Sociopath vs. psychopath: is there a difference?

Posted on February 16, 2015 by luckyotter

I’ve been using the terms psychopath and sociopath interchangeably on this blog, even though I’m aware there are differences between the two. I was curious enough to Google what the difference is, and came across an article in Psychology Today that explains how they are alike–and how they differ.

How to Tell a Sociopath from a Psychopath
By Dr. Scott Bonn

Many forensic psychologists, psychiatrists and criminologists use the terms sociopathy and psychopathy interchangeably. Leading experts disagree on whether there are meaningful differences between the two conditions. I contend that there are clear and significant distinctions between them.

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), released by the American Psychiatric Association in 2013, lists both sociopathy and psychopathy under the heading of Antisocial Personality Disorders (ASPD). These disorders share many common behavioral traits which lead to the confusion between them. Key traits that sociopaths and psychopaths share include:

A disregard for laws and social mores
A disregard for the rights of others
A failure to feel remorse or guilt
A tendency to display violent behavior
In addition to their commonalities, sociopaths and psychopaths also have their own unique behavioral characteristics, as well.

Sociopaths tend to be nervous and easily agitated. They are volatile and prone to emotional outbursts, including fits of rage. They are likely to be uneducated and live on the fringes of society, unable to hold down a steady job or stay in one place for very long. It is difficult but not impossible for sociopaths to form attachments with others. Many sociopaths are able to form an attachment to a particular individual or group, although they have no regard for society in general or its rules. In the eyes of others, sociopaths will appear to be very disturbed. Any crimes committed by a sociopath, including murder, will tend to be haphazard, disorganized and spontaneous rather than planned.

Psychopaths, on the other hand, are unable to form emotional attachments or feel real empathy with others, although they often have disarming or even charming personalities. Psychopaths are very manipulative and can easily gain people’s trust. They learn to mimic emotions, despite their inability to actually feel them, and will appear normal to unsuspecting people. Psychopaths are often well educated and hold steady jobs. Some are so good at manipulation and mimicry that they have families and other long-term relationships without those around them ever suspecting their true nature.

When committing crimes, psychopaths carefully plan out every detail in advance and often have contingency plans in place. Unlike their sociopathic counterparts, psychopathic criminals are cool, calm, and meticulous. Their crimes, whether violent or non-violent, will be highly organized and generally offer few clues for authorities to pursue. Intelligent psychopaths make excellent white-collar criminals and “con artists” due to their calm and charismatic natures.

The cause of psychopathy is different than the cause of sociopathy (1). It is believed that psychopathy is the result of “nature” (genetics) while sociopathy is the result of “nurture” (environment). Psychopathy is related to a physiological defect that results in the underdevelopment of the part of the brain responsible for impulse control and emotions. Sociopathy, on the other hand, is more likely the product of childhood trauma and physical/emotional abuse. Because sociopathy appears to be learned rather than innate, sociopaths are capable of empathy in certain limited circumstances but not in others, and with a few individuals but not others.

Psychopathy is the most dangerous of all antisocial personality disorders because of the way psychopaths dissociate emotionally from their actions, regardless of how terible they may be. Many prolific and notorious serial killers, including the late Ted Bundy and John Wayne Gacy, and Dennis Rader (“Bind, Torture, Kill” or BTK) are unremorseful psychopaths. Psychopathic killers view their innocent victims as inhuman objects to be tormented and violated for their amusement.

Contrary to popular mythology, most serial killers are not mentally ill or “evil” geniuses. See my related article: http://www.psychologytoday.com/blog/wicked-deeds/201406/serial-killer-myth-1-theyre-mentally-ill-or-evil-geniuses

Although both were deadly serial killers, Ted Bundy was a psychopath who gave a good impression and knew how not to get caught; Ed Gein was most likely a sociopath who acted more impulsively, was more disorganized and didn’t give a very good first impression. Though both men’s crimes were equally heinous, Bundy’s eyes seem “colder” than Gein’s.

