The diagnosis of Antisocial Personality Disorder (ASPD) is not a medical observation, but rather a political instrument designed to pathologize the individual at the absolution of the system. It functions to medicalize resistance, framing dissent and the rejection of bourgeois norms as symptoms of a broken mind rather than rational conclusions of political analysis. By labeling non-compliance as a disorder, the state effectively removes the moral weight from its own violence and redirects it onto the psyche of the oppressed.
This framing becomes patently clear when we examine the scope of the diagnosis. ASPD is far too broad to be clinically useful outside of this context. The criteria themselves reveal the absurdity of the construct:
• Failure to conform to social norms with respect to lawful behaviors, as indicated by three or more of the following:
- Repeatedly performing acts that are grounds for arrest.
- Deceitfulness, as indicated by repeated lying, use of aliases, or conning others.
- Impulsivity or failure to plan ahead.
- Irritability and aggressiveness, as indicated by repeated physical fights.
- Reckless disregard for safety of self or others.
- Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations.
- Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another.
• Childhood presence of "conduct disorder" as evidenced by a history of any of the following in at least three distinct ways:
• Aggression
• Destruction of property
• Deceitfulness or Theft
• Serious violation of rules
• Is not explained by Bipolar Disorder or Schizophrenia
• Leads to distress or impairment
The requirement of functional impairment is the most damning part. You can display every "symptom", but if you get away with it then it's not a disorder. Billionaires don't meet criteria, but half of prisoners do. The "distress or impairment" clause is merely a class filter: if you have the power to evade consequences, your behavior is "visionary"; if you don't, it's mental illness.
Sure, if someone struggles with impulse control or emotion dysregulation, those are treatable symptoms that, if resolved, might improve their quality of life. But the vast majority of people who meet the criteria do so simply because they break the law, lie about it, and don't feel bad about it. Why would they? To rebel with intent within an inherently oppressive system and then feel remorse about it would be incongruent. This behavior should not be pathologized. It doesn't need treatment, it needs liberation.
The diagnosis isn't a disorder or disability. ASPD is a made-up label created to pathologize criminality. Practically any anarchist or ADHDer who's been to jail will meet the criteria. The label doesn't serve the individual- it serves the state, and it ought to be discarded. Normalizing ASPD as a diagnosis subverts the notion that smashing the state is good and that people should do so without remorse.
A distinction should be made, however, between the system's use of the label and an individual's relationship to it. For someone already labeled as such, reclaiming the term while refusing to internalize its shame can be a form of resistance in itself. If, however, a client without the diagnosis laments their struggle of acting without thinking, regretting it, and wishing to better navigate social boundaries to improve their wellbeing, e.g., there are several far more relevant diagnoses to choose from rather than funneling them into a category which only serves to stigmatize dissent.
The role of a psychotherapist shouldn't be to subdue the retaliation of the oppressed, but to help them understand that their "symptoms" are often adaptive responses to a unwell society and, importantly, that there exist effective outlets for it. We must reject the idea that the state's laws are in any way a baseline for mental health. The diagnosis is a construct, and the "cure" is revolution.