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Content Warning: This section of the guide includes discussion of mental illness.
When Stout asks people what they would do if they were not impeded by their conscience, she finds that most do not have an answer because their conscience prevents them from wanting to do such things. She argues that humans are “selected by nature to be social, sharing creatures” and that this evolutionary trait is what defines humanity (182).
Though ASPD can sometimes seem like an advantage, Stout points out its inherent disadvantages, noting that many, if not most, people with ASPD end up precipitating their own ruin. This can be said of many dictators throughout history, but also of many ordinary people like Doreen, who took one too many risks and inevitably caused her own downfall. People with ASPD have a constant need for stimulation that, for most other people, is left behind in childhood, and this need is never fulfilled. As a result, many people with ASPD turn to drugs, alcohol, or risky sexual activity. Stout also points out that many people with ASPD have hypochondria (a constant fear of illness/dying) because of their self-obsession. While other people can assuage these fears by remembering that others will live on, people with ASPD do not have this connection to wider humanity.
Stout argues that conscience and love are directly intertwined and that love is what brings life meaning and happiness; without this experience, a person with ASPD may lead a mundane existence. She concludes by reminding the readers that having a conscience is always better than not having one.
Stout presents the scenario of Tillie, a 70-year-old woman with ASPD who lives in a neighborhood in which she is highly unwelcome. Tillie goes out of her way to make other people angry, upset, and miserable, and her neighbors all wish that she would move away. Tillie complains about where the neighbors park and causes people unnecessary stress. One day, Tillie notices a groundhog in her backyard and calls the neighbor with whom she shares a fence, Catherine, to tell her. Catherine doesn’t understand why she’s being told until later when she sees Tillie place a large rock on top of the groundhog’s hole. That night, Catherine and her husband go into the yard to remove the rock and save the groundhog. A few days later, Tillie moves out of her house after secretly selling it. She expects to shock all her neighbors. While none of them knew that she was selling, they also don’t really care. Each of them has their own lives and people they care about. They are glad when Tillie leaves, but their lives quickly return to their full, meaningful states, while Tillie lives out her mundane life.
Both science and religion can agree on the importance of compassion and unity for the human species and the planet as a whole. Stout cites teachings from Buddhism, Christianity, Hinduism, Indigenous traditions, and Islam, which all teach the importance of putting others’ needs ahead of one’s own, of treating others as one wishes to be treated, and of the everlasting unity among all things. The assertion that what one does to another one also does to themselves is consistent with the scientific notion that abuse and exploitation lead to pain and trauma. The conscience brings spirituality and psychology together under one umbrella. Stout emphasizes the power of the conscience to instill hope and meaning for people and praises those who live with compassion and empathy first.
In these concluding chapters, Stout highlights The Importance of Conscience in Human Interaction by noting that those who lack it (people with ASPD) often meet terrible ends. For instance, dictators frequently face terrible demises, and many of the book’s figures experience similar outcomes on a more personal scale—becoming unhappy, bored, alone, and hated. By contrast, the closing chapters make clear that love is the secret to happiness and that those with a strong conscience do everything in their power to make the world a better place. For Stout, elements of conscientious living include moral clarity, personal accountability, and a positive unification of self and moral aims. Lasting happiness arises when one’s personal goals align with one’s moral principles. Stout borrows from biblical language in describing the universal importance of the conscience: “Conscience is the still small voice that has been trying since the infancy of our species to tell us that we are evolutionarily, emotionally, and spiritually One, and that if we seek peace and happiness, we must behave that way” (216). The phrase “still small voice” comes from the Bible (1 Kings 19:12), in which God speaks to the prophet Elijah in the form of a “still, small voice” from within his consciousness. This allusion emphasizes the importance of the conscience in fostering a sense of interconnectedness and unity that leads to fulfillment and peace.
Since the Introduction and early chapters gave credence to the widespread assumption that ASPD is an advantage, Stout concludes by refuting this idea. While some people with ASPD use their lack of scruples and talent for manipulation to gain wealth and power, Stout argues that even the most powerful among them are ultimately doomed to unhappiness. People with ASPD are prone to boredom and are always looking for greater risks and extreme thrills. Similar to the impulsive conduct frequently observed in children, this addiction to stimulation gets increasingly hazardous and destructive as the person gets older. To elicit the same emotional reactions, people with ASPD require more intense kinds of stimulation, such as drug usage or dangerous sexual behavior. Discussing The Real-World Effects of ASPD, Stout argues that ongoing self-preoccupation coupled with a lack of genuine desire or motivation leads to lives that are hollow and unfulfilling.
This all-or-nothing language reflects the book’s sense of its readers and purpose. There is no effort here to advise those with ASPD on how to live more fulfilling lives. Stout presumes that her readers do not have ASPD, and her aim is to help them understand (and protect themselves from) those who do—in keeping with the theme of Protecting Against the Consequences of ASPD. In the closing chapters, she reassures her readers that they are good people and will be rewarded with happiness and fulfillment, while those with ASPD will be punished for their bad behavior, even if they appear to reap temporary and material rewards. Critics have argued that this moralizing framework is antithetical to the scientific and therapeutic aims of psychology.
The book highlights the close relationship between the conscience and love, implying that these two components cooperate to give life purpose. The conscience, which has its roots in moral reasoning and emotional attachment, guides people toward actions that will ultimately bring them fulfillment. A person’s sense of connection to the world and to other people is strengthened by love, both morally and emotionally, which gives life purpose and a route to happiness. Stout argues that a purposeful human experience, in contrast to the emptiness felt by people with ASPD and those without a conscience, requires the integration of these elements.
The story of Tillie, in Chapter 11, serves as a fable to cement Stout’s underlying moral claim about the importance of the conscience. Tillie believes that she is the center of the world, but when she leaves her home, the neighbors soon forget about her: Tillie’s selfishness and lack of deep connections leave her isolated and ignored. Tillie’s life narrative is shown as monotonous, repetitious, and ultimately devoid of happiness, whereas the nearby groundhog stands for liberty and tranquility. Tillie’s life is meaningless and superficial in comparison to those of the neighbors, who experience contentment and satisfaction through human connection. This storytelling technique emphasizes the sharp contrast between a life based on selfishness and one that values freedom and compassion.
Stout concludes by referencing religious beliefs to remind readers of the value of compassion and unity. She points out that the so-called “golden rule”—treat others as you wish to be treated—appears in slightly different forms in nearly all world religions, and she argues that this universal moral precept is consistent with both religion and science, calling back to the evolutionary biologists who view the conscience as an adaptive trait for early humans who, as social animals, depended on group cohesion for survival. The book promotes a cohesive strategy in which religion and science work together to foster compassion. Beyond the confines of both scientific and spiritual viewpoints, the message is unmistakable: Compassion and togetherness are essential to a harmonious existence.



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