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Warning: Semi-professional rambling ahead

Having read many comments, posts and extended essay on the subject of the Holmes Brothers and their myriad of psychiatric problems – I feel that I too should throw something into the psychoanalysis pot. In my case it’s going to be a much loved copy of the Oxford Handbook of Psychiatry. I explore Sherlock's "autism" and his incredibly arrogant declaration of being a "high functioning sociopath".





As a medical student everyone is compelled to study psychiatry (if only to pass finals) and unfortunately once psychiatry gets into your brain it never truly leaves you. You find yourself reading ICD-10* (the European equivalent of the DSM-IV diagnostic manual for mental illnesses) in the morning – only to diagnose yourself with ten different disorders by lunch time. It’s called Medical Student Syndrome. Sadly this illness seems to have affected Sherlock and Mycroft by virtue of being over psychoanalysed. Between them,  I believe they have managed to rack up: sociopathy, psychopathy, narcissistic personality disorder, autism and Asperger’s syndrome to name but the most common diagnoses.

*A side note on diagnostic manuals – they are the Bible of psychiatry. Most of the world uses ICD-10, which is produced by a convention of world leading psychiatrists and endorsed by the WHO. America uses its own DMS-IV manual, which is slightly different but just as comprehensive. Most psychiatrists believe if it’s not in the manual it’s not a real disease (but if it is in the manual it may not be a real disease either…)

I believe from spending far too long on the psychiatry rotation that Mycroft and Sherlock Holmes are completely healthy human beings and if you find this conclusion terribly dull please feel free to stop reading.

Needless to say their behaviour alone would make them dearly loved by all medical examiners to utterly befuddle the poor students trying to pass their finals. Why? Because when you’re looking at a man sitting in a hospital cubicle you want there to be something wrong with him. You want to find an underlying reason to every tiny detail about him that doesn’t fit your idea of the norm. You are compelled to make the facts fit a diagnosis even if the correct answer is that the patient is completely healthy. That is exactly what happens in Sherlock Fandom – we are presented with a flawed genius and we have this obsession to pinpoint a reason. This can lead people to overstress and over-analyses behaviours that in the wider context may not be “normal” but certainly to not fall in the “diseased” spectrum.



Sherlock is to Autism as Eeyore is to Depression







If most lay people were compelled to psychoanalyse Winnie the Pooh, the first character to get a diagnosis would inevitably be Eeyore. Why? Well, it’s obvious that he’s depressed – always sounding so glum and ever the pessimist. Even his tail looks so sad dangling down like that.

However if you could take Eeyore to a GP (you don’t need to even imagine a psychiatrist for this) you would both leave empty handed, which is saying something as prescriptions of fluoxetin (Prozac) are flying through the roof.

Eeyore, if you question him closely, is not actually depressed. He might look like he’s in a permanently low mood but it doesn’t affect his life. Crucially he is still able to function perfectly well within his society. He also doesn’t display the other hallmarks of depression (anhedonia, low energy, sleep disturbance, early morning waking, low appetite). So what is wrong with Eeyore? Well in one word – nothing – he’s just a rather sad talking donkey, and he likes it. Eeyore doesn’t want to cheer up, being sad is what defines him.

Putting donkeys aside – Sherlock Holmes is in exactly the same situation. As obvious as it may seem to many viewers he doesn’t have autism or even Asperger’s Syndrome (a separate condition but under the same umbrella group pervasive developmental disorders).

There are several reasons why no psychiatrist would label Sherlock (in his current state) autistic:

He understands human emotion – Sherlock repeated emotionally manipulates people (most strikingly in TBB when he actually produces fake tears). Throughout the series we can see that Sherlock has an insightful understanding of human emotion and it is invaluable to understanding motivations behind crimes. Humans are inherently emotional and the vast majority of crime is emotionally motivated. If Sherlock was autistic he would be a rubbish detective. He definitely wouldn’t have worked out Irene’s password.

Human social interaction and understanding of human emotional behaviour is mostly innate, which is why despite intensive therapy it is never possible to get people with autism to fully understand human emotions in the way that a “normal” person could. If you had autism you certainly could never be trained understand human emotions to the extent that Sherlock does.