Although the traits of a psychopath more closely resemble those of a person with Narcissistic Personality Disorder (NPD) than those of the more impulsive, disorganized sociopath, both are actually described here as variations of ASPD, not NPD. Once again, if ASPD is really “NPD on crack” then it follows that NPD and ASPD are both on the same spectrum, with ASPD (and psychopathy/sociopathy) at the top of the spectrum. If this is in fact the case, people with NPD, even malignant narcissists, may border on psychopathy, but would not actually qualify as true psychopaths.

Here’s a little graph I devised to illustrate where all the Cluster B disorders may fall on a spectrum. These are just my guesses and are not based on psychological research, just my instinct and gut feelings.

Click image to enlarge.

Is antisocial personality disorder really NPD on crack?

Posted on February 12, 2015 by luckyotter

I have to admit I’ve been confused by the distinctions between the Cluster B personality disorders, especially those of NPD and ASPD. There seems to be little distinction in most literature between NPD and ASPD (antisocial personality disorder) with most experts saying the difference is just a matter of degree, with ASPD (psychopathy or sociopathy) being higher on the spectrum than NPD.

Let’s turn to the Bible of mental disorders for some clarification. These are from the DSM IV-TR, but have apparently been updated, because these descriptions are all labeled obsolete. But for our purposes, I’ll stick with these criteria.

Diagnostic criteria for 301.81 Narcissistic Personality Disorder

A pervasive pattern of grandiosity (in fantasy or behavior), need for admiration, and lack of empathy, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) has a grandiose sense of self-importance (e.g., exaggerates achievements and talents, expects to be recognized as superior without commensurate achievements)

(2) is preoccupied with fantasies of unlimited success, power, brilliance, beauty, or ideal love

(3) believes that he or she is “special” and unique and can only be understood by, or should associate with, other special or high-status people (or institutions)

(4) requires excessive admiration

(5) has a sense of entitlement, i.e., unreasonable expectations of especially favorable treatment or automatic compliance with his or her expectations

(6) is interpersonally exploitative, i.e., takes advantage of others to achieve his or her own ends

(7) lacks empathy: is unwilling to recognize or identify with the feelings and needs of others

(8) is often envious of others or believes that others are envious of him or her

(9) shows arrogant, haughty behaviors or attitudes

Diagnostic criteria for 301.7 Antisocial Personality Disorder

A. There is a pervasive pattern of disregard for and violation of the rights of others occurring since age 15 years, as indicated by three (or more) of the following:

(1) failure to conform to social norms with respect to lawful behaviors as indicated by repeatedly performing acts that are grounds for arrest
(2) deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure
(3) impulsivity or failure to plan ahead
(4) irritability and aggressiveness, as indicated by repeated physical fights or assaults
(5) reckless disregard for safety of self or others
(6) consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations
(7) lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another

B. The individual is at least age 18 years.

C. There is evidence of Conduct Disorder with onset before age 15 years.

D. The occurrence of antisocial behavior is not exclusively during the course ofSchizophrenia or a Manic Episode.

Just for comparison’s sake, let’s include the (obsolete) criteria for the other two Cluster B disorders: BPD (Borderline Personality Disorder) and HPD (Histrionic Personality Disorder):

Diagnostic criteria for 301.83 Borderline Personality Disorder

A pervasive pattern of instability of interpersonal relationships, self-image, and affects, and marked impulsivity beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) frantic efforts to avoid real or imagined abandonment.
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(2) a pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

(3) identity disturbance: markedly and persistently unstable self-image or sense of self

(4) impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, Substance Abuse, reckless driving, binge eating).
Note: Do not include suicidal or self-mutilating behavior covered in Criterion 5.

