The Empathy Trap

Understanding Antisocial Personalities

Jane McGregor

• Publisher: Sheldon Press
• Year: 2013
• Print ISBN: 9781529329209
• eBook ISBN: 9781847092779
• Topic: Personal Development
• Subtopic: Self Improvement

Sociopathy affects an estimated 1- 4% of the population, but not all sociopaths are cold-blooded murderers. They're best described as people without a conscience, who prey on those with high levels of empathy, but themselves lack any concern for others' feelings and show no remorse for their actions. Drawing on real life cases, The Empathy Trap: Understanding Antisocial Personalities explores this taboo subject and looks at how people can protect themselves against these arch-manipulators. Topics include: - Defining sociopathy, and related conditions such as psychopathy, narcissism, and personality disorder - How sociopaths operate and why they're often difficult to spot - Identifying sociopathic behavior - The sociopath's relations with other people and why they often go unpunished - Coping with the aftermath of a destructive relationship - Re-establishing boundaries and control of your life - Practical advice for keeping sociopaths at bay - Resources and further help.

1

Introduction: what the book is about

This book is designed to heighten awareness of the problems of sociopathic abuse – and equip you to spot, avoid or remove sociopaths from your life.

Sociopaths are individuals with little or no conscience or ability to empathize with others’ feelings. One sociopath (some people prefer the term psychopath) in the course of his or her lifetime will affect many, many people in a myriad harmful ways: bullying work colleagues, abusing children, instigating domestic violence or traumatizing friends and family through a sustained campaign of emotional abuse. Our purposes in writing the book are to reach out and offer supportive guidance to those who already have been targeted by a sociopath, and to forewarn and forearm others who want to reduce the likelihood of being a target of abuse themselves.

The book is also about harnessing your powers of empathy. On the one hand, empathic people prove eye-catching quarry to the sociopath; on the other, if the expression of empathy was more widely approved by society at large it could provide a powerful antidote to sociopathic abuse. This is the ‘empathy trap’ of the book’s title.

Sociopaths in society

For simplicity’s sake we use sociopath in the book as a catch-all term. Because the medical profession continues to debate the exact features of this condition, we will not be exploring it in detail. Our aim is to highlight not the condition itself, but the destructive effects of sharing your life with someone who has a sociopathic disorder.

Sociopaths are chameleon-like and lurk freely among us. They pose a serious threat to humankind, harming individuals, families and communities the world over, affecting the health and well-being of millions daily. Yet, for reasons explored in this book, they exist largely unseen; and this lack of awareness and responsiveness means that the traumas they inflict upon their many targets go undetected.

Sociopaths exist in greater numbers than you might suppose, although it is hard to know for sure just how many there are. Since most estimates are derived from data based on specific sub-groups like prison populations rather than the general population, and the condition has been subject to regular redefinition, estimates for sociopathy in society vary considerably. Martha Stout, a psychologist who treats the survivors of psychological trauma, informs us in her valuable book The Sociopath Next Door that 4 per cent of the general population are sociopathic. This estimate is derived from a large clinical trial involving primary care patients in the United States, which found that 8 per cent of men and 3.1 per cent of women met the criteria for a diagnosis of anti-social personality disorder (AsPD), one of the terms used to describe those displaying sociopathic traits. The frequency of the condition was higher (13.4 per cent for men and 4 per cent for women) for those people with a history of childhood conduct disorder (a precursor of adult sociopathy).¹ Meanwhile researchers Paul Babiak and Robert Hare estimate that 1 per cent of the population have the condition, with another 10 per cent or more falling into what they call the ‘grey zone’. In their book Snakes in Suits,² Babiak and Hare suggest that the prevalence is likely to be higher in some groups including the business world, the philosophy and practices of which encourage sociopathic traits such as callousness and grasping behaviour.

Australian psychologist John Clarke has been working along the same lines as Babiak and Hare. In his book Working with Monsters³ he reports that up to 0.5 per cent of women and 2 per cent of men could be classified as sociopathic (like Babiak and Hare he prefers the term ‘psychopath’). A British study has estimated the prevalence of sociopathy in the general population at just under 1 per cent (approximately 620,000 people in the UK), although like other studies, this study found that prevalence is higher among certain groups including prisoners, the homeless, and people who have been admitted to psychiatric institutions.⁴

As you can see, estimates of sociopathy in the general population vary from less than 1 person in 100 to 1 in 25. Even at the more conservative end of the estimates, this translates into a possible 3.13 million sociopaths in the USA. And worldwide it equates to a figure of around 70 million. So the fact that sociopathic abuse remains such an overlooked problem is surprising, if not shocking. The cruelty of sociopaths finds no bounds, for there is no recourse, treatment or punishment to permanently stop them.

