I know I shouldn’t say this – since readers today are as rare as phone booths – but I can’t help myself. This book is a must read. Ok, I said it, now we can move on. Just think, every time you go to a neighborhood barbecue or a sports bar or a small party or a Bible reading or a kayaking class, chances are quite good there is a sociopath in your midst. One in twenty five is thus categorized and even given a plus or minus uncertainty factor – this is an appalling statistic. The identifying characteristic of this condition is a lack of conscience but the talents, personalities and interests of these villains are as varied as the rest of ours.

Most of us think of extremists when we think of sociopaths: Charles Manson, John Wayne Gacy, Ted Bundy, Jim Jones, BTK, David Berkowitz etc. On the political stage we think Hitler, Stalin, Mussolini, Saddam, Mao, Pol Pot, Quaddafi, Kim Jong II etc. These are surely all sociopaths but what many fail to realize is that not all so afflicted become mass murderers or serial killers. The majority spread their poison in other ways. We all know them; they’re our teacher, our priest, our mailman; we just may not know the name or characteristics of their disorder – as they are very good at hiding it – except from their victims.

That’s a decided strength of this book; it uses anecdotes as illustrations. Dr. Stout describes the life story of five sociopaths and the damage they wreak. She demonstrates convincingly how they have different interests, talents and goals although the shell within remains consistently empty. One is a slacker who uses women as providers – he initially turns on the charm until entrapment, then ignores them after getting what he wants; another is a smart, charming, handsome but bitterly cruel CEO; the third a jealous woman who lives only to destroy her colleagues; yet another is a high school Principal that ends up murdering an intruder after secretly dealing drugs and mauling teenage girls – and lastly we’re told of a horrible suburban woman who lives only to torment her neighbors. These are the sociopaths next door. They can be anyone and are four of every 100 individuals.

By the way, to reduce confusion right off the bat, the terms sociopath, psychopath and anti-social personality are all synonymous. The clinicians should know better than to confuse us – it’s hard enough to get a bead on these cancerous leeches without experts adding to it. And their latest (anti-social personality disorder) is extremely lame. It sounds like a minor cocktail party liability, not the sadistic soulless affliction that it is. I prefer to stick with psycho as we all know what a psycho is, we all remember Anthony Perkins, and we all know the chill we felt upon first seeing some of the aforementioned sickos on TV for the first time. Why change a good word? Isn’t psychopathy, a disease of the psyche, exactly what we’re talking about? The author even brings up the term narcissist and makes a distinction, stating that narcissists have a conscience and feelings just no empathy. Well, could be, but when you combine with the term malignant – that’s another story. Stubbornly, I insist that malignant narcissist is yet another synonymous term. For the purpose of this discussion, lump them all together. Whatever term is currently en vogue, I think of them as sub-human sharks; cold, calculating and without feeling. Anyway, forgive the rant; just don’t let the terms confound you.

The fundamental characteristic – lack of conscience – is something most of us can’t even conceive of. With no moral inner voice to guide – any behavior is acceptable. If sadistic by nature and sexually deviant, a serial killer results, if indolent and apathetic – a shameless parasite, if bright and competitive – a CEO, if envious – a heartless career destroyer, if enthusiastic and presentable – a perverted school Principal; the list encompasses all professions and classes. The world is their oyster yet if the shell cracks open, nothing is there.

Dr. Stout produces a comprehensive list of the warning signs and anyone familiar with studies of these predators over the last century will feel a familiar ring. I won’t list them here but a real-life example – that is a possibility – is the former politician John Edwards. I don’t know for certain he’s a sociopath but from what little I’ve read, an affirmative wouldn’t surprise me in the least. Certainly has the glib and superficial charm thing down. Knows how to put on a mask for the cameras. His best friend is the mirror. But behind closed doors Mr. Hyde emerges. It’s probably a good thing he destroyed himself before getting into a position of further power.

Perhaps the most telling revelation in the book is the author’s discovery that sociopaths often use one particular emotion as their trump card, their ticket in, and their ace in the hole. It’s the ultimate empathic emotion called pity. If you pity someone you let them get away with anything. Think about it, it’s ingenious really. These creatures are cold, calculating and diabolical. They’ve spent a lifetime pushing buttons and playing roles to get what they want. Beware the pity ploy. Other warning signs should be common sense but people fall for them again and again – especially the vulnerable. Be wary of serial compliments and a remarkable interest in your thoughts – this is how the game begins. Going too fast or a push for a quick marriage is another red flag. Dr. Stout allows for two early lies for a normal person, we all have our faults after all, but three in succession indicates pathology. After achieving their objective, the mask is removed and it’s not pretty – the “Picture of Dorian Gray” comes to mind.

