The Sociopath Next Door

by Martha Stout PhD

  As a counterpoint to sociopathy, the condition of narcissism is particularly interesting and instructive. Narcissism is, in a metaphorical sense, one half of what sociopathy is. Even clinical narcissists are able to feel most emotions as strongly as anyone else does, from guilt and sadness to desperate love and passion. The half that is missing is the crucial ability to understand what other people are feeling. Narcissism is a failure not of conscience but of empathy, which is the capacity to perceive emotions in others and so react to them appropriately. The poor narcissist cannot see past his own nose, emotionally speaking, and as with the Pillsbury Doughboy, any input from the outside will spring back as if nothing had happened. Unlike sociopaths, narcissists often are in psychological pain, and may sometimes seek psychotherapy. When a narcissist looks for help, one of the underlying issues is usually that, unbeknownst to him, he is alienating his relationships on account of his lack of empathy with others, and is feeling confused, abandoned, and lonely. He misses the people he loves, and is ill-equipped to get them back. Sociopaths, in contrast, do not care about other people, and so do not miss them when they are alienated or gone, except as one might regret the absence of a useful appliance that one had somehow lost.

  For their own reasons, sociopaths sometimes marry, but they never marry for love. They cannot fall genuinely in love, not with their spouses, their children, or even a pet. Clinicians and researchers have remarked that where the higher emotions are concerned, sociopaths can “know the words but not the music.” They must learn to appear emotional as you and I would learn a second language, which is to say, by observation, imitation, and practice. And just as you or I, with practice, might become fluent in another language, so an intelligent sociopath may become convincingly fluent in “conversational emotion.” In fact, this would seem to be only a mildly challenging intellectual task, quite a lot easier than learning French or Chinese. Any person who can observe human actions even superficially, or who can read novels and watch old movies, can learn to act romantic or interested or softhearted. Virtually anyone can learn to say “I love you,” or to appear smitten and say the words, “Oh my! What a cute little puppy!” But not all human beings are capable of experiencing the emotion implied by the behavior. Sociopaths never do.

  Nurture

  Still, as we know from the study of so many other human characteristics, genetic predispositions and neurobiological differences do not comprise unavoidable destinies. The genetic marble of our lives predates our birth, but after we are delivered, the world takes up its sculptress's knife and begins to chisel with a vengeance, upon whatever material nature has provided. Heritability studies tell us that for sociopathy in particular, biology is half of the story at most. In addition to genetic factors, there are environmental variables that affect the condition of being without conscience, though, as we are about to see, just what these influences are remains somewhat obscure.

  The speculation about social factors that makes the most immediate, intuitive sense is childhood abuse. Perhaps some people with a genetic and neurological predisposition to sociopathy ultimately become sociopathic, while others do not, because the ones who become sociopaths are abused in childhood, and the abuse worsens their psychological status and possibly even their already compromised neurological functioning. After all, we know as a certainty that childhood abuse has a large number of other negative outcomes, among them run-of-the-mill (nonsociopathic) juvenile delinquency and violence, adult depression, suicidality, dissociation and various divisions of consciousness, anorexia, chronic anxiety, and substance abuse. Psychological and sociological studies show us beyond the shadow of a doubt that childhood abuse is unrelentingly toxic to the psyche.

  But the problem with attributing sociopathy to early abuse is that, quite unlike nonsociopathic juvenile delinquency and ordinary violent behavior, there is no convincing body of findings linking the core characteristic of sociopathy—that is, the absence of conscience—with childhood maltreatment. Furthermore, sociopaths as a group are not afflicted with the other tragic consequences of childhood abuse, such as depression and anxiety, and we know from a substantial accumulation of research evidence that survivors of early abuse, whether they be lawbreaking or not, are predictably plagued by such problems.

  In fact, there is some evidence that sociopaths are influenced less by their early experience than are nonsociopaths. In Robert Hare's diagnostic and statistical studies of American prison inmates, for example, for prisoners who were diagnosed as psychopaths, using the Psychopathy Checklist developed by Hare, quality of family life in childhood had no effect whatsoever on the timing of criminal behavior. Whether their family life had been stable or not, those diagnosed as psychopaths first appeared in court at an average age of fourteen. In contrast, for inmates who were not diagnosed as psychopaths (prisoners whose underlying personality structures were more normal), the age at which criminal behavior began was strongly linked with quality of family background. Those with a more stable past first appeared in court at an average age of twenty-four, and those with a troubled background came to court for the first time at about fifteen. In other words, a hardscrabble existence nurtures and hastens ordinary criminal activity, just as one might expect, but the criminality that results from the remorselessness of sociopathy has the appearance of flowering all by itself, and according to its own timetable.

  Still searching for environmental influences on the development of sociopathy, many investigators have turned to the concept of attachment disorder, rather than childhood abuse per se. Normal attachment is an innate system in the brain that motivates an infant to seek the nearness of her parent, or whatever caregiver is available, so that the very first interpersonal relationship can be formed. This first relationship is crucial not only for reasons of infant survival but also because it allows the infant's immature limbic system to “use” the mature functions of the adult's brain to organize itself. When a parent reacts empathically to an infant, the child's positive emotions, such as contentment and elation, are encouraged, and her potentially overwhelming negative emotions, such as frustration and fear, can be moderated. This arrangement promotes a sense of order and safety that will eventually be encoded in the baby's own memory, providing her with a portable version of what John Bowlby referred to in Attachment and Loss as a “secure base” in the world.

