When I tell people I was diagnosed as a sociopath, the response is usually a mix of astonishment and delight. I get it. Society today is as terrified of sociopaths as it is obsessed with them. People get their definitions from media and entertainment, and both are filled with misinformation that associate sociopaths with danger and little else. But the truth is that the sociopathic personality is far more nuanced than most people realize.
According to the original version of the Diagnostic and Statistical Manual of Mental disorders a sociopath is an individual with a personality disorder, the hallmarks of which are antisocial behavior and trouble conforming with the “prevailing cultural milieu.” Today, the term sociopathy — much like the people it represents — has all but disappeared under the general heading of antisocial personality disorder. Hardly anyone knows what the word means anymore.
But I’d like to change that.
In attempting to define the sociopathic personality, it is generally agreed that sociopathy, psychopathy, and ASPD are used to describe the same disorder. But it is also understood that these terms vary in their representation of severity. They’re like uniquely-shaped pieces of the same puzzle. As a result, they require different psychological diagnostic tools to be identified
I prefer to think of sociopathy, psychopathy, and antisocial personality disorder as different shades of the same color. That is why, for the purposes of this post, I intend to identify them based on their diagnostic measures. Remember, these terms do not represent different disorders. Rather, they are used in concert to illustrate the spectrum along which a single disorder resides.
Confused? Don’t worry. It gets easier (sort of).
Sociopathy vs Psychopathy vs Antisocial Personality Disorder
Psychopathy is a personality disorder with traits that include shallow emotional affect, reduced capacity for empathy, and poor behavioral control. A measure called the PCL-R (Psychopathy Check List – Revised) is considered to be the gold standard in diagnosing psychopathy.
Psychopathy, as measured by the PCL-R, demonstrates varying degrees of severity. In attempting to differentiate between what is considered to be the extreme (and quite rare) category of psychopath and the lesser (and more common) version, researchers have relied on terms such as “primary” and “secondary” psychopathy. Others have used the more widely-recognized label of sociopathy.
Sociopathic personality disorder was the term that was used in my psychological assessment. Therefore I will use the term “sociopath” to describe the more moderate version of this personality type. Conversely, I will use the term “psychopath” when referring to the more extreme version.
The biggest difference between sociopathy and psychopathy (as measured by the PCL-R) is biology. Psychopaths are believed to suffer from abnormalities in the brain which make it all but impossible for them to experience compassion or remorse. This predisposes them to engage in extreme types of antisocial behavior with zero regard for other people. But more problematic is that this abnormality also renders them immune to traditional methods of treatment. Psychopaths are widely considered to be biologically incapable of empathy, so they are believed to not have access to the full range of human emotions.
When speaking in terms of emotions, it’s important to separate the inherent from the learned. The psychologist Robert Plutchik did just this when he identified the eight fundamental or “primary” emotions: anger, fear, sadness, disgust, surprise, anticipation, trust, and joy.
According to Plutchik, everyone – including psychopaths – experiences primary emotions because they are hard-wired in the brain. We are all born with them. But there is another set of emotions that are not hard-wired. Reactions like guilt, shame, remorse, and love belong to another category of feelings known as the “social” emotions. Unlike the ones on Plutchik’s list, social emotions are not inherent. They are learned.
Social emotions are learned by observing the emotions, behavior, and thought process of other people. If a typical child does something to make his mother sad, for example, he will observe that reaction and be negatively affected by it. In this way the child learns to feel guilt. Psychopaths are incapable of this. Psychopaths are not affected by the feelings of others and are therefore extremely unlikely to internalize social emotions.
As children, psychopaths are not receptive to socialization. They don’t care about blending into society nor are they bothered by punishment or disapproval. They don’t make the connection between antisocial behavior and punishment. They don’t learn to establish relationships with others. As a result they are unable to progress through the so-called normal stages of development, and are typically diagnosed with conduct and/or antisocial personality disorder at an early age.
Primary or true psychopathy is believed to be fairly rare – affecting roughly one percent of the population. Because it is so uncommon, psychopathy hasn’t drawn the necessary attention required to foster further research. Sociopathy, on the other hand, is believed to be far more common – roughly five percent more common (and I believe this is an extremely low estimate). This is why I believe that it is so important not only to distinguish this disorder as a less extreme version of psychopathy, but also to understand it.
Let’s take a look at some of the traits characterized by the sociopathic personality, as measured by the PCL-R: deceitfulness, a failure to conform to social norms, disregard for lawful behavior, aggressiveness, emotional shallowness, lack of remorse and guilt, superficial charm, manipulativeness, and lying.
