Joey, a client with antisocial personality disorder belches loudly. A staff member asks Joey, “Do you know why people find you repulsive?” This statement most likely would elicit which of following client reactions?

Correct Answer: A. Defensiveness

When the staff member asks the client if he wonders why others find him repulsive, the client is likely to feel defensive because the question is belittling. The natural tendency is to counterattack the threat to self-image.

• Option B: Embarrassment is a painful but important emotional state. Most researchers believe that the purpose of embarrassment is to make people feel badly about their social or personal mistakes as a form of internal (or societal) feedback, so that they learn not to repeat the error.
• Option C: Shame is an unpleasant self-conscious emotion typically associated with a negative evaluation of the self; withdrawal motivations; and feelings of distress, exposure, mistrust, powerlessness, and worthlessness.
• Option D: One of the hallmarks of people with Borderline Personality Disorder or Narcissistic Personality Disorder (BP/NP) is that they often do not feel truly sorry. Even though a BP/NP may say he or she is sorry, there is often something lacking. The BP/NP may regret an action, but it is hard to see true remorse in their response. Remorse involves admitting one’s own mistakes and taking responsibility for one’s actions. It creates a sense of guilt and sorrow for hurting someone else and leads to confession and true apology. It also moves the remorseful person to avoid doing the hurtful action again.