Who is a Sociopath?

A sociopath is a psychologically disturbed individual with a severe form of Antisocial Personality Disorder (ASPD). According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), psychopaths are individuals with a tendency to break rules and social norms. Other definitive characteristics of such individuals include:

• Manipulation and controlling behavior
• Little of no empathy 
• No feeling of guilt or remorse
• Deception
• Aggression and compulsive behavior

Sociopath vs Psychopath: What’s the difference?

From a clinical perspective, there’s a very thin line between sociopath and psychopath. Meaning, the two antisocial personality disorders are one and the same, from a clinician’s view point.

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However, to a psychologist, a sociopath refers to someone with ASPD that manifests in the form of violation of social conventions, but has some degree of empathy. A psychopath, on the other hand, has ASPD, follows social norms, but lacks empathy.

Another noteworthy difference between the two is that sociopaths usually express physical aggression, manipulation, anger & hostility, and unpredictable moods. On the other hand, psychopaths are usually charming, fearless, exploitative individuals. In addition, psychopaths are usually not loving, careless and have considerably poor judgment of situations.

Signs and Symptoms of Sociopathy

Psychopaths can be very difficult to spot from a far, especially if you haven’t interacted with the person before. That notwithstanding, here are some signs and symptoms associated with sociopathy that you really need to look out for: 

a). Hostility and Aggression

Sociopaths are usually very hostile and aggressive towards others. As such, they are far more likely to harbor racist, sexist, or misogynistic ideas. Moreover, they might also show some rather covert forms of violence and aggression, usually in the form of bullying, teasing, and guilting. Some often use these techniques to get what they want.

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b). Pathological dishonesty and deception

They have an inherent tendency to twist or exaggerate facts to suit their intentions. And when cornered, sociopaths often deny or redirect their version of the story in order to avert responsibility.

c). Readily Irritable and Angered

Studies have shown that sociopaths have very few options when it comes to emotions. Unlike normal people who may express sadness, happiness, anger, guilt, fear, among other emotions, sociopaths tend to have a ready access to anger and irritability. This is usually seen in their daily interactions, in relationships, and even at the workplace.

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d). Poor judgement and decision making

Sociopaths are known to be careless and irresponsible when it comes to decision making. Because of the pattern of rash decisions they often make, such people are likely to endanger not only themselves, but also the people around them. Similarly, they also have a very poor judgment of situations.

e). Very charming and persuasive

Sociopaths are naturally very charming when you meet them the first time. However, all that is superficial and will wear off when your interaction with them becomes routine. For instance, when you start dating or get married or maybe after lending them some money. It’s like the charm is used as a tool to persuade and win you over so that they get what they want.

f). Few close friends

Friendship or relationship with sociopaths rarely last. And the reason for that has a lot to do with the fact that they are not very trustworthy. Often, they end  up with very few friends, mostly family members or relatives. They often have an ever growing list of enemies, mostly people they have wronged or betrayed.

g). Manipulation

Sociopaths have a tendency to want to manipulate others to do things for them. Usually, this comes in the form of guilting, persuasion, or lying. 

Other Definitive Signs of Sociopathy

• Emotional absence
• Antisocial opportunists out to profit from other people’s misfortunes
• Disregard for moral compass and social norms

Causes of Sociopathy

Research studies have attributed sociopathy to a number of causes. Some common causes are as follows:

• Damage to the frontal lobe of the brain following head injury or progressive conditions such as dementia.
• Child upbringing: some studies have shown that children who are subjected to parental neglect or abuse at an early age tend to develop sociopathic tendencies later in life. 
• Hereditary factors: psychopathy is also linked to innate factors which can be inherited by the child from the parents.

