Doctors Take You Into the Mind of a Sociopath

Every sociopath is not a serial killer. There’s more to them than Ted Bundys and Dexter Morgans of this world.

No, every unsocial person is not a sociopath. There’s a demarcation between being unsocial and antisocial and it very well exists. Also,  every sociopath is not a serial killer. There’s more to them than Raman Raghavs, Ted Bundys and Dexter Morgans of this world.

Who is a Sociopath/Psychopath?

At a glance, a characteristic every sociopath exhibits is lack of empathy. This is further accompanied by a disregard for others’ feelings, emotional problems, inability to sustain relationships and behaving in ways that are not culturally ‘normal’ or accepted. Everyone has been unkind, non-conforming and indifferent at some point of their life for various reasons. This does not make you a sociopath.

If these patterns become recurrent to the extent of causing pain and hurt to those around you, as well as an inability to maintain relationships, that’s when it’s a concern.

Sociopathy is primarily a personality disorder and there are no definite, conclusive tests for it. It can be deducted by a health professional by using behavioural patterns as an index.

At the same time, it should be remembered that it’s unfair to simply write off someone showing these traits as “evil” or bad. It’s not the presence of ill feelings, but just the absence of any - kindness, empathy, ability to connect.

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Doctors Explain Things to Watch Out For

Dr Sameer Malhotra, Senior Consultant Psychiatrist, Psychotherapist and Drug Deaddiction Specialist, Max Hospitals, New Delhi, emphasises that lack of empathy and concern for the feelings of others is a marker of a sociopathic personality.

It’s also characterised by gross and persistent attitude of irresponsibility and disregard for social norms/rules/obligations, low frustration tolerance, low threshold for aggression, lack of remorse or guilt and a tendency to blame others or rationalising their own behavior which further leads them into conflict with society.

Dr Sameer Malhotra

Dr Bhavna Barmi, Consultant, Psychology, Fortis Escorts Heart Institute, describes it in the following manner:

People who have been experiencing this disorder do not have the capacity to comprehend or understand others’ feelings. They often take hasty decisions without feelings of regret or guilt that the decision might cause thereafter. Those regarded as sociopaths may be profound, caring and trustworthy. But they may lack the sense of being empathetic towards anyone or anything which allows them to act in ways that they might know as being wrong.

Usually sociopaths are diagnosed if they show behaviou ral traits of not reflecting any emotion in the lives of others, trying to manipulate people with their charm, intelligence, not being able to hold up a good and a positive relation, making threats and never acting upon them, she adds.

How Does the Brain of a Sociopath Differ From an Average Person?

A sociopath’s brain is wired differently from an average person’s. Dr Barmi breaks it down.

The brain of a sociopath is different from an individual as they do not exhibit the connection with the ventromedial prefrontal cortex. This part of the brain makes the sociopaths not experience feelings like empathy and fear. These emotions are an integral part of a person’s life as these help us in dealing with people more promptly and in a manner that doesn’t hurt their sentiment.

Dr Bhavna Barmi

And this is not where it ends. The amygdala is the part of the brain which is responsible for invoking feelings of fear and anxiety. However, Dr Barmi adds, due to reduced connections with these parts, in a sociopath these emotions are not present.

The amygdala, which is present in an average individual would exhibit feelings of fear and anxiety. It allows one to see emotionally relevant information at the time of threats.

On the topic of feelings, she adds:

Sociopaths might be able to develop deep feelings with their family, but they show less harmonised activity between the two structures in the brain that are known to control social and emotional behavior which doesn’t seem to be linked well. 

Dr Bhavna Barmi

Consequently, sociopaths are not able to judge a situation like an average person. There could be situations when they choose to cooperate with a person or a particular circumstance, but those would be exceptions and isolated incidences.

Dr Malhotra further says that studies have also pointed at the role of neurotransmitters and hormones like high levels of dopamine, high levels of testosterone when it comes to sociopathy.

Occurrence of Sociopathy

According to Dr Malhotra, psychopathy or sociopathy is not very common in India, though he has seen some traits in people in his experience. According to Martha Stout’s The Sociopath Next Door, societies like the US which encourage individualism are more likely to have sociopaths amidst them, points out this study.

