As a therapist, I specialize in the treatment of psychological trauma survivors. Over the last twenty-five years, my practice has included hundreds of adults who have been in psychological pain every day of their lives on account of early childhood abuse or some other horrendous past experience. As I have detailed in case studies in The Myth of Sanity, my trauma patients suffer from a host of torments, including chronic anxiety, incapacitating depression, and dissociative mental states, and, feeling that their time on earth was unbearable, many of them have come to me after recovering from attempts to commit suicide. Some have been traumatized by natural and man-made disasters such as earthquakes and wars, but most of them have been controlled and psychologically shattered by individual human perpetrators, often sociopaths—sometimes sociopathic strangers, but more typically sociopathic parents, older relatives, or siblings. In helping my patients and their families cope with the harm done to their lives, and in studying their case histories, I have learned that the damage caused by the sociopaths among us is deep and lasting, often tragically lethal, and startlingly common. Working with hundreds of survivors, I have become convinced that dealing openly and directly with the facts about sociopathy is a matter of urgency for us all.
About one in twenty-five individuals are sociopathic, meaning, essentially, that they do not have a conscience. It is not that this group fails to grasp the difference between good and bad; it is that the distinction fails to limit their behavior. The intellectual difference between right and wrong does not bring on the emotional sirens and flashing blue lights, or the fear of God, that it does for the rest of us. Without the slightest blip of guilt or remorse, one in twenty-five people can do anything at all.
The high incidence of sociopathy in human society has a profound effect on the rest of us who must live on this planet, too, even those of us who have not been clinically traumatized. The individuals who constitute this 4 percent drain our relationships, our bank accounts, our accomplishments, our self-esteem, our very peace on earth. Yet surprisingly, many people know nothing about this disorder, or if they do, they think only in terms of violent psychopathy—murderers, serial killers, mass murderers—people who have conspicuously broken the law many times over, and who, if caught, will be imprisoned, maybe even put to death by our legal system. We are not commonly aware of, nor do we usually identify, the larger number of nonviolent sociopaths among us, people who often are not blatant lawbreakers, and against whom our formal legal system provides little defense.
Most of us would not imagine any correspondence between conceiving an ethnic genocide and, say, guiltlessly lying to one's boss about a coworker. But the psychological correspondence is not only there; it is chilling. Simple and profound, the link is the absence of the inner mechanism that beats up on us, emotionally speaking, when we make a choice we view as immoral, unethical, neglectful, or selfish. Most of us feel mildly guilty if we eat the last piece of cake in the kitchen, let alone what we would feel if we intentionally and methodically set about to hurt another person. Those who have no conscience at all are a group unto themselves, whether they be homicidal tyrants or merely ruthless social snipers.
The presence or absence of conscience is a deep human division, arguably more significant than intelligence, race, or even gender. What differentiates a sociopath who lives off the labors of others from one who occasionally robs convenience stores, or from one who is a contemporary robber baron—or what makes the difference between an ordinary bully and a sociopathic murderer—is nothing more than social status, drive, intellect, blood lust, or simple opportunity. What distinguishes all of these people from the rest of us is an utterly empty hole in the psyche, where there should be the most evolved of all humanizing functions.
For something like 96 percent of us, conscience is so fundamental that we seldom even think about it. For the most part, it acts like a reflex. Unless temptation is extremely great (which, thankfully, on a day-to-day basis it usually is not), we by no means reflect on each and every moral question that comes our way. We do not seriously ask ourselves, Shall I give my child lunch money today, or not? Shall I steal my coworker's briefcase today, or not? Shall I walk out on my spouse today, or not? Conscience makes all of these decisions for us, so quietly, automatically, and continually that, in our most creative flights of imagination, we would not be able to conjure the image of an existence without conscience. And so, naturally, when someone makes a truly conscienceless choice, all we can produce are explanations that come nowhere near the truth: She forgot to give lunch money to her child. That person's coworker must have misplaced her briefcase. That person's spouse must have been impossible to live with. Or we come up with labels that, provided we do not inspect too closely, almost explain another person's antisocial behavior: He is “eccentric,” or “artistic,” or “really competitive,” or “lazy,” or “clueless,” or “always such a rogue.”
Except for the psychopathic monsters we sometimes see on television, whose actions are too horrific to explain away, conscienceless people are nearly always invisible to us. We are keenly interested in how smart we are, and in the intelligence level of other people. The smallest child can tell the difference between a girl and a boy. We fight wars over race. But as to what is possibly the single most meaningful characteristic that divides the human species—the presence or absence of conscience—we remain effectively oblivious.