As we discussed above, most of these traits are similar to those exhibited by the psychopath. The difference is that psychopaths are believed to act this way because of biological defects. Sociopaths, on the other hand, are thought to do so because of environmental stressors. Sociopaths are capable of internalizing guilt. They are capable of experiencing anxiety and they are able to learn how to empathize. Their sociopathic behavior is not a symptom of biological shortcomings. It’s actually a type of defense mechanism.
Sociopaths do not suffer from brain abnormalities, but researchers believe they are born with temperaments that make socialization difficult. I liken this disposition to an emotional learning disability. Although sociopaths are physically capable of learning how to empathize, they struggle with the concept of remorse and the ability to process emotion. This makes the empathic learning process a difficult one.
Difficult… but not impossible.
The Sociopathic Child
Imagine two kids at their first tennis lesson. One kid is an obvious prodigy. She picks up the racquet and is immediately comfortable with the swing. She hits most of the balls and has the spatial recognition to correct her mistakes. She’s a pro in the making.
The other kid isn’t so lucky. She swings and misses repeatedly. She trips over the ball. Her hand/eye coordination is terrible and she’s very clumsy. Both kids are physically capable of learning to play tennis properly, but the second kid is going to need a lot more lessons.
Sociopaths are like the second kid in this analogy. Only instead of being mediocre athletes with bad swings and clumsy feet, they are social outliers with limited emotional range and a penchant for lying.
Research tells us that “normal” children are born with a temperament that makes socialization (and the learning of social emotions) close to instinctual. This innate disposition makes them highly receptive to traditional concepts of guilt, wrong versus right, and good versus evil. In most cases if you tell a kid not to do something because it is bad, he will internalize it, feel guilty about it, and eventually stop doing it. He will become conscientious, which is “the general preference to avoid antisocial behavior”.
But sociopathic children aren’t like this. Sociopaths are born with temperaments that make socialization difficult. As I explained earlier, it’s akin to having an emotional learning disability. Psychopaths are not believed to be able to overcome this disability due to biological defects. But sociopaths (a.k.a. secondary psychopaths, as diagnosed by the PCL-R) do not have these defects. This means they are capable of learning social emotions in spite of having a temperament that makes it difficult. Their innate disposition is not emotionally turn-key so the process of learning socialization takes a bit more time.
Children who are sociopaths don’t have an automatic guilt response and they are not concerned with altruism. They don’t respond to shame and they aren’t inherently worried about the feelings of others. When told he shouldn’t do something because it is wrong or bad, the sociopathic child’s reaction is usually one of, “So what?”
This is not because he is a bad kid but because he has a harder time learning social emotions. This child needs more than, “Because it is wrong.” Sociopathic children don’t automatically grasp these concepts. But just because empathy doesn’t come naturally to these types of children doesn’t mean it won’t come at all. Sociopathic kids just need a little extra help.
One problem is that parents in today’s society are completely unprepared to deal with these types of kids. This is especially true in single-parent households where there is often barely enough time to socialize normal children much less ones with emotional problems. Dozens of researchers have studied the relationship between single-family households and antisocial behavioral patterns and have discovered that children raised in single-parent homes are far more likely to display sociopathic traits. But single moms and dads aren’t the root of the problem.
Modern parenting techniques are designed for “normal” kids – and only these kids. So when parents find themselves with a child that doesn’t seem to care about rules or basic principles of normal behavior, there is nowhere to go for help. There are no books to read about sociopathic kids, there are no psychologists to visit, there are no support groups to attend or online tips to research. Socializing a sociopath is hard and despite doing the best they can, most parents simply don’t know how to do it.
Without the introduction to socialization they are expected to receive at home, sociopathic children generally have a difficult time at school. They don’t understand basic social mores and are subsequently rejected by other kids. After this happens enough times, these children start to hide their behavior and learn to mimic the reactions and behaviors of their classmates so that they won’t be rejected. They teach themselves what normal looks like, but don’t ever internalize it.
Better grades, better relationships with teachers, better chances for college, better prospects for career – everything is better for the person who appears to be normal. So sociopaths hide. They lie. They manipulate. They learn to become master impersonators and they blend right in. Sociopaths can’t help the fact that they aren’t naturally remorseful. This is a symptom of their personality type and they have no control over it. So they conceal it. They deal with the symptom but not the disease, and they usually have to do it on their own.
Sociopaths have little choice but to deal with their problems by themselves because most psychologists don’t know how to help, don’t even know that they can help. The disorder is largely perceived as untreatable, and many “experts” in the field claim there is no cure for sociopathy. But that’s not what the research says.