History
Sociopaths have been around since the dawn of man and are largely responsible for the terrible destruction that defines our history. We surely wouldn’t have the Greek legend of Narcissus if these self-absorbed monsters weren’t well known in the ancient world. We know of the evil idiot Nero and his exploits, the world-class raper and pillager Ghengis Khan, and the mad sadist Vlad the Impaler. Wherever a despotic tyrant takes control – a sociopath reigns – and the tyranny continues to this day. These loathsome miscreants have been called many things over the centuries but their destructive trails are a model of consistency. As well as we know the extreme historical figures, consider how many millions have been ordinary Joe Blow sociopaths – who have slipped beneath the radar screen – but whose egregious destruction through family, friends and colleagues differs from the genocidal maniac only in degree. In the 19th century the popular term for this condition was moral insanity, a term I still prefer. A Doctor involved in the Jack the Ripper slayings in 1888 gave a remarkably perceptive description of the type of man who was likely responsible – and it stood out only for its mundaneness; quite simply he suggested the killer likely the last man suspected in all of East London – a quiet, nondescript loser who kept his mask on until the coast was clear.

Science
Science has come a long way in its studies of these twisted creatures over the past 100 years. Especially of late, in the last decade or so, great leaps have been made in neuroscience. We now have hard evidence that the brains of sociopath’s differ from the rest of us. There are deficiencies in the neo-cortex and primitive limbic system that deal with emotion and socialization. In reactive tests, sociopaths’ flatline despite viewing terribly tragic scenes – the biological response to a bloody car wreck is identical to that of a set of tea cups. Their skin can be literally cold to the touch and they rarely jump if startled from behind. Sweating and nervousness are virtually non-existent. Risk taking, fearlessness, shamelessness, impulsiveness and boredom are hallmarks and many scientists believe these behaviors result from an absolutely unfathomable emotional vacuity, one so empty that dangerous extremes are the only thing that makes them feel alive!

Modern experiments suggest sociopathy to be at least 50% heritable and (perhaps to the chagrin of many Freudians) nature appears to be solidly trumping nurture in the debate. While it makes us feel better to say he had a poor childhood or his mother didn’t hug him enough or his father was cold and distant, it appears more and more likely that Johnny was just born that way. It’s been suggested that rather than the mother neglecting the infant; the sociopathic child instead rejects the mother, and especially her motherly affection. This is beyond terrifying and opens up a whole Pandora’s Box of moral questions. If, for example, we could determine in utero if a socio/psychopath was developing or if labeled with an early diagnosis – what should we do? Such a philosophical discussion is beyond the scope of this review but I will mention this, and Dr. Stout divulged few details, but apparently in the UK if diagnosed with Narcissistic Personality Disorder (NPD), measures are under discussion for legislating some sort of segregation – that’s all I know currently, stay tuned for further developments. I’m afraid we must eventually confront this dilemma – one doesn’t have to be a murderer to be extremely toxic and destructive – as the societal toll is incalculable. As much as I hate to say it, with its ancient and supernatural connotation, we have no better word than evil. But don’t be fooled, this evil comes from within, and its name is sociopathy and its face is an appealing mask. Perhaps if genetic engineering advances and becomes acceptable, we may one day zap sociopathic genes just as we would cancerous or schizophrenic ones.

Twenty percent of the prison population is sociopathic but consider how many are free, out and about, and walking among us. Remember, many are too clever to get caught and others technically commit no crimes. Emotional abuse is not against the law, is it? Neither is bullying nor bad mouthing nor alcoholism nor rampant promiscuity – doesn’t mean they aren’t detrimental.

Anytime there’s a Ponzi schemer, pedophile, con artist, religious charlatan, bank robber, embezzler, wife beater etc., chances are we’re dealing with a sociopath. With a rapist or murderer it’s nearly a sure thing. If this is at least half genetic and is present in one in twenty five, the glaring scientific question is: why do these blood suckers exist? The answer is rather disheartening and we’ve largely ourselves to blame (or at least our genes). To wit: those without consciences are great in times of war! Whenever you need a good torturer or a madman to do things like enter burning buildings, execute enemies, infiltrate enemy cartels, set fire to villages or drop nukes; these heartless robots are the ideal candidates. Unfortunately, in times of peace they are of no value whatever. Such is our conundrum.

