The Defuse Podcast – Psychology 101 Part 2 – Psychopaths, sociopaths, pathology, Fixation and the impact of Social Media with Dr Caroline Logan

In this episode, part 2 of the series, we expand on the discussion of the psychological terms and learn about psychopathy, how high functioning psychopaths become CEOs, politicians and leaders, the difference between psychopaths and sociopaths, the impact that social media and the internet has on mental health.

Caroline Logan is a Consultant Forensic Clinical Psychologist. For nearly 30 years, she has worked as a researcher and honorary senior lecturer at the Universities of Liverpool and Manchester in the UK, as a lead clinician in secure forensic mental health services in the north of England and Norway, and as a consultant/contractor with law enforcement services in the UK and elsewhere. Dr Logan has ongoing clinical and research interests in personality disorder (including psychopathy), risk, violent extremism, and forensic clinical interviewing, and she has a special interest in gender issues in the range of offending behaviour. She has published five books and over 70 articles on these subjects, including Violent Extremism: A Handbook of Risk Assessment and Management [uclpress.co.uk], co-edited with Randy Borum and Paul Gill, published in November 2023, and a second edition of Managing Clinical Risk: A Guide to Effective Practice [routledge.com], co-edited with Lorraine Johnstone, published in December 2023.  

https://www.linkedin.com/in/caroline-logan-31656b9a/

Chapters

• 0:01 Psychopathy and Sociopathy
• 20:05 Exploring Psychopathy and Sociopathy Characteristics
• 30:30 Fixation, Obsession, and Recovery in Psychology
• 46:29 Impact of Social Media on Adolescence

Transcript

Philip Grindell: 0:01

Welcome to the Defuse podcast with host Philip Grindel, CEO and founder of D Diffuse, a global threat and intelligence consultancy that blends psychology and intelligence to mitigate threats and risks to prominent people and brands, again with Dr Caroline Logan, and this is phase two of our, of our exploration, I guess, of psychology and the terminologies that are used, the personalities and all those, those issues that we probably all hear about, we read about, we think we know about, but I know, having listened to the, having done the first session, it's, it's um, it's such a fascinating subject and I'm kind of thinking of already people I want to say you've got to listen to this, you've got to listen to this and have a discussion. So let's move on to kind of what we call phase two, which I think for me and I might be wrong here, so correct me I know you will do around some of the more perceived dangerous elements of personality, of the more perceived dangerous elements of personality. And so there are terms we hear, such as sociopath and psychopath.

Caroline Logan: 1:15

What do they mean and what are the differences between them?

Caroline Logan: 1:19

Oh gosh Right.

Caroline Logan: 1:22

We talked in the first session about personality and personality problems. We've got to see sociopathy and psychopathy as more severe forms of problems that a person might experience with their personality that can't be accounted for by other conditions, and psychopathy is the worst of all, the worst in terms of severity. So we would use the term psychopath to mean somebody who's profoundly extremely disturbed in their psychological makeup in ways that can't be accounted for by major mental illness like paranoid schizophrenia or brain injury, for example. So they have, um, they have. The combination of nature and nurture has meant that they have severe problems in the ways in which they see themselves and relate to the world and other people in the world. So last time we talked a bit about pathological narcissism, and that's a problematic presentation. We can see that being an issue in a number of offence types, and the kinds that we talked about in that session were fraud, deception, extortion and also sexually harmful behaviours such as rape. Pathological narcissism is an element of psychopathy, but there are other things that make up psychopathy as well, so it's like a comorbid personality presentation. So it's a disordered personality with lots of complexity, um, and lots of severity. So, for example, we might look and the studies that have, the epidemiological studies that have been done in the UK in our prison and probation services, and these figures will vary in other jurisdictions, like in North America for example. So we might expect between two-thirds and three-quarters of men in prison. Because men and women are different, as you might have noticed. They present their difficulties in quite different ways. That's another interesting question, but um, not for right now.

Caroline Logan: 3:48

Um, if we look at men in prison, we might see two-thirds to three quarters of them showing symptoms of personality problems, the most common being, um, problems with adherence to rules, which might be referred to as anti-cial personality disorder. It's not very nice. Niceness has got nothing to do with it. It's not a very orderly personality disorder type category. So just lots of behaviours. People break the rules a lot. There's some assumption that they have problems with obeying rules, but we can see lots of people with personality difficulties, anti-social we talked last week about Borderline, we didn't talk so much last week, but it's also relevant Paranoid personality disorder. We can see these in quite a lot of people in our prison services, prison and probation services. If we look at psychopathy, we can come on to how we might measure that shortly. If we look at psychopathy, we did expect only a small proportion of those to be so severe that we would describe them as psychopaths. So maybe about 10 percent of people, 10 to 15 percent of people, of men, in prison in the UK.

Philip Grindell: 5:05

So 10% of men in prison. I think, you're on mute, I'm talking to you and I'm on mute, sorry. So 10% of men in UK prisons could be described as psychopaths.