He’s a genius – his IQ score would be phenomenal if he ever bothered to get it tested (but he doesn’t need affirmation of his brilliance, he has John Watson). One of the defining features of autism is below average IQ. Only a small percentage of people with autism have an IQ score within normal (>70) and above average intelligence is almost unheard of in autism.

So does he have Asperger’s Syndrome instead? Consider the following:

He has empathy –  empathy is different from conscience although they both require the ability to “put yourself in someone else’s shoes”. Empathy is the ability to deduce how other people feel and then feel the emotion yourself(and then experience your own guilt, sorrow, joy etc). This requires an intricate network of neurones within the brain to be fully present and fully functional. This does not occur in people who have Asperger’s Syndrome. They are physically unable to experience empathy as evidenced by brain scans.

Dissociation of cognitive and emotional empathy in adults with Asperger syndrome using the Multifaceted Empathy Test

Who cares? Revisiting empathy in Asperger syndrome.




However Sherlock is visibly moved in many occasions during the series: after the bomb goes off and kills an old lady in TGG, when John gets dressed up as a suicide bomber, when he upsets Molly during the Christmas party, when Irene Adler “dies”, to name but a few.

More importantly Sherlock displays empathy. The diagnostic criteria is not so much about what emotions you are experiencing, its how you display the emotions.

Amendment: I personally think this definition of empathy is clinical, superficial and really doesn't get to true heart of what it means to feel empathy. The truth is we diagnose people with Aspergers syndrome on the lack of ability to display the normal human range of empathy. Maybe deep down inside people with Asperger's do feel empathy - just not in a way they can explain or express.

He doesn't demonstrate any of the other symptoms of Asperger's Syndrome - not being able to understand human emotion and lack of empathy are just two symptoms in the one category of the Adult Asperger's Assessment. Sherlock doesn't demonstrate symptoms in several other important categories:


  1. Qualitative impairments in communication - Sherlock does not have: limited range of intonation, poor prosody and  rhythm, inappropriate pitch, tangential content, sometimes incoherent content with mark verbosity (many words when few will suffice).
    Sherlock gets this message across really well. Although John has difficulty understand why he does things, he has no difficulty understanding what Sherlock wants to do.

  2. Disturbance causes clinically significant impairment in social, occupational, or other important areas of functioning. Sherlock appears to function perfectly well in society. He gets to do what he loves and makes a living from it whilst contributing to society.

  3. Restricted repetitive and stereotyped patterns of behaviour, interests and activities. If there is one person who doesn't follow a routine - it's Sherlock. At least John can normally be seen drinking regular cups of tea. This detective appears to alter his schedule to suit his cases and is amazingly adapative to new environments (the cross keys pub for example) than we would expect of someone with Aspergers. Yes Sherlock only has one passion in life but this passion actually encompasses an incredibly diverse range of activies and is not the general narrow hobby we see in people with Asperger's.

  4. Motor impairments - mostly apraxia and propriceptive impairment. Classic suffers are often clumsy and physically awkward. Sherlock is far too agile.

Diagnosing Asperger's syndrome require more than just one group of similar symptoms. In the same way that a high blood creatine level does not mean someone has kidney failure - poor social skills does not mean Sherlock has Asperger's syndrome. You need much more than this to reach a diagnosis.

I completely agree with many viewers who have pointed out that Sherlock demonstrates some features classically associated with Aspergers and that is possibly enough to get him a psychiatrist appointment but ultimately he would not be diagnosed with the disorder by the vast majority of psychiatrists.

Amendment: Could you find a psychiatrist who would diagnose him with Asperger's? Yes, of course you can. Pyschiatric diagnoses are almost entirely subjective. Psychiatrists like their patients are on a spectrum with some outliers who will have a very low threshold for diagnosing Aspergers. However does this mean that the general body of psychiatrist would agree with their opinion? Of course not.

Does this mean Sherlock doesn't have Asperger's? This is a much trickier question - diagnosing Asperger's is not like diagnosing pneumonia. There is no obsolute way of saying you have it or you don't. It is actually entirely psychiatric/clinical opinion whether he has the disease or not and in real life on the NHS, if there is doubt that Sherlock has Asperger's because he does display only a narrow range of symptoms, he would not be diagnosed because he wouldn't benefit from the medical support any way. As it's a matter of clinical opinion if Sherlock isn't offically diagnosed then he does not have Asperger's Syndrome.


