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Content Warning: This section of the guide includes discussion of mental illness and emotional abuse.
In The Sociopath Next Door, Stout emphasizes the immense importance of the conscience in human interactions, arguing that the absence of this moral guardrail can lead individuals to manipulate, harm, and use others without feeling regretful or guilty. The conscience not only is a philosophical construct but also has practical implications, particularly for how people navigate relationships. Without guilt or remorse, people with ASPD often manipulate others for personal gain, acting without regard for the feelings or well-being of those around them. Stout highlights the vulnerability of those who are exposed to people with ASPD, many of whom suffer profound trauma as a result. By working with trauma patients, Stout has seen firsthand how the absence of a conscience in others can create trauma, especially when those individuals are in positions of trust or power, such as a teacher, parent, or boss.
Given that the conscience inhibits individuals in pursuing their needs and desires, it might appear superficially to run counter to the evolutionary principle of “survival of the fittest.” Stout thus asks the rhetorical question, “Why have a conscience?” (15). This question is crucial in understanding human nature and people’s ability to live together harmoniously. She draws on more recent research in evolutionary biology suggesting that for social animals, natural selection is as likely to produce traits that facilitate group survival as those that facilitate the survival of the individual. The conscience is more than just an internalized set of rules or laws; it serves as a guide that connects people with each other and the greater good of society. Stout stresses that in order to create a better world, it is essential to understand the nature of people who consistently act against the common good, and she thus focuses specifically on people with ASPD.
Before exploring the individuals who lack a conscience, Stout discusses the idea that the conscience is what fundamentally defines human beings. It is not merely something people think about or do; it is something people feel. Through the anecdote of Joe, who goes back home to feed his dog, Stout illustrates that the conscience arises from emotional attachments. Joe’s decision was based on an emotional tie to the dog, rather than on any calculation of risk and benefit to himself. This emotional connection acts as a reminder of our moral responsibilities to one another and to nature. The development of the conscience can be seen as a progression “from a judge in the head to a mandate of the heart” (33), meaning that it develops from an intellectual awareness of duty to an internalized, emotional drive.
The absence of a conscience is a defining characteristic of ASPD according to Stout. People with ASPD typically demonstrate an inability to feel guilt or remorse for actions that cause harm to others. In contrast, individuals with a well-developed conscience will experience feelings of guilt when they harm others and thus will typically avoid doing so. Moral reasoning guides people in their decision-making, but people with ASPD lack this moral reasoning, leading them to act solely for their own gain without regard for the welfare of others. Stout suggests that the essence of the conscience is tied to a sense of oneness or unity. This feeling of connectedness is not only biological but also deeply ingrained in cultures, beliefs, and religions around the world. At its core, the conscience reflects an understanding that we are all interconnected and that actions that harm others ultimately harm ourselves. This realization, Stout argues, is the very foundation of the conscience and is essential for creating a world that is both compassionate and just. The conscience, therefore, is not just a personal moral compass; it is a force that unites humanity and enables us to live together in harmony.
Stout ties the conscience directly to love, suggesting that love is the force that gives life meaning. The emotional attachment we feel for others is what allows us to develop a conscience and act in ways that contribute to the common good. She writes that the “conscience makes every experience worth having” because it allows us to live in a way that is aligned with our shared humanity (196). In this sense, the conscience is not only about preventing harm or acting ethically but about fostering deep emotional connections that enhance our lives and the lives of those around us: “Beginning in our genes and spiraling outward to all our cultures, beliefs, and many religions, it is the shadow of the whisper of the beginning of an understanding that we are all one. And whatever its origins, this is the essence of conscience” (180). This concluding statement positions the conscience as the foundation of the human experience, a concept fundamental to both psychology and religion.
Stout’s book The Sociopath Next Door sets out to provide a set of tools that people can use to protect themselves from those who have ASPD. Stout argues that much of the trauma and suffering in the world is caused by this small percentage of people, and she believes that it is her duty to help others become more aware, resilient, and trusting of their self-protective instincts. She insists that “only by seeking to discover the nature of ruthlessness can we find the many ways people can triumph over it, and only by recognizing the dark can we make a genuine affirmation of the light” (17). Stout presents advice throughout the work, culminating in a straightforward set of principles in the eighth chapter.