Sociopath-induced distress and trauma

Individuals who have been targeted by a sociopath often respond with self-deprecating statements like ‘I was stupid’, ‘What was I thinking?’ or ‘I should’ve listened to my gut instinct.’ But being involved with a sociopath is like being brainwashed. The sociopath’s superficial charm is usually the means by which he or she conditions people. On initial contact a sociopath will often test other people’s empathy, so questions geared towards discovering whether you are highly empathetic or not should ring alarm bells. Those with a highly empathetic disposition are often targeted. Those who have lower levels of empathy are often passed over, though they may be drawn in and used by sociopaths as part of their cruel entertainment, as we discuss later in the book.

Those living with a sociopath usually exist in a state of constant emotional chaos. They may feel anxious and afraid, not knowing when the sociopath will fly into a rage. The sociopath meanwhile carries on untouched, using aggression, violence or emotional bullying to abuse his or her partner. Sociopaths are often aggressive, though not all of them exhibit violent or criminal behaviour. Aggression is not limited to men either; sociopathic women can be aggressive and violent too. Sociopaths make up 25 per cent of the prison population, committing more than twice as many violent and aggressive acts as other criminals do. Violent sociopaths who cheat on their partners or defraud people are the ones most likely to get caught. According to Robert Hare, the author of Without Conscience, in the United States approximately 20 per cent of male and female prisoners are sociopaths. They commit more than twice as many violent and aggressive acts as do other criminals and are responsible for more than 50 per cent of all serious crimes. When they get out of prison, they often return to crime. The reoffending rate of sociopaths is about double that of other offenders and for violent crimes it is triple.⁵

As well as inflicting physical trauma on others, there is the added and less visible burden of sociopath-induced emotional trauma, which if left unchecked can lead to anxiety disorders, depression and post-traumatic stress disorder (PTSD). Chronically traumatized people often exhibit hyper-vigilant, anxious and agitated behaviour. They may also experience insomnia and assorted somatic (bodily) symptoms such as tension headaches, gastrointestinal disturbances, abdominal pain, back pain, tremors and nausea. Exposure to and interaction with a sociopath in childhood can leave lifelong scars, including a deep mistrust of other people and anxiety in social situations. Yet for all these problems, no one knows the true extent or depth of mental anguish suffered by those on the receiving end of chronic sociopathic abuse, because in the majority of cases the physical and mental health problems either go undetected or the root cause is overlooked.

We believe that sociopathic abuse thus has a substantial public health dimension and as such warrants far more attention than it attracts at present. The public need to be more alert and equipped to counter the problem and to stop sociopaths from interfering in adverse ways in other people’s lives. Furthermore, effective responses and interventions are required to reduce the range and extent of sociopathic abuse suffered by people the world over.

Defining the problem

As we stated at the outset, this book is not about sociopaths or the condition per se; it is about surviving the harm they cause. We will only set out to define the condition loosely, because we aren’t convinced that current terminology and labels are especially useful. The distinctions between labels like sociopathy, anti-social personality disorder, borderline personality disorder (BPD), narcissistic personality disorder (NPD),⁶ and psychopathy are blurred and confusing. In fact we hope at some point that psychiatry will get away entirely from the existing labels and redefine them all as conditions of low or zero empathy – something we discuss further over the next few pages. Nevertheless we feel some discussion of the changing conceptualization of sociopathy is justified, so we’ll next highlight some key turning points in defining the problem.

The idea that there are people who look human but are not, and who exist without empathy or concern for the rest of humanity, was first mooted in 1801 by the physician Philippe Pinel (1745–1826).⁷ In his work A Treatise on Insanity, Pinel named the condition manie sans délire, which roughly translated means ‘madness without delusion’. Some time later, an English doctor, J. C. Pritchard (1786–1848), ascribed the term ‘moral insanity’ to the condition. Pritchard described it as ‘a form of mental derangement in which the intellectual faculties [are uninjured] while the disorder is manifested principally or alone in the state of feelings, temper or habits . . . The moral principles of the mind . . . are depraved or perverted, the power of self-government is lost or greatly impaired, and the individual is . . . incapable of conducting himself with decency and propriety in the business of life’.⁸

Nearly 100 years on, in 1941, American psychiatrist Hervey Cleckley published The Mask of Sanity, a book which first described the diagnostic criteria for the ‘psychopathic personality’. This was based primarily on experience with adult male psychopaths hospitalized in a closed institution. From his observations Cleckley drew up a set of diagnostic criteria, including superficial charm, a lack of anxiety or guilt, undependability or dishonesty, egocentricity, an inability to form lasting intimate relationships, a failure to learn from punishment, poverty of emotions, a lack of insight into the impact of one’s behaviour, and a failure to plan ahead. Interestingly his definition of a psychopath made no reference to physical aggression or breaking the law.