The Rainbow Spectrum

Every disease has a spectrum from pneumonia to autism - doctors know this. We also know that the diseased and the normal spectrum can overlap and that's what makes our lives very difficult. We see this phenomon all the time with blood test results. The result may be within the range of normal but actually be catastrophic for the patient. The same is true of the reverse - I've seen people with sodium levels in the their blood that technically aren't compatible with life but they are perfectly fine.

So you need to look at the patient - and identify their norm. This includes taking a detailed family history and social history of the patient. For example, the patient with a horrendously high sodium - this might be a family trait or she's got a mutation that means she always high sodium. If we actually look at Sherlock's family - we can immediately see that his brother (not matter which way you slice it) is probably just as eccentric as he is. Therefore Sherlock may display symptoms of Asperger's syndrome but no psychiatrist would actually give him that diagnosis. Firstly because we don't like labelling people with unnecessary diagnoses (does marking Sherlock with Asperger's improve his quality of life?) and secondly because his behavioural problems are not organic in nature (they are a nasty by product of his campaign to dehumanise himself).


I have written a more detailed meta on Sherlock and his Asperger's



Conclusion: Sherlock is no more on the autistic spectrum than John is, so what is wrong with Sherlock Holmes? In one word – nothing – he just can’t be bother navigating the maze social niceties we all feel obliged to do every day. It’s all part of his grand plan to make himself a machine dedicated to the pursuit of logic. You could say he was just plain rude but he’s so brilliant you feel compelled to forgive him for it

Three psychiatrists specialising in diagnosing autistic spectrum disorders also agree that Sherlock doesn't have either Asperger's or Autism.

Sherlock is not qualified to diagnose himself – and never will be.





For everyone who bought Sherlock’s line “I am a high functioning sociopath – do your research!”, I am afraid to burst your bubble with two boring psychiatric facts:


  1. There is no such thing as a high functioning sociopath

  2. Sociopaths no longer official exist – at least not countries that use ICD-10 diagnostic manual.

Sociopaths (and psychopaths) are now all given the charming label “dissocial personality disorder” in ICD-10 (antisocial personality disorder in DSM-IV). It may conjure up images of troubled teenagers who pay loud music but the defining hallmark of DPD is a lack of conscience and empathy. Now you might think that everyone who was ever mean to you lacks a conscience but it can be demonstrated by PET scans that people with DPD lack fundamental hard wired emotional responses to gruesome images and pain. Therefore many psychiatrists argue that conscience actually exists as a physical end result of a certain pathway of neurone excitation, like pain.

There is an organic difference between people with DPD and people who are just mean/anti-social/criminal. It is true that DPD is more prevalent in the prison population but if you have no conscience there is nothing to stop you from murdering someone for the smallest of personal gains. So much of what we motivate us as individuals and as a society is driven by our conscience and our empathy. When that is stripped that only thing left is self-gratification.

Sherlock as I have already written does demonstrate that he is physically capable of empathy and given that he has chosen a career bring justice to the worst criminals, what can we deduce from his heart?

From a professional point of view - I am quite certain that if anyone ever managed to drag Sherlock into a consultation with a psychiatrist, he would simply be impossible to correctly diagnose if he refuses to co-operate. Sherlock is a brilliant man and I would not stretching plausibility to suggest that he knows the diagnostic manuals for psychiatric disorders pretty well. He is also a talented actor (given he can cry on command in TBB). Combine these two and you get a patient who can convincingly mimic any disorder he wants.

Psychiatry is very much pattern recognition - it becomes very difficult to recognise the correct pattern if the information you are presented with is skewed or false.

The Psychopath Test - many people have pointed that Sherlock ticks several boxes on the Hare Check List for Psychopathy.

Psychopathy has been suggested as “sub-disorder” of DPD which has more severe characteristics than general ASPD.  (Sociopathy, by the way, has never been readopted the psychiatric community. However there are still a few psychiatrists that use it to describe patients who develop ASPD symptoms due to social rather than biological reasons. There is very little scientific evidence to suggest that a subgroup like this even exists but that is a study for another time. )

The checklist for psychopathy PCL has never been officially recognised in DSM-IV or ICD-10. Psychiatrists who work with the most extreme cases of DPD such as those at Broadmoor Hospital in the UK fine the PCL is useful in identifying the most dangerous patients.

