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What Is a
Sociopath?
What Is a

Sociopath Vs.
Psychopath?
What Is a

Psychopath Vs.
Narcissist?
Differences

Narcissist: What Is the

Between
Disorders

Difference?
Potential
Causes
Treatment
Options
Written by: Hailey Shafir, LCMHCS, LPCS, LCAS, CCS
Tips for
Coping
Reviewed by: Rajy Abulhosn, MD
Conclusion
Published: May 23, 2023

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Sociopaths, psychopaths, and narcissists have similar traits

and tendencies with important distinctions. Psychopaths
tend to be the most violent and dangerous because they
lack empathy, conscience, and respect for authority.
Sociopaths are similar but often use manipulation and
deceit over violence. Narcissists can also be selfish and
cruel but are less likely to engage in illegal or violent
behaviors.1, 2, 3, 4, 5

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What Is a Sociopath?
Sociopaths refer to those diagnosed with a severe form of
antisocial personality disorder (ASPD). Frequent signs of a
sociopath include a lack of empathy, morals, and care or
concern for the feelings and needs of other people. These
traits make them more likely to harm or take advantage of
other people, especially when there is a potential benefit
involved for them. Their weak conscience makes it easier
for them to justify antisocial behaviors and dodge some of
the normal feelings of guilt and remorse most people would
experience afterward.2, 6 ASPD occurs on a spectrum, with
sociopathy and psychopathy being the most severe forms
of the disorder.

Some of the most common signs of a sociopath include:1, 2, 7

Superficially charming but has few stable, long-term

relationships
Having a weak conscience or moral compass
Easily provoked by others, becomes defensive often
Emotionally unstable, moody, and prone to outbursts
Prone to using others for personal benefit or gain
Manipulative, deceptive, and dishonest
Impulsive, reckless, or self-destructive behaviors
 Irresponsibility or failure to meet expectations
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Hot and cold in interactions with other people

What Is a Psychopath?
Psychopaths have the rarest and most severe form of
antisocial personality disorder, making them potentially
very dangerous.2, 7 Unlike sociopaths, psychopaths are
often completely lacking in empathy and moral conscience,
and some are even sadistic and enjoy causing pain and
suffering. Many psychopaths don’t experience a normal
range of human emotions, which makes it even more
difficult for them to relate and connect with others.
Personality traits and signs of a psychopath include a
tendency to be cold, callous, and predatory and a high
statistical probability of engaging in criminal and violent
acts.2, 6

Some of the most common signs of a psychopath include:1, 2,

6, 7

Disregard for the feelings, rights, and needs of other

people
Fearless, bold, and unconcerned with the consequences
of their actions
Ruthless in their pursuit of money, sex, power, or other
goals
An artificial charm that can be turned on or off to get
what they want
Impulsive, irresponsible, like to seek thrills, and gets
bored easily
History of violent, illegal, or predatory behaviors dating
back to childhood/adolescence
Sadistic pleasure in causing harm, suffering, or pain to
other people
Both psychopaths and sociopaths have severe forms of
Newsletter
antisocial personality disorder, which has the following
symptoms:1, 2

A blatant disregard for rules, laws, and norms–resulting

in criminal behavior
Lying, deceitfulness, and manipulative tactics used for
profit or personal gain
Impulsive or reckless patterns of behavior without
concern for consequences
Irritability and aggression, causing frequent arguments,
conflicts, or fights
A complete disregard for the safety of oneself and others
A pattern of irresponsible behavior and poor decision
making
Lack of remorse for actions that are wrong, immoral, or
harmful to others

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What Is a Narcissist?
Narcissists have narcissistic personality disorder (or NPD),
which makes them highly sensitive to praise, criticism, and
external feedback. Signs of narcissism include overly
relying on external forms of validation like praise,
recognition, status, or career achievements to feel good
about themselves. While they can appear overly confident,
many experts believe narcissism arises from a deep sense
of shame and insecurity. Still, these insecurities are masked
by many aggressive defense mechanisms that make the
narcissist a difficult and potentially dangerous personality.3,
5