Caroline Logan: 5:26

So how would that relate to the general population of the UK? Great Now. So we tend to see, because psychopathy is associated and we'll come to the characteristics in a moment because psychopathy is associated with a phase of disregard for rules and the rights and integrity of other people, we will tend to see a concentration of them in our criminal justice services. So I'd expect to go there and see the biggest concentration of them. Sorry, I slightly misled you. I said the UK, but actually the studies that have been done that look at Scotland separately. I'm only just putting this out there, but there would appear to be slightly fewer people.

Philip Grindell: 6:07

So there's less psychopaths in Scotland. That's what you're saying.

Caroline Logan: 6:10

Yes, no, I would like to think that's because you know, for obvious reasons, because you know Scottish people are more Okay, so hang on.

Philip Grindell: 6:20

Let's just challenge this there just for a moment. Does that include Scottish people that are in English prisons?

Caroline Logan: 6:26

That's what I was going to come on to say, because it looks like it would appear to be the case that actually quite a lot of Scottish people who are psychopathic have left Scotland. And, yes, one study did suggest that there was a disproportionately large number of Scottish psychopaths in English prisons. Yes, I would like to think that just because Scottish people are like myself, are thoroughly well, well constructed, but it's not the case at all. Oh, yes, so if we're like 10 to 15 percent of men in English and Welsh prisons, because the study was done in England and Wales of men in English and Welsh prisons, because that study was done in England and Wales, sorry for misleading you if we roll back and say, well, what would it be in the general population? Studies suggest, epidemiological studies that look at psychopathy in the general population are likely to suggest that it's between 0.75 and 1 percent of the general population and just to put that into perspective, the prevalence of schizophrenia that we talked about last time is about one percent. And you think how many people you know about or see on the streets perhaps, unfortunately, who are clearly responding to voices that only they can hear? They're clearly not very well and you think, well, that's a fair number of people.

Caroline Logan: 7:51

People with psychopathic personality traits are amongst us. They are not just in prison and we may see the more functional of them as CEOs of business. There may be some of them. We talked last time about politicians. There may be some of them gravitate to positions of authority where they are not just being forward thinking and have the super confidence to be able to put their views forward and to press ahead with them. They are actually actually duplicitous, deceptive. They are slippery in how they report financial dealings and all the rest of it, so they actually break the law or are suspected of broken the law or being prosecuted for law breaking. So about one percent the population, prisons and probation type services will see a greater concentration of one percent of males in the population, or just one percent of the population very good question.

Caroline Logan: 8:54

The studies that have been done in general population are mixed men and women, but we have a problem with measuring psychopathic personality traits in women. Yeah, the main ways in which, or the main way in which psychopathy is measured was developed on men, so it was calibrated to the behavior of men. Not everybody agrees with this position, but I have been consistent in putting it forward that women are not funny shaped men, that women do things differently and for different reasons. But that doesn't mean to say they don't have the same fundamental pathology. It's just manifested in a different way. So that if the tests, interviews that we might use are calibrated for men, my concern is that they will miss some of the problematic behavior of women.

Philip Grindell: 9:49

We've talked about this a little bit previously in terms of the testing of, of, you know, various um research things and and I think we agreed previously that very often the testing is done on white men, you know, usually so in terms of the testing for psychopathy, etc. Is there any cultural differences around that?

Caroline Logan: 10:12

gosh. Two points there. One it's it's slightly worse than white men because it's generally white middle-class men or people, because it's mostly. Well, a lot of these self-report questionnaires are developed on university students who are not always representative of the general population. There's been a lot of work done fairly recently to try to address that and generally the developers of tests will go out of their way to try to sample a broader population. But when you think about just participating in a study in which you've got to write things and understand, sometimes quite, you know, quite sophisticated terms, then it's going to be a little bit more disposed towards people who are literate which may not necessarily cover everybody who might, because schooling can be interrupted for all sorts of different reasons.

Caroline Logan: 11:14

everybody who might be interested in terms of the potential for harmful behaviour. Oh shoot, what was the second point? And then you said about Cultures, different cultures.

Caroline Logan: 11:28

Well, I made reference to that when I said about Scotland, and it's the same researchers, professor David Cook, who's done a lot of work on psychopathy internationally but has also looked at psychopathy as it manifests across cultures.

Caroline Logan: 11:49

He's published quite a lot on this, such as to suggest that what a person who's psychopathic might look like in North America could be quite different from what a psychopathic person looks like in the UK or in Scandinavia or in Southeast Asia, for example, and we have to take these cultural characteristics into account. In the first session we talked about context. That context colours everything that we make sense of when we're trying to understand somebody's view of the world. So cross-cultural variation does matter, and myself and David and another colleague, professor Stephen Hart, who's based in Canada, david's based in Scotland we've done some work looking at psychopathy where we've made a particular focus on cultural variations, a cultural difference and not just culture in terms of um people's you know where they live in the world and how they've been raised and cultural norms and mores and the like um, but also in terms of language, how people um use language, and also we can think of those big cultural specifiers such as age and sex and gender as well.

Caroline Logan: 13:06

So we've looked at across the board, because we think what we want to capture is the thing that's common to all. Yeah, not just the cultural representation of psychopathy in north america. Let's say and assume that that's the case everywhere else.