(5) recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

(6) affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

(7) chronic feelings of emptiness

(8) inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

(9) transient, stress-related paranoid ideation or severe dissociative symptoms

Diagnostic criteria for 301.50 Histrionic Personality Disorder

A pervasive pattern of excessive emotionality and attention seeking, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

(1) is uncomfortable in situations in which he or she is not the center of attention

(2) interaction with others is often characterized by inappropriate sexually seductive or provocative behavior

(3) displays rapidly shifting and shallow expression of emotions

(4) consistently uses physical appearance to draw attention to self

(5) has a style of speech that is excessively impressionistic and lacking in detail

(6) shows self-dramatization, theatricality, and exaggerated expression of emotion

(7) is suggestible, i.e., easily influenced by others or circumstances

(8) considers relationships to be more intimate than they actually are

It does seem that ASPD is more linked to criminality than NPD, most likely due to poor impulse control, which isn’t a problem in people with NPD. People with ASPD are more willing to break the law and are more likely to be in prison. They are less likely to be concerned with image or consequences of their actions (most people with NPD want to maintain their sqeaky clean image which means staying out of prison). Antisocials also seem more prone to violent behavior.

The DSM criteria for ASPD seem to describe psychopathy/sociopathy. Most narcissists are probably not psychopaths, but are on the same spectrum. Does this mean that ASPD and NPD should really be considered the same disorder, with ASPD higher on the psychopathy spectrum?

BPD is more clearly distinguishable from ASPD and NPD because a person suffering from this disorder does have a conscience and can feel empathy and remorse, but like someone with ASPD they have problems with impulse control. Also, their motives for doing what they do are different: they fear abandonment, while people with ASPD and NPD fear their true self being exposed.

HPD seems very similar to the somatic form of narcissism and includes many narcissistic traits. However, it seems that someone with HPD would be more prone to drama, neediness and tantrum throwing (although these traits aren’t unknown in narcissists). Like BPD, the motives for the sufferer’s behavior seem based on insecurity and fear of abandonment rather than the need to maintain a false front.

NPD and ASPD are more common in males than females, and HPD and BPD are more common in females than males. Does gender determine what disorder a child is more likely to develop later in life? Are BPD and HPD really the “female” forms of the other two disorders?

ASPD almost seems like an exaggeration of typically male traits–aggressiveness, lack of emotion (except rage), and risk taking; whilst HPD seems like an exaggeration of typically female traits — excessive emotionality, preoccupation with beauty/sexiness, and excessive neediness. BPD and NPD are somewhere in between these two and can include elements of both: ASPD –> NPD –> BPD –> HPD

The fact that the American Psychiatric Association keeps changing their criteria just makes things even more confusing.

Grandiose and “vulnerable” narcissists: how do they differ?

Posted on February 7, 2015 by luckyotter

Both the beggar and the king could be narcissists with a different M.O.

An interesting article in Psychology Today explains the difference between grandiose (invulnerable) narcissists, and “vulnerable” narcissists. Either can be somatic or cerebral, and either can also be malignant or non-malignant.

The two kinds of narcissists can seem very different on the surface:

Grandiose narcissists can seem emotionally cold, convinced of their achievements or success, and rarely if ever talk about their fears or their problems. They can be very quick to judge others though. On the surface they seem strong and tough. You won’t see them show emotions other than rage or pride, and if they are ever sad or fearful, you will never see that side of them. Like all narcissists, they are never happy,but they can “act” happy if they need to. And like all narcissists, they are incapable of love but may be able to put on a show of “falling in love” to obtain a new source of narcissistic supply.

Grandiose narcissists are the CEOs, politicians, narcissistic celebrities and others who have achieved a high level of success. Those who haven’t achieved success will stop at nothing to rise to the top, even if it means destroying their competition in the process. They are ruthless predators. Our current society glorifies the traits of the grandiose narcissist and doesn’t seem to bemoan what they don’t have: the ability to show emotion and feel love or empathy. Grandiose narcissists don’t care what others think of them.

Vulnerable narcissists, rather than brag about their achievements and never showing their feelings, are given to bouts of self pity, and use emotions (like crying, whining, demanding, or sulking) to manipulate others into giving them what they want. They are less likely to be materially successful, and may be dependent on others for their survival. In fact, they may seem to take a kind of perverse pride in their failures and hard luck. Vulnerable narcissists are the emotional and financial vampires who will suck your funds dry and constantly demand attention and comfort for their many problems. They are high-maintenance “drama queens.” They seem to have no self esteem. They will wear down their sources of supply with their constant demands and mind games. Both types of narcissists will shamelessly manipulate others to have their way.