From our perspective, Cleckley’s best definition of psychopathy comes in a later edition of the book, in which he described a psychopath as ‘a biologic organism outwardly intact, showing excellent peripheral function, but centrally deficient or disabled’. We like both the elegance of this description and the way it pinpoints how hard it is to spot sociopaths given their ordinary outward appearance.

Subsequent to Cleckley’s book, revisions of the classification were made by the American Psychiatric Association (APA). The classification of psychopathic personality was changed to that of sociopathic personality in 1958. In 1968 it was changed again to anti-social personality. After this Robert Hare elaborated on Cleckley’s work to create the Psychopathy Checklist (PCL) and later a revised version, the PCL-R, which became the ‘gold standard’ assessment measure used to diagnose psychopathy. The PCL-R, which remains the standard measure today, identifies as typical of the psychopath interpersonal deficits such as grandiosity, arrogance and deceitfulness, affective deficits (lack of guilt and empathy), and impulsive and criminal behaviours.

Hare stated that the difference between psychopathy and sociopathy ‘reflects the user’s views on the origins and determinates of the clinical syndrome or disorder’. In other words some experts are convinced that the condition is forged entirely by social forces and call the condition sociopathy, whereas others are convinced that it is derived from a combination of psychological, biological and genetic factors and hence prefer the term psychopathy.⁹

Debate surrounding sociopathy and psychopathy and whether they are the same or different continues unabated today. The International Classification of Diseases diagnostic criteria of the World Health Organization (ICD-10) do not include psychopathy as a personality disorder and neither psychopathy nor sociopathy is currently referred to in diagnostic manuals, though both terms are widely used by mental health professionals and the public alike. In medical circles in recent years both terms have been replaced by the term anti-social personality disorder, though controversy over the definition of the disorder continues in debates over the American Psychiatric Association’s upcoming Diagnostic and Statistical Manual of Mental Disorders V (DSM V). The current manual – DSM IV – puts emphasis on AsPD, but the criterion for AsPD lacks some key elements of sociopathy and psychopathy, with some experts regarding the current definition as describing criminality rather than sociopathy. Plenty more people can be diagnosed with AsPD than sociopathy or psychopathy, leaving the condition closer to the parameters of ‘normal’ human behaviour. In contrast the terms sociopathy and psychopathy help maintain the idea that the condition is distinct and extreme, hence serving to reassure the rest of us that the problem exists only in small numbers and only at the margins of society.

Adding to the debate, some theorists speculate that people behave cruelly not because they are intrinsically evil (a concept many consider outmoded), but because they lack empathy. According to Simon Baron-Cohen, an expert in developmental psychopathology at the University of Cambridge, limited or zero empathy may result from physical and psychological characteristics but empathy deficits can be turned around if people are taught to be more empathic. He points to the need to identify treatments (as yet none are available but trials are currently being conducted with families of children with conduct disorder, a child version of sociopathy) that will teach empathy to those who lack it.

Putting empathy under the microscope – or rather the modern-day gadgetry of functional magnetic resonance imaging (fMRI) – Baron-Cohen explores new ideas about empathy in his book Zero Degrees of Empathy.¹⁰ He suggests that the level of empathy most of us experience varies according to the conditions we face at any given moment, although all of us have a predetermined level of empathy which we generally return to (our pre-set position, if you like) on what he calls the empathy spectrum. This spectrum ranges from six degrees at one end, down to zero degrees at the other. At six degrees we have highly empathic people, while at zero degrees we have the sociopath. For his research Baron-Cohen constructed an Empathy Quotient or EQ test that is intended as a measure to determine how easily you pick up on and how strongly you are affected by others’ feelings. This is accessible online and we have also included it at the back of this book (see the Appendix).

Baron-Cohen also suggests that deep in the brain lies the empathy circuit. This is thought to involve at least ten interconnected brain regions, all regions of what is termed the ‘social brain’. The first is the medial prefrontal cortex (MPFC), which is thought of as the ‘hub’ for social information processing and considered important for comparing your own perspective to someone e...

Table of contents

• FC
• The Empathy Trap: Understanding Antisocial Personalities
• Overcoming Common Problems Series
• Title
• Dedication
• Copyright
• Contents
• Acknowledgements
• 1 Introduction: what the book is about
• 2 Everyday sociopaths
• 3 A profile of the sociopath
• 4 Interactions of the sociopath
• 5 Coping in the aftermath of a destructive relat
• 6 Establishing boundaries and regaining control of your life
• 7 Dealing with complex family situations
• 8 End-stage recovery
• Appendix: The Empathy Quotient (EQ) test
• Useful addresses
• References
• Further reading and resources
• Search terms