By David Marchese – Feb 23, 2024 – New York Times Mag – Photo Illustration by Bráulio Amado

My cmnt: I’ve included below four articles respectively from Cleveland Clinic, Mayo Clinic, WebMD and Forbes Health.

My cmnt: My takeaway from these articles? Sociopathic behaviors are now called antisocial personality disorder and exist on a spectrum much like Asperger’s Syndrome which is a form of Autism Spectrum Disorder. In other words everyone has a little of it.

My cmnt: So this interview (below) with Patric Gagne in New York Times Magazine is mostly just fun to read, because like a good movie (Silence of the Lambs or Psycho) it’s more about entertainment than information and like Hannibal this woman seems to enjoy her disorder more than suffer from it. Or like the old joke: Do you suffer from insanity? No, I enjoy every minute of it.

My cmnt: This quote is making the rounds on the internet: My therapist told me my ability to cut people off and self-isolate is not a skill I should be proud of but rather it’s a trauma response rooted in never having anyone to depend on.

My cmnt: See Adam Sandler’s Talking Goat skit here for another look at how we find sociopaths (the boys towards the goat) amusing or at least entertaining. Other examples are Dumb & Dumber, Step Brothers and the Three Stooges.

Sociopaths are modern-day boogeymen, and the word “sociopath” is casually tossed around to describe the worst, most amoral among us. But they are not boogeymen; they are real people and, according to Patric Gagne, widely misunderstood. Gagne wrote “Sociopath,” her buzzy forthcoming memoir, to try to correct some of those misunderstandings and provide a fuller picture of sociopathy, which is now more frequently referred to as antisocial personality disorder. As a child, Gagne found herself compelled toward violent outbursts in an effort to try to compensate for the emotional apathy that was her default. As she got older, those compulsive behaviors turned into criminal ones like trespassing and theft. Eventually, she discovered that there was a name — that dreaded word — that could be used to describe and explain her experiences of remorselessness, criminality and lack of empathy. The desire to destigmatize her experience and also to help others who may share it (Gagne previously worked as a therapist to those with the disorder and has also written about sociopathy) put Gagne on a path that led to “Sociopath.” “I’m not trying to say, ‘Sometimes we do bad things, but we’re really sweet on the inside,’” says Gagne, who is 48. “I’m saying there is more to this personality type.”

When I hear the word “sociopath,” I think of an antisocial, uncaring person who is interested only in satisfying his or her own desires. What’s a clearer picture? Sociopathy is a perilous mental disorder; the traits¹ associated with sociopathy aren’t great. But that only tells part of the story. The part that’s missing is you can be a sociopath and have a healthy relationship. You can be a sociopath and be educated. That’s a very uncomfortable reality for some people. People want to believe that all sociopaths are monsters and that all monsters are easy to spot.

(1 Traits may include lack of remorse, deceitfulness and a disregard for the feelings of others as well as right and wrong.)

In the book, you write about stabbing a classmate with a pencil when you were a kid, and then as you got older trespassing² and stealing cars. You don’t succumb to those sociopathic compulsions anymore. How did you learn to control these urges? As a kid, I didn’t understand why I was acting out the way that I was. All I knew was I felt this pressure, and something in my brain was telling me, Punch that kid, and you’ll feel better. As I got older I understood, OK, there’s a name for this, there is a whole group of people who share this diagnosis. Once I understood that I wasn’t out in space untethered and going crazy, I was on the path to understanding that when I had those feelings of “go steal a car,” I could go, Yes, I could do that, but now I understand what’s going on. That understanding helped break the cycle — or at least redirect the compulsion toward something less destructive.

(2 Specifically, breaking into people’s homes.)

What does that redirecting look like in practice? Every once in a while, I will have an urge to do something destructive just because I can, and my redirect is, Do you want this destructive behavior? Or do you want to continue to maintain this life that you have, which requires that you not do those things? I have to have that conversation with myself.

What’s a recent sociopathic impulse that you had? This is a very vanilla example. When I go to the grocery store and I come home, if anything that I’ve purchased has gone bad, I’ll make a mental note: I’m stealing this next time.

You write about your difficulty with understanding other people’s emotions, feeling apathy and lacking empathy. But you also write about experiencing love. Why are you innately able to feel love but not, say, empathy? The way I experience love seems to be very different from the so-called neurotypical experience. My experience of love seems less emotional. If I had to explain what love feels like to me, I would say symbiotic. So, a relationship that’s beneficial to both people involved. Not transactional, not possessive, not ego-driven. Mutual homeostasis. It’s not that I’m unable to access emotions or empathy. It’s that my experience of those emotions is different.

