The Sociopath Next Door: The Ruthless Versus The Rest Of Us

Stout presents the case of Doreen, who used fake credentials to get hired as a psychiatrist and went unnoticed in this position for 14 years. Doreen was a middle-aged woman whose ASPD manifested in the form of envy. She was painfully envious of a coworker named Jackie, who seemed prettier, smarter, and more successful than Doreen felt she herself was. Doreen had no way of “adopting” these traits from Jackie, so she instead sought to rob her of them. Jackie enthusiastically referred a patient named Dennis to Doreen; Jackie believed that Dennis had improved and was nearly ready for discharge. Doreen took advantage of Dennis’s paranoid schizophrenia and told him that Jackie believed the opposite. She attempted to destroy Dennis’s trust in Jackie and Jackie’s own self-esteem regarding her ability as a therapist. Fortunately for Dennis, Jackie was persistent in visiting Dennis and eventually broke through to him again. Dennis told Jackie everything, but her own supervisor refused to believe that Doreen would do such a thing.

Years later, Doreen was finally exposed when the husband of her patient determined through connections of his own that Doreen was a fraud. Doreen was fired but never charged or fined in any way, and her story speaks to two important factors in considering people with ASPD. The first is that people with ASPD may go unnoticed for years or even decades, as not only do people around them refuse to believe that they would be capable of such things, but people with ASPD are also successful charmers and manipulators. The second factor worth considering in Doreen’s case is the idea that most people with ASPD will, at some point or another, harm others; the difference lies in whether or not they are caught.

In questioning why Doreen was able to pull her charade for 14 years without being noticed, Stout explores the “tools of the trade” that a typical person with ASPD uses to manipulate others into becoming blind to their actions (87). The first of these tools is charm, which is commonly ascribed to people with ASPD and is one of the most prominent shared traits. People with ASPD can be charismatic, and Stout argues that they often use sexual seduction and other forms of flattery to win people over. They seem to have a keen sense of who is vulnerable and in what way and take full advantage of those vulnerabilities. People with ASPD have natural skills as actors and can mimic emotions they don’t actually feel, making them seem just as emotive as anyone else, if not more so.

Stout explores another technique used by people with ASPD: gaslighting. The term “gaslighting” derives from the 1944 film Gaslight, a psychological thriller in which a woman’s sadistic husband slowly causes her to question her own mental well-being by making it seem like there’s a ghost living in the house. He manipulates the gas lamps to turn on and off by themselves, leading the woman to doubt her perceptions. Gaslighting can come either from the outside, as in this instance, or from within; a person with ASPD may gaslight another into believing that they could never do something horrible, and a person may likewise convince themselves that someone with ASPD could never be capable of such acts. Because people with a conscience cannot understand the “why” behind the actions of people with ASPD, it is difficult for them to imagine that such people exist at all. Stout points to a woman named Barbara Graham, who managed to gaslight much of the public into believing that she could not have murdered an elderly woman, despite ample evidence to the contrary.

Stout argues that in order to protect society from the actions of people with ASPD, people must be encouraged to stand up for themselves, beginning in childhood. Stout recalls seeing a young girl stand up for her peer when she witnessed bullying, and she argues that girls are socially conditioned to accept, remain silent, and not speak out. Similarly, boys are taught to obey authority unconditionally, which leaves them vulnerable to being taken advantage of. Children of all genders should be taught to speak up for themselves.

Stout is often asked how a person can tell whom to trust or distrust, and there is no easy answer to this question. She notes that most people do not have ASPD and are trustworthy to some extent, but she also adds that there are few surefire ways to tell whether someone has ASPD until one has known the person for many years. Stout believes that human nature is generally “good” and that people with ASPD are on the outside of what is considered “normal” human nature.

Stout argues that the most reliable way to know if someone has antisocial tendencies is by whether they take advantage of a person’s sense of pity. People with a conscience will feel sorry for those who are vulnerable or disadvantaged, and people with ASPD will prey on this human trait. They will use the emotions of others to achieve their own ends, whatever that may be.

Stout worked with a patient named Sydney, who divorced a man named Luke. Luke had ASPD, and though he was not violent or even ambitious, his antisocial tendencies manifested in the form of using Sydney, preying on her desire for a family, and constantly manipulating her into pitying him. Sydney fell for Luke because he was intelligent and seemed to make her life more interesting, and she ignored all the early warning signs that something was off. Luke showed no interest in the son they eventually had together, and he quit his job once he and Sydney were married. He spent most of his time lounging by the backyard pool. Sydney and Luke eventually divorced, but Luke continued to hang around Sydney’s house as though he still lived there. He even played on his own son’s pity, acting forlorn when Sydney would tell him to leave. Sydney would then let Luke stay, even though she didn’t want to. It took years for Sydney to understand that Luke lacked a conscience because such a possibility never occurred to her.