Philip Grindell: 13:19

So generally we will have to take that into account so so often I've interpreted a psychopath as someone who has no kind of remorse or doesn't feel any compassion or any guilt around anything. Is that accurate?

Caroline Logan: 13:33

Yes, it is Right, but it's more than that. It's not just those things. Those are probably the defining features of people who are psychopathic.

Philip Grindell: 13:43

So are they sadistic? Is that kind of one of their traits or not?

Caroline Logan: 13:49

Well, just to get technical, yes, well, sadism is associated with people who don't have regard for the consequences of their action on other people and in fact they may be entertained. They may be positively gratified by the response of another person, the fearful or humiliated response of another person. Sadism is often associated with sexual behavior. It's a paraphilia, sexual sadism. We can see sadistic acts which are not sexually motivated or don't have a sexual component to, but all of that is predicated on the sadistic person's desire to see and experience and to be enlivened by the fear, subjugation and humiliation of the other.

Caroline Logan: 14:45

We can see sadistic traits in psychopaths. We may not always see sadistic traits at that level. They may be more Machiavellian, which is probably so. We talked before about politicians and of course Machiavelli's the Prince was about political figures in the Italian court maneuvering one another for personal gain immediately evoke the suggestion of sadism. But the dark triad or dark tetrad will tend to see Machiavellianism, sadism, psychopathy, narcissism as sort of coalescing. They may not necessarily be present at severe levels in the one person. All four characteristics in the one person.

Philip Grindell: 15:43

There may be variations which allow us to account for why people are different and so how does a if you get a psychopath, who's who's a high-functioning psychopath, you know they're in, they're in, um, I don't know business or the military, or you know positions of leadership somewhere how do they manage their psychopathy so that they don't end up being violent and becoming one of these famous murderers or something?

Caroline Logan: 16:12

Possibly, just by maybe being less severe.

Philip Grindell: 16:16

Right.

Caroline Logan: 16:20

Because we tend to associate psychopathy with impulse control problems. So we tend to see them as being disruptive, reckless, restless, unreliable. So psychopaths in top business are probably less common than they are in business in prison. Yeah, what we may see in the top of industry, politics, the military, the law, all professions, is people who are pathologically narcissistic, which means that they are selfish, that they are self-centered, they self-aggrandize, they self-justify everything's everybody else's fault. But they have studied, they've kept things together, they can cover up any duplicitous acts on their part until eventually they may well be caught, or they may not be caught, so they might in fact be able to keep it together enough to stay in those positions of seniority and if it's?

Caroline Logan: 17:28

if it's bringing people around them yeah to insulate them from those charges. So we might see some of when. You know there's been various studies of dictators, yeah, who are probably are psychopaths, but they have insulated themselves by having a coterie of protectors and a whole hierarchy of people and a system that then comes behind that that insulates them from prosecution until it doesn't, either by history or by the courts.

Philip Grindell: 18:01

I don't know whether this is correct or not, but then this might be a clunky way of saying this, but is this one of the reasons why it's so important that more women get into senior positions? Because they're less prone to the psychotherapy or pathological narcissism and therefore behaviour might change.

Caroline Logan: 18:25

Oh go on, then I have to correct you there, um, because, uh, the, the means we've had, the most common means by which we might measure psychopathy and indeed pathological narcissism, have been developed on men, yeah, our main measures pathological narcissism similarly have been developed on men.

Caroline Logan: 18:43

Our main measures of pathological narcissism similarly have been developed just on the behaviour of men. And there are problems applying that ruler, as it were, to women and assuming that women calibrate in the same way that men do. They don't. Therefore we can't make the assumption that there are fewer women who are psychopathic just yet because we don't, we've not got the empirical basis for saying that. We think theoretically, we think they probably do exist at the same rate as men pathological narcissistic women, more severely affected psychopathic women.

Caroline Logan: 19:26

So I wouldn't just want women in industry, just for the sake of it in the sense because they will somehow counter a psychopath or they will not be psychopathic. I think more women in all these senior positions is just generally a good idea, because the world is 50% men and women. Well very, very approximately, with a big grey area in the middle. We need diversity in our boardrooms and in our industries and in politics, et cetera, to reflect populations.

Philip Grindell: 20:00

It's an important point because I'm making an assumption which isn't clearly proven. But is ambition a trait of theirs, then?

Caroline Logan: 20:09

Oh, definitely, and that would be the case for men and for women, I think. It's just that men, I think, because poor impulse control is symptomatic, as symptomatic of people who are psychopathic, as lack of remorse and empathy they tend to get caught Right. So they tend to be reckless with how they behave, how they manage themselves, and so they often get, if they've not got this big coterie of um people behind them that insulate them from heart, from prosecution, then they just get caught, and so I deal mainly with the ones that get caught with plenty who've been grasped up by other people and they are dead interesting because they didn't necessarily get caught, because of a mistake

Caroline Logan: 20:57

yeah, their own mistake, although they maybe trusted somebody who they shouldn't have trusted. Um so um, ambition is absolutely fundamental to it, and we can see that in men and women. It will play out in different ways, though. I think what we'll see with women who are towards the pathological the severely pathological end of narcissism and into psychopathy. It will play out in different ways. It may be less women are less likely to become serial killers and mass murderers, as you well know, because you can probably count the number of women serial killers and the fingers of one hand.