While there are different types of narcissism, some of the

overarching signs include:1, 3, 5

Inflated ego or excessive degree of self-absorption

An excessive need for external validation, praise,
recognition, or admiration
Hypersensitivity and defensiveness when criticized or
challenged
A heightened need to be right, successful, wealthy,
powerful, etc.
Behaving in selfish or entitled ways to get what they
want
A pattern of using people, turning on them, or ‘discarding’
them
A tendency to avoid taking responsibility and blame
others when wrong
The symptoms of narcissistic personality disorder include:1
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1. A sense of grandiosity or excessive self-importance
2. Recurrent fantasies of being powerful, successful,
beautiful, or important
3. Feeling as though they are special and exceptional and
can only associate with those who are on the same level
as them
4. Excessive need for validation, praise, and admiration
from others
5. A sense of entitlement or feeling like one deserves
special treatment
6. Exploiting others for personal gain or selfish reasons
7. Lacking empathy or being unwilling to identify with the
needs of others
8. Being envious of others or believing others are envious
of them
9. Arrogant or haughty behavior, acting better than others

What Are the Differences

Between a Narcissist,
Sociopath, & Psychopath?
Narcissistic personality traits are more common than the
antisocial traits displayed by sociopaths and psychopaths
and are often less dangerous, too. Part of the reason
narcissistic people are less dangerous is that they’re usually
driven by prosocial desires like wanting to be liked,
accepted, and respected by others. Psychopaths and
sociopaths, on the other hand, don’t have as many prosocial
desires and instead use antisocial behaviors like violence,
deceit, and exploitation to get what they want at the
expense of other people.1, 2, 3, 6
Below are some key differences between narcissists,
Newsletter
sociopaths, and psychopaths.1, 2, 5, 6, 7

Narcissistic Sociopathic Psychopathic

traits & traits & traits &
tendencies tendencies tendencies

Arrogant & self- Erratic & Cold, callous &

absorbed emotionally cruel
unstable

Highly defensive Highly Emotionally

to criticism emotionally detached
reactive

Tries to impress Tries to Tries to control

others manipulate others
others

Often feels pride Emotional highs Often feels

& shame and lows indifferent

Repressed Weak empathy Little or no

empathy empathy

Projects blame to Weakened Little or no

avoid shame conscience conscience

Selfish and Impulsive and Cold and

entitled actions chaotic actions calculating
actions

Prone to self- Prone to Prone to violence

promotion manipulation & & crime
deceit

Competitive Exploitative Predatory

towards others towards others towards others
 Transactional Parasitic Avoids close
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relationships relationships relationships

Feels insecure, Feels confident, Feels confident,

acts confident acts insecure acts fearless

Low-stress Low-stress High-stress

tolerance tolerance tolerance

Emotionally Parasitic lifestyle Solitary lifestyle

dependent
lifestyle

Narcissist Vs. Sociopath & Psychopath

Narcissistic personality disorder and antisocial personality
disorder are both ‘cluster B’ personality disorders. Cluster
B personality disorders are all characterized by dramatic,
impulsive, and attention-seeking behaviors.1 The main
difference between narcissism and antisocial personalities
is that narcissists are motivated by a desire for social
recognition and acceptance, and psychopaths and
sociopaths are not. This means that narcissists are more
likely to care about the feelings and opinions of other
people, which acts as a safeguard against more violent,
criminal, or deviant behaviors.3

While narcissists still sometimes engage in these behaviors,

they make more of an effort to appear normal and make
positive impressions on other people. The most difficult
and cruel tendencies of a narcissist are often only apparent
to those who are closest to them or to those who have
offended or upset them. When a narcissistic injury (i.e. ego
wound) occurs, narcissists use immature defense
mechanisms like projection, blame, and passive aggression.
Sometimes, they even cut ties with people they’re mad at or
end relationships with people no longer ‘useful’ to them
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(aka narcissistic discard).3, 8, 9

Sociopath Vs. Psychopath

While both psychopaths and sociopaths have traits and
symptoms of ASPD, psychopaths have the most rare and
severe form of the disorder. It’s estimated that only 1-3% of
people with ASPD are psychopaths, and about 30% are
sociopaths.2 Psychopaths are more likely to have stunted
emotions, a lack of empathy, and no conscience than
sociopaths, which also makes them more prone to violent
and illegal acts. Psychopaths are often cool, calculating, and
ruthless, but they can sometimes still win people over with
their superficial charm or suave demeanor.2, 3, 6