When you write about becoming a mom,³ you say that profound feelings of love toward your child were non-intrinsic, and you had to work to experience them. Can you tell me about that work? As a woman — forget my personality type — you’re inundated with all these images: Your child is born, it’s incredible. I did not experience that. I didn’t have that immediate baby is born, I’m overwhelmed with love. It was, I don’t know this person. This person is very loud! That connection just isn’t there. It’s not innate. But over time, you can build it. Much like when I first met David:⁴ I knew right away that this person was going to be important in my life, but I didn’t have those sweeping romantic, flowery emotions affiliated with that experience. That was the same when I first met my son. Now I just think he’s a great kid!

(3 Gagne has two school-age children.) (4 Gagne’s husband, whom she has known since they were teenagers.)

Are you able to describe how you’ve built a sense of morality? Just because I don’t care about someone else’s pain, so to speak, doesn’t mean I want to cause more of it. I enjoy living in this society. I understand that there are rules. I choose to follow those rules because I understand the benefits of this world, this house where I get to live, this relationship I get to have. That is different from people who follow the rules because they have to, they should, they want to be a good person. None of those apply to me. I want to live in a world where things function properly. If I create messes, my life will become messy. I think people are uncomfortable with the idea of, You don’t really care? What does it matter? What does it matter why I choose to help the woman cross the street? Why does it matter why I choose to pick up a wallet and hand it to the person in as opposed to keeping it? It’s not because I’m a good person. It’s not because I would feel shame or guilt. But why does that matter?

What advice do you have for neurotypical people about how best to interact with someone who identifies as sociopathic? I’m not sure neurotypicals need any, because I have been identifying as a sociopath for years now, and my experience with people who don’t know that has been positive. I have yet to encounter anybody who, when I disclose my diagnosis, acts afraid or upset. I think, inherently, neurotypicals are fascinated by sociopathy because it’s a relatable disorder. Everybody has that darkness in them. Everybody has those thoughts that they shoo away because of guilt. If more conversations between neurotypical and so-called neurodivergents were to occur, it would benefit both. It would benefit the sociopathic person because that acceptance lets 80 percent of the air out of the balloon, but it would help the neurotypicals, like, Oh, I can share things with this person that maybe I couldn’t share with other people. I get more secrets from strangers after telling them my diagnosis; you wouldn’t believe the things that people have told me because they feel safe.

What secrets do they tell you? Oh, man. I was sitting across from a man at a dinner party — this was like two years ago — and my diagnosis came up, and 30 seconds afterward he said, “You know, I have thoughts of killing my wife a lot.” Not to normalize that, but I was like, Tell me about that. And he goes: “I’ve really thought about it. I’ve reached out to people about hiring somebody to kill her.”

So people just assume that you’re a sympathetic audience? Yeah, because these are things you’re not supposed to think about. So to be able to talk to somebody — you don’t have to worry that I’m going to start clutching my pearls.

You were a practicing therapist, and we think of therapists as highly empathic, invested in the emotions and stories of their clients. So how did you relate to your clients? I didn’t relate to them. Now, that is not to say I didn’t care about my patients. The easy answer is, of course I care about you. I wouldn’t continue to see you if I didn’t, but why do you need that reassurance from me? My job is to help you understand what’s going on with you. My job is to help you take your emotions, separate them out, explore your motivation. That’s my job. I think that I was a good therapist because I was able to parse those things out unemotionally. My gift to my therapy patients was that I was able to lend them sociopathy: Why do you care? What does it matter? What do you need from that? That, I felt, helped them achieve things that maybe a nonsociopathic therapist couldn’t have offered.

In the book, you describe things like mirroring people back to themselves or your conscious and intentional manipulation in the moment. Is that happening now? Listen, everyone has a front-facing persona. Most people use that persona as a preference: a desire to be liked, a fear of judgment, wanting somebody to be friends with them. But sociopaths use it out of necessity, and that’s a really important distinction. My decision to mask⁵ is not because I have some dark ulterior motive. It’s because you guys are interesting to me. Neurotypical emotions are so colorful and complex. In order for me to engage with you, you have to feel comfortable with me. In order for you to feel comfortable with me, I have to mask. I find that people are unnerved by me when I’m not masking. Because otherwise I’m quiet. I ask invasive questions. I stare. My affect is low. The bottom line is that I want you to feel comfortable, so I engage. I smile. I mirror. It’s not nefarious; it’s necessary. The issue here is motivation. I don’t mask because I’m secretly trying to kill you. I mask because I want you to feel comfortable because I find you interesting.

(5 By which Gagne means adopting prosocial mannerisms.)

What’s an invasive question you want to ask me? Why are you interested in me? Why are you interested in sociopathy? Talk to me about your darkness. I’m not expecting answers.

You want to get into it? Oh, yes. I find neurotypical people absolutely delightful!

