My favorite sociopath

The continuing education units tell you to manage the risk. The instructors tell you to document the lack of remorse. They treat the antisocial client like a biohazard. I find that approach boring. It is a defense mechanism for therapists who cannot handle the fact that some people choose to be cold. I worked with a man for several months who fit every criteria for antisocial personality disorder. He is the most interesting person I have ever sat with. I do not say that because I am a fan of true crime. I say that because he forced me to be a better clinician. He forced me to stop using the canned language of the profession.

I do not believe in the standard clinical view of these clients. The literature describes them as a professional burden. It says they are a drain on resources. It warns you about manipulation and boundary violations. I think those warnings are often a cover for a lack of imagination. If I am bored by a client, I am failing that client. If I am bored by a personality structure that prioritizes power over connection, I am not paying attention. Interest is a clinical variable. I do not treat every presentation with the identical level of engagement. I cannot. The profession lies about that. We pretend that our attention is a steady stream we turn on for fifty minutes. My attention is a response to the material. This specific client provided material that required a level of intellectual precision I rarely get to use.

He came to me because a court told him to. He did not pretend to want to change. He told me during the first ten minutes that he intended to lie to me if it served his interests. I appreciated the honesty of that threat. Most clients lie to me for months while pretending to be transparent. They lie about their drinking. They lie about their affairs. They lie about how much they hate their parents. This man put the lie on the table as a strategic asset. He transformed the therapy into a game of chess. I like chess.

The therapists who work well with this population are the ones who find the clinical picture compelling. I do not mean that I find the crimes compelling. I find the cognitive architecture compelling. I find the lack of social friction fascinating. Most people spend their lives vibrating with anxiety about what others think. This man did not have that vibration. He operated with a clarity that was almost refreshing. I had to audit every sentence I spoke to him. If I used a phrase that sounded like a greeting card, he caught it. If I tried to appeal to a moral center that did not exist, he laughed. He demanded a therapist who was as sharp as he was.

I remember a specific moment during our second year. He had successfully liquidated a small business belonging to a former partner. He did not do it for the profit. The profit was negligible. He did it because the partner had insulted his intelligence during a board meeting. He walked me through the steps of the liquidation. He described the way he used legal filings to freeze the partner’s assets. He explained how he waited for the partner to miss a mortgage payment before filing the next motion. He was not looking for a catharsis. He was not asking for forgiveness. He was showing me his work. He wanted me to see the logic of his revenge.

I did not judge him. I did not tell him that his actions were harmful. He knew they were harmful. That was the point. I asked him if the result satisfied the initial insult. I asked him if the time he spent on the liquidation was worth the return on his ego. We talked about the efficiency of his malice. That conversation was more productive than any lecture on empathy. He respected my focus on the strategy. I respected the complexity of his plan. By finding his process interesting, I remained in the room with him. If I had focused on the tragedy of the ruined business partner, I would have lost my client. He would have checked out. I would have become another moralizing figure he had to outmaneuver.

The clinical literature suggests that finding an antisocial client interesting is a sign of countertransference. They suggest it is a danger. I argue that it is a precondition for success. If I do not find the client interesting, I have no use. These clients have spent their lives being the smartest person in the room. They have manipulated parents and teachers and probation officers. They expect the therapist to be a soft target. When I show interest in the way their mind works, I stop being a target. I become a peer. I become a mirror that they actually want to look into.

I do not think the goal of therapy with an antisocial client is to create a conscience. That is a fantasy. The goal is to identify where their self-interest aligns with pro-social behavior. I can only find that alignment if I am willing to look at their world without flinching. I have to see the appeal of the power they wield. I have to acknowledge that their lack of empathy gives them a tactical advantage in many areas of life. If I pretend that their life is a tragedy of missed connections, I am lying to both of us. He did not miss connections. He discarded them.

My interest in him was not a mistake. It was the only thing that kept him coming back. He told me once that I was the only person he could talk to without having to translate his thoughts into the language of nice people. That is a clinical win. It allowed us to discuss his violent impulses as tactical errors rather than moral failings. We could talk about his urge to defraud a local charity as a high risk move with a low reward. Because I found the mechanics of his fraud interesting, he allowed me to critique his logic. We avoided a new indictment because he started to value my perspective on his strategy.

The profession wants us to be blank slates or warm blankets. Neither of those roles works with a sociopath. You have to be an observer. You have to be a person who can sit with a predator and discuss the hunt without becoming the prey. I find the hunt interesting. I find the predatory instinct to be a fundamental part of the human condition that we usually try to talk our way around. This client did not talk around it. He lived it. Working with him was like studying a different species. I learned more about the nature of influence and power in those months than I did in all my graduate school seminars.

I have colleagues who complain about their antisocial clients. They talk about the missed appointments and the unpaid bills. They talk about the feeling of being used. I think those colleagues are missing the point. If the client is using you, that is the data. That is the therapy. If the client is lying to you, look at the shape of the lie. Look at the purpose it serves. If you find the lie annoying, you are in the wrong specialty. If you find the lie interesting, you have a chance.

I do not use the word interesting as a synonym for “fun.” I use it as a clinical term. Interest is the energy required to sustain a long term intervention with a person who does not value you. It is the fuel that prevents burnout. I did not burn out on this client because I never expected him to care about me. I never expected him to get better in the traditional sense. I only expected him to be himself. He was exceptionally good at being himself.

The idea that all presentations demand identical engagement is a lie. I give more of my intellectual self to the antisocial client than I do to the client with generalized anxiety disorder. The anxious client needs a container. The antisocial client needs a sparring partner. I find the sparring match to be the highlight of my week. I find the intellectual demand of staying three steps ahead of a manipulator to be the most rewarding part of my practice. Admitting that does not make me dangerous. It makes me effective.

I stopped trying to be a “good” therapist in the way the textbooks define it. I do not aim for warmth. I aim for utility. I want to be useful to the client who has no use for anyone else. I can only be useful if I am willing to be fascinated by the parts of them that the rest of the world finds repellant. My favorite client was a man who had no regard for the law or the feelings of others. He was a predator. He was also a brilliant strategist. I did not try to fix him. I tried to understand him. By the time the work was finished, he was still a sociopath. But he was a sociopath who had decided that the risk of prison was not worth the thrill of the con. That is a better outcome than most of my colleagues get with their “standard” clients. I got that outcome because I was willing to admit that I liked the way his mind worked. I did not need him to be a different person for me to do my job. I only needed him to be interesting. He was. He always was.