Philip Grindell: 21:40

You'd have to google it to get more than the obvious but we've seen a few, haven't we recently, as an example within the nhs in terms of some of the behaviors around children you know around and that which seems to be very specific.

Caroline Logan: 21:55

Yes.

Philip Grindell: 21:56

And obviously I think not.

Caroline Logan: 21:58

That's a good point we tend to see. When we look at the population, the cohort of serial killers, we will see extraordinarily high rates of psychopathy amongst them. You know some of the big names that you think about. The true crime shows that you watch in the morning, when you can't sleep, on Channel 5. These are great programs, but just reminding you just how bizarre some people and how awful some people can be, and over and over, and, over and over and over again, um, but not all serial killers, not all people who have killed multiple people, apparently for the same motive in separate incidents, um, are are psychopaths okay so people can.

Caroline Logan: 22:41

It's a small number, but people can kill for other reasons as well, in ways that wouldn't necessarily be badged as psychopathy okay it's an accusation it's often thrown at psychologists that we make things complicated, but it is.

Caroline Logan: 22:58

People are complicated. You were talking about red in the last session. We were talking about how people can be put into pigeonholes boxes that are red and blue and green and Myers-Briggs types and things, and these are really handy to have when you think about different types. But people don't just sit in one box, people have multiple strands. And that's the thing about psychologists clinical psychologists, forensic psychologists what we do. We're sort of connoisseurs of complexity. We specialise in feeling comfortable with people who are complicated and trying to synthesise that down More straightforward. You can get your head around, but that shouldn't be mistaken. For well, actually the problem's quite simple.

Philip Grindell: 23:41

And so what then, is a sociopath? What's the difference there?

Caroline Logan: 23:44

Right, that was your original question. So what's the difference between a sociopath and a psychopath? A psychopath is more profoundly disturbed. So they will be disturbed across the range of their relationships with other people, their attachments, the way in which they behave, the ways in which they think, the ways in which they relate to other people. They'll be disposed towards dominating other people, the ways in which they experience and express emotions which will probably be quite shallow, and the big daddy of them all is their self. Their sense of self will be very, very overriding, very powerful, seemingly very strong and very self-focused. Somebody was a sociopath. The assumption is that the dysfunction they experience is less all-encompassing. The difficulties they have may relate largely to how they interact with other people. So people you might use the term sociopath to describe somebody who has otherwise achieved quite a lot but struggles because they dominate or they ignore other people. So if we think about that term I used earlier on Machiavellian, we may use the term sociopath to describe some of the ways in which somebody we also might describe as Machiavellian acts.

Caroline Logan: 25:13

But psychopathy is should definitely be seen as the more profound, the more profoundly disturbed individual and we've used sorry, go on, go on okay if I interviewed a psychopath I'd expect to be um to see all that a broad array of problems with a sociopath. I could expect to see some actually reasonably good levels of function. Might be really bright. They might have been able to stay at university.

Philip Grindell: 25:40

There might be problems of getting on with other people yeah but they've actually been able to function quite well and in the first session we talked about um borderline personality and or emotionally detached personalities. Is that kind of sociopathic or detached personalities?

Caroline Logan: 25:56

Is that kind? Of sociopathic.

Caroline Logan: 25:56

No I wouldn't, use that, no, no, no, I wouldn't use that term to describe somebody who would be borderline. I think I would keep well clear of that. That's not to say that somebody couldn't, you know, have some characteristics in common, but I would want to stay a little clear of that. I mentioned in that session that borderline is a little bit of a controversial personality description or diagnosis to you. One of the reasons it's controversial is because an awful lot of the people that you see, who have got this description or diagnosis of borderline personality disorder emotionally unstable personality disorder have been abused as young people. Their early learning experiences are dysfunctional by any count. By anyone's reckoning, they were sexually abused, neglected, for example. We may have seen them at an early stage in their life turning to unhelpful ways of coping because it seemed to work. That could be hurting themselves. It could be being themselves. It could be being reckless with regards to their own safety or care. It could be the use of substances.

Caroline Logan: 27:02

I would be very reluctant to put a description like sociopath or even psychopath on top of a person like that without a very, very, very thorough assessment, because if we use a term like, certainly a term like psychopath, there's an assumption that the seat of that problem is within that individual right. So you are this way because and this this is a debatable point which I can come back to the genetic basis and warrior gene and some of that research that suggests so maybe people can't always help themselves if they're psychopathic, which is an interesting perspective. It doesn't carry a lot of water legally, but occasionally has.

Caroline Logan: 27:42

I wouldn't want to make that assumption about somebody who's emotional yeah yes, because a lot of people who I've seen with that label borderline I would be more inclined to describe them as having chronic PTSD.

Philip Grindell: 27:55

Okay, interesting.