…narcissists feel emotions like vulnerability, sadness, empathy and compassion in a shallow way, if at all, and cover them up with rage, blame, manipulation and disdain for others. This coping mechanism has a heavy price: they don’t feel secure enough to relax and really feel happiness and joy, although they may have fleeting moments of those emotions.

Vulnerable narcissists tend to swing back and forth between acting superior and feeling hurt; may become self-destructive when their vulnerabilities are pointed out; they may accuse their spouse or significant other of having affairs and being unfaithful, and may resort to spying on their partner or constantly asking for reassurance. They also have a pattern of looking for the “perfect mate” and then demand constant reassurance they are loved and valued.

Grandiose narcissists have much in common with people with Antisocial Personality Disorder; while vulnerable narcissists have more in common with people who have Borderline Personality Disorder. Both of these disorders, along with NPD and Histrionic Personality Disorder, comprise the Cluster B (dramatic) personality disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM). It can be very difficult to distinguish those who have NPD from those suffering from one of the other two disorders.

Grandiose narcissists were more likely to have been spoiled as children and treated like a little king or queen by their families; vulnerable narcissists are much more likely to have been abused or neglected as children.

But both types are still narcissists, so they still have many things in common under the surface, especially their sense of entitlement, lack of empathy and inability to feel joy.

According to the Psychology Today article, the main difference between vulnerable narcissists and and invulnerable narcissists is in the way they feel:

With their fragile self-esteem, vulnerable narcissists experience helplessness, anxiety, and depression when people don’t treat them as they desire.

They feel shamed and humiliated by negative feedback or when others challenge their superior self-image. They also experience anxiousness, bitterness, dissatisfaction, and disempowerment.

They suffer from many BPD-like emotions, like feelings of emptiness and inadequacy. Others find them sensitive and emotional; preoccupied with fears of rejection and abandonment. They are touchy, quick to be offended, and easily provoked.

A vulnerable narcissist may seem “nice” at first, but their constant demands will wear you out and they will never ask you how your day was or how you feel. They don’t care. Vulnerable narcissists may seem sensitive but they are only sensitive about themselves and how others feel about them; they are oblivious (or just don’t care) if you are suffering or have been hurt or need to talk. They are unable to give love in return for the love they demand. They cannot feel joy or ever appreciate anything. They are vampires who will keep taking until you have nothing left to give–or leave.

Earlier I said both types of narcissists can be somatic or cerebral. My guess is that women, who are more likely to be somatic narcissists, are also more likely to be the “vulnerable” type of narcissist. Acting needy and helpless are traits that are still found more socially acceptable in females than in males. That being said, I’ve known several males of the vulnerable type and some of them are cerebrals. My ex-husband is a great example of a “vulnerable” cerebral narcissist.

I also think it’s possible to be both types at once, swinging back and forth between acting invulnerable/grandiose and vulnerable/helpless. Their dramatic mood swings would probably make this hybrid type of narcissist easily misdiagnosed as suffering from the manic-depressive form of Bipolar Disorder.

A narcissist can also be vulnerable in one area of their life and grandiose in another. The high achieving company president who never seems ruffled and terrifies his underlings may go home to his wife and demand attention and sympathy from her, and sulk or whine if he doesn’t get it. The snobbish, perfectly groomed and physically fit trophy wife may fall apart and act helpless and needy if forced to look for a job.

Respect my boundaries!

Posted on January 12, 2015 by luckyotter

My daughter is either a somatic histrionic narcissist (same as my mother) or has borderline personality disorder (BPD) in addition to diagnosed PTSD and bipolar disorder. She would be somatic if she’s got NPD because she’s obsessed with clothes and shopping and she takes more selfies than every Hollywood starlet put together in one room. She’s very attractive and she knows it and has been able to use her looks to get what she wants, at least from males.