I’ll give you two reasons I’m interested: I was sent the book, and I started reading, and the opening involved you as a second grader stabbing a kid in the head with a pencil. I thought, Holy moly, readers will be interested in this! So there was a mercenary quality to my own interest. Then also, there are times when I’ve wondered if the skills that I’ve learned from doing my job over the years are basically just forms of interpersonal manipulation, and I was curious to talk to you as a roundabout way of exploring that question for myself. Where does that question reach you?

What do you mean? Do you manipulate people in order to execute your job?

I think there is a degree of manipulation, but what do we really mean by manipulation? Is manipulation by definition negative, or does manipulation just mean intentionally creating a certain interpersonal context? That sounds like a justification to me, which means you’re sidestepping shame or sidestepping guilt.

I disagree. That would be like saying therapists are always guilty of “manipulation.” Just so we’re clear, when I said justification, I wasn’t trying to say that what you were doing was bad. You’re talking to a sociopath! I don’t think anything that you’re doing is bad. Yes, you are manipulating people to a certain extent — to your point — in the way that I might manipulate somebody in therapy, but I would never feel the need to justify it, and your justification came so quickly. That’s why I was like, Hey, what’s happening that you felt the need to defend your answer?

We don’t usually say we have to justify a positive thing. That’s probably why I reacted that way. What else? How much of that dark side of sociopathy can you relate to? And if you don’t have an easy answer for that, was it comforting to read about somebody who was open with their experience of being fully immersed in their darkest impulses and a lot of times carrying them out?

Well, I would say that one question that the book raised for me was the extent to which a lot of behaviors that people do could be considered sociopathic, and we just don’t understand them that way. Plenty of us do things that we know are bad because the transgressions feel good. It feels good. Why? I think it feels good because it feels free. To do something bad, it’s like, I don’t give a [expletive]. The consequences — be it internal guilt or getting thrown in jail — happen after. In this moment, I’m going to do this because it feels [expletive] great to just not care. That is what the sociopath experience is almost all the time. One piece of advice I would give to anyone who sees themselves in my description is to find an external philosophy that works for you. I liked karma. It seemed clean. It seemed organized. Find that philosophy for yourself, because you’re not going to get to rely on internal checks and balances.

I realize I didn’t quite understand what you meant when you said that you can experience empathy, just differently. What is empathy to you? Eventually as I got older, what I started to realize is that if I can connect to something that I can internalize naturally, I use that as a bridge to broaden my empathic response. For example, I’ve found frequently that a lot of people who exhibit sociopathic symptoms have strong feelings for pets. That’s a great bridge: You would feel upset if something happened to this animal that you care about. Now let’s extend that feeling to someone close to you that you have a strong relationship with.

But when you say “extend that feeling,” is it cognitive understanding that you’re describing or an emotional response? At first it is cognitive. Then, over time, that does grow into the emotion. It’s the understanding of it that leads to the feeling. I’m sure you’ve had a situation where someone is explaining something to you, and at first you’re like, I don’t care.

Multiple times a day! [Laughs.] Great. Now, imagine if that’s your first instinct, but you understand that you have to be like, Oh, yeah, I understand that I have to care. That is cognitive empathy. You’re not faking it, but you’re internalizing it. That’s your first take on something, and then maybe you get to know the situation better, or you find something about that situation that you can anchor to, and then the feeling kicks in.

Do you see your sociopathy as beneficial to you? I think my sociopathy is entirely beneficial to me. I see my friends struggling with guilt. On an almost daily basis I think, I’m glad I don’t have that. The psychological characteristics of sociopathy are not inherently bad. Lack of remorse and shame and guilt has been misappropriated to mean this horrible thing, but again, just because I don’t care about you doesn’t mean I want to cause you more pain. I like that I don’t have guilt because I’m making my decisions based on logic, based on truth, as opposed to ought or should. Now, there is a flip side. I don’t have those natural emotional connections to other people, but I’ve never had those. I don’t feel like I’m missing anything. Just because I love differently doesn’t mean my love doesn’t count.

Opening illustration: Source photograph by Kristia Knowles, via Simon & Schuster

This interview has been edited and condensed for clarity from two conversations.

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My cmnt: It’s so very important to remember that modern psychiatry presupposes a strictly material world, hence everything is to be understood in those terms. The big question to ask is: Are we material beings having a spiritual (i.e., an imagined manifestation of physical interactions in our brains) experience or primarily real spiritual beings incapsulated in flesh having a material experience? Or we could ask: Are nonmaterial values like faith, hope and love or beauty, goodness and truth real or just projections of evolutionary survival mechanisms? Or: Is the primary furniture of the universe information or at bottom just particles randomly colliding under physical laws producing a meaningless complexity that only mimics intelligence?