However you must remember it is a checklist (and a very long one at that) o fpersonality traits. A personality trait is a set of behavioural responses that are both consistent and persistent in time and social context. This means that everyone at sometime has displayed “lack of remorse or guilt” or “impulsiveness” or a myriad of other points on the checklist but they don’t do it all the time, everytime.

Sherlock is positively inconsistent with his “Lack of remorse or guilt” and “Callous/lack of empathy” or “Failure to accept responsibility for own actions”. For example: he demonstrates great (if restrained) remorse at having help Irene Adler bring the nation to its knees and he accepts responsibility for his actions – even apologising to his brother at the end. His apology is anything but “Emotionally Shallow”.

Besides, in order to qualify as psychopath you need to tick 30 out of 40 traits, even with a gun-hoe medical student attitude you would be hard pressed to label Sherlock a psychopath based on the Hare checklist.

The checklist can be used to describe some of Sherlock’s actions some of the time but his personality traits are definitely not on that checklist.

Conclusion -I cannot deny that Sherlock has issues and behaves eccentricly but this does not mean he has a psychiatric illness. One of the hardest things to grasp in medicine is that the range ofnormalextends way beyond our own narrow comfort zone and the hardest thing to acknowledge is that in the diagnosis of psychiatric conditions we are greatly influenced by our own prejuices. Therefore it is wrong to jump to conclusions.



Other Parts in the Series

2. Mycroft on the Examination Couch

3. Sherlock, Himself and His Aspergers.



Feedback is always welcome! I love to discuss things with commenters.

Comments

( 85 comments — Leave a comment )
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pengke
Sep. 10th, 2012 12:19 am (UTC)
I find the fact that Sherlock professes the ability to delete information and experiences from his brain, at will, to be utterly fascinating. And if you presume that he had this ability during childhood or adolescents then the implications for his psyche are profound. What would it do to you as a person if every time you did something embarrassing, you either deleted all memory of what you had done or deleted all memory of being embarrassed?
runawaylemon
Oct. 29th, 2012 03:52 pm (UTC)
It would turn you into a shitty human being. My father does that. He literally forgot a lot of the things he did in his life, most of which have hurt me terribly. He honestly believes they never happened, and thinks he is an amazing father. (Spoiler: he is not.)
ariadnechan
Sep. 10th, 2012 03:42 am (UTC)
I the asperger syndrome emphatia exist but is much less than a neurotypical, you are wrong at that
Because aspergers is an spectrum too.

My son as i said to you is asperger, and he has emphaty, but selective one, and very diluded, but has!
If something happens to me or his brother he is really affected and worried, he tried to help his brother as his brother help him and me without me asking him, not always but it is there, not as an obligation. I'm sick and he help me he notice that i'm sick, he worries about it and do something. That is empathy.
But if one of his schoolmates get sick he says to me that that day was weird because someone doesn't go so there were 24 and not 25.
So the empathy exist but it is only with few people

The old lady was special to him, because he found her brave, she was upto give him all the details she can so he could something to work on... The lost of an intelligent been was a lost, in that explotion died like 10 people, but he was only emphatic about the old lady, not because she was old, not because she was blind, but because she was up to find the culprit before her life and that is interesting and in this case really sad for Sherlock.
He is really emphatic about John, Lestrade and Mrs. Hudson, maybe a little for Mycroft even if he won't acknowledge the fact. He was impressed by Irene so obviously she entered in his circle of care and emphaty...
But this not include too more other people. And if it is there is much much less than the one of a neurotypical.

Clearly Sherlock is not sociopath or psychopath...

And i think he is not Bi-Polar as ACD Sherlock was most catalogued. Not Depressive. (i'm depressive with axiety disorder)

I really think he is aspergers but in the more near neurotypical rank of the scale, so a lot of traits of aspergers but a lot more grasp and hability to fit in if he wanted to in a neurotypical life... And a low selective empathy more than my son's but less than a neurotypical.

My point really is that you are looking at the by the book asperger and asperger is a spectrum in itself... And aspergers have normal to high IQ their problem it is that it is not equilibrium in all the areas specially as children. Sherlock been a genius sure that desequilibrium it is less noticitable and he is an adult so it will be less than a child.