  Research tells us that adequate attachment in infancy has many happy outcomes, including the healthy development of emotional self-regulation, autobiographical memory, and the capacity to reflect upon one's own experiences and actions. Perhaps most important, attachment in infancy allows the individual to create affectionate bonds with other people later on. The earliest attachments are formed by seven months of age, and most human infants succeed in becoming attached to a first caregiver in a way that develops these important capabilities.

  Attachment disorder is a tragic condition that occurs when attachment in infancy is disrupted, because of parental incompetence (as in serious emotional disorder on the part of the parent) or because the infant is simply left too much alone (as in an old-fashioned orphanage). Children and adults with severe attachment disorder, for whom attachment was not possible during the first seven months of life, are unable to bond to others emotionally, and are thereby directed to a fate that is arguably worse than death. In the extreme case, as was discovered in the United States in the ultrahygienic orphanages of the nineteenth and early twentieth centuries, infants who are not touched at all, for purposes of antiseptic perfection, are prone to die quite literally. Succumbing mysteriously to a condition then referred to as marasmus, a Greek word that means “wasting away”—a disorder now called “nonorganic failure to thrive”—nearly all of the untouched babies in these orphanages perished. In the intervening hundred years, developmental psychologists and pediatricians have learned that it is crucially important to hold, cuddle, talk to, and caress babies, and that the consequences of not doing so at all are heartbreaking.

  In Western Europe and
in the United States (which, ironically, is one of the least tactile societies on earth), the grief and loss that attachment disorder can bring was personally experienced by many families during the compassionate rush in the early 1990s to adopt orphaned children from Romania. In 1989, when the Communist regime in Romania fell, horrifying photographs were released to the rest of the world of the hundreds of orphanages that had been kept secret by the psychopathic dictator Nicolae Ceauşescu. Under his regime, Romania was a nation of nearly unsurvivable poverty, and yet Ceauşescu had prohibited both abortion and birth control. Hundreds of thousands of starving children resulted, and nearly 100,000 orphaned children ended up in state-run institutions. Overall in these orphanages, the ratio of orphans to staff was about forty to one. Conditions were grotesquely unsanitary, and except for being given enough food to keep most of them alive, the babies and children were ignored.

  The kindest solution seemed to be for affluent foreigners to adopt as many of these children as possible. Well-meaning Western Europeans and North Americans brought Romanian babies into their homes and lovingly tried to nurse them to health. And then a couple in Paris would discover that their beautiful ten-month-old Romanian daughter was inconsolable, and only screamed louder when they tried to hold her. Or a couple in Vancouver would walk into their three-year-old son's bedroom, to find that he had just hurled the new kitten out the window. Or parents in Texas would finally have to admit to themselves that they could not keep their adoptive five-year-old son from spending his days staring into a corner, and that he sometimes viciously attacked their other children in the middle of the night as they slept. Western Europe and North America had imported an attachment disorder nightmare created by a sadistic Romanian sociopath who was no longer even alive. Having been completely deprived of attachment in infancy, many of these rescued children were loveless.

  In June 2001, the new leadership of Romania ordered a ban on foreign adoptions, not out of humanitarian concern, but for political and financial reasons. The European Union had just pronounced that impoverished Romania, with its outflow of orphans, had become a “marketplace for children,” and would be unlikely to achieve membership in the prosperous fifteen-nation union unless the politically incorrect out-of-country adoptions were terminated. At this writing, more than forty thousand children—a small city's worth—still live in institutions in the Republic of Romania, which is angling for EU membership in 2007.

  Especially since the exposure of the Romanian orphan crisis, psychologists have wondered whether attachment disorder might be the environmental root of sociopathy. The similarities are obvious. Children who suffer from attachment disorder are impulsive and emotionally cold, and are sometimes dangerously violent toward their parents, siblings, playmates, and pets. They tend to steal, vandalize, and start fires, and they often spend time in detention facilities when they are young and in jail when they become adults, just like sociopaths. And children with severe attachment disorders are the only children who are almost as fundamentally scary to us as young sociopaths are.

  These similarities have been noticed in many parts of the world. In Scandinavian child psychiatry, for example, a condition called “early emotional frustration” is thought to be caused by a lack of mutual bonding between mother and child, and in Scandinavia, this diagnostic term (early emotional frustration) is used to flag a child's greater than average chance of developing a sociopathic character disorder by adulthood. Early emotional frustration is statistically linked to factors that may make mother-infant attachment more difficult, such as preterm birth, extremely low birth weight, and maternal substance abuse during pregnancy.