Cleveland Clinic – Health Essentials – Sept 9, 2021

How to Recognize Signs of Sociopathy

An expert explains whether you can tell if you have sociopathy

Chances are that, at some point in your life, you’ve encountered someone who doesn’t seem to take any consideration for your feelings or understanding social norms. They lack an understanding of right and wrong no matter who gets hurt.

The term “sociopathy” can often be used and, sometimes, you might even find yourself in a moment of self-reflection asking, “Do I have sociopathy?”

It’s not quite that simple, though, so we talked to psychiatrist Andrew Coulter, MD, about what having sociopathy really means, how to deal with it and what to do if you think you have it.

What is sociopathy?

Sociopathy is another term for antisocial personality disorder. “It’s a mental health condition where somebody persistently has difficulty engaging appropriately with social norms,” says Dr. Coulter.

The chronic nature of sociopathy, he adds, is what differentiates this condition from other, episodic mental health conditions like depression, panic attacks or bipolar disorder.

What are the traits of sociopathy?

The list of common traits you might see in someone who has antisocial personality disorder, says Dr. Coulter, include:

• Not understanding the difference between right and wrong.
• Not respecting the feelings and emotions of others.
• Constant lying or deception.
• Being callous.
• Difficulty recognizing emotion.
• Manipulation.
• Arrogance.
• Violating the rights of others through dishonest actions.
• Impulsiveness.
• Risk-taking.
• Difficulty appreciating the negative aspects of their behavior.

Some with sociopathy may not realize that what they’re doing is wrong while others may simply not care. And sometimes, Dr. Coulter says, it can be both.

“There’s just a total lack of empathy or recognizing that what they’ve done has hurt someone or it’s only benefited themselves,” he says. “And sometimes they might recognize what they’re doing is wrong, they just don’t care or they justify it to themselves.”

What causes sociopathy?

Sociopathy can be both a learned condition and one you’re born with, says Dr. Coulter.

“These behaviors aren’t episodic in nature. They’re a chronic condition, part of a chronic way in which a person interacts with the world,” he says. “In a lot of cases, it’s something you’re born with, this personality structure or way of engaging with those around you.”

But, he adds, there are cases in which sociopathy is seen as adaptive behavior. “Someone may have grown up in a difficult environment,” he notes, “or you may see some of these traits in someone who has a chemical dependency.”

In those situations, he says, psychiatrists have to be careful with their diagnosis. “We have to look at this person and determine if this is a long-term pattern of behavior or the manifestation of something else,” he says.

Can I tell if I have sociopathy?

It’s possible to hurt someone close to you without realizing it and once you understand it, it can be alarming. And, in some cases, you might begin to worry that you have sociopathy.

According to Dr. Coulter, the answer is probably no. “Most people with an antisocial personality disorder don’t really seek help or treatment or even recognize what they’re doing is problematic,” he points out.

“It really can be an egocentric illness because you do things without the regard for others and it benefits you this way,” he adds. “More often, people find out that they have this diagnosis when someone else tells them.”

If you do grow concerned about a long-standing pattern of behavior that’s problematic, though, Dr. Coulter advises seeking out a mental health professional for evaluation, especially if it’s causing problems in your personal life or at work.

What’s the difference between having psychopathy and sociopathy?

Both psychopathy and sociopathy fall under the diagnosis of antisocial personality disorder, Dr. Coulter notes. But, he adds, that doesn’t mean they’re the same: “Most people with psychopathy meet criteria for antisocial personality disorder but not all people with antisocial personality disorder have psychopathy.”

Those with sociopathy tend to be more erratic and impulsive whereas those with psychopathy are often able to maintain the appearance of stable, normal life. “We make a diagnosis of antisocial personality disorder based heavily on behavior we can see,” he adds.

“With sociopathy, we’re often making the diagnosis based on what we or others see. With psychopathy, the diagnosis is based more on what that person is thinking and how they got to that point.”

What treatments are available for sociopathy?

There are no medications specifically for antisocial personality disorders, says Dr. Coulter. “When we use medication with these individuals, we’re treating aggression, hostility or a co-occurring condition like depression or alcohol use,” he says.

Psychotherapy is often recommended but that can be difficult. “For psychotherapy to be beneficial, the patient has to recognize the issue and want change,” he notes. “Unfortunately, with a condition like this, it doesn’t always pan out.”

There’s not a lot of motivation to work through a course of psychotherapy when so much of what has gotten a person with this condition to that point is a lack of self-awareness or a complete disregard for the consequences of their actions.

How can you deal with someone with sociopathy in your life?

It can be particularly tough, Dr. Coulter says, to deal with a friend or family member who has sociopathy because of that lack of self-awareness. “You can gently recommend a psychiatric or psychological evaluation if their behavior is causing problems, especially if they’re impairing themselves as well as impairing you,” he says.