Fake an emotion like sadness or laugh it is the first thing an asperger learn... But they laugh and are sad for themselves, but they doesn't recognise this emotion in themselves and how it looks like as children... As adults they do it better and to understand faces and emotions in others.

Finally Sherlock takes months and months to understand Irene's feelings.. Even if he get that she fancy him in some grade, not for the flirting and such, that he doesn't get too well, but for physical reactions he learnt to notice
Like dilatation of the iris and higher beatings of her heart.

Only when she said all this awful things about him and he still can find the physical reaction is that Sherlock knows that she feels for him, so the obvious password must be him!

So i'm not agree with you!
There isn't so many people by the book around in the streets people have this and that and/or in a spectrum because we are all different.
wellingtongoose
Sep. 10th, 2012 06:31 pm (UTC)
Yes - I agree that Asperger's is a spectrum and the disease spectrum overlaps with the normal spectrum. That is why psychiatrists never diagnose anyone with "borderline" Asperger's syndrome. People who have some symptoms of Asperger's but not all. This is because people in that overlap often function perfectly well in society - how would labelling them with a mental disorder (which they may or may not have) really improve their quality of life.

Sorry if I didn't make it very clear - Sherlock (at a gigantic push) might be on the very end of the Asperger's spectrum but no self-respecting psychiatrist would ever diagnose him.

Also I'm not convinced his behavioural problems are organic (or disease related). His abruptness and rudeness are a by product of Sherlock's constant campaign to make himself less human (and less flawed). What would anyone expect from a person who is told by his brother that caring is not an advantage?

Sherlock takes a long time to understand Irene's feelings because he doesn't have any experience in the area of romance. He is also unwilling to think down that route at the time.

Edited at 2012-09-10 06:35 pm (UTC)
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azriona
Sep. 10th, 2012 03:58 am (UTC)
Excellent essay - and I'm really looking forward to the next. There are so many terms bandied about for Sherlock (and I've never believed any of them, and it's nice to see proof of that), but I can't remember there being so many for Mycroft. I'd like to see what might stick to him, but doesn't in reality. (Er, fictionally. Whatever.)

So I'm reading the original ACD stories, and I've noticed that in them (so far), Holmes seems to be more anti-social than Sherlock is. Like, way more. I'm not sure if that's just the way Watson tells the story (whereas within the show, we see Sherlock sort of through John's eyes but are also better able to form our own opinions), or if Sherlock has been humanized more for the modern audience. ("Humanized" is probably the wrong term, but hopefully you'll know what I mean.) I wonder - have you read the ACD stories, and how do you think Holmes would fare on the psychiatrist's couch?
wellingtongoose
Sep. 11th, 2012 08:17 pm (UTC)
ooooh! You have given so much inspiration! ACD!Holmes and his problems which are a whole new kettle of fish. I think ACD!Holmes actually shows more symptoms of bipolar than BBC!Sherlock - his mood swings are quiet extreme when under pressure but there are long periods in between when he is mood is level.

ACD!Holmes definitely has better social skills than BBC!Sherlock - and perfectly capable of negotiating the labyrinth of Victorian morals, attitudes, manners and general social conventions. However he's also older and lives in a different time when manners were much more important. However I don't think I'd put him even in the "suspicion of Asperger's" group.

Unfortunately ACD was never particularly consistent with Sherlock's "symptoms" so it's quite hard to actually put my finger on the principle mental disorders I would look to investigate in him. But that was the best fun I've had for a while, thank you!
labellecreation
Sep. 10th, 2012 09:40 am (UTC)
For me I spot the symptoms of both bipolar with additional OCD in him, but that's probably since I have it, so I'm projecting my symptoms on to his. :-/
wellingtongoose
Sep. 11th, 2012 08:10 pm (UTC)
I think we all do that at times. I once managed to convince a patient (very wrongly) that they had an anxiety disorder because I was feeling particularly anxious about getting his diagnosis right. Absolutely terrible but done entirely unconsciously.
aeron_lanart
Sep. 10th, 2012 06:02 pm (UTC)
Fascinating - and well thought out.

I personally agree with you that Sherlock is probably just one of the Great British Eccentrics, sometimes people *are* just odd and I know from experience with some members of my family that intelligent people can be very lacking in patience for a start.