Caroline Logan: 27:57

Post-traumatic stress disorder from that early and compounded, problematic, abusive early experience and what they've done perhaps is they've learned to survive in an unhelpful way.

Caroline Logan: 28:15

It's a sort of definitely limping life strategy, but it's a way that they've learned to survive. Yeah, in an unhelpful way it's a sort of definitely limping life strategy, but it's a way that they've learned to survive and I think to to even call it personality disorder gets lots of people's backs up and I'm completely and I'm very sympathetic with that. So I think we use that term broad line with care until we've got a really good idea and it comes down to a good clinical skill of history taking and asking other people as well.

Philip Grindell: 28:39

You've used the term pathological a number of times. Yeah, can you tell me what is the correct? You know psychological meaning of pathological Because I hear it quite often used in my world when we're talking about someone who is fixated.

Caroline Logan: 28:58

Oh, yeah, yeah. Well, you're absolutely right. And to ask about this, the technical definition of pathological so it's of clinical concern would be along the lines of this way you are causes clinically significant distress or impairment to the individual to the end to like to me. So if you said I had a pathological narcissism?

Caroline Logan: 29:28

yep ie pathological narcissistic personality disorder. You are saying that my self-regard is excessive, such that it's causing problems. Now I may not think I've got problems, a bit like the fellow I told you about. I may not think I've got problems. I may think you're the problem for saying these nasty things about me, but those problems are evident to many other people and they may be objectively evident because I've been arrested for a sexually harmful act which was a vengeful, sexually motivated attack against somebody who didn't give me what I thought I was entitled to. So that's our kind of technical definition chronically significant distress or impairment, and the diagnostic guidelines give us criteria by our guidance, by which we may judge the severity thereafter if there's a degree of clinically significant distress or impairment, impairment, impairment, present.

Caroline Logan: 30:30

You talked about fixated. Now we can all be a bit fixated. I I have a fixation on the Scottish football team which causes me a great deal of upset on a fairly regular basis, but I will out. So we can all be a little bit fixated on things. I've got hobbies and interests and I can be a little bit fixated on things. I've got hobbies and interests and I can be a little bit fixated on them at certain times when I'm on holiday, for example, and I have more leisure time. That would not count because it doesn't cause impairment. It doesn't cause me any problems. In fact it does nothing but cause me happiness. My family might not be so entertained because.

Caroline Logan: 31:15

I'm distracted by shitting at the television or whatever. Um, but it doesn't cause problems. Yeah, so when you use a word like fixated, I'm immediately going to think it's causing clinically significant distress or impairment, and that means the person may be doing that activity to the exclusion of other activities like family activities, childcare activities, occupational activity. They might be fixated because they are unemployed and working on the internet all the time, fixating and exploring whatever it is. They're fixated on the person they might be stalking or an organization they might be pursuing or whatever legal case whatever, and they're not out looking for a job which would give them social contact with other people which might then offer them an opportunity to reflect on what they think or to counter arguments, that sort of thing. So fixated, I would expect it to come at the cost of other activities which offer more balance.

Philip Grindell: 32:22

The person is therefore imbalanced in terms of what occupies their mental space and in that context, then, what's the difference between a fixation and an obsession?

Caroline Logan: 32:33

good, Good question. Obsession, obsession. Well, I think the term obsession they do overlap. I haven't thought about how closely they might be related. Actually, I'm speaking off the cuff here.

Philip Grindell: 32:50

The reason I ask the question as a context is, if you look at some of the um the discussion around the topic of stalking, yes I've seen it in a couple of organizations where they use this acronym of four and they use fixated and obsessive as two separate components of stalking behavior. Yes, which I'm not necessarily. Yes, I don't necessarily buy into that difference because I think they're almost the same thing, but I'm interested in your professional opinion around. You know, am I missing something in the kind of technical I think fixated would be locked on.

Caroline Logan: 33:36

So it may be that they have locked on to a particular individual and that particular individual or organization or whatever has absolutely engaged them. They are like a missile and they are locked yep onto the trail of that individual or entity. Obsession um relates. It has a more general definition. Obsession takes account of the time that a person might spend thinking about something, engaged in activities pertaining to an object of interest or entity of interest, reflecting on it, discussing it with other people. It's more of a preoccupation.

Philip Grindell: 34:26

So all-consuming.

Caroline Logan: 34:27

So all-consuming, but in manifestly different ways.

Philip Grindell: 34:34

So their internet posts, their activities, their decoration of their home might reflect various aspects of it so we could argue, then that a fixation is a, is a, um, you know, locking onto a person, as you say, or an ideology, or cause, or something. And then the obsession is the behavior that fixation causes in terms of, you know, from the minute they wake up to the minute go to sleep, this is what they're obsessed, this is what their behaviors are focused on.

Caroline Logan: 35:02

Yeah, and it pushes out other things. Yeah. And it comes at the exclusion of other activities which could offer more counterbalance. One of the things we tend to do when we want to work with people who have that all consuming preoccupation with an individual or an entity is try to compete with it in terms of getting them interested or encouraging their interest in other things.