Because those with sociopathy don’t often recognize what they’re doing is wrong, he says, it’s best to set firm boundaries. “Make sure there’s a limit on how much they can intrude on your rights or limits,” he says. “Have that appropriate distance you’re comfortable with to avoid getting hurt.”

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Mayo Clinic – (no date)

Antisocial personality disorder

Overview

Antisocial personality disorder, sometimes called sociopathy, is a mental health condition in which a person consistently shows no regard for right and wrong and ignores the rights and feelings of others. People with antisocial personality disorder tend to purposely make others angry or upset and manipulate or treat others harshly or with cruel indifference. They lack remorse or do not regret their behavior.

People with antisocial personality disorder often violate the law, becoming criminals. They may lie, behave violently or impulsively, and have problems with drug and alcohol use. They have difficulty consistently meeting responsibilities related to family, work or school.

Symptoms

Symptoms of antisocial personality disorder include repeatedly:

• Ignoring right and wrong.
• Telling lies to take advantage of others.
• Not being sensitive to or respectful of others.
• Using charm or wit to manipulate others for personal gain or pleasure.
• Having a sense of superiority and being extremely opinionated.
• Having problems with the law, including criminal behavior.
• Being hostile, aggressive, violent or threatening to others.
• Feeling no guilt about harming others.
• Doing dangerous things with no regard for the safety of self or others.
• Being irresponsible and failing to fulfill work or financial responsibilities.

Adults with antisocial personality disorder usually show symptoms of conduct disorder before the age of 15. Symptoms of conduct disorder include serious, ongoing behavior problems, such as:

• Aggression toward people and animals.
• Destruction of property.
• Lying and dishonesty.
• Theft.
• Serious violation of rules.

Antisocial personality disorder is considered a lifelong condition. But in some people, certain symptoms ― particularly destructive and criminal behavior ― may decrease over time. It’s not clear whether this decrease is a result of the effect aging has on their mind and body, an increased awareness of the impact that antisocial behavior has had on their life, or other factors.

When to see a doctor

People with antisocial personality disorder are not likely to seek help on their own. If you suspect that a friend or family member may have the condition, you might gently suggest that the person seek help from a mental health provider and offer to help them find one.

Causes

Personality is the combination of thoughts, emotions and behaviors that makes everyone unique. It’s the way people view, understand and relate to the outside world, as well as how they see themselves. Personality forms during childhood. It’s likely shaped by inherited genes as well as life situations and experiences.

The exact cause of antisocial personality disorder isn’t known, but:

• Genes may make you vulnerable to developing antisocial personality disorder — and life situations, especially neglect and abuse, may trigger its development.
• Changes in the way the brain functions may have resulted during brain development.

Risk factors

Certain factors seem to increase the risk of developing antisocial personality disorder, such as:

• Diagnosis of childhood conduct disorder.
• Family history of antisocial personality disorder or other personality disorders or mental health conditions.
• Experiencing abuse or neglect during childhood.
• Unstable or violent family life during childhood.

Men are at greater risk of having antisocial personality disorder than women are.

Complications

Complications and problems resulting from antisocial personality disorder may include:

• Spouse abuse or child abuse or neglect.
• Problems with alcohol or drugs.
• Being in jail or prison.
• Attempting suicide or trying to kill someone else.
• Having other mental health conditions such as depression or anxiety.
• Financial, educational or social problems.
• Dying early, usually because of violence.

Prevention

There’s no sure way to prevent antisocial personality disorder from developing in those at risk. Because antisocial behavior is thought to have its roots in childhood, parents, teachers and pediatricians may be able to see early warning signs. It may help to try to identify those most at risk, such as children who show signs of conduct disorder, and then offer early intervention.

By Mayo Clinic Staff

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WebMD

Sociopaths: Warning Signs and Red Flags

Medically Reviewed by Zilpah Sheikh, MD on December 26, 2023

 Written by Deanna Altomara

• What Is a Sociopath?
• Sociopath vs Psychopath
• Sociopathy Traits
• How to Deal With Someone With ASPD

7 min read

What Is a Sociopath?

Sociopath is an outdated, informal term for someone who has antisocial personality disorder (ASPD). This disorder can cause you to lack empathy, which means you don’t care about or understand other peoples’ feelings. You might not feel remorse for bad things you do, and you might often take advantage of others for your own personal gain. 

Scientists aren’t sure exactly what causes ASPD, but both nature and nurture seem to be involved. You are more likely to have ASPD if you have a family history of the disorder or you experienced something traumatic while growing up. You are also more likely to have it if you are male, had behavioral problems as a child, or grew up in an unstable environment. Many people are unaware of the disorder and may never be diagnosed. 