Aspergers does occur on a spectrum though and the closer you are to 'normal' the more likely you are to at least have some empathy, it also depends on circumstances/people and so on.

There's that word 'borderline' that is used so much that people often ignore and leap wholeheartedly into a diagnosis when they only exhibit *some* of the traits of an illness/syndrome.

One of my friends who has Aspergers once described her issues as not lacking in empathy as such but sometimes feeling *too* much, but not in a way that was understood by the majority of people and then not always being able to explain it.
wellingtongoose
Sep. 10th, 2012 06:26 pm (UTC)
Yes I agree that Asperger's is on a spectrum - sorry for not making that clearer. I've written in a new section in the meta to explain why I don't think Sherlock is on the Asperger's spectrum - hope that helps.

Sadly psychiatrists don't go in for borderline Asperger's simply because if you're on the borderline the consensus is that you function well enough in society - how would being labelled with a disease really improve your quality of life. Sherlock (at a really big push) might be on the borderline but in real life the psychiatrist would spend out half an hour with him, send him home and write a letter to his GP complaining about wasting their time :)- I've seen it happen a lot.

Edited at 2012-09-10 06:29 pm (UTC)
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certainetymolo
Sep. 10th, 2012 06:19 pm (UTC)
Great analysis - much needed.

I think that apart from establishing that the diagnoses bandied around on the show don't fit (and that having a character trait or at times displaying a behaviour that looks a bit like a symptom of a mental disorder doesn't actually mean you have a disorder), it's also interesting to look at the context in which these statements were made on the show. They are not tearful confessions or serious statements from the mouths of therapists having worked with Sherlock for years, and it's therefore not likely that the writers of the show intended them to be taken seriously.

Sherlock's "high-functioning psychopath" remark was a snide comeback at Anderson (and probably a jab at the unfortunate tendency of some people to dole out diagnoses and labels without knowing what they're doing). When John referred to Sherlock's "Aspergers", he was lightly chatting with Lestrade and seemed to use it as a shorthand for "being weird" and it was clearly a tongue-in-cheek remark (much like people with mild quirks sometimes refer to themselves as having an OCD, without meaning much by it). Also, Sherlock kinda fits the "pop-version" of Aspergers 80% of self-diagnosed people on the internet seem to suffer from (highly intelligent, misunderstood, socially awkward/not bothering with societal niceties), where it is sometimes treated as a mark of distiction (b/c of the highly intelligent part), so it makes sense for John to use the word in this colloquial sense.
wellingtongoose
Sep. 11th, 2012 08:09 pm (UTC)
Yes I definitely think that Benedict's portrayal of Sherlock has incorporated Asperger's symptoms but at the same time the writers also wanted him to show a "normal" side as well. Throughout the second series we see more of the "normal" and less of the "atypical" in Sherlock's behaviour.

I definitely think John would know better than to actually believe Sherlock has Aspergers.
xsenseofdoubtx
Sep. 10th, 2012 07:16 pm (UTC)
Thank you! THANK YOU! My thoughts exactly although I probably never would have taken the time to write it all out like that so I'm glad you did.

Personally I believe that the Asperger's spectrum is hugely overlapping with the "normal" spectrum and depending on who has to or wants to judge, you have Asperger's, autism, or you are just a little weird. That goes for overly concerned teachers as well as professional psychologists.

As for psychopathy/sociopathy, I'm so tired of people who have watched an episode of CSI in their lives and believe themselves capable of diagnosing everyone around them with it. I once overheard a mother talking to someone, telling them her son could be a real psychopath at times. Huh. How can someone be a psychopath "at times"?

On the other hand, I've met a few people who scored high on the PCL and I could never have told from talking to them once or twice. Which is exactly the point with this rash diagnosis.

If someone is rude and seemingly not caring at all, like Sherlock is portrayed, chances are you're not dealing with a psychopath. If someone can charm their way into a woman's life because she's going to be useful for him, then believably sham at being gay because it fits his plans - different story altogether. But when "Jim from IT" first made his appearance no one would have suspected him of being a psychopath - not even Sherlock.

Yeah, my little rambling on the topic. ;)
hoppytoad79
Sep. 10th, 2012 08:49 pm (UTC)
Psychopaths, lacking the ability to feel empathy and sympathy, learn to fake it.