Philip Grindell: 35:26

So you know we've talked a lot about all the various definitions and meanings of things, but I know that as a clinical practitioner, you know part of that role and you talked about it at the beginning of the first session. Part of that role is helping people to recover from those yes, various personality um problems. You know how do you go about that is is it, is it therapeutic, is it is it drug related, is it a combination? I know it's a large subject because of course we're talking about lots of different degrees of severity, but presumably, presumably, but presumably, you must believe that everything has some opportunity to improve. You may not cure, but it might improve.

Caroline Logan: 36:09

Yes, I do. I'm not therapeutically nihilistic. That's not to say that the kinds of interventions that we would like to see available for people who are profoundly disordered are available at the rates and in the places where we would like them to be available. Um, where we need to start really is this we can't change people's personalities. So if you're, if you're an extroverted person I'm not, I can't make you, I wouldn't want to make you an introverted person. That can't happen. But what I might try to influence is the way in which you express your extroversion, especially if that then endangers or impacts negatively on other people.

Caroline Logan: 36:54

So a lot of the therapies for people who have personality problems relate to them, the way in which they express themselves. Remember, we spoke in the first session about somebody who might have a little. Kids might be raised in different ways to manage their tendency the dispositional tendency to be anxious about things, and one child might have had good support and have learned not to be overwhelmed by anxiety. Another may have had less support and uses a variety of less helpful ways of coping with that anxiety. So what we might do in our therapies is go back to some of those learning experiences and try to offer alternative ways in which people can deal with the way emotions make them feel. So, rather than you know, if I feel a strong emotion, I might cut myself in order to put a hard stop on that emotion. That's not a great strategy for coping with emotion. It doesn't deal with why the emotion came up. It marks you for life, it hurts, you can get infections. It leaves a scar.

Caroline Logan: 38:03

What I might do, and as I have done on many occasions, is work with people to reduce the reliance on self-harmful behaviour as a way of hard-stopping emotions and instead try to build on their tolerance of emotions, build their ability to construct an environment around them that won't provoke strong emotions as often, and give them alternatives for when those emotions do come up. Like speak to somebody, yeah, or do this or that, and so we do that together. You know, like, what will you do if you feel this strong emotion? That's, you know it's the weekend, you know you're never very good on a saturday night. That's when you had these early experiences that were so problematic, maybe abusive experiences. Um, how will you cope with this trigger time? And so we might plan and prepare and eventually erode the reliance dependency on a way of coping self-harmful behaviour and build the person's confidence in other ways of coping which might not be so hard. Stopping but work and the person's willingness to give those other ways of coping a little bit longer to be effective.

Philip Grindell: 39:24

How do you do that, though, if you're in a prison or hospital environment, where they're in a particularly, I suppose, a controlled environment with rules and the ability to segregate and all sorts of other mechanisms if you like, segregate and all sorts of other um mechanisms if you like, and so you may get them to manage their behaviors within that context? But when they come out into the real world, when there's the real pressures of life and and there isn't those necessary mechanisms, that must be such a different environment to operate in yes, there's so many more temptations um and there's so much more stress real life money stressful simple things lucky.

Caroline Logan: 40:09

Yes, we're lucky, we have. We don't even think about paying bills or finding somewhere to live find somewhere to live, being able to keep it clean and tidy, that sort of thing. You're ready to feed the dog? Um, we we take for granted and of course, the longer people spend in institutions, the more those basic skills and the confidence and the use erode well, also, the world's changed, isn't it?

Philip Grindell: 40:34

if you're someone's in there for a long, long period of time, you know, if you, if someone's done 20 years in prison as an example, you know, 20 years ago we didn't have social media, we didn't have. You know, the world was far less complicated technically and all that. So they're coming out into a world that they may not recognise and they need different coping mechanisms just to survive as a normal person. I say normal in inverted commas.

Caroline Logan: 40:59

Yeah, absolutely. There's no such thing as normal, there's just more of us getting behind.

Philip Grindell: 41:03

Yeah.

Caroline Logan: 41:03

But you're absolutely right and I have a lot of understanding for people who come out of prison and can't handle it and do something to get back into prison, where life is very predictable. It's very sort of black and white. I do this, I do that, I don't do the other.

Philip Grindell: 41:18

Yeah.

Caroline Logan: 41:27

And also, it's their comfort blanket, isn't it? They know the rules. Well then, I don't share a comfort blanket.

Philip Grindell: 41:29

I think most of them would rather not be there, but prisons are really horrible, yeah, but what I mean is it's more in terms of um it's a known it's a known place, yeah yeah, what's the better?

Caroline Logan: 41:39

the devil you know yeah, yeah um, so I, so you're right.

Caroline Logan: 41:46

So our objective is to try to bring a person up a bit right in order that when they go outside with support, they can carry that on.

Caroline Logan: 41:55

Now we are extremely fortunate in the in england and wales in having something called the offender personality Disorder Pathway, in which I still am involved and was involved from the start, and what that operates within HMPPS, his Majesty's Prison and Probation Services. We might start this sort of intervention work with somebody in custody and we've got services in the community that will try to pull through from custody into the community and support them, and there are some incredible services, incredible colleagues working on those services trying to do that. It won't work for everybody, but it works for enough of them well enough that it can turn people's lives around, and there's no better feeling as a practitioner than seeing somebody make a goal of being in the community so that they can actually say I don't want to go back there. Really, I really don't want to go back there. I've got a life out here that I think I can sustain and nourish yeah, so you've been doing this.

