What Is the Difference Between a Sociopath and a Psychopath?

In the realm of mental health, few disorders garner as much worry as sociopathy and psychopathy. After all, famous sociopaths and psychopaths negatively dominate the news, and popular literature perpetuates the fear. But sociopaths and psychopaths are real people, and they make up anywhere between 1%-4% of the United States. So, if you know more than 25 people, you likely know a sociopath or psychopath. As such, it’s important to understand and humanize these conditions. But what is the difference between a sociopath and a psychopath?

In this article, you’ll learn about:

• The differences between sociopaths and psychopaths
• Myths about sociopathy and psychopathy
• What treatment is helpful and treatment prognoses

What Is the Difference Between a Sociopath and a Psychopath?

In the mental health field, sociopaths and psychopaths don’t exist, at least not diagnostically. The official diagnostic resource for therapists, psychologists, and psychiatrists, Diagnostic and Statistical Manual of Mental Disorders (DSM-5), has not listed sociopathy or psychopathy as disorders for decades. Instead, there is a single diagnosis: antisocial personality disorder (ASPD).

To be diagnosed with ASPD, you need to exhibit the following symptoms, according to the DSM-5:

1. The presence of a pervasive pattern of disregard for and violation of the rights of others. This behavior begins by age 15 and is present in various contexts. Clinical features include ≥3 of the following:
   1. Failure to conform to social norms concerning lawful behaviors, such as performing acts that are grounds for arrest.
   2. Deceitfulness, repeated lying, use of aliases, or conning others for pleasure or personal profit.
   3. Impulsivity or failure to plan.
   4. Irritability and aggressiveness, often with physical fights or assaults.
   5. Reckless disregard for the safety of self or others.
   6. Consistent irresponsibility, failure to sustain consistent work behavior, or honor monetary obligations.
   7. Lack of remorse, indifference to or rationalizing having hurt, mistreated, or stolen from another person.
2. The individual is at least age 18.
3. There is evidence of conduct disorder with onset before age 15.
4. The occurrence of antisocial behavior is not exclusively during the course of schizophrenia or bipolar disorder.

Are There Really No Differences?

However, it would be incorrect to say there are no differences between sociopaths and psychopaths. Even though there are no official diagnostic criteria, sociopaths and psychopaths express their symptoms in different ways.

Sociopaths

People who experience sociopathy have a limited ability to feel social emotions, including guilt, empathy, and shame. As a result, they may not respond in a socially appropriate way when others are hurt or in pain. They may also become easily enraged and demonstrate impulsiveness. At times, they may form social connections, but they often find socializing difficult.

Typically, sociopaths do not care about hiding their lack of social emotions. They may know logically that what they’re doing is not what other people would do, and they might even recognize they’ve done something wrong. However, they will likely justify their actions in some way.

Because of their condition, sociopaths often struggle to hold down a regular job.

In her memoir Sociopath, Dr. Patric Gagne, a therapist and someone living with sociopathy, describes experiencing a pressure that builds within her whenever she expends energy trying to resist her urges. Doing something socially frowned upon or even harmful releases the pressure and provides her with temporary relief.

It’s unclear how many sociopaths relate to Gagne’s experience, but her account provides valuable information on how it feels to be a sociopath from a sociopath’s perspective.

Psychopaths

Psychopaths do not feel social emotions, so their condition often mimics sociopathy to a certain degree. However, a psychopath generally knows how to mask their condition. They learn how to act like they have the emotions they don’t experience, and they often manage to lead a normal life, even if it’s a cover up for criminal activity.

In general, their behavior is usually cold-hearted. They may take and hold a job but not care about stepping over people to get what they want. Sometimes, they commit crimes against the company and try to cover their tracks.

Like sociopaths, psychopaths often fail to form genuine connections with other people, though they might form fake relationships.

Myths About Sociopaths and Psychopaths

Sociopathy and psychopathy are rarely properly understood, and the media perpetuates many myths about these conditions.

First, people often assume sociopaths and psychopaths are all violently dangerous. This is not necessarily true. Certainly, sociopathy and psychopathy have driven people to violent crime before, but most sociopaths and psychopaths do not commit such crimes.

However, sociopaths and psychopaths might end up hurting people in different ways, such as stealing from them or conducting invasive behaviors.

Second, people assume these people can’t live normal lives. In truth, with the right forms of treatment, sociopaths and psychopaths can improve to the point where they can go to school, hold jobs, and even raise families. Still, life will likely be more difficult for them given their challenges.

Proper Treatment for Sociopathy and Psychopathy

If you suspect you or a loved one might suffer from sociopathy or psychopathy, it’s crucial for you to find the proper treatment. Dr. Gagne echoes this sentiment in Sociopath, writing that while sociopaths may not always be violent or get arrested, they still can be dangerous without treatment.

In addition, very few therapists receive in-depth training on treating these conditions. So, you need to exhibit great care in your selection of a mental health provider. Look for someone with experience in treating these conditions

Likewise, you want to look for someone who practices cognitive-behavioral therapy (CBT). This form of therapy focuses on thoughts, emotions, and actions and helps people make changes in their thoughts and behaviors.

Further, you’ll want to look into seeing a psychiatrist. Psychiatrists go to medical school and work as doctors, so they can prescribe medication to help with anger, mood changes, and aggression.

Treatment Prognosis

Despite Dr. Gagne’s optimism that people can get better with treatment, other therapists display greater pessimism. In general, therapists view sociopaths and psychopaths as difficult to treat. In fact, research on how therapy impacts sociopaths and psychopaths is scant because of this pessimism.

Still, some people, like Dr. Gagne, have made great strides through receiving treatment. They have even developed coping mechanisms to help them live healthier lives.

Mental Health for Sociopaths or Psychopaths

What is the difference between a sociopath and a psychopath? In sum, the differences are minimal, but each person still has a responsibility for ensuring they live in as healthy a manner as possible given their condition. That way, sociopaths and psychopaths can safely live in society, feel less isolated from others, and pose less of a danger to those around them.

No matter what, everyone must remember sociopaths and psychopaths are still people, and they didn’t choose to have their conditions. So, taking the mental health of sociopaths and psychopaths seriously is important. If you know a sociopath or psychopath, finding ways to assist them in their wellness journey can help them and everyone else around them.