Sociopathy is a personality disorder (there are 10 types of personality disorders) which simply means an inability to abide by the accepted societal norms. It’s not simply an act of rebellion or non-conformity, but a vehement rejection to the point that it starts disrupting your life and of those around you.

When it comes to India particularly, Dr Barmi says:

Personality disorders are common in India, but are not diagnosed as people don’t like talking about their personality outcomes which might hamper their sense of self. Two percent of the clinical population has been diagnosed with sociopathy. Personality plays a very important role in a person’s life, therefore, people with deviant personalities should get it diagnosed and treated.

Dr Bhavna Barmi

Sociopath, Psychopath and Antisocial Personality

When we talk about sociopathy, two other terms that are often used interchangeably include psychopathy and antisocial personality. Dr Barmi points out that the three terms are interrelated, but differ in their own way based on their severity.

Sociopaths have less severe symptoms than the psychopaths. The sociopaths maybe able to develop good bonds with family, but a psychopath cannot. Antisocial personality disorder also has the same severe symptoms, but the treatment for sociopathy has helped patients.

Dr Bhavna Barmi

When it comes to psychopathy, also a personality disorder, symptoms are more severe. They usually lack guilt and do not show any empathetic behavior towards others. It is usually referred to as the failure of having developed any sense of moral responsibility and the capacity to perform any violent behaviour without any remorse. People usually exhibit criminal and corrupt behavior without any repentance. They even lack the ability to love and uphold the relations that are important.

When it comes to treating the three, while psychotherapy (counsellor or the therapist talks to the client) helps manage their behaviour, cognitive therapy is another option that can be explored. It may or may not cure the problem entirely, but it definitely helps in establishing positive behaviour, says Dr Barmi.

However in case of psychopathy and anti-social behaviours, there are no such treatments which could help the client get away with the symptoms. If diagnosed during childhood, it might help the child to recover from the symptoms so that they don’t take severe forms.

Dr Bhavna Barmi

The more difficult bit is the acceptance on the part of the person with the disorder. Dr Barmi says that people with this disorder don’t think that are facing any problems. The realisation is hence the first and a very significant process.

There’s a Myth that Sociopathy is a Disability

Both doctors agree that sociopathy is a personality disorder and not a disability, irrespective of the myth that it’s considered a cognitive disability in some countries.

No, sociopathy is not a disability or disorder for that matter, it is a personality type. If sociopaths are pervasively dysfunctional then they qualify for antisocial personality disorder which is then considered to be a disability that requires professional help.

Dr Bhavna Barmi

What is the Role of Nature-Nurture Here?

When it comes to the reasons behind it, there are both genetic factors as well as influence of experience - nature-nurture both have a role to play.

While a few sociopaths may have a genetic predisposition, life’s everyday experiences can also provide a trigger or stimuli to activate the behavioural patterns for sociopathy. Other sociopaths may have had this genetic inclination, they were born ordinary, but they had strong negative stimuli that forced their brain into the coping mechanisms of sociopathy by the activation of these triggers.

Dr Bhavna Barmi

Dr Malhotra agrees that it’s a combination of both, genetics and social environment.

During growing years, it could include triggers like emotional neglect, hostile environment, domestic violence, physical/sexual abuse, substance use in the family. All of this can contribute to making a person believe the world to be a dangerous place. Impulse dyscontrol and conduct disorder during childhood, may later turn into antisocial personality and substance dependence. 

Dr Sameer Malhotra

The role of genetics is important since having a parent with the disorder puts one more at the risk, says Dr Barmi. Children of an alcoholic parent are also at a higher risk.

Researchers have also estimated that 25 percent of girls and 40 percent of boys with conduct disorder will have antisocial personality disorder as adults.

Dr Bhavna Barmi

What Are Some Signs to Watch Out For?

A person with antisocial personality disorder may display a tendency or express the need to exploit, manipulate or violate the rights of others, says Dr Barmi.

Dr Malhotra summarises the points in the following manner.

Lack of empathy, disregard for the feelings of others, being harsh/physically cruel towards pets/animals/siblings, sadism, tendency to break rules, disregard for social norms. A sociopath would also be very impulsive, have frequent temper tantrums, anger dyscontrol, be vindictive and indulge in frequent lying or breaking promises. 

Dr Sameer Malhotra

Other activities can also include stealing, truancy, being a bully, high on sensation/thrill seeking, high on experimentation and substance use.