The word sociopath (and its cousin, psychopath) carries a lot of stigma and misconceptions. Popular movies and books tend to show sociopaths as cruel and heartless. As a result, people often think that those with ASPD are always criminals, but this isn’t true. These stereotypes make it hard for people with ASPD and their families to identify the condition and seek help.

To avoid stigmatizing people with the disorder, it is best to avoid calling someone a sociopath or psychopath. In casual conversation, focus on a person’s problematic behaviors, such as lying or illegal behavior, rather than labeling them a sociopath. When talking about the clinical disorder, say “person with ASPD.” These simple changes lower the shame around the disorder so that people feel more comfortable getting a diagnosis and seeking treatment.

High-functioning sociopath

This is an outdated, non-clinical term that refers to people who have mild ASPD traits or are good at hiding them. As a result, they can be successful in everyday activities like working or going to school. Some may hold highly respected careers, such as a businessperson. They might seem charismatic or charming but are actually manipulative. They might excel in their profession by using or manipulating others. The same can be true in their personal life. 

• RELATED:Treatment-Resistant Depression: Taking Control

It’s harder to tell when someone has high-functioning ASPD, but that doesn’t mean it’s not harmful. Their insincerity and lying can still hurt the people around them.

Low-functioning sociopath 

This is also an outdated, non-clinical term informally used to describe people who struggle to hide their ASPD traits. They might not have the social skills to quietly manipulate and deceive. Instead, they might rely on threats or violence to get what they want. They may also engage in illegal behavior, and they often have other harmful conditions like addiction. ASPD can also be part of another serious mental health condition, such as bipolar disorder.

Borderline sociopath

There is no such thing as a borderline sociopath. ASPD is often confused with a similar condition called borderline personality disorder (BPD). Both are part of a family of disorders called cluster B personality disorders. These tend to cause emotional, unpredictable, and dramatic behavior. People with BPD have mood swings driven by stress, low self-esteem, and fear of abandonment. It’s common for people with ASPD to also be diagnosed with BPD.

Sociopath vs Psychopath

People often confuse the terms sociopath and psychopath and use them interchangeably. They aren’t different in the clinical sense — neither is an official diagnosis. They both refer to someone who has ASPD. You can think of psychopathy as a subset of ASPD with it’s own set of behaviors that set it apart from sociopathy. On the ASPD spectrum, psychopathy is generally seen as a more severe form of ASPD than sociopathy. 

According to research, psychopathy has a stronger genetic association. Scientists think that parts of the brain involved in emotions don’t fully develop. Although sociopathy can also be inherited, abuse and trauma in childhood are more common causes.

Sociopathy Traits

It is important to realize that people have many personality traits. Someone may exhibit selfishness or act aggressively, but that doesn’t mean they have ASPD. Since many people who have ASPD don’t recognize these traits as a problem, watching for consistent behavior patterns is necessary.

• RELATED:Prioritizing Mental Health: Where to Start

These are some common signs of ASPD:

• Lack of empathy for others
• Impulsive behavior
• Attempting to control others with threats or aggression 
• Using intelligence, charm, or charisma to manipulate others
• Not learning from mistakes or punishment
• Lying for personal gain
• Showing a tendency toward physical violence and fights
• Generally superficial relationships
• Sometimes, stealing or committing other crimes
• Threatening suicide to manipulate without the intention of actually doing it
• Abusing drugs or alcohol
• Trouble with responsibilities such as a job, paying bills, etc.

Common things people with ASPD say

People with ASPD can be very manipulative. Some may use outright threats, whereas others hide their intentions with charm or passive-aggressiveness. 

Manipulation can sound like:

• “It wasn’t my fault.” Instead of accepting blame, manipulators might lie about or downplay their role in a conflict. This might make you feel sympathetic. 
• “That’s not true.” People with ASPD often lie to get what they want. 
• “I’ve never met someone as kind as you.” Flattery is used to get your support, and later, favors. 
• “At least you don’t have it as bad as me.” People might use this phrase to invalidate your feelings so you can focus on them instead.
• “Just kidding!” Some people use sarcasm to hide mean remarks.
• “You’re so sensitive.” People with ASPD might say this to make you feel like you’re overreacting to something hurtful they’ve said or done.
• “I did it for you.” This pins the blame on you, not the speaker.
• “If you really loved me, you would do this.” Manipulators might take advantage of your feelings to get their way.
• “If you break up with me, I’ll kill myself.” Manipulators use threats to force you to do what they want.
• “You’re imagining things.” This form of manipulation is called gaslighting. It makes you doubt yourself and your sanity.

