The devil wore J. Crew

So how do you spot a sociopath?

This is very unscientific, but small children seem to be better than adults at being afraid of people who are not warm, people who have damaged interpersonal emotion abilities. There is an instinct in all of us to know when someone is not relating to us with a real attachment.

More scientifically, the best I can offer is the rule of three. If someone lies to you once or twice, it could be a misunderstanding. If someone lies to you three times, then chances are you're dealing with a liar. And deceit is the central behavior of sociopathy.

You say in your book that sociopaths can be very charming. We've all had the experience of being around someone who is very flattering and uses that salesman's trick of saying your name a lot. Is that what we're talking about?

It can be that. But it can also be a quiet kind of charm -- the all-American boy or girl. The shy person who needs to be rescued. People also talk about sociopathic eyes. There is a primal predatory charm that no one has been able to explain. What you hear over and over is that these charming eyes suddenly turned into empty, reptilian eyes.

Are you worried about people getting paranoid from reading the book?

I was concerned that people would begin to see sociopaths all around them, but I have not found that. What I have found, and what breaks my heart, is that I'm hearing from good people who are afraid that they are sociopaths. They are feeling disconnected from people for a variety of reasons and are questioning their own dark sides. But if you're questioning your attachments to others and questioning your dark side, you don't have very much of one. That is not a concern that a sociopath would have.

Do you ever see sociopaths in therapy?

Not unless the court refers them. They feel just fine about themselves.

Do they think we feel love and empathy? Or do they think we're all just faking it?

They see that we have love and empathy. But I've heard them say that conscience is a sham, that it doesn't exist. They'll say, "That schmuck didn't go for what he wanted because it was against his conscience. Who does he think he's kidding?"

In your book you use composites of sociopaths and their victims. Why did you decide to tell their stories this way?

I did that way in "The Myth of Sanity" also. It's part of my instinct as a therapist to preserve everybody's confidentiality, even the guilty. I also have to have legal concerns about making statements about people.

You have one example of a women caught practicing psychology without a license or even a degree, and she did some pretty devastating harm to her patients. She told them that other therapists were lying to them and even sent one man to a locked ward after his therapist had recommended his discharge. How did she react when she was caught?

There was a complete lack of guilt or even embarrassment. After being seriously questioned about it, she walked out of the room as if she had been talking about the weather. She was one of the spookiest people I've ever met.

Do sociopaths seek out positions with a lot of authority, so they won't be questioned?

I think there are certain professions that we understand as being humanitarian and good, and you won't be questioned as much. And there are certain professions where you can make people jump, or the way you make them feel bad about themselves is more private. Certainly psychotherapy would be one of those. On the other side, there are the power professions where the goal is to win -- politics, banking, etc. Those professions tend to be good places for sociopaths to hide and prosper, unfortunately.

Prosper because of the focus is on winning to the exclusion of other things?

Yes. It tends to excuse behavior that we might otherwise condemn. A little bit of lying might be considered clever rather than amoral. I think this particularly true in business and politics, especially in the West.

Is there the same level of sociopathy in other cultures?

No. In East Asian countries, China and Japan in particular, there is substantially less sociopathic behavior observed. It seems to me that the only explanation for that would deal with overall cultural attitudes. In the East, individual winning is not considered the appropriate goal. The culture is more group-oriented. A sociopath born in such a culture might learn to behave appropriately the way one might learn table manners. They might not have a conscience, but because sociopaths need to fit in, the behavior might be tamped down a bit.

Is a conscience something you're born with?

About 50 percent of the variant seems to be accounted for by heredity. The other 50 percent would be shaped by something in the environment. The interesting thing is that we haven't been able to determine what that is. Everyone's first guess is child abuse, but it turns out that as group they haven't been abused any more than any other group.

Can it actually be an advantage to be a sociopath?

For a while it can be an advantage. But most sociopaths end not with a bang but a whimper. There's not much on this planet for us except our relations with other living forms. So for sociopaths, it's a fairly barren landscape. In the end it can't work out, but for a while it looks like it does.

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