Diagnosis of Sociopathy

How exactly do therapists or psychologists diagnose sociopaths? Well, the diagnosis is purely based on the criteria outlined in the DSM-5. Here are some pointers used to diagnose ASPD:

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• Patient must be at least 18 years of age
• Evidence of conduct disorder before 15 years of age.
• The ASPD tendencies affect different aspects of the person’s life.
• No evidence of bipolar disorder or schizophrenia

Mental Disorders Closely related to Sociopathy

Some mental health disorders also present in a similar manner to antisocial personality disorder (ASPD). They include:

• Conduct disorder: This is a childhood antisocial disorder that often starts before the age of 16 years. It’s a major risk factor for ASPD when one becomes an adult.
• Schizophrenia: May present as an aggressive antisocial behavior. And like the case with ASPD, schizophrenic patients have trouble recognizing facial emotions. It may also have a psychotic aspect of it. This isn’t the case with ASPD though.
• Bipolar I Disorder: Victims usually present with aggressiveness, irritability, impulsivity, and suicidal tendencies. In this type of bipolar disorder, there is the occurrence of at least one episode of mania with or without psychotic features.
• Intermittent explosive disorder (IED): Manifests as extreme verbal or physical outbursts which are usually repeated time and again in the form of assault on others or animals, or damage to property.

Treatment of Sociopathy

The available treatment options may be classified into two main groups:

1. Psychotherapy

Psychotherapy, also called therapy, involves talking to a therapist about behaviors and thoughts that usually trigger aggression or destructive tendencies. That way, he or she can come up with ways to help the person struggling with the disorder. Psychotherapy comes in different forms. These include:

a). Mentalization-based therapy (MBT)

MBT endeavors to help people understand the emotional and mental mindsets of others. The treatment option targets those struggling with ASPD or borderline personality disorders. It helps people with ASPD deal with personal danger, aggressive behavior, paranoia, anger, and problems with other people.

b). Democratic Therapeutic Communities

In this model of psychotherapy, individuals seeking therapy are divided into small groups. Inside these groups, collaborative decisions are made regarding how to deal with certain behaviors associated with ASPD. The approach seeks to inspire a community mindset among people with antisocial personality disorder. It is often used in closed communities, such as prisons or boarding facilities.

c). Cognitive Behavioral Therapy (CBT)

The main aim of CBT is to help people learn to empathize with others. It makes people appreciate alternative means of resolving conflicts and disagreements (e.g., mediation, negotiation, etc.) instead of using violence. So, people with ASPD will have better skills to deal with people and situations, which will lead to more productive behaviors.

d). Contingency Management

In this psychotherapy approach, people struggling with ASPD who have sought therapy are rewarded for the little things they do to improve their behavior during the course of treatment.

2. Pharmacotherapy (Use of medications)

Sociopathy has symptoms that can be treated with conventional drugs, just like other personality disorders. Here are some classes and examples of drugs that your doctor may prescribe to manage the symptoms:

• Anticonvulsants: e.g. Tegretol (carbamazepine), phenobarbital, etc. 
• Selective Serotonin Reuptake Inhibitors (SSRIs) antidepressants: e.g. Prozac (fluoxetine), amitriptyline, etc. 
• Antipsychotics for aggression management and mood stabilization e.g. Risperidone, lithium, etc.

How to Cope with Sociopathy

The first step in knowing how to deal with people with sociopathy or ASPD is to understand the symptoms associated with these personality disorders. That aside, here are some additional tips  to help you cope:

•  Encourage them to seek professional assistance from a therapist or a counselor. If possible, consider hooking them up with one, or share with them contact info of some therapists in the locality. In addition, seeking therapy will also help you build coping skills, explore productive communication skills, and figure out whether or not you still want to be close to the person diagnosed with ASPD, especially if you are in a relationship or are married already.
• Set clear boundaries and rules of engagement in order to protect yourself emotionally and physically.
• Take time to share with them how their conduct affects you and other people around them.
• Understand that most people struggling with ASPD do not fully understand their emotions.

Conclusion

Even though sociopaths show little or no regard for other people’s rights, emotions, and experiences, it is important to know that individuals with antisocial personality disorder never fully understand their own emotions. Luckily, treatment options such as psychotherapy and pharmacotherapy have helped such people to deal better with others.