Culture
It is a very astute move by the author to include a cultural discussion on this theme of personality disorder. If it’s a genetic condition why does the Western world, especially the U.S., seem to have so many more of these nasty individuals? In a word, we promote it. We love the rugged individualist who climbs to the top of the corporate ladder but do we bother to ask how he got there? Of course not, the end justifies the means and we often call his victims complainers or whiners or simply envious. Money and beauty are our twin gods and we idolize those that obtain them -regardless of the price of acquisition. Predatory sexual aggression gets sloughed off as ‘boys will be boys’, playground bullies are justified with “Oh, he’s just being assertive”, ‘that kid was a wimp who deserved it’ etc. Whistle blowers become pawns in political battles while the perpetrator comes off smelling like Chanel No 5. We’ve created a money grubbing race to the top and sociopathic traits are boon rather than bust. A greedy Capitalistic and socially Darwinistic culture is heroin to the narcissistic junkie. Need I mention Bernie Madoff, Jeffrey Skilling, and Bernie Ebbers? Is it a surprise that a recent study suggested that 10% of Wall Street traders are sociopaths? Do you think John Edwards wants to go through a clinical evaluation? How about Dick Cheney or Bill Clinton? Now again, I’m not impugning these politicians as sociopaths, but would it surprise us if they were? What about Leona Helmsley? This affliction doesn’t spare women; they are equally represented but for cultural reasons often operate undetected. The purpose here isn’t to indict Western culture or Capitalism or the United States, the author simply makes it clear that in a society like ours, sociopathic behaviors are often rewarded rather than punished. The good news is that most of these psychos flame out by the age of 40 or 50. It’s difficult to maintain the con that long; they usually end up in jail or as junkies/alcoholics or in some broken-down flophouse devoid of friends. This is the good news but unfortunately, some ride the con through a long and infamous life.

Many Eastern cultures are far different as they emphasize the collective (the family, the community, the village) over the individual. Petulant egoism is discouraged. Sharing is a virtue. Cooperation is rewarded. These cultural traits probably create a Pavlovian response that keeps run-of-the-mill sociopaths in check. Now again, the idea isn’t to suggest that sociopaths don’t exist in the East, far from it, and from their leadership – including Genghis, Mao, Hirohito and the current Kim Il Jong, we know they have risen to the top, but in everyday ordinary life they are less obvious and successful. Culture is the only explanation. This is a very interesting topic introduced by Dr. Stout and one which begs further research, and if lucky, could someday yield at least a best-case scenario for dealing with these devils in disguise.

Strategy
After an insightful list of the red flags to be on the alert for, the good Doctor discusses options if already ensnared in a web of destruction. Run! Scamper! Skedaddle! While acknowledging the difficulties of escape if the shark is your spouse, child or parent and if financially under a psychopath’s thumb, the only solution is separation, as history has shown these scoundrels to be incurable – especially as they admit no deficiencies. Would you negotiate with a wild leopard, a starving bear, an angry crocodile? This scenario is comparable. Get out of the relationship as fast and painlessly as possible. Dr. Stout’s aware this is no easy task but a fully focused effort is crucial. The alternative is a life of pain.

Conclusion
All of us are attracted to a shiny surface and beauty is a universal calling card but beware the falcon in a fedora, the barracuda in a bmw, the sadist in a seersucker suit, the lovely Lolita layered in lapis lazuli. If someone seems too good to be true they probably are – go with your gut instinct – victimization is a painful predicament. The best strategy vs. sociopaths is avoidance. If you don’t bite you can’t be reeled in. If you’ve been snared run like a wild cheetah.

Dr. Stout has used her many years of clinical experience to alert us to the dangers, the warning signs, and the web of deceit propagated by the sociopath. She is trying to help those of us not yet left in tatters by these demons. Her knowledge and research skills are impressive, her case studies insightful and her empathy endearing. I’ve merely touched the surface here, with my usual tangents and asides, so read the book for its depth, breadth and details. I’ll close the circle with a reiteration of my initial statement, do read this book, you never know, it just might save your life.

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Read more from this author:

Solaris – A Review

Metaphysics

Review of “god is not Great”

Are Humans the Homeliest Species?