Sociopaths, on the other hand, tend to be more moody and

impulsive. They’re more easily riled than psychopaths and
often lash out when upset. What makes them slightly less
dangerous than psychopaths is the fact that many
sociopaths still possess weak empathy and conscience,
which makes them slightly less antisocial. Sociopaths also
tend to rely on less violent means to get what they want
and are more likely to lie, extort, or manipulate people than
to physically attack them. Because they experience a wider
range of emotions, sociopaths are also more likely than
psychopaths to feel afraid of potential consequences.2, 3, 6

What Causes Psychopathy,

Sociopathy, & Narcissism?
A combination of genetics and social and environmental
factors is believed to cause most mental illnesses, including
personality disorders. Most of the time, it’s believed that
people who become sociopaths, psychopaths, and
narcissists have a genetic or biological predisposition that’s
activated by their environment and choices. In many cases,
Newsletter
the “activating” environmental factors involve childhood
trauma, including abuse and neglect.2, 4, 7

In most cases, people who develop narcissistic or antisocial

personality disorder first develop traits and symptoms in
childhood or adolescence. People with more severe forms
of antisocial personality disorder tend to display problem
behaviors like fighting, stealing, and cruelty towards
animals at a younger age. Both antisocial and narcissistic
personality disorders are more common among males than
females, but female sociopaths are much more common
than female psychopaths.2

Some of the potential causes of antisocial and narcissistic

personality disorder include:2, 6, 7, 10

Experiencing abuse or neglect in childhood

Extremely permissive, strict, or inconsistent parenting
styles
Having a parent who has NPD or APSD
Insecure attachment styles linked to childhood trauma
Certain personality traits like extraversion, neuroticism,
or impulsivity
Early exposure to predatory, abusive, or illegal behaviors
Early engagement in violent or aggressive behaviors
Early involvement in criminal activities
Being bullied or rejected by peers
Chemical imbalances in the brain
Abnormalities in parts of the brain governing emotions
and fear
Impaired executive functioning & abnormal frontal lobe
development
Psychopathy, Narcissism,Newsletter
&
Sociopathy Treatment
Treatment for psychopaths, sociopaths, and narcissists is
complicated and has a lower success rate than treatments
for other mental illnesses. Unfortunately, many people with
these personality-disordered traits don’t seek treatment
voluntarily. While there’s always hope for people who have
a sincere desire and willingness to engage in treatment,
psychologists have not been able to find a specific kind of
treatment for NPD or ASPD.2, 7, 10, 11

Most of the time, ASPD and NPD co-occur with other

mental health or substance use disorders.7 People who are
seeking treatment often benefit from a combination of
therapy and psychiatric medication, which can help to
target some of the symptoms of their personality disorder
as well as other comorbid conditions. Involving family
members or partners is recommended when treating
people with antisocial and narcissistic personalities.7, 10, 11

Therapy
There are a number of different types of therapy that may
benefit people diagnosed with narcissistic or antisocial
personality disorder, but none are evidence-based. Some of
these therapeutic approaches target unhelpful ways of
thinking, others focus on improving interpersonal
relationships, and others try to teach behavioral skills like
impulse control.

Below are some therapy approaches that may be

recommended:7, 10, 11

Cognitive behavioral therapy (or CBT): CBT is a

structured therapeutic approach that aims to help
 people adjust or change unhelpful thinking and
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behavioral patterns.
Supportive therapies: Unstructured approaches like
person-centered therapy focus on developing a strong
rapport and trusting relationship between the therapist
and client to facilitate the therapeutic process.
Family or couples therapy: Family therapy involves two
or more people attending therapy sessions to improve
communication, reduce conflict, and provide support for
couples and families affected by narcissism or antisocial
personality disorder.
Group therapy: Group therapy sessions provide
information about a mental health condition and teach
coping and impulse control skills to people dealing with a
similar issue or diagnosis.
Schema therapy: Schema therapy focuses on helping
people identify and change unhelpful core beliefs about
themselves, others, and the world that may be
contributing to their symptoms and problem behaviors.
FRAMES: An experimental therapeutic approach for
personality disorders that focuses on providing
feedback, taking responsibility for your actions,
identifying effective coping skills and responses,
improving empathy, and building self-efficacy.
Trauma-focused therapy: Trauma-informed approaches
like ART, somatic therapy, EFT tapping, CPT or EMDR
may help people resolve old traumatic experiences
contributing to their current symptoms and problem
behaviors.