How can someone be a psychopath "at times"?

I know! Armchair psychiatrists/doctors/detectives/forensic pathologists/[profession] really, really, really irritate and annoy me. The amount of damage that can be done because someone who thinks they understand something perfectly...*twitchtwitchtwitch* I like to think I know just enough about various things to grasp how little I actually know and that any definitive answer needs to come from someone with more knowledge, wisdom, and experience than me.
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donutsweeper
Sep. 10th, 2012 07:47 pm (UTC)
Very interesting! I always had issues with Sherlock's self diagnosis of high functioning sociopath, it seemed to be something he wanted to be rather than something he was.

A sociopath wouldn't care, wouldn't be bogged down by emotions and have his judgment clouded by unnecessary feelings. In a lot of ways this is Sherlock's goal. He tries to convince John of it in TGG, but shows how much he fails at it when John's turned into the victim.
hoppytoad79
Sep. 10th, 2012 08:34 pm (UTC)
I always had issues with Sherlock's self diagnosis of high functioning sociopath, it seemed to be something he wanted to be rather than something he was.

This. You put it perfectly.
hoppytoad79
Sep. 10th, 2012 08:33 pm (UTC)
This is excellent. Thank you for explaining and breaking down the issue of Sherlock's supposed 'high functioning sociopathy'. With all the misinformation out there about sociopaths/psychopaths, autism, and Asperger's, a clear presentation of the facts is always a good thing.

I think what can be said for certain about Sherlock's mental status is that he'd benefit from getting some therapy, but that's never actually going to happen because the chances of him coming to that realization are slim.

I'm looking forward to what you have to say about Mycroft. My armchair psychiatrist diagnosis is that he suffers from what's commonly known as a Stick Up His Arse. ;)
wellingtongoose
Sep. 10th, 2012 08:45 pm (UTC)
A very astute diagnosis for Mr Holmes the elder - although in some circles it might be term "umbrella up his arse".

Thank you very much - Mycroft's piece has a more in depth look at psychopathy/dissocial personality disorder. It's not about Mycroft as a whole (sadly) it's more geared towards whether Mycroft is the true psychopath in the Holmes family. It was written due to an ask on tumblr. I hope that doesn't put you off.
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dkwilliams
Sep. 11th, 2012 03:09 am (UTC)
I totally agree with what you are saying about bright people - I work for a university and a number of the really brilliant teachers have zero social skills but are not by any stretch Aspergers. For the most part, they have just devoted all their time/attention to their area of interest and very little time on their social side. And often times their teachers and parents were so delighted with their brilliance that they let them slide on the social side, excused their poor manners, and didn't encourage them to balance their book education with social activities.
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blue_midnight
Sep. 11th, 2012 12:08 am (UTC)
Very interesting! I've thought this to be true for a while but it's nice to have someone put it so well and with knowledge to back it up.
wellingtongoose
Sep. 11th, 2012 09:57 am (UTC)
Thank you very much! Also thank you for liking on tumblr - I assume the account with same name and picture is the tumblr version of you?