The most important step in preventing oneself from being abused and manipulated by someone with ASPD is to understand the disorder and be aware that it can manifest in any type of person, from any culture or background, and that it does not necessarily lead to physical violence. Equipped with this awareness, people will be more likely to identify ASPD in their personal lives, and by accepting that some people have this disorder, people can be more attuned to the ways it appears in everyday life. People with ASPD have a persistent need to dominate and control others, but this domination can manifest in many forms, including gaslighting, lying, extreme laziness, and superficial charm. Its underlying cause is a lack of the empathy, guilt, and sense of responsibility that most other people possess. Stout points to examples like Doreen, who abused vulnerable psychiatric patients to achieve her own ambitions, and Skip, who used his own wife and daughter to protect his reputation. Stout insists that people must take back control of their own lives, stand up for themselves, and create emotional distance between themselves and those who want to harm them.
Some other key ways that people can be vigilant and protect themselves include following their intuition and trusting that when a situation or person doesn’t feel right, it probably isn’t. Stout urges readers to be suspicious of lying and ploys for pity and empathy, as well as to distinguish between fear and respect. Fearing a person likely means that they have, at some point, used intimidation or aggression to cause that fear. Stout also explains that readers should distance themselves from harm and avoid unnecessary conflict whenever possible. Finally and perhaps most importantly, Stout reminds readers that “living well is the best revenge” (142): Rather than stooping to the level of an abusive person, it is much better to rise above and find happiness despite past abuse. Stout explores this concept through the story of Hannah, who eventually used her experiences of abuse to become a legal activist for human rights.
ASPD has profound effects on both the person with the disorder and those around them. Unlike what is frequently depicted in media, ASPD does not necessarily make someone violent or physically dangerous, though it can; more often, it causes a person to do immeasurable harm to themselves (though they often do not realize this) and to others as a result of a lack of empathy and an overall absence of connection to other human beings. Stout’s book refers to these symptoms as a “lack of conscience.” While some critics have called this an oversimplification, Stout uses “conscience” to encompass all the values and emotional factors that lead people to behave well toward one another, to put each other first, and to love.
People with ASPD may appear to have an advantage in life because of their lack of guilt and remorse and their willingness to take risks, but these traits often backfire on them in the end. People with ASPD do not experience emotional stimulation in the same way other people do, and their prefrontal cortex appears to require far more stimulation than is typical. As a result, people with ASPD are often bored, frustrated, and restless, which leads to issues such as addiction, risky sexual activity, and other forms of risk-taking. Some people, like Doreen, might take risks with their job and reputation in order to make life worse for someone they have deemed an enemy. Typically, the “rush” derived from these activities is only satisfying for a while, and the pursuit of the next rush leads to increasingly extreme behaviors. Another unfortunate consequence of ASPD is that while most people derive meaning from their relationships with others, people with ASPD do not have this privilege of human connection. Feelings of meaninglessness can lead to depression, a general lack of long-term ambition or drive, and extreme fear of death, while the need for constant stimulation can lead to criminal activity and excessive risk-taking. The result is that ASPD is, in many ways, a severe disadvantage—one that, Stout argues, separates people with the disorder from the rest of society.
ASPD also affects other people in the person’s life, as well as society as a whole. Stout presents dictatorships and genocides as examples of how ASPD can affect society as a whole. Wealthy business owners who exploit nature and human communities offer another example of the societal impacts of ASPD. On a smaller scale, people with ASPD may become involved in crime or may abuse people close to them, such as children, spouses, and coworkers. They may also be more likely to exploit pity and empathy and to use people for financial or sexual gain. As a result, Stout argues that many people who experience trauma and/or post-traumatic stress disorder do so because of encounters (either temporary or lifelong) with people with ASPD. She cites the example of her patient Hannah, who found herself reliving a lifetime’s worth of trauma at the hands of her father, who had ASPD. Hannah’s father treated her and her mother as prizes and emotionally neglected them when they did not meet his standards for appearance and behavior. Part of the reason why Stout wrote her book was to expose the damaging effects of ASPD in everyday life.



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