Research indicates that while there are limited treatment methods appropriate for primary psychopathy, sociopathy is actually quite receptive to certain types of treatment. Therapeutic interventions — including those targeting anxiety and re-socialization, for example — are known to be very effective for the treatment of sociopathy. But in order to benefit from such treatments, sociopaths must first get a correct diagnosis.
The Antisocial Personality
One of the biggest obstacles in the identification of sociopathy (and psychopathy) is the commonly held misconception that it must be diagnosed using the criteria for antisocial personality disorder (or ASPD). Let me cut straight to the chase on this point: It’s not.
When attempting to diagnose any mental illness, therapists refer to the Diagnostic and Statistical Manual of Mental Disorders, which (as of early 2021) is currently in its fifth edition. The DSM is published by the American Psychiatric Association. Typically, psychologists refer to it when attempting to diagnose someone they believe might fall on the antisocial spectrum.
This is where things get complicated.
Although psychopathy, sociopathy, and antisocial personality disorder are generally agreed to define the same general disorder, their diagnostic measures are actually quite different. Here is a good example:
The DSM-5 offers a clear set of diagnostic guidelines for antisocial personality disorder. When attempting to gain a precise diagnosis for psychopathy or sociopathy, however, it is generally agreed that the PCL-R is a more reliable test. This is because the PCL-R is specifically designed to test for more extreme versions of this personality type.
Unfortunately, in order to be considered as a candidate for the PCL-R, many clinicians believe that a patient must first be diagnosed as having antisocial personality disorder. This would appear to make sense, considering that ASPD, psychopathy, and sociopathy all represent varying degrees of the same disorder. The problem is that many people with psychopathy and sociopathy (myself included) do not meet the diagnostic qualifications for antisocial personality disorder. And the reason is because a lot of these qualifications are based on conduct.
According to the DSM-5, a diagnosis for ASPD is appropriate for those who have repeatedly exhibited acts that are grounds for arrest, have been expelled from school, have been the aggressor in repeated physical assaults, and who are consistently irresponsible.
But this diagnosis is usually only considered applicable if the patient in question has engaged in such behaviors prior to the age of fifteen. What this means is that an antisocial diagnosis is only applicable to people who acted up as kids and got caught doing it.
This is the problem.
We’ve already learned that because of their social anxiety and fear of rejection, sociopaths are better off staying under the radar. With that in mind, do you know how many of these kids have taught themselves how to be invisible?
Trying to diagnose a sociopath based on conduct criteria is like trying to fish with a giant hole in your net. You might catch a few, but most of us are figuring out very quickly how to swim through the opening.
I went to dozens of therapists, all of whom told me that I couldn’t be labeled a sociopath because I hadn’t met the criteria for antisocial personality disorder. And the reason I hadn’t met this criteria was not because my behavior wasn’t overtly antisocial. I simply hadn’t been expelled, arrested, or red-flagged as having conduct disorder by a mental health professional at any point in my life.
Never mind the fact that I struggled with empathy. Never mind that I exhibited little to no remorse. Never mind the fact that I was callous, manipulative, or that my sociopathic behavior (at the time) was increasing in severity. Based on the DSM criteria at the time, I could not be diagnosed as antisocial. And – because I wasn’t antisocial – I wasn’t considered a proper candidate for the PCL-R.
Fortunately for me, I got lucky. I kept trying. I continued to seek treatment until I found a therapist who was able to distinguish the disorder from the diagnostic criteria. But what about all of the others?
What about the sociopaths, who are believed to represent anywhere from four to eight percent of the population? If the DSM criteria is limited to the diagnostics for antisocial personality disorder (and many sociopaths do not meet the criteria for ASPD), then how are those classified as sociopathic by the PCL-R supposed to get help?
Right now they can’t. And this is mostly because the mental health field lags behind the research in both its understanding and diagnostic criteria for the disorder. This has created a giant diagnostic loophole that some of the most troubled and potentially dangerous individuals are slipping right through. But there is a silver lining.
Sociopaths are capable of self-awareness and self-control. This means they are able to learn from their mistakes and are entirely capable of indulging in either good or bad behavior when it is in their best interests to do so. With practice they can turn their sociopathic tendencies on or off like a switch. And the biggest indicator that any of this is possible is the presence of anxiety among sociopaths.
The Anxious Sociopath
Anxiety plays a huge role in the life of a sociopath. Studies show that sociopaths score relatively high on tests related to anxiety, and many researchers believe that these individuals experience a great deal of anxiety when engaging in destructive behavior. But this is actually good news.
The fact that sociopaths suffer from anxiety is what makes many professionals believe they can be treated. One of the first psychiatrists to understand this was Dr. Benjamin Karpman.