Edited at 2012-09-11 09:57 am (UTC)
(no subject) - blue_midnight - Sep. 11th, 2012 12:17 pm (UTC) - Expand
burning_moon117
Sep. 11th, 2012 01:01 am (UTC)
I love all your informational posts! Also have to say, nursing students also get Medical Student Syndrome
wellingtongoose
Sep. 11th, 2012 09:56 am (UTC)
Haha! I can imagine - I spent an hour in lectures trying to figure out if I have an anxiety disorder and was then completely unfazed by the fact that my rent was a month in arrears...I need help but not for an anxiety disorder :)
nerthus
Sep. 11th, 2012 01:23 am (UTC)
My reply part 1!
My son has been diagnosed with borderline personality disorder; he has always had trouble with anger and impulsiveness and not knowing how to 'behave' around groups of people. He also has depression and a Mensa-level IQ. He gets accused of being cold and heartless sometimes, but he once told me, sobbing in true anguish the whole time, that he feels everyone else's feelings TOO MUCH and it makes him feel like it's tearing his soul apart,like he can't filter it all out. He feels his only 'defense' in such instances is to be offensive and rude and dismissive and to push others away to protect his own psyche; he has lost almost every job he's ever had because after awhile the relentless flow of others' emotions and energies around him make him depressed and super anxious. He refuses all medications and uses his Buddhist meditations in lieu of chemical cocktails in order to 'calm' himself down. People who don't know him are afraid of him because he's this hulking 6'2", 270 lb giant with this fierce scowl when he's concentrating so hard to keep control of all the emotions coming at him; but then when he speaks, people are shocked because he speaks in a very precise, courtly, almost overly-courteous manner. He is awesome at helping people online; he finds it easier to 'filter out' raw emotions when they're once-removed via computer screen, and he has people from all over talking to him asking his advice because he is usually spot-on with identifying the core of their problem and talking them through how to find solutions. But by the same token he can be cuttingly sharp and sarcastic online when he's chatting at political websites and so on because he has little patience for what he calls 'willful idiocy' on the part of so many people out there who just refuse to educate themselves on all sides of an issue. So I find my son a fascinating, very complex person, much like Sherlock; my son is so crippled socially/emotionally in so many ways yet he's managed to genuinely help and encourage so many people and he writes the most lyrical, poignant prose. He takes care of his younger, handicapped sister as well while I am at work, and anyone who can devote hours of care daily to another person is not a 'psycho,' as he has hurtfully been called by people who don't know better,who don't truly know my son.
nerthus
Sep. 11th, 2012 01:28 am (UTC)
My reply part 2!


I also have an autistic child, my oldest daughter; she has been diagnosed with asperger's, but she is nowhere near as 'high-functioning' as so many people online who also claim that diagnosis.. She functions socially/emotionally on the level of a young elementary school child; her condition was compounded by being born with a genetic defect called Turner Syndrome and having a mild stroke a few years ago (which regressed some of her previous 'higher' functioning behaviors quite a bit). She has the usual autistic penchant for focusing in on one or two very narrow subjects of interest almost to the exclusion of any other interests, she has trouble understanding slang, euphemisms, etc. and she has definite problems with empathy and understanding facial expressions or tones of voice. Even after years of 'therapy' where they worked on helping her recognize and identify facial expressions and feelings and how she SHOULD respond, she still just cannot relate. If I feel ill she will rather coldly inform me that I am NOT sick because SHE feels fine, even though we've explained to her numerous times that just because she can't FEEL other people's feelings doesn't mean other people are lying or don't have feelings different from her own. She does love her family and even genuinely tells us she loves us; when it's herself instigating physical affection she can be affectionate and hug us,etc. She doesn't respond as well, however, to receiving spontaneous affection from us in return unless we ask her first if we might hug her. She seems quite often to consider me, in particular, as merely an extension of herself and her own will and becomes rather testy with me sometimes when I don't react as she predicted I would or believes I should. But there's no question she possesses and displays emotion; she LOVES her calico cat, genuinely and fiercely; that cat is her best friend and she takes great joy in having had Lala as her companion for going on 9 years now. She can read at upper middle school level, can remember things in meticulous detail that happened to her on very specific dates going back to when she was only three or four, and every school year she memorizes all the birthdays of over 2 dozen children in my class and reminds me during the year that it's so-and-so's birthday today; but she can't tie her own shoes or put her clothes on right-side out or be responsible for taking her daily meds or testing her blood sugar for her diabetes. She too reminds me in a very narrow way of Sherlock, but as I said before, her 'level' of functioning as a supposed 'aspie' is much lower than the stereotypical 'movie/tv' trope for asperger's.
wellingtongoose
Sep. 11th, 2012 09:54 am (UTC)
Re: My reply part 2!
Wow! That is by far the longest, most detailed comment I have ever received. I am flattered you sat down and wrote all of it.

I actually agree that Sherlock has symptoms correlating with Asperger's syndrome. I'm going to write a more detailed analysis with a better explanation of why he would never be diagnosed.

Thank you for sharing thoughts on your family - I wish you all the best for the future.

Edited at 2012-09-11 09:54 am (UTC)
grandilloquism
Sep. 11th, 2012 06:09 am (UTC)
You are excellent. I feel like half the time people are getting their medical information from poorly researched fiction and just parroting that sort of pop psychology, which helps no one. Thank you for this.
wellingtongoose
Sep. 11th, 2012 08:06 pm (UTC)
Thank you for your support - there will be more to come!
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