The devil wore J. Crew

But if there isn't much data, how can you feel confident about your conclusion?

The 4 percent figure involves my equalizing a certain assumption that there are probably as many female sociopaths as male sociopaths. In the beginning, people thought that it was just men. Now we're getting to the point where most researchers will say that perhaps there are as many women as men. Their behavior is just more difficult to pinpoint. You're not going to get everyone to agree on that, but it seems to be coming to that.

So you consider this figure an estimate?

Definitely. And I consider it a conservative estimate. And let's say it's half that -- that's still one in 50 people. I feel very confident about it, and many of my colleagues have told me off the record that they also think it's a conservative estimate.

Why off the record?

Because they're not referring to any particular research. They're just making observations based on their own practice.

Why is women's sociopathy more difficult to pinpoint?

In general, women are less physical and more verbal in the way they express things. For a sociopath who is a woman, one would expect more social manipulation. Of course, women can be violent, but it's less likely.

And that's why we don't see them as criminals? Because beating someone is a crime, but harming them emotionally is not?

Exactly. Getting someone fired or tormenting your children is usually pretty private and not always actionable.

What makes you decide that a person is or isn't a sociopath?

Conceptually, for the purposes of the book, I'm talking about people who have exhibited symptoms such as extreme chronic deceitfulness, lack of remorse, lack of personal responsibility, and a general desire to control people and make them jump.

Clinically speaking, if someone is suspected of sociopathy, then the therapist would consider the DSM [The Diagnostic and Statistical Manual of Mental Disorders IV's assessment for antisocial personality disorder] and apply the Hare inventory [the Psychopathy Checklist developed by Dr. Robert Hare]. Then we would talk to other people in the person's family and in that person's past and try to pin down the diagnosis.

You mention the Psychopathy Checklist. What's the difference between a psychopath and a sociopath?

There is no completely agreed-upon difference between those two terms, but there are people who in their own studies will make a distinction. I tend to use them synonymously, and for the book I settled on "sociopathy." People confuse "psychopathy" with "psychotic" -- someone who is crazy and has hallucinations. That's not what we're talking about, so I think "sociopath" is clearer.

What does it mean to lack a conscience?

It's a completely alien mindset. Most of us can imagine what it's like to have depression or even be crazy. But not having a conscience? You can't love anyone, even your own children? I believe that conscience, or lack of it, is a much more fundamental distinction than our moods or sense of rationality. All of us can be a little irrational. But our capacity to be emotionally linked to other people is much more fundamental, so much so that we don't even think about it. You don't ask yourself if you're going to give your child lunch money. You don't think of that as making a choice.

You said you became aware of this problem because of the things that your patients told you. What kinds of issues were they dealing with?

The people I work with were traumatized in childhood. I'm talking about moms and dads who inflicted terrible tortures on their children, stories that are very hard to hear. Kids that were seriously abused physically and sexually, kids that were abandoned.

Are the majority of sociopaths committing really heinous crimes?

No. Most sociopaths are not violent and probably never will be. They are the people we see every day: The boss who likes to ridicule people. The seduce-and-abandon lover who does this mainly for fun. The person who marries for money or prestige and no apparent other reason. These people aren't necessarily serial killers, but they cause a lot of harm.

So how do you know if your boss is a sociopath or just a jerk?

If you have a jerk boss who's lazy and always wants you to do things at the last minute, or asks for unreasonable things like making coffee, that's not necessarily sociopathy. If you have a boss who likes to ridicule people and make them jump and seems to get a kick out if it, that's more likely to be sociopathy. It's motivation.

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