Very few people, no matter how educated they are in other ways, know the meaning of the word sociopathic. Far less do they understand that, in all probability, the word could be properly applied to a handful of people they actually know. And even after we have learned the label for it, being devoid of conscience is impossible for most human beings to fantasize about. In fact, it is difficult to think of another experience that quite so eludes empathy. Total blindness, clinical depression, profound cognitive deficit, winning the lottery, and a thousand other extremes of human experience, even psychosis, are accessible to our imaginations. We have all been lost in the dark. We have all been somewhat depressed. We have all felt stupid, at least once or twice. Most of us have made the mental list of what we would do with a windfall fortune. And in our dreams at night, our thoughts and our images are deranged.
But not to care at all about the effects of our actions on society, on friends, on family, on our children? What on earth would that be like? What would we do with ourselves? Nothing in our lives, waking or sleeping, informs us. The closest we come, perhaps, is the experience of being in so much physical pain that our ability to reason or act is temporarily paralyzed. But even in pain there is guilt. Absolute guiltlessness defies the imagination.
Conscience is our omniscient taskmaster, setting the rules for our actions and meting out emotional punishments when we break the rules. We never asked for conscience. It is just there, all the time, like skin or lungs or heart. In a manner of speaking, we cannot even take credit. And we cannot imagine what we would feel like without it.
Guiltlessness is uniquely confusing as a medical concept, too. Quite unlike cancer, anorexia, schizophrenia, depression, or even the other “character disorders,” such as narcissism, sociopathy would seem to have a moral aspect. Sociopaths are almost invariably seen as bad or diabolical, even by (or perhaps especially by) mental health professionals, and the sentiment that these patients are somehow morally offensive and scary comes across vividly in the literature.
Robert Hare, a professor of psychology at the University of British Columbia, has developed an inventory called the Psychopathy Checklist, now accepted as a standard diagnostic instrument for researchers and clinicians worldwide. Of his subjects, Hare, the dispassionate scientist, writes, “Everyone, including the experts, can be taken in, manipulated, conned, and left bewildered by them. A good psychopath can play a concerto on anyone's heartstrings. . . . Your best defense is to understand the nature of these human predators.” And Hervey Cleckley, author of the 1941 classic text The Mask of Sanity, makes this complaint of the psychopath: “Beaut
y and ugliness, except in a very superficial sense, goodness, evil, love, horror, and humor have no actual meaning, no power to move him.”
The argument can easily be made that “sociopathy” and “antisocial personality disorder” and “psychopathy” are misnomers, reflecting an unstable mix of ideas, and that the absence of conscience does not really make sense as a psychiatric category in the first place. In this regard, it is crucial to note that all of the other psychiatric diagnoses (including narcissism) involve some amount of personal distress or misery for the individuals who suffer from them. Sociopathy stands alone as a “disease” that causes no dis-ease for the person who has it, no subjective discomfort. Sociopaths are often quite satisfied with themselves and with their lives, and perhaps for this very reason there is no effective “treatment.” Typically, sociopaths enter therapy only when they have been court-referred, or when there is some secondary gain to be had from being a patient. Wanting to get better is seldom the true issue. All of this begs the question of whether the absence of conscience is a psychiatric disorder or a legal designation—or something else altogether.
Singular in its ability to unnerve even seasoned professionals, the concept of sociopathy comes perilously close to our notions of the soul, of evil versus good, and this association makes the topic difficult to think about clearly. And the unavoidable them-versus-us nature of the problem raises scientific, moral, and political issues that boggle the mind. How does one scientifically study a phenomenon that appears to be, in part, a moral one? Who should receive our professional help and support, the “patients” or the people who must endure them? Since psychological research is generating ways to “diagnose” sociopathy, whom should we test? Should anyone be tested for such a thing in a free society? And if someone has been clearly identified as a sociopath, what, if anything, can society do with that information? No other diagnosis raises such politically and professionally incorrect questions, and sociopathy, with its known relationship to behaviors ranging from spouse battering and rape to serial murder and warmongering, is in some sense the last and most frightening psychological frontier.
Indeed, the most unnerving questions are seldom even whispered: Can we say for sure that sociopathy does not work for the individual who has it? Is sociopathy a disorder at all, or is it functional? Just as unwelcome is the uncertainty on the flip side of that coin: Does conscience work for the individual, or group, who has it? Or is conscience, as more than one sociopath has implied, simply a psychological corral for the masses? Whether we speak them out loud or not, doubts like these implicitly loom large on a planet where for thousands of years, and right up to the present moment, the most universally famous names have always belonged to those who could manage to be amoral on a large-enough scale. And in our present-day culture, using other people has become almost trendy, and unconscionable business practices appear to yield unlimited wealth. On a personal level, most of us have examples from our own lives in which someone unscrupulous has won, and there are times when having integrity begins to feel like merely playing the fool.
Is it the case that cheaters never prosper, or is it true, after all, that nice guys finish last? Will the shameless minority really inherit the earth?
