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(Kyle)
What is the difference between a sociopath, a psychopath and a narcissist?
Here to answer this intense question is doctor Ramani. Help us out here.
(Dr. Ramani)
Well, it's, you know, again, there's a lot of overlap,
but the fact is a lot of people are
using these terms interchangeably.
(Kyle)
And should they be?
No, they shouldn't, they're different things. Okay.
One rule of thumb to remember right off the bat:
Every psychopath is narcissistic, but not every narcissist is psychopathic.
Makes sense? There's your key difference.
A narcissist is somebody who lacks empathy,
is grandiose, is entitled, is constantly 
seeking validation, is arrogant.
It's a disorder of self-esteem and they have trouble regulating their self-esteem.
But when a narcissist does a bad thing,
they feel a fair amount of guilt and shame.
More shame than guilt, frankly, because they're concerned about how other people view them.
Shame is a public emotion.
So they don't like being viewed negatively 
in the public eye or by other people--
that's where the shame comes from.
But they'll feel a little bad,
like if they cheat on their wife,
"uuuh, I probably shouldn't have done that."
(Kyle)
Yeah.
A psychopath's a different animal. They're all of those things except: no guilt/no shame.
They don't feel remorse when they
do something bad.
(Kyle)
[whispered]
Wow.
So they're, they're great
serial killers,
(Kyle)
Oh!
hired assassins.
People who are gonna go in and literally sort of 
gut a business. These are your guys.
They're like I don't, I don't care who gets hurt.
They'd say that and they'd mean it.
Okay, where narcissist is like, 
"I hope no one gets hurt." Okay?
The difference between the psychopath and the sociopath is the one where most people get confused
because the sociopath is a lot like the psychopath --
they do bad things and they don't care. Okay?
Here's the key difference:
a psychopath is born and a sociopath is made.
(Kyle)
[expresses understanding]
Mmmm
Okay, that's the key.
So a psychopath in fact, we know in the research on psychopathy--
which has also been called Antisocial Personality Disorder in our diagnostic manual--
these are people who are actually believed to have slightly different autonomic nervous systems.
Our autonomic nervous system is actually that
part that holds our sympathetic nervous system,
which is our fight-or-flight system.
So when our autonomic nervous system, 
for a normal person, gets charged up,
which it would if we broke a rule,
if we did something
embarrassing or rude, if we ran through a red light--
our heart starts racing,
(Kyle)
Uh hmmm
we sweat, our pupils get wide,
we look around because we're
afraid of the consequence.
A psychopath doesn't have that same kind of arousal.
That's why they're able to lie on lie-detector tests.
That's how they get away with it.
They don't have that same kind of arousal.
So where you or I may go on a roller coaster,
feel that sense of excitement,
we need to get that arousal in a good way.
We don't like feeling it when we do something wrong.
They don't feel it.
(Kyle)
So do they get stressed?
No, not in the same way.
(Kyle)
So if they're driving,
(Dr. Ramani)
Mm-hmm
because if I'm driving and I see
police sirens coming behind me.
I mean it is a full-on, "Oh my gosh, 
I can't believe I'm gonna get pulled over."
(Dr. Ramani)
Oh, yeah, you're not a psychopath.
But a psychopath would see that and go, 
"Oh, I'm gonna get pulled over."
Well, this could be, they could have a dead body in the trunk and they wouldn't, they wouldn't show that.
And so they pull over, they get the ticket 
and they don't...care?
No, they don't care.
(Kyle)
And they pay the ticket?
And believe it or not they'll even probably get an attorney to get him off or say yeah,
you know my understanding of your state laws is you can't really be doing this and they'll be cool as can be.
And this is, this is a
difference in their... makeup?
They're actually, how their nervous systems
are wired and their brains are.
There's actually been interesting 
research done with PET scans
where you can see brain function
and what they've shown...
(Kyle)
Just a clarification, not "pet" like
dogs and cats, P. E. T. scans.
No, that's positron emission tomography, scans of the brain, which show brain functioning, if you will,
and what they see is that the,
the section of the brain that serves empathy,
that doesn't naturally light up in them.
And you can actually teach them to be empathic
for a minute but it doesn't last.
A lot of psychopaths who commit violent crimes
end up in jail and the ones who commit more like
white-collar crimes, I guess they end up as
multi-billionaires because they're willing to do
really, really rough stuff in their business and get through, like, a cartel leader or something like that,
call for the killings of other people.
Now, their interesting counterpart
are the sociopaths.
Psychopaths are born. They tend. . . their belief is that they may very well have. . . this might be genetic.
In fact psychopaths often have fathers
who have lots of antisocial tendencies.
Now how much of it is learned,
how much of it is genetic
it's a little bit harder to suss out. But we do see that there is that difference in your true psychopath.
They also tend to be, have really glib, shallow charm, they tend to be really intelligent.
That's why they get away with stuff.
If they were really. . .
