Theodore Millon's antisocial personality disorder framework and child sexual abusers

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Position Statement on Personality Theorist Theodore Millon The contributions Theodore Millon to the conceptualization of personality disorders are immense. Further, their continued relevance to the field of personality psychology today cannot be overstated. According to the National Children’s Alliance (2018), “nearly 700,000 children are abused in the U.S. annually.” A significant percentage of these children are victims of sexual abuse. It is important to note that the thoughts, feelings, as well as behaviors of persons having antisocial personality disorders, i.e. pedophiles, differ from those of persons regarded normal. Could Millon’s contributions be extrapolated to those perpetrating sexual abuse amongst children? I am of the opinion that despite there being no probability of an overlay of an isomorphic nature, the antisocial personality disorder domains proposed by Millon match the basic identifiers of a pedophile. For a long time, clinicians attempted to make sense of the behaviors and motivations of persons who commit acts that appear so savage to the extent that the perpetrator is deemed insane. The only problem was that the said perpetrators’ clinical presentations did not in any way match known mental syndromes. One of those who attempted to understand this anomaly and present a framework for its evaluation was Prichard who in the 1800s came up with the phrase ‘moral insanity’ to describe the condition whereby an individual’s moral compass is extremely perverted, but their intellectual abilities/facilities appear normal (Kiehl, 2014). An individual in this category was considered as being incapable or being unable to maintain moral uprightness and decency. At the turn of the 18th century, and for most of the 19th century, the moral insanity diagnosis was roundly embraced especially as a defense in most American courts. Later on, some, including but not limited to Schneider and Kraepelin helped in the formulation of psychopathy and personality disorder schools of thought in an attempt to describe persons with personality disorders. It should, however, be noted that it was Henderson, as Kiehl (2014) points out, who formulated a sound basis for the present-day depiction of personality disorders in seeking to describe persons who present antisocial conduct despite conforming to a certain intellectual calibration. In essence, antisocial personality disorder, as Millon and Davis (1996) point out, is termed as “a pervasive pattern of disregard for and violation of the rights of others…” The first domain to be considered herein is the behavioral domain. In this case, persons exhibiting antisocial behavior are seen as having an impulsive mode of conduct. Most of their acts are largely triggered by the ‘heat-of-the-moment’ and they have a tendency to adopt a specific course of action without taking into consideration the resulting consequences. Pedophiles have this ‘short-sighted’ tendency, with their actions being motivated by the ‘heat-of-the-moment.’ This effectively means that their control of impulses is extremely poor. While an average person would be expected to be familiar with the consequences child abuse - i.e. to the victim and their families, and to the perpetrator if caught - pedophiles seem to have no forethought of the consequences of their actions. This behavior is truly consistent with the elaboration Million gives to the behavioral domain of antisocial personality disorder. Next, we have the interpersonal domain. Here, ‘irresponsible’, as Craig (2005) observes, is the general description of an antisocial. To be more specific, the antisocial in this case exhibits irresponsible tendencies and has a habit of failing to honor obligations. Further, he displays other poor interpersonal relationship skills such as deceitfulness and failure to honor or respect the space and rights of other people. The inability of an antisocial to abide by specific and well-defined social codes is remarkable. It is important to note that, in essence, the society expects adults to not only protect but also nature children. This is more so the case given their vulnerable nature. A pedophile goes against this social code of conduct. The behavior they exhibit is not only irresponsible, but also against the expectations of the general public. This is a clear case of an inherent inability to honor or respect social expectations. Cases appearing in the media over time have also exposed the deceitful nature of pedophiles. The said deceitfulness is exhibited in the form of luring their victims and in covering their tracks after committing the offense. Towards this end, therefore, it is clear that the behavior of pedophiles matches the highlights of this particular domain of psychopath conduct. The cognitive approach when it comes to the phenomenological domain is, according to Craig (2005), reported as being ‘deviant.’ It is important to note that those who harbor antisocial tendencies tend to have a different perspective of events from that of normal persons. Their morals as well as beliefs tend to be manifestly unusual, unconventional, and in most cases perverse. With this in mind, it is important to note that the conduct and behavior of pedophiles is not only bizarre, but also anomalous. Their desires and resulting actions could be termed deviant. It is this cognitive deviancy amongst pedophiles that links their behaviors to the descriptors of antisocial personality disorders. Next, we have ‘debased’ as the term used when describing antisocial object representation domain. In this case, the representation of other people in the mind of an antisocial tends to be diminished. It is this same diminished perspective of children that pedophiles tend to have. In that regard, therefore, they use the child to satisfy their sexual desires without any regard to the emotional and/or physical pain the said child experiences. The fifth domain is the self-image. Here, the general domain description according to Craig (2005) is ‘autonomous.’ Antisocial persons in this case do not feel bound by expectations as a consequence of longstanding relationships, friendships etc. They desire a free and unconfined nature and do not feel the need for personal loyalties or allegiances. Pedophiles have been shown to have no respect for boundaries and the fact that there have been instances where they have exploited their own relatives, friend’s children, etc. is a clear indication of this fact. The intrapsychic and morphological domains could also be matched to pedophile descriptors – with the former domain postulating that that the antisocial is likely to ‘act out’ and the former pointing towards an ‘unruly’ behavior. With regard to ‘acting out’, there is little or no restraint when it comes to the adaptation or modulation of thoughts and/or behavior. Pedophiles demonstrate little or no constraint in the attunement of their offensive thoughts as well as actions. ‘Unruly’ behavior, on the other hand, has got to do with the demonstration of quite a low threshold for behaviors as well as thoughts that could be seen as being intolerant and unfortunate. Those who abuse children sexually could be said to be having an unhealthy inclination towards pervasive behavior. Lastly, there is the biosocial domain, which according to Craig (2005) describes those exhibiting antisocial behavior as being cold-hearted, unfeeling, and callous. They are also unlikely to display any contrition or sorrow. This is consistent with the tendency of pedophiles to exhibit unacceptable behavior towards children - with their actions fitting the description of callous and cold-hearted. Lack of remorse makes their behaviors habitual. In the final analysis, it should be noted that the fact that there is an overlap of sorts between the personality traits of pedophiles and the domains put forth by Millon offers us an opportunity to tackle the child abuse monster in our contemporary society. This is despite the fact in this case, two spectrum disorders are being examined. A discussion of this nature is not only timely, but also relevant, especially given that the problem cuts across all cultures and its impact spreads across many generations. Given the psychopathic-like characteristics of pedophiles, Millon’s domains could be used to understand the modus operandi of a pedophile so as to design the most effective intervention measures. This is more so the case given that as Millon and Davis (1996) point out, psychiatric disorders “may be better understood as dimensions of general personality functioning rather than as discrete illness categories.”