Karpman’s extensive case studies revealed that psychopaths behave antisocially without fear or remorse. Sociopaths, however, engage in similar antisocial behavior but experience considerable anxiety in the process. Dr. Karpman’s research indicates that the underlying cause of sociopathy is acute anxiety, and that this anxiety is the direct result of environmental stressors.
Karpman isn’t the only researcher to have established a link between sociopathy and anxiety. Dr. David Lykken is also well known for his progressive work studying sociopaths. Lykken took Karpman’s theory a step further and studied the behavioral motivators of thirty-nine individuals he identified as sociopaths using the PCL-R.
While testing these subjects, Lykken found the sociopaths scored higher than expected on anxiety tests. He also found that they were likely to learn from mistakes and were able to control inappropriate responses. From this and other studies he conducted, Lykken theorized that the antisocial behavior exhibited by many sociopaths was driven by anxiety associated with frustration or inner conflict. What’s more, he believed that this anxiety was treatable.
Lykken later expanded his studies to include sociopathic children and reached a similar conclusion. His research discovered that sociopathic youths also suffer from acute anxiety, and that their sociopathic behavior is a defense against rising anxiety. He concluded that this anxiety is largely driven by exclusion from prosocial peer groups.
Sociopathic kids don’t “grow out” of their personality. It isn’t “just a phase”. They simply learn to hide their behavior so they aren’t caught. At least the smart ones do. They start hiding in plain sight, but they never truly make friends. They never truly fit into regular society. They just grow up. They get jobs at places where they aren’t understood. They endure relationships with people who don’t really know them. All the while their anxiety grows and grows.
The human brain didn’t evolve to function without access to emotion. Apathy can be scary, even for a sociopath. In the absence of feeling, individuals will do almost anything to force an emotion, a “jolt” of feeling. I spent the greater part of my early life doing just that — self-medicating through destructive behavior in order to feel. I didn’t do this because I was bad, but because my brain was trying to right itself into emotional homeostasis.
A researcher named Linda Mealey proposed that sociopaths are simply psychologically disadvantaged people who use manipulative behavior and cheating strategies to “make the best of a bad job.” I couldn’t agree more, but I believe Jessica Rabbit described it best when she said, “We’re not bad, we’re just drawn that way.”
Sociopaths are not bad people; we just have an emotional learning disability that makes bad behavior an easier choice. We rarely have to deal with the consequence of regret – a social emotion – so deciding to do the right thing is just that, a decision. It’s not something we are compelled to do based on shame or guilt.
I understand this first-hand. As a sociopath, I can’t be blamed for the way that I feel (or don’t feel). I can only be blamed for my actions. So I try to make the right decisions because I want to make them, since – unlike most – I am not compelled to make them.
Mealy’s stance on the intervention/treatment of sociopathy addresses these disadvantages as well as the urge many sociopaths have to pretend to be someone they’re not. She proposes classes that encourage self-acceptance among sociopaths, and suggests therapy for underlying anxiety as treatment for the disorder.
I couldn’t agree more.
Instead of wandering through life alone and trading one social mask for another, sociopaths should be encouraged to be themselves. They should be taught to respect the psychological facets of their personalities while moderating the behavioral ones. Most importantly, they should be showered with compassion.
It might sound counter-intuitive, but sociopaths are in desperate need of empathy. This might not be a concept to which they can relate, but it is certainly one from which they can benefit. After all, how can anyone be expected to demonstrate compassion if they have never witnessed it for themselves?
I can tell you from experience that empathy is a game changer for sociopaths. Once I knew I wasn’t alone, once I understood that I wasn’t “bad,” and once I was taught that my personality type was not “wrong” but different… that is when the anxiety began to lessen and the destructive urges began to cease. That’s why I started this blog. Because I wanted to do for others what someone once did for me: demonstrate empathy.
Empathy is a psychological skeleton key. It opens every door. It softens every stance. To empathize with someone is to relate to them. To relate is to understand. Understanding the personality of sociopaths is the first step in seeing these people as human beings – not monsters.
Sociopaths aren’t bad; they’re just drawn that way. In fact, a lot of us are quite friendly. And why wouldn’t we be? Ours is a personality type unlike anything else — one that is full of perks and surprises. Trust me: You’d be amazed. You just have to know where to look.
How about you? Are you someone whose personality is hidden? Do you struggle with destructive urges and antisocial behavior? Has this blog post hit a nerve? Do these definitions and explanations make sense? Do you recognize yourself in these words? Do you recognize someone you love?
If so then I want to help you. A sociopathic diagnosis isn’t a death sentence. It also doesn’t have to be “bad,” or scary or lonely or without hope. All it takes is a little understanding and a willingness to learn.
Trust me. I’ve been there.