Psychopaths, sociopaths, and narcissists: What’s in a label?

In countless discussions about workplace bullying, mobbing, and abuse, we often speculate on whether the chief aggressors may have narcissistic, psychopathic, or sociopathic tendencies. These conversations may be informed by some clinical knowledge of the symptoms of, and differences between, these personality disorders. Other times, they’re based on bits of information picked up from the media and popular culture. In any event, given the relevance of this general topic to workplace mistreatment, I thought it might be useful to appeal to some experts in taking a closer look.

For starters, if you have 12 minutes for an informative and fascinating video, check out MedCircle‘s interview of Dr. Ramani Durvasula (Cal St U-Los Angeles), “Narcissist, Psychopath, or Sociopath: How to Spot the Differences.” Here are a few highlights:

• A lot of people “are using these terms interchangeably,” but they shouldn’t.
• “One rule of thumb to remember right off the bat. Every psychopath is narcissistic, but not every narcissist is psychopathic.”
• A narcissist “lacks empathy, is grandiose, is entitled, is constantly seeking validation, is arrogant . . . it’s a disorder of self-esteem.”
• Narcissists do feel shame and guilt when they do bad things, but psychopaths feel no shame or guilt when doing the same, they “don’t care who gets hurt.”
• The “sociopath is a lot like the psychopath: They do bad things and they don’t care. . . . Here’s the key difference: A psychopath is born, and a sociopath is made.” However, Dr. Durvasula recognizes that the influences of genetic and environmental factors may be difficult to distinguish.
• Unfortunately, psychopaths and sociopaths rarely seek treatment, unless it is court-ordered.
• “Psychopaths and sociopaths and narcissists make great chameleons.” Psychopaths and sociopaths, in particular, “view the world as an instrument to fulfill their desires.”

Narcissistic personality disorder

In a piece for PsychCentral, Dr. Steve Bressert summarizes the symptoms of “narcissistic personality disorder” this way:

The symptoms of narcissistic personality disorder include: grandiose sense of importance, preoccupation with unlimited success, belief that one is special and unique, exploitative of others, lack of empathy, arrogance, and jealousy of others. These symptoms cause significant distress in a person’s life.

Dr. Bressert reports that research studies on the causes of NPD are inconclusive, leading him to suggest that biological, genetic, social, and psychological factors may all play a role. As to treatment of NPD, it “typically involves long-term psychotherapy with a therapist that has experience in treating this kind of personality disorder.”

Antisocial personality disorder

PsychCentral‘s founder, Dr. John Grohol, echoes and expands upon much of what Dr. Durvasula says about the differences between psychopaths and sociopaths, and explains how the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V) combines psychopathy and sociopathy under the single clinical category of “antisocial personality disorder”:

The common features of a psychopath and sociopath lie in their shared diagnosis — antisocial personality disorder. The DSM-5 . . . defines antisocial personality as someone have 3 or more of the following traits:

1. Regularly breaks or flouts the law
2. Constantly lies and deceives others
3. Is impulsive and doesn’t plan ahead
4. Can be prone to fighting and aggressiveness
5. Has little regard for the safety of others
6. Irresponsible, can’t meet financial obligations
7. Doesn’t feel remorse or guilt

Two peas in a pod?

Can antisocial personality disorder be treated? Read between the lines of this PsychCentral piece by Dr. Donald Black and you may reach the same conclusion as I did, namely, that psychopathy and sociopathy do not easily respond to psychological and psychiatric treatment. In fact, Black concludes:

Incarceration may be the best way to control the most severe and persistent cases of antisocial personality disorder. Keeping antisocial offenders behind bars during their most active criminal periods reduces their behaviors’ social impact.

The “almost psychopath”

I’ve periodically referenced Dr. Ronald Schouten’s (Harvard Medical School) work on the “almost psychopath,” i.e., individuals who fall short of a clinical diagnosis of psychopathy, but who demonstrate some of the most disturbing psychopathic behaviors. In their co-authored book, Almost a Psychopath (2012), Schouten and attorney James Silver acknowledge that although they have dealt with genuine psychopaths in their professional practices, there’s another type of individual they encounter more often, the almost psychopath, whom they describe this way:

Nevertheless, we much more frequently find ourselves dealing with people who don’t meet the current technical definition of a psychopath, but who have more than the usual amount of difficulty following rules, fulfilling obligations, or understanding how to treat others.

. . . Whether because of the nature of their behavior . . . or because they violate social or legal norms so frequently, these people live their lives somewhere between the boundaries of commonplace “not-so-bad” behavior and psychopathy.

Almost is bad enough

Relevance to workplace abuse

Well, I’m now stating the obvious: We’ve known for a long time that, on an individual level, psychopathic, sociopathic, or narcissistic traits are associated with bullying, mobbing, harassment, and other forms of workplace mistreatment. They also fuel the organizational cultures that enable such abuse and protect the abusers.

Among the bottom-line points that resonate most strongly with me are that narcissists, psychopaths, and sociopaths are (1) unlikely to seek treatment; and (2) treatment may not make much a difference anyway. A good number of these folks occupy positions of power in society and thus significantly impact working conditions for millions of people.