But due to her intense mood swings and the fact she does show some empathy and remorse, then she’s also likely to be be a borderline, a related Cluster B disorder which is more common in women than in men (narcissism is more common in men) but has much in common with NPD. Whatever she is, she’s a high maintenance drama queen. I’ve joked with her that she’d be perfect for a reality show like “Bad Girls Club,” but to be honest, I could definitely see someone like her on a show like that!

Of course I love my daughter dearly and enjoy her company too (she can be a lot of fun and easy to talk to, which is why she makes friends easily) but her disorders definitely make her difficult to deal with, especially now that she’s moved back in with me.

She has been home for almost two weeks. Things have been going swimmingly (okay, maybe that’s a slight exaggeration) and there have been no real problems. I read her the riot act on her return and she agreed to some new rules. She does not appear to be doing drugs and is taking steps to get her life in order, including seeing a therapist this week. I told her if I saw pain pills or any other evidence of hard drugs, there was the door.

But tonight she invaded my boundaries. She had gone to the mall with some friends, and came home in an upbeat mood, which was fine, but my daughter also gets a little obsessive and impatient when she’s excited and happy, and has a bad habit of not respecting my boundaries. I also think she’d had a drink or two.

Because there are only two bedrooms (my roommate has the other one) and I took over Molly’s bedroom when she had moved in with Paul (and I won’t give it up!) she has been having to sleep on the couch in the living room. She’s turned it into a large bedroom and it actually looks nice, if a bit cluttered. I almost never have company anyway, so it’s not like I really need a living room.

But tonight when she got home at about 10:30 she wanted to pull some more of her things from my room (things she never uses and didn’t need tonight). I told her it was late, I have to be up early for work (and to drive her to the DMV) and I needed some alone-time before going to bed. I needed time online too. As an Aspie, she knows if I don’t get my “alone time” I get very cranky and snappish. I do not like my Aspie routine to be interrupted. She knows this well.

But she kept rummaging around in all the drawers and pulled boxes out of the closet, tossed shoes and bags and papers and stray clothes all over the floor, messed up my things in the process, and was making a racket doing so. I must have told her three times or more to please do this tomorrow, but she wouldn’t listen and kept saying “one more minute!” But it wasn’t one more minute, it wasn’t three more minutes or five or twenty: this shit went on for almost an hour. I was ready to scream and pull my hair out.

When she finally finished tearing my room apart looking for her things, she took them into the living room. Then she decided she needed to find a place to plug in her humidifier (she suffers from dry sinuses and mild asthma). She proceeded to start unplugging things from the wall, including the damned router. It took me another twenty minutes to get connected to the Internet again. I actually burst into tears of frustration (the kind of tears I shed more than any other kind–it’s almost impossible for me to cry when I’m sad).

It wasn’t that this was something that couldn’t be fixed easily, but I’d had more than enough. I was so stressed and completely frustrated with my daughter and the chaos she was creating and the boundaries she was violating due to her inability to wait for anything. She wants what she wants when she wants it.

In a near rage, tears streaming, I’m afraid I snapped and told her I wished she never moved back in because she had no respect for my boundaries or anything else. She started to cry, and I told her I was sorry and apologized. She asked me if I really meant what I said and I told her no truthfully. I explained again why I need my quiet time at night and why it was a bad time for her to decide to redecorate. She said she understood…but does she?

Time will tell.

Narcissists who use 12-step programs to further their agenda

Posted on October 12, 2014 by luckyotter

Today I was reading a couple of new blog articles by Dr. George K. Simon, which can be found here and here. Dr. Simon has written a number of books about psychopathy, narcissism and other “character disorders” (his term for the DSM “Cluster B” personality disorders, which are in part characterized by a lack of empathy or capacity to feel remorse). The two articles I was reading focus on narcissistic/antisocial behavior and addiction.

Indeed, many disordered individuals have a concurrent alcohol or drug problem, but unlike neurotics (people with anxiety issues who have the capacity to feel shame, empathy and remorse–usually so much that they sabotage themselves), the character-disordered are not very likely to seek treatment for their addictions. This really isn’t any surprise, since Cluster B types (especially Narcissists and people with antisocial personality disorder) aren’t likely to seek any kind of psychological treatment or therapy because they’re not the ones suffering–they’re more likely to cause others to suffer. Narcissists and those with APD also think they’re superior human beings who don’t need any help. Instead, they blame their victims for being the ones with the mental or emotional problems.