How to Deal With Someone With ASPD

The most important thing when you’re dealing with someone with ASPD is to protect yourself. Even though it might be a friend or loved one with the disorder, you have to put your well-being first. Although your first thought might be to help them get treatment, that can be very difficult. People with ASPD are unlikely to seek professional help or even realize they have a problem. 

• RELATED:The Future of Major Depressive Disorder Treatment

To protect yourself, take these steps:

Maintain your boundaries. Keep your interactions with them short and to the point. Avoid engaging with them emotionally, and do not give them any personal information or sensitive details. 

Seek support and guidance. Turn to trusted friends and family members for emotional support. If possible, consult with a mental health professional for further guidance on how to deal with the person with ASPD.

Educate yourself. Learn the signs of ASPD so that you can spot the behaviors and understand their tendencies and motivations.

Avoid confrontation. The situation can quickly escalate and become unsafe. Remain neutral and composed when dealing with someone with ASPD. Showing emotion can leave you vulnerable to manipulation.

Do not try to change them. People with ASPD do not see that they have a problem and it can be very difficult to change their view. It may also cause them to become more enraged, violent, and manipulative. 

If someone you love has ASPD, it can be very isolating. You can get help from a therapist or find a support group. You won’t be able to change your loved one’s behavior, but you can learn ways to understand and cope, or ways to set boundaries and protect yourself.

If you have experienced anxiety and depression as a result, support groups or therapy can help you. Having someone to talk to can make things easier. 

Takeaways

People with ASPD aren’t evil — they have a condition that makes it hard for them to empathize with others or act according to social and societal norms. If you or someone you know has ASPD, talk with a mental health professional. They can provide information about possible treatments or strategies to address manipulative behaviors.

FAQs

Can people with ASPD love their children? 

People with ASPD can love close family members, but they might struggle to connect with anyone else.

What upsets someone with ASPD? 

Many people with ASPD crave love and connection. However, they struggle to empathize with those around them, which makes it hard for them to form meaningful relationships.

What is someone with ASPD’s weakness? 

It is difficult for people with ASPD to control their impulsive and thrill-seeking behavior. This can cause a lot of frustration as well as dangerous outcomes.

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Forbes Health

Sociopath vs. Psychopath: What’s The Difference?

By Becca Stanek Contributor – Expert Reviewed by Deborah Courtney, Ph.D., L.C.S.W., M.A. Mental Health

Published: Jan 28, 2022, 9:21am

You’ve likely heard the terms “sociopath” and “psychopath” before, but what do they actually mean? In fact, neither is a clinical diagnosis, and while both suggest a similar set of traits relating to antisocial behavior and emotional detachment, they have different origins—and varying relevance in today’s scientific community.

Read on to learn more about the differences between a sociopath and a psychopath, from their traits to potential treatment options.

What Is the Difference Between a Sociopath and a Psychopath?

Today, both psychopathy and sociopathy may be used as terms implying an antisocial personality disorder, the official diagnosis for an individual displaying the traits of either term. While there is much overlap between psychopathy and sociopathy, they are not one and the same.

What Is a Sociopath?

The term sociopathy was coined in the era of behaviorism between 1920 to 1950 as a primary psychological theory, but it has since fallen out of use. “This term has not been used in modern science for several decades—for example, you cannot get funding from the National Institute of Health [NIH] to study ’sociopaths,’” says Kent Kiehl, Ph.D, a neuroscientist studying brain imagine, criminal psychopathy and other psychotic disorders in Albuquerque, New Mexico.

When the term was still in use, it was believed that people were born as blank slates and subsequently shaped by their environment or social forces, ultimately resulting in a good or bad personality, says Kiehl. However, this view was determined to be incorrect and, as focus shifted to increasing accuracy and reliability in diagnosis, the term “sociopathy” was dropped from the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) about 20 years ago.

What Is a Psychopath?

Even though the term is not an official diagnosis per the DSM-5, psychopathy remains a term in psychology today to indicate individuals who display high levels of unemotionalism or callousness, as well as impulsiveness or developmental antisocial traits, such as destructive or aggressive behavior.

Symptoms of psychopathy generally appear in early childhood and impact all areas of an individual’s life, including relationships with family, friends, at school and at work. About 1.2% of the adult population has psychopathy, according to a 2021 study in Frontiers of Psychology^[1]. Those with psychopathy tend to display antisocial behaviors, such as a lack of empathy and disregard for the well-being and emotions of others, which can negatively impact relationships both personally and professionally as they struggle to connect and trust the world around them.

Psychopath and Sociopath Traits

The traits of a psychopath and a sociopath are “the same,” according to Kiehl, with both falling under the clinical diagnosis of antisocial personality disorder.