Such questions reflect a central concern of this book, a theme that occurred to me just after the catastrophes of September 11, 2001, propelled all people of conscience into anguish, and some into despair. I am usually an optimistic person, but at that time, along with a number of other psychologists and students of human nature, I feared that my country and many others would fall into hate-filled conflicts and vengeful wars that would preoccupy us for many years to come. From nowhere, a line from a thirty-year-old apocalyptic song invaded my thoughts whenever I tried to relax or sleep: “Satan, laughing, spreads his wings.” The winged Satan in my mind's eye, roaring with cynical laughter and rising from the wreckage, was not a terrorist, but a demonic manipulator who used the terrorists' acts to ignite the kindling of hatred all over the globe.
I became interested in my particular topic of sociopathy versus conscience during a phone conversation with a colleague of mine, a good man who is normally upbeat and full of encouragement but who was at that moment stunned and demoralized along with the rest of the world. We were discussing a mutual patient whose suicidal symptoms had become alarmingly worse, apparently on account of the disasters in the United States (and who has improved a great deal since then, I am relieved to report). My colleague was saying how guilty he felt because he was torn apart himself and might not have the usual amount of emotional energy to give to the patient. This extraordinarily caring and responsible therapist, overwhelmed by events, like everyone else, believed he was being remiss. In the middle of judging himself, he stopped, sighed, and said to me in a weary voice highly uncharacteristic of him, “You know, sometimes I wonder, Why have a conscience? It just puts you on the losing team.”
I was very much taken aback by his question, mostly because cynicism was so unlike this man's usual hale and hearty frame of mind. After a moment, I replied with another question. I said, “So tell me, Bernie. If you had a choice, I mean really, literally had a choice in the matter—which you don't, of course—would you choose to have a conscience like you do, or would you prefer to be sociopathic, and capable of . . . well, anything at all?”
He considered this and said, “You're right” (although I had not meant to imply telepathy). “I'd choose to have a conscience.”
“Why?” I pressed him.
There was a pause and then a long, drawn-out “Well . . .” Finally, he said, “You know, Martha, I don't know why. I just know I'd choose conscience.”
And maybe I was thinking too wishfully, but it seemed to me that after he made this statement, there was a subtle change in Bernie's voice. He sounded slightly less defeated, and we started to talk about what one of our professional organizations planned to do for the people in New York and Washington.
After that conversation, and for a very long time, I remained intrigued by my colleague's question, “Why have a conscience?” and by his preference to be conscience-bound rather than conscience-free, and by the fact that he did not know why he would make this choice. A moralist or a theologian might well have answered, “Because it's right,” or “Because I want to be a good person.” But my friend the psychologist could not give a psychological answer.
I feel strongly that we need to know the psychological reason. Especially now, in a world that seems ready to self-destruct with global business scams, terrorism, and wars of hatred, we need to hear why, in a psychological sense, being a person of conscience is preferable to being a person unfettered by guilt or remorse. In part, this book is my answer, as a psychologist, to that question, “Why have a conscience?” To get to the reasons, I first discuss people who are without conscience, the sociopaths—how they behave, how they feel—so that we can look more meaningfully into the value, for the other 96 percent of us, of possessing a trait that can be aggravating, painful, and—yes, it is true—limiting. What follows is a psychologist's celebration of the still small voice, and of the great majority of human beings who find themselves graced with a conscience. It is a book for those of us who cannot imagine any other way to live.
The book is also my attempt to warn good people about “the sociopath next door,” and to help them cope. As a psychologist and as a person, I have seen far too many lives nearly obliterated by the choices and acts of a conscienceless few. These few are both dangerous and remarkably difficult to identify. Even when they are not physically violent—and especially when they are familiar and close to us—they are all too capable of mangling individual lives, and of making human society as a whole an unsafe place to be. To my mind, this dominance over the rest of us by people who have no conscience at all constitutes an especially widespread and appalling example of what novelist F. Scott Fitzgerald referred to as “the tyranny of the weak.” And I believe that all people of conscience should learn what the everyday behavior of t
hese people looks like, so they can recognize and deal effectively with the morally weak and the ruthless.
Where conscience is concerned, we seem to be a species of extremes. We have only to turn on our televisions to see this bewildering dichotomy, to encounter images of people on their hands and knees rescuing a puppy from a drainage pipe, followed by reports of other human beings slaughtering women and children and stacking the corpses. And in our ordinary daily lives, though perhaps not so dramatically, we see the contrasts just as plentifully. In the morning, someone cheerfully goes out of her way to hand us the ten-dollar bill that we dropped, and in the afternoon, another person, grinning, goes out of his way to cut us off in traffic.
Given the radically contradictory behavior we witness every day, we must talk openly about both extremes of human personality and behavior. To create a better world, we need to understand the nature of people who routinely act against the common good, and who do so with emotional impunity. Only by seeking to discover the nature of ruthlessness can we find the many ways people can triumph over it, and only by recognizing the dark can we make a genuine affirmation of the light.
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