(Kyle)
So they've learned behavior to assimilate into society. But there's...it's all a façade.
(Dr. Ramani)
Oh, yeah
It's all a façade, they're SO charming.
(Kyle)
So if they're born this way
would a three-year-old, then, not get
stressed out if it got scared?
(Dr. Ramani)
Might not
(Kyle)
That's incredible.
So what we see when we diagnose Antisocial Personality Disorder,
which is sort of our diagnostic equivalent to being a psychopath. In order to get that diagnosis
you have to have shown a pattern
prior to the age of 15 of things like:
truancy, violence towards other kids, 
stealing, skipping school,
(Kyle)
And not felt bad about it
torturing animals,  setting fires.
They just do it.
They don't care and that before the age of 15. So it's a long-standing pattern
That's what makes us call them a psychopath or having antisocial personality.
Now, this is different than sociopathy.
(Kyle)
Yes, okay.
Sociopathy, they look a lot like the psychopath. 
The difference is they were made.
So this...some examples here...the kid who grows up in a really, really, really, really rough neighborhood
and learns criminality to get by
or learns to be a bully or like
you know gets involved with sort of like
the wrong kids and uses a lot of muscle
because that's survivalism,
but they...it's not necessarily always
comfortable for them. They just learn it.
It's the person who grows up with a father
who teaches them the business
and teaches them how to break the rules.
(Kyle)
They, but they, they don't,
they, would they feel, would they start sweating and have their heart race if they got pulled over?
They might. They may not feel so good about...
they'll be a little bit more uncomfortable with it
but in time they'll learn it and that, that.... 
What it's almost like, they,
they get trained in not being as aroused by it.
Listen, if you broke enough rules,
if you lived under certain
conditions of lawlessness long enough, 
you'd adjust to that "new world order", if you will.
(Kyle)
Um hmm, um hmm.
That's what the sociopath does and so they're the person who someone who said,
"He was actually a great kid until he got to high school and then it seems like he got in with the wrong kids."
That feels more like the sociopath.
(Kyle)
[whispered]
Wow.
(Dr. Ramani)
Okay, that's almost like a training
that might happen from
within the family, within their community,
within even the job they get.
Some cases even, within
some form of military training.
Have you had sociopaths and psychopaths as clients?
Not really, no. They don't tend to come in for therapy. They don't see any benefit to it.
The only time you would tend to see
psychopaths or sociopaths
come into therapy with any consistency
is if they were court-ordered. So...
I thought you were gonna say couples therapy.
No God no, no.
No, it's because they're court-ordered
so the judge will make that a 
condition-of-release kind of thing
or they're within prisons and jails 
and getting some treatment in there.
This is so incredibly fascinating to me. If a psychopath goes to jail
he
isn't upset about going to jail?
Um, in some ways it becomes
a cost of doing business.
You know, but it's also--they, no.
They're not happy about it. There was....
Psychopaths, and to some degree sociopaths,
don't think about consequences.
That's why they pull really penny-ante silly crimes
like holding up a liquor store.
Basically, "I need a hundred fifty bucks. Here's a liquor store. It's open. Let's go get the money" kind of thing.
So it's like they act first and think later.
So they often don't plan in terms of consequences.
That's why they have a tendency to lie, cheat, steal and they tend to have very inconsistent work histories--
because they, they're not able to hold a job.
(Kyle)
Yeah, of course.
They use aliases.... It's definitely like,
it's more of a griftery kind of a space.
So, we've talked in previous videos about
how to cope while dating a narcissist.
If you find yourself dating
a sociopath or a psychopath
is there any coping or you just got to get out?
You're in trouble. It could be actually be a very dangerous relationship.
(Kyle)
Sounds like it.
Yeah, in fact you know,
even with the narcissistic piece,
um, I do, I've done research and work in the
area of domestic violence,
or what's also called intimate partner violence,
most people who perpetrate domestic violence
are either narcissistic or psychopathic
and so, so there's a danger there.
In other words, they will dispose of you
if you get in their way.
I want to share a story with you to get your feedback.
This was told to me by a friend and she said in college she dated a guy for a year
but the guy started to get
just a little weird and they broke up.
For the next year he courted her and
did everything she wished he had done the first year - showed up on time, brought her gifts, blah blah blah.
They started dating again. He was perfect for a year. He...they went to Thanksgiving at her family's house,
he was perfect to her parents,
just became the perfect man for her because
he knew what she wanted.
And after a year, on their one-year anniversary
he broke up with her and said, "I've been playing you this whole time because I wanted to crush your heart.
(Dr. Ramani)
Yep.
I, I am not actually behaving this way."
Or, "This isn't real,
I've been faking it for a year
just so I can crush you."
Would that be a psych....
That's more psychopathic, you know or sociopathic is more likely, you know, um.
But if they have no empathy then-- why would they want to hurt somebody?
Because, because, empathy, empathy is not,
empathy is