Published February 24, 2005 in issue 0408 of the Hook

BY JOHN HONG, MD

Imagine sitting in a tropical paradise. Brad Pitt and Jennifer Aniston-- oops, scratch that. Okay, Catherine Zeta Jones-look-alikes serve you drinks and fresh papaya.

Then the Creature From The Black Lagoon sits down beside you, starts to yell at his wife/girlfriend/date-of-the-moment, swears at the servers, and plays his Marilyn Manson music at 130 decibels. You have not entered the Twilight Zone. You have just met one of the 5 percent of men who have Antisocial Personality Disorder (ASPD). How do you deal with such cruel people who seem to have no conscience?

Once I was at a cultural event, and an old man and young girl sat behind us. They arrived late, yapped during the performance, and "made-out." I didn't know you could make out in public after the age of 18. The girl-- who looked like Courtney Love on heroin-- was probably 17, so technically she could make out in public. However, the man looked like Ebenezer Scrooge.

Because their slurping sounds (yes, they slurpedlike in Joe Millionaire!) went on for at least half an hour, I turned around and gently put my finger to my lips to ask them to keep it down. The old man stuck his middle finger in my face, threatened to hit me, started to swear at me, and then used degrading slurs. Everyone around this ASPD man behaved just like a politician: no one acknowledged anything was wrong. Even the usher and house manager didn't know what to do.

"Hmm, he's making physical threats, yelling slurs, and swearing like Margaret Cho. Should we get gelato after the show?"

Let's face it: almost everyone has at least one relative he/she hates because this person has no sense of regret, remorse, or conscience. Maybe it's Uncle Jim, who feeds your pet fish to the cat. Or your brother who stole your car and racked up $10,000 on your credit card in Vegas. Perhaps Cousin Timmy has a habit of pulling out his gun every time the doorbell rings or a telemarketer calls.

The amazing thing about a Personality Disorder (PD) is that the person who has it usually doesn't suffer. Those around the PD person are the ones who feel the pain of the illness. It's like Pépé LePew, who adores the cat but doesn't realize he smells well, like a skunk.

About two-thirds of prison inmates have ASPD. ASPD people tend to get into trouble with the law because of stealing, violence, and alcohol and drug abuse. ASPD people often abuse or have abused animals because they lack respect for life. I fear for Mickey Mouse around an ASPD person.

Don't be fooled by a charming man like Ted Bundy. Dr. Jekyll's Mr. Hyde is the personification of a man with ASPD. To manipulate people around him, the ASPD man will be kind, if not dazzling at times, to build trust. But when his prey is vulnerable, he goes for the jugular. How many Lifetime movies does one need to watch to see ASPD behavior, such as a wife-beater abusing his wife one day and giving her gifts the next morning?

Like the common cold, there is no cure and really no effective therapy. Therefore, the key to dealing with someone who has ASPD is not to react but to think and act. Set clear consequences for their behavior and clear boundaries you will uphold. ASPD people thrive on reaction-- like Sean Penn and paparazzi.

In my case, I told the old man who threatened me at the performance that his behavior was inappropriate and was going to get him arrested. (Little did I know he had frequent flyers miles at the local prison.)

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