anti-social personality disorder in particular? So do patients with anti-social personality disorder tend to feel remorse for the crimes that they've committed? In general what is the case is not that there's no remorse. Very few people have no sense of remorse but if you are anti-social you have a lower capacity for remorse and some more than others. All of these traits have the common denominator that it's some people more than others. Some people steal more than others, some people lie more than others and some people can show remorse more than others. And the people who have very low capacity will tend to be very difficult to work with and be very difficult to live with. Do you think there is maybe a spectrum for anti-social personality disorder? Do you think that everyone to some extent will be on that spectrum at some point but some people are maybe just higher on the spectrum than others? Definitely. I think the word spectrum is very important. And as Morten mentioned some people may be very low on remorse and some people may have better access to remorse. So that's already there, you've got a spectrum. And people with depression and anxiety, it's the same with anti-social personality disorder. Some people are more prone to violence and some have better control of their impulses than others. So there are some core features that are alike but each person is an individual so it will have different character. So I think it's very important to remember and also it's very important when you want to treat and engage them in treatment that you're aware of the individual differences. Okay, well, thank you very much for talking with me. I'm such a fantastic starter. Thank you Claire.