  There are some minor design problems in this kind of research. For instance, certain factors, such as maternal substance abuse during pregnancy, could easily implicate sociopathic mothers, and therefore a return to the genetic explanation. But the major problem with the equation of attachment disorder and sociopathy, despite the scientifically tempting commonalities of the two, is their persistent and undeniable dissimilarity with respect to the trademark features of sociopathy. Quite unlike sociopaths, children and adults afflicted with attachment disorders are seldom charming or interpersonally clever. On the contrary, these unfortunate individuals are typically somewhat off-putting, nor do they make any great efforts to “fake” being normal. Many are isolates. Their emotional presentation is flat and uninviting, or sometimes directly hostile, and they tend to swing between the distinctly nonseductive extremes of belligerent indifference and unmeetable neediness. None of this allows in any way for the chameleonlike manipulations and con games of the sociopath, with his smiling deceptions and disarming charisma, or for the intermittent success in the material world that the rather sociable sociopath often achieves.

  Many clinicians and parents have reported that sociopathic children refuse to form warm relationships with family members. They tend to pull away, both emotionally and physically. And, of course, so do children with attachment disorders. But very unlike the situation with the sad attachment disorder child, detachment from family is much more likely to be a result of the young sociopath's way of being in the world than it is to be the cause of it.

  And so, in summary, we have some idea of what one of the underlying neurobiological deficits in sociopathy may be. The sociopaths who have been studied reveal a significant aberration in their ability to process emotional information at the level of the cerebral cortex. And from examining heritability studies, we can speculate that the neurobiological underpinnings of the core personality features of sociopathy are as much as 50 percent heritable. The remaining causes, the other 50 percent, are much foggier. Neither childhood maltreatment nor attachment disorder seems to account for the environmental contribution to the loveless, manipulative, and guiltless existence that psychologists call sociopathy. How nongenetic factors affect the development of this profound condition, and they almost certainly do have an effect, is still mainly a puzzle. The question remains: Once a child is born with this limiting neurological glitch, what are the environmental factors that determine whether or not he will go on to display the full-fledged symptoms of sociopathy? And at present, we simply do not know.

  Culture

  It is entirely possible that the environmental influences on sociopathy are more reliably linked with broad cultural characteristics than with any particular child-rearing factors. Indeed, relating the occurrence of sociopathy to cultures has so far been more fruitful for researchers than looking for the answer in specific child-rearing variables. Instead of being the product of childhood abuse within the family, or of attachment disorder, maybe sociopathy involves some interaction between the innate neurological wiring of individuals and the larger society in which they end up spending their lives.

  This hypothesis is bound to be disappointing to some people, because though altering the conditions of pregnancy, childbirth, and child treatment on a massive scale would be no small project, changing the values and belief systems of an entire culture is an even more gigantic undertaking, with a time horizon that seems distant and discouraging. We might feel a little less daunted if we were to identify a set of child-rearing practices that we could try to correct in our lifetimes. But perhaps society is the true parent of certain things, and we will eventually find that, as William Ralph Inge said in the early twentieth century, “The proper time to influence the character of a child is about 100 years before he is born.”

  From recorded observations, we do know that sociopaths, by various names, have existed in all kinds of societies, worldwide and throughout history. As an illustration, psychiatric anthropologist Jane M. Murphy describes the Inuit concept of kunlangeta, which refers to a person whose “mind knows what to do but does not do it.” Murphy writes that in northwest Alaska, kunlangeta “might be applied to a man who, for example, repeatedly lies and cheats and steals things and does not go hunting, and, when the other men are out of the village, takes sexual advantage of many women.” The Inuits tacitly assume that kunlang
eta is irremediable. And so, according to Murphy, the traditional Inuit approach to such a man was to insist that he go hunting, and then, in the absence of witnesses, push him off the edge of the ice.

  Though sociopathy seems to be universal and timeless, there is credible evidence that some cultures contain fewer sociopaths than do other cultures. Intriguingly, sociopathy would appear to be relatively rare in certain East Asian countries, notably Japan and China. Studies conducted in both rural and urban areas of Taiwan have found a remarkably low prevalence of antisocial personality disorder, ranging from 0.03 percent to 0.14 percent, which is not none but is impressively less than the Western world's approximate average of 4 percent, which translates to one in twenty-five people. And disturbingly, the prevalence of sociopathy in the United States seems to be increasing. The 1991 Epidemiologic Catchment Area study, sponsored by the National Institute of Mental Health, reported that in the fifteen years preceding the study, the prevalence of antisocial personality disorder had nearly doubled among the young in America. It would be difficult, closing in on impossible, to explain such a dramatically rapid shift in terms of genetics or neurobiology. Apparently, cultural influences play a very important role in the development (or not) of sociopathy in any given population.

  Few people would disagree that, from the Wild West of the past to the corporate outlaws of the present, American society seems to allow and even encourage me-first attitudes devoted to the pursuit of domination. Robert Hare writes that he believes “our society is moving in the direction of permitting, reinforcing, and in some instances actually valuing some of the traits listed in the Psychopathy Checklist—traits such as impulsivity, irresponsibility, lack of remorse.” In this opinion he is joined by theorists who propose that North American culture, which holds individualism as a central value, tends to foster the development of antisocial behavior, and also to disguise it. In other words, in America, the guiltless manipulation of other people “blends” with social expectations to a much greater degree than it would in China or other more group-centered societies.