Sociopath, psychopath – Lovefraud’s proposal for naming the disorder

One reason why many of us found ourselves victimized by sociopaths is because we did not know that dangerous personality disorders existed.

We may have heard of crazy people, but we assumed that we could spot them because they looked and talked crazy. We may have heard of psychopaths, but we assumed they were serial killers or some other type of obviously hardened criminal.

We did not know that people existed who could convincingly proclaim their love, cry tears of sadness, and make glowing promises for the future, all simply to exploit us. We did not know that these people were called sociopaths and/or psychopaths.

In my opinion, a big reason for the public’s unawareness of, and confusion about, this dangerous personality disorder is the lack of agreement in the mental health profession about naming and defining it. How can you educate the public about these social predators when you can’t even decide what to call them?

Range of names

Research psychologists in major universities use the term “psychopath.” The main reason is that they run their studies using the Psychopathy Checklist Revised (PCL-R), developed by Dr. Robert Hare.

The PCL-R is recognized as the gold standard for evaluating the disorder. The instrument includes a list of 20 characteristics. An individual is rated 0, 1 or 2 on each item, and the points are added up for a total score. A person must score 30 to be diagnosed as a “psychopath.” For more on the PCL-R, read Researchers minimize the psychopathy problem.

Psychiatrists and other clinicians follow the American Psychiatric Association’s Diagnostic and Statistical Manual, now in the 4th edition. At the moment, the official term in the manual for this malady is “antisocial personality disorder.” Psychiatrists use the term “sociopath” for short.

Currently, the DSM-IV recognizes 10 personality disorders, divided into three clusters—A, B and C. Cluster B covers dramatic, emotional or erratic disorders.  It includes antisocial, borderline, histrionic and narcissistic personality disorders.

All of this, however, is in the process of change—the 5th edition of the manual is now being written. A year ago, a draft of the new manual was posted on the Internet, and the public was invited to comment. For the most part, the diagnostic criteria were much improved, but Dr. Liane Leedom and I had problems with a few of the descriptive statements. Read our views in Lovefraud’s comment about sociopaths for the DSM-5.

My biggest problem with the revision is that it creates yet another name for this condition, “antisocial/psychopathic type.” Personally, I think this term is ridiculous. I don’t even know how it would be used in a sentence. Do we say that someone is an “antisocial slash psychopathic type”?

Selecting “sociopath”

When I was first developing Lovefraud.com back in 2004, I had to decide which term to use. After some informal market research, I selected “sociopath.”

The main reason was that “psychopath” was just too scary. Hollywood and the media portray psychopaths as deranged serial killers. I worried that people would not believe they had a psychopath in their lives, because he or she had never killed anyone, and would therefore dismiss all of the information about this disorder.

My reasoning was supported by last year’s Lovefraud survey. The survey asked the following questions:

Before your involvement with this disordered individual, what did you understand the term “sociopath” to mean?

• Criminal: 19.2%
• Serial killer: 19.4%
• Someone who was delusional: 6.4%
• Person without empathy or a conscience: 19.7%
• I didn’t know what it meant: 35.3%

Before your involvement with this disordered individual, what did you understand the term “psychopath” to mean?

• Criminal: 15.0%
• Serial killer: 51.2%
• Someone who was delusional: 13.4%
• Person without empathy or a conscience: 8.9%
• I didn’t know what it meant: 11.5%

Fully half of the 1,378 survey respondents believed a psychopath was a serial killer. I think it’s safe to assume that this level of misinformation pervades the general public.

Overlap

So the experts argue over terminology. I’ve even had two college psychology professors contact me to tell me that I’m using the wrong name. Although they didn’t seem to be aware of the disagreement in the field, I am, and I summarize the disparate views on the Lovefraud.com page, Psychopath/sociopath.

In practice, the behaviors and traits exhibited by individuals diagnosed with psychopathy, sociopathy narcissism, and even borderline personality disorders overlap, so it’s hard to tell where one ends and another begins. Many Lovefraud readers simply describe the individual they were involved with as P/S/N, for psychopath/sociopath/narcissist. Others say that the individual has a “cluster B” disorder. Of course, no one knows what that means, but it is less prejudicial and more likely to be believed.

Proposed name

I propose a solution to the name problem. I propose that “sociopath” become the general term for a social predator, someone who exploits others.

In the general category of “sociopath,” there can be subcategories that reflect the different types of exploiters. “Psychopath” can be defined as someone who scores 30 or more on the PCL-R. “Narcissist” can be someone who uses others, but doesn’t necessarily set out to cause them harm. “Antisocial personality disorder” could describe the people who are worse than a narcissist, but not as bad as a psychopath. Other subcategories can be defined as the experts see fit.

“Sociopath” has the advantage that it is already in the lexicon, but does not carry the cultural baggage of “psychopath.” People are generally aware that the word has something to do with bad behavior. But, as our survey pointed out, the largest number of respondents didn’t really know what “sociopath” meant, so they could be educated.

“Sociopath” could be analogous to the term “cancer.” There are many types of cancer—lung cancer, skin cancer, colon cancer—but we all know that cancer is bad and we take precautions to avoid it. We don’t smoke. We use sunscreen. We eat fiber.

Here’s a key point: For many people, the harm caused by sociopaths is completely avoidable, if we take precautions.

Some of us were unlucky in that we were born to a sociopathic parent, or into a family that contained sociopaths. We were stuck in those situations until we could find a way to get out.

But the rest of us invited the sociopaths into our lives. If we knew that these predators existed, if we knew the warning signs, we never would have done it. We could have avoided the trauma that they caused.

In my view, settling on a clear name and diagnostic criteria for this disorder is a public health issue. People have learned how to protect themselves from cancer. With education, we can learn how to protect ourselves from sociopaths as well.