Sociopaths and psychopaths are not necessarily monsters. Experts urge using these terms properly

To learn how to spot a psychopath and a sociopath, one must begin by dispelling a common myth about them: They are not all murderers.

This may come as a surprise to some readers. When we hear about psychopaths, it is usually in the context of true crime stories or horror movies, such as when the Michael Myers of the 2007 "Halloween" series is described as having "the eyes of a psychopath." Similarly, when the word "sociopath" is dropped, it often refers to abusive, manipulative and cruel people. 

But these are related to real, diagnosable mental conditions not confined to Hollywood monsters.

Regardless, people are conditioned to be wary of both psychopaths and sociopaths, with the two terms often conflated or used as epithets applied (correctly or otherwise) to seemingly narcissistic and un-compassionate celebrities like past Miss Universe Kanika Batra and former President Donald Trump. Although sociopathy may not be as stigmatized as psychopathy, people are still trained to fear sociopaths as potential life-wreckers utterly without empathy.

Yet experts who spoke with Salon argue that the terms "psychopath" and "sociopath" can be both overused and misused. Indeed, neither are literal clinical terms: People with the traits labeled "psychopath" and "narcissist" often have a clinical condition officially known as antisocial personality disorder. That does not mean the terms "psychopath" and "sociopath" are useless, though; rather that they must be regarded as colloquial concepts rather than real medical diagnoses.

Similarly, they must be employed as precisely as possible. One of the experts who warns against reckless usage of the term is sociologist Dr. Bob Faris, who teaches at the University of California at Davis.

"Misuse of the terminology in the media muddies the waters," said Faris. "It also intrudes on the air of scientism that the field wishes to present: if the New York Times is running op-eds about Trump being a sociopath, it encroaches on the special power and privilege that psychologists have to make those determinations, and so they push back, arguing that such a diagnosis can only be made by a professional, in a clinical setting."

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Not everyone agrees that it is dangerous to armchair diagnose politicians. Speaking with Salon in 2023, Dr. Jerome Kroll — a professor of psychiatry emeritus at the University of Minnesota Twin Cities — said he opposes policies like the American Psychiatric Association's so-called Goldwater Rule, which restrict what psychiatric professionals can say about public figures they have not personally treated.

"What psychiatrists owe their patients (confidentiality, respect, thoughtfulness, technical knowledge) has nothing to do with offering public comments about a public figure about whom there is a controversy," Kroll said. "I see this as an issue of free speech, which often leads to ill-advised, divisive, even stupid statements, but not to an ethical breach of my professional responsibilities. A court of law can determine my liability if the person commented on takes offense."

Regardless of where the scientific community stands on questions like the Goldwater Rule, there is little debate that ordinary people should accurately understand what they mean when using terms like sociopath. Dr. Ramani Durvasula, a licensed clinical psychologist and professor of psychology, explained to Salon that psychopaths are people who lack remorse, have a cold and calculating interpersonal style and tend to exploit people in their interpersonal relationships. Sociopaths are similar in many ways: Like psychopaths, they tend to have a "grift parasitic lifestyle," lack remorse and do not display empathy, but while narcissists care about looking good to the world, a sociopath will violate social norms and rules.

By contrast, sociopathy is more of a "sociological criminological term. We tend not to use it as much clinically, but it's a term that reflects this sort of messy crossroads between psychopathy and narcissism," Durvasula said.

According to Dr. Paul Hokemeyer, a marriage and family therapist and author of "Fragile Power: Why Having Everything Is Never Enough," the best way to understand both psychopathy and sociopathy is to remember that they are both informal terms for antisocial personality disorder, a very real and severe mental health syndrome. Psychopathy refers to a more violent and criminal manifestation of what is ultimately the same underlying condition.

Antisocial personality disorder is "a severe mental health syndrome that causes people to disregard moral standards, social laws and interpersonal commitments," Hokemeyer said. "People who suffer from it live to take advantage of other people. Their relational histories are defined by betrayal, sexual objectification, financial exploitation and Machiavellian power grabs. They need to win at all costs and have no problem engaging in criminal activity that they subsequently deny."

He added, "They lash out at anyone who dares challenge them and have no remorse for their abusive behaviors. They frequently are highly charismatic and use charm to seduce others into following them absolutely and blindly."

Perhaps it is easiest to view all of these conditions as existing on a spectrum. When someone talks about a psychopath or a sociopath, the chances are that they really want to describe someone with antisocial personality disorder. "It's not an either/or" situation, says Durvasula.

"I think it's very, very important to view all of these things as being along a continuum," Durvasula said. "That is why that your friend who has little empathy, is entitled, is on Instagram all the time and feels like an overgrown adolescent is obviously a very different experience than somebody who is sort of a grifter and keeps taking advantage of people and doing real harm. They just don't feel like the same person, but the core personality may be the same."

This is why the term "Dark Triad" exists — a catch-all for people with narcissistic, Machiavellian and psychopathic traits.

"These formulations get at the idea that these styles all overlap," said Durvasula. "What we tend to see is that narcissism, psychopathy, Machiavellianism, sadism — and I'd even argue some to some degree paranoia — all sort of overlap. And when you have that kind of complex stew, it really then is going come down to things like impulsivity, reactivity, other behavioral pieces that are gonna tell us whether this is someone who's very more as a psychopathic, sociopathic or a narcissistic presentation."

To distinguish between more innocuous cases of narcissism and the literally dangerous varieties, Durvasula offered a thumbnail test: "Narcissists who are narcissistic do feel remorse," Durvasula said. "They will feel shame, they might even feel guilt — but they tend to lash out at people who bring up that sense of shame by letting them know they did something bad. Psychopathic and sociopathic people tend not to care at that assessment that they've just done a bad thing."

At the same time, all of the experts who spoke to Salon agreed that one should not turn these antisocial personality disorders into something supernatural. This is where the pop culture conceptions (such as Myers as reimagined by director/writer Rob Zombie), though entertaining as works of art, are less effective as fair representations of mental health — even if they are quite good at capturing how the public views people with the Dark Triad of conditions.

Despite pop culture depictions of sociopaths as inherently violent, there is strong evidence people with mental illness are more likely to be a victim of violent crime than those causing it. Just like we must do away with the stigma toward autism, ADHD, depression, PTSD and other mental conditions, judging people for antisocial personality traits is just as harmful.