However, in terms of social construction, the two terms are viewed somewhat differently. Specifically:

• Sociopaths tend to act more impulsively and erratically compared to psychopaths.
• Sociopaths generally struggle to maintain a job or a family life, whereas psychopaths may be able to do so.
• While psychopaths generally struggle to form attachments, sociopaths may be able to do so with a like-minded individual.
• Psychopaths may be better able to disassociate from their actions and experience less guilt than sociopaths.

In order for a patient to be diagnosed with antisocial personality disorder, they must display a “persistent disregard for the rights of others,” according to the DSM-5 clinical criteria as listed in the Merck Manual, a medical reference guide. This disregard is indicated by the presence of three or more of the following traits:

• Disregarding the law (such as committing acts that are grounds for arrest repeatedly)
• Acting in a deceitful manner (lying repeatedly, deceiving others for personal gain or using aliases)
• Being impulsive or failing to plan ahead
• Acting irresponsibly on a consistent basis (quitting a job without plans to get another or failing to pay bills)
• Being easily provoked or aggressive (frequently getting into physical fights)
• Failing to feel remorse (feeling indifferent to or rationalizing the mistreatment of others)

However, the most utilized method to assess traits of a psychopath in clinical or forensic work is the Hare Psychopathy Checklist-Revised (PCL-R), says Kieh. The assessment can be used to predict violence and other negative outcomes, as well as explore treatment potential.

The assessment includes 20 items on which individuals are rated on a scale of zero to two based on how much their personality or behavior matches the item’s description. This results in two primary scales—one to measure emotional detachment and one for antisocial behavior—which combine for a total score. The highest score an individual can get on the PCL-R is 40, and a score of at least 30 is needed for someone to be classified as a psychopath.

Items on the assessment include:

1. Glibness/superficial charm
2. Grandiose sense of self-worth
3. Need for stimulation
4. Pathological lying
5. Conning/manipulative
6. Lack of remorse or guilt
7. Shallow affect
8. Callous/lack of empathy
9. Parasitic lifestyle
10. Poor behavioral controls
11. Promiscuous sexual behavior
12. Early behavioral problems
13. Lack of realistic, long-term goals
14. Impulsivity
15. Irresponsibility
16. Failure to accept responsibility
17. Many short-term relationships
18. Juvenile delinquency
19. Revocation of conditional release (meaning someone was granted a conditional release from prison and that release has been revoked.)
20. Criminal versatility

Psychopathy and Sociopathy Causes

While sociopathy—when the term was still in use—was a disorder believed to stem from a person’s environment, psychopathy is believed to arise mostly from biology and genetics with some environmental influence, though research on psychopathy’s causes is ongoing.

“There’s a lot of current research examining how biology/social forces interact and contribute to the development of psychopathic traits,” says Kiehl. “We generally review ‘primary’ psychopathy as coming from a larger biology/genetic component, contrasted with ‘secondary’ psychopathy, which is hypothesized to come from more social forces (such as bad parenting or perhaps trauma as a child) contributing more than biology.”

Risks of Psychopathy

There are a number of risks associated with psychopathy. Indeed, psychopathy is “one of the best predictors of future violence that we know of,” Kiehl notes. Although not all people with psychopathy are physically violent, studies find that while psychopaths account for less than 1% of the general population, they are responsible for between 30% and 50% of all violent crimes^[2].

Still, psychopathy does increase a person’s tendency toward antisocial and aggressive behavior, which can manifest in various ways in school, the workplace and social situations. “Interpersonal relationships are also highly prone to failure,” Kiehl notes.

An affected individual struggles to form trusting bonds and tends to manipulate others and engage in antisocial behaviors, all of which can pose challenges to forming positive interpersonal relationships. That being said, how a person with psychopathy ultimately behaves varies based on the individual, their environment and their community.

When to See a Doctor

Despite common misconceptions about the disorder, psychopathy can be treatable. “Research work suggests good progress in reducing bad outcomes in those who score high on these traits,” Kiehl says.

Possible approaches to treating psychopathy, according to the non-profit organization PsychopathyIs, may include:

• Individual and family-focused therapies
• Residential treatment
• Medication

In general, the organization states that “the most successful approaches to treating psychopathy are multimodal,” meaning they include a number of approaches simultaneously.

Kiehl also emphasizes the importance of addressing issues early. Specifically, factors parents may look for include a lack of guilt, low levels of empathy, fearlessness, a tendency towards deceitfulness and low affiliative behaviors, which are generally those that promote human connection, such as smiling and nodding.

“Generally, the earlier you curb bad tendencies, monitor, prevent consolidation of bad behaviors, etc., the more likely you will prevent the full manifestation of the condition,” he says. “Educating parents is important, [as] it will help to train parents on how to use positive reinforcement, minimize negative reinforcement (it doesn’t work) and help to promote positive outlets.”

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