Medications
There are no FDA-approved medications for personality
disorders like narcissism and sociopathy, or psychopathy.
Sometimes, psychiatric medications are used to treat other
underlying or co-occurring conditions and other times, they
Newsletter
are sometimes prescribed “off-label” for personality
disorders.

It’s important to note that there’s a significantly increased

risk of addiction for people with both antisocial and
narcissistic personality disorders, which makes it important
to monitor for signs of medication misuse or abuse.7
Because of this, some prescribers will be hesitant to give
controlled medication prescriptions to people with these
two disorders.10

Here are some of the most commonly prescribed

medications for people who are diagnosed with narcissistic
or antisocial personality disorder:7, 10, 11

Carbamazepine and Lithium to help control impulses &

urges
SSRI antidepressants that target serotonin and other
mood-related brain chemicals
SNRI antidepressants that target serotonin,
norepinephrine, and other mood-related brain chemicals
Anti-anxiety medications like benzodiazepines, beta-
blockers or Buspirone which help to reduce the fear and
stress responses in the body and brain

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7 Tips for Dealing With a

Psychopath, Sociopath, or
Narcissist
Dealing with someone who has narcissistic, psychopathic,
or sociopathic traits is never easy. Because people with
these disordered personalities can be predatory and even
dangerous, many experts advise that people distance
themselves from narcissists, sociopaths, and psychopaths.
When this is not an option, the precautions and tips below
may be helpful to people who have to interact with a
narcissist, sociopath, or psychopath.8, 9, 12

Seven tips for dealing with a psychopath, sociopath, or

narcissist are:

1. Limit your interactions and keep your guard up around

the person: Less frequent contact with someone who
displays traits of a narcissist, sociopath, or psychopath is
safer. Try to keep any conversations short, sweet, and to
the point, and pause to think before responding to them,
reminding yourself that they may have ulterior motives.
2. Be cordial and polite but standoffish: Being polite but
somewhat distant or detached is one of the safest
strategies around someone with a narcissistic or
antisocial personality disorder. This keeps a boundary
around your relationship that deters them from
 intruding on parts of your life that you want to keep them
Newsletter
away from.
3. Approach conversations as exchanges of information
with them: Think of conversations with them as
exchanges of information. Approach them only when you
need certain information from them, and be courteous
when they make appropriate requests for information
you have. Focusing on exchanging information will help
remind you to keep your interactions as direct and
impersonal as possible at a safe distance.
4. Limit personal or potentially damaging personal
information: Try to limit their access to personal,
sensitive, and potentially consequential information.
Narcissistic and antisocial people have a tendency to
weaponize this kind of info, using it as intel against
enemy targets (who are always growing in numbers).
5. Diffuse any competitive vibes early on: Competitive
vibes from someone with an antisocial or narcissistic
personality aren’t the kind of attention you want from
them and can graduate into full-blown revenge if they
“lose.” When possible, avoid direct competition with a
narcissist, sociopath, or psychopath. Even when you
notice them getting jealous or insecure because of you,
try evening the keel or even letting them have their way
if you sense a lot of animosities.
6. Interact more publicly than privately with them: Public
interactions have at least one casual witness or
bystander and can be a great protection strategy for a
narcissist or sociopath at work. This can sometimes keep
them in check by threatening their reputation or image
for saying or doing toxic things.
7. Keep a written log of issues or interactions if needed:
Because (narcissistic or psychopathic) gaslighting is so
common, it can sometimes help to keep a written log of
interactions or facts if you have frequent interactions
 with one of these personalities. Keeping a written log can
Newsletter
also help you build an informal case against them, even if
you only use it in the event that they come after you.

Final Thoughts
People with narcissistic or antisocial personality disorder
share some traits, qualities, and tendencies, as well as some
differences. Sociopaths and psychopaths have antisocial
traits and tendencies in common, but psychopathy is less
common and more severe, with a high correlation to crime
and violence. The narcissistic need for attention and
external validation is very prosocial and primarily
distinguishes them from antisocial personalities. When
narcissists, sociopaths, and psychopaths seek help in a
sincere way, I believe recovery is possible.

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For Further Reading

Sociopath vs. Psychopath: Understanding the
Differences
Tips for How to Deal With a Narcissist
Introduction | Antisocial personality disorder:
prevention and management | Guidance
Personality disorders – NHS
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1. American Psychiatric Association.
Show more (2013). Diagnostic
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