Caroline Logan: 42:55

Go on, sorry just to say that. A key thing that we have to work on with people, though, however and coming back to your people with psychopathy and pathological narcissism in prison is motivation. Right, because, um, if I think I'm perfect, you coming along and telling me I've got problems is going to be like well, you can stuff your problems where the sun don't shine, and so I could be very rejecting of interventions just because of the assumption underpinning them. So, with a lot of people, we have to do a bit of work, just saying, look, you keep ending up in prison and you've got all these big ambitions, so let's hook into your motivational hooks, drivers, and let's see if we can get you to a better place. And because it's not in your interest to keep offending, not offending.

Philip Grindell: 43:47

So we we're not curing people, we're negotiating with them in a way that means that other people are safe and so sometimes so sometimes it's it feels like a little bit, like almost kind of parenting in a way, in terms of teaching them skills to manage their emotions.

Caroline Logan: 44:05

It can be a lot like that. It can be a lot like that, yeah.

Philip Grindell: 44:09

So you've been doing this for a number of years. We won't repeat how many number of years, but a number of years. What's changed?

Caroline Logan: 44:20

Goodness me, what's changed? I think the most obvious thing that's changed is complexity. When I started in the 80s in Glasgow, I don't remember seeing people as complicated as are now my bread and butter, albeit that I tend to see the more complicated cases. I supervise a lot of early career professionals and they're starting off in cases that are very complicated in a way in which, when I was starting, were not complicated. People have really complex lives and experiences wherever they've derived those experiences through their homes or through the places where they were born and have migrated from much more complicated. That's one huge thing.

Caroline Logan: 45:07

A second thing, which is more recent, is the internet and social media and my, I guess. I mean I think generative AI is amazing, but I am unclear where that's going and where that will take us and what that will do to younger people. I think I'm lucky. I've got many years behind me. I've got a sense of myself that was raised. You know that was developed the old fashioned way. You know that was developed the old fashioned way and I can look at and take or leave social media. My social media is all puppies and kittens and Scottish football team. It's very benign, but when I think of the young people that I know, I'm related to, and the children of my friends and the grandchildren of my friends, and I see the world they're trying to negotiate and the impact of the world in their pockets through in the form of a smartphone. I think of all the ways in which remember we talked earlier on about consistent messaging.

Caroline Logan: 46:18

So you give young people consistent messaging about what emotions they have so they can communicate them reliably to other people and get what they need when they need it. Adolescence is a tremendously turbulent time of anybody's life, where you kind of separate yourself from those parental caregivers in terms of identity and try on lots of different identities for size and then settle on the one that feels closest in terms of comfort and familiarity that's your own and you come back to roughly where your mother was yeah before you know, just being like the kind of person you can I ask you this then on that now we've got the, I just say, now we've got the internet and social media.

Caroline Logan: 47:01

Social media influences not allowing those parental caregivers to have the consistent messaging through that most turbulent of times.

Philip Grindell: 47:08

You may not be able to answer this question. You may not choose to answer this question, but it just flags on from what you've just saying. This whole movement of gender identity is that something that's always been there, or do you think that's been escalated through the internet and social media and other causes?

Caroline Logan: 47:28

I think it's always been there. I remember, actually, a very early case a very early patient service user that I worked with was a person who was transgendered, transgender and um, so it's. It has always been there. I think what, um, social media and the internet has done has made it more something that we can talk about. I don't feel that and this is a controversial view and I'd love to talk to anybody who feels very different from me I kind of don't feel that that gender diversity is the problem.

Caroline Logan: 48:09

I think what we're seeing is a greater intolerance of different points of view yeah not just in this field, but in many other fields as well the world's become very black and white, hasn't it't it?

Philip Grindell: 48:21

We don't have the kind of the grey ground or the. I hear what you're saying. I may not agree with it, but I'm interested to your point of view. It's kind of you're wrong.

Caroline Logan: 48:30

You're absolutely right, and it's not just that you're wrong because your view is different from mine, but that I'm going to threaten to kill you or you deserve to die or somebody needs to come and rape you because your view is different from me yeah and that's that, to me, is the more terrifying thing.

Caroline Logan: 48:46

I think we will have always seen these debates where we will see a group within society become, thankfully, become more visible, and then there's there's a settling down and super visible, and then there's a settling into a kind of business as usual, and that's good. We've seen that, these movements. If we look back across the last couple of hundred years or so, since the real growth of urbanisation, we can see those social developments and they are a force for the good. But what's less good is this polarized debate, the intolerance of of opposing points of view. I can't remember that view, that the expression somebody said. We said that, um, I may disagree with what you say, but I'll fight to the death for your right to disagree, to say it and I think we've lost that and I actually don't know how we might get that back.