But there are some character disordered people who do join 12 step programs like Alcoholics Anonymous. They may be aware they have a substance abuse issue, but that’s as far as any insight into themselves goes. These are the “recovered” addicts and alcoholics who lord their recovery over others, and treat their 12-step program like a religion that allows them to believe they are superior to everyone else.

My mother falls into this category. She’s a Narc who, back in the early 1980s, decided she was an alcoholic and became involved with AA. Speeding through the 12 steps at a pace that was most likely unrealistic for most people trying to recover, she went from being merely abusive to intolerably, infuriatingly abusive. While her drunkenness had been mostly unpleasant, at times she could almost be “fun,” or at least so out of it that she handled her abuse of me clumsily and sometimes forgot she was supposed to be abusing me and would shift into treating me as a younger woman she could party with. But after discovering AA, suddenly she became a self-righteous, judgmental, rigid you-know-what who lorded her new “religion” over me in particular. Mind you, I am not dissing AA or any other 12 step program, as they have helped many people turn their lives around and free themselves from addiction. But when narcissists find these programs, they use them to further their own agenda, and as they do with everything else, turn the steps of recovery into weapons to be used against others. Narcissists in recovery programs are as bad as the worst kind of religious zealots and treat the program as if they alone discovered it, seeming to equate themselves with Moses being hand picked by God to discover the Ten Commandments.

They also turn the various slogans associated with these 12 step programs into handy justifications for being even more self-centered, arrogant and unempathic than they already were. My Narc mother, for example, now had handy canned excuses for her horrific treatment of others. For example, if you called her out for a hurtful action or comment, she’d respond with “your feelings are your own responsibility, not mine” or “stop taking my inventory.” If she wanted to belittle you, she’d say “you’re on a dry drunk” (actually she was the one on the dry drunk) or “that’s your addiction talking.” (she thought everyone who wasn’t a teetotaler or occasionally indulged in a little pot was an alcoholic or drug addict).

The 4th step of AA is “taking a fearless moral inventory” and a later step is “making amends to those you have harmed.” While these two steps would seem like holy water is to the devil for a Narc, sending them off flailing and screaming, some narcissists can and do take these steps (others get “stuck” at step 4, and may quit the program), but if they do, they work these steps in a shallow, glib manner, usually only addressing the substance abuse itself, while glossing over any pain they caused others. This is how my mother handled these steps, and when she “made amends” to me, I didn’t feel any sincerity there at all. Her “amends” seemed as phony as an mass-mailed Christmas card from your local bail bondsman. I suppose I’m guilty of “taking her inventory” but that’s how it felt to me. She was never one to apologize for anything, ever. No narcissist is.

Another interesting thing about Narcs who join 12 step programs is they don’t dig any deeper. Many non-narcissist alcoholics and drug addicts come to a point in recovery where they want to learn more about themselves, what makes them tick, and perhaps what led them to self-medicate in the first place. They realize that the addiction, while it very likely has a genetic component, can also be caused by psychological factors and they want to dig deeper to find out why they drank or used in the first place. A Narc will never do that, because any sort of therapy requires introspection into their own behavior and that is terrifying to them–because even they know that all they’ll see when they look into the mirror is….an endless black void of nothingness. As I’ve talked about in previous posts, for whatever reason, narcissists don’t have a true “self”–instead they wear a series of masks meant to dupe others into believing there is something there when there isn’t anything there at all.

So beware of the recovered addict or alcoholic who treats their 12-step program like a religion and uses it as a pedestal to make others feel deficient–you’re almost certainly dealing with a narcissist. And as you might expect, many narcissists are active in churches, especially those that are autocratic, evangelical or fundamentalist in nature, because it allows them an easy way to feel superior even if they haven’t achieved anything notable in life: they’re “saved” and you’re going to hell. Narcissists in 12 step programs use the program’s tenets almost exactly the same way.