Philip Grindell: 49:46

Yeah, I agree with that. I think, certainly in my world, in terms of what I've dealt with over the last few years, politics and otherwise that seems to be the biggest change is this lack of willingness to accept other people have a view that's contrary to yours.

Caroline Logan: 50:02

And I think the problem with the internet I mean, I think, face-to-face. Well, let me clarify this I think face-to-face people are often more nuanced than they're capable of being online. The problem with online is the anonymity. It affords you to be able to say what you like almost with impunity, and and, and I think that what we get is this contagion, this, uh, outrage sharing, and it cycles and morphs and metastasizes on the internet, affecting people, and I think the people more prone to be affected are often people who are young and maybe more, have got less experience of being able to say well, that's just nonsense or maybe the ones that are searching for that, that, that that sense of self, and they're looking for that.

Philip Grindell: 50:55

Where do I fit in in this complex world?

Caroline Logan: 50:59

and we can see some. There's loads of influences out there that are phenomenally useful, and my house is a better place as a result of the way in which they've influenced me to take better care of it in my garden, all the rest of it and myself. But I think there are people out there who operate as influences, as gurus, as whatever you might refer to them, whose influence is more toxic, and they are exactly the people who can get in there to somebody who's uncertain and searching for a sense of self that's more secure than the one they maybe feel they have just now, and these people can offer certainty when they have no right to offer it. It often comes at a tremendous cost.

Philip Grindell: 51:46

And I think that comes back to the point you've made throughout the two sessions is that you know we are complex beings and we're multifaceted and complex and interesting and flawed, and interesting and flawed, and all those various components in a in different scales, and every different human being to split.

Philip Grindell: 52:06

You know almost so. You know, I know when you and I talked in France about you know where you are different to your sisters for different reasons, and you're, you know, and and yet we've had the same childhood roughly. So we are complex human beings and I, we sometimes um want to put ourselves in boxes because it simplifies us as a race, but actually it doesn't take notice of the fact that, yeah, I agree with you that, but I don't necessarily agree with you with that, or you know so we all agree with you in this, but I still really like you yeah yeah, and also it's this kind of you know, this ancestry of tribalism that we come from, where we fit into certain tribes and therefore you know, we're all told, we're told that through rapport building and stuff like that, you know we all feel more aligned to our own kind and therefore there's that tribal element there.

Philip Grindell: 52:56

So anything further away from that is a threat and that's just kind of a really simplified view that probably isn't particularly accurate anymore.

Caroline Logan: 53:08

But I'm so sympathetic for the one which people can feel just now because, whilst that diversity and our individual differences are wonderful and we are enriched by having, however big our social network is, it might be just very small and everybody may be very similar to us, or it might be really, really broad and everybody may be all shapes and sizes and wondrousnesses.

Caroline Logan: 53:35

For a person who's young, for a person who's maybe got a lot on, that diversity can be bewildering, and I absolutely get it that they might look for a life raft of simple explanation, and the internet unfortunately offers lots of simple explanations, many of which are unjustifiably simple and come at a cost, and I worry about the way in which people can be influenced by some of that negativity in ways that at a later point, on reflection, they will go, oh my God, back in the day, when I was a kid, I used to go out on a Saturday night and I would be dressed like a complete numpty.

Caroline Logan: 54:25

I'd come downstairs from my bedroom and my father would look at me and say, my goodness me, you are not going out dressed like that. You are not. You look ridiculous. And I'd have to go back upstairs and take off my lurid orange top and my know dangly earrings, 15 sets of dangly earrings or whatever you know crazy stuff that you know on retrospect I'm thinking thank god he did that that those sort of guiding hands. I think we've lost a lot of that and people are finding their own way in the world and there are too many negative voices saying, oh, I've got the solution to your life's problems yeah just pay a lot of money yeah a lot of quick fixes to complex problems.

Philip Grindell: 55:08

Yeah, caroline, thank you so much for your time. I've, you know, we've not had anybody. You're the first person we've ever had to do two sessions because and it's because I think it's been from personally, for me absolutely fascinating and and and interestingly, of all the kind of subjects we, we, we touch on, you know, this is the kind of bedrock or the foundations of all of it, because it's about personality, it's about how you know, why do people behave in different ways and do things which threaten the safety be it physical or reputational or psychological of others? And so I think that's why this has been so interesting and so important, because it really does explain a lot of those complex issues. We now have a point of expertise, when we hear certain terms, to go back and think, well, actually that's not what the expert says, that's a media version of this complex subject.

Philip Grindell: 56:05

Um, so, you know, huge, huge thank you. Um, you know, and powerful, powerful lessons. So, um, you know, I'm so thrilled to have, uh, two of our paths have crossed in sunny paris and, um and over, several beers and what have you, and some reasonably good food, and so, you know, thank you, thank you, thank you for this incredible two sessions.

Caroline Logan: 56:32

Thank you for the opportunity to talk about something that's very close to my heart.

Speaker 1: 56:36

Thank you for listening to the Diffuse podcast with host Philip Brindell, CEO and founder of Diffuse. Please rate, review and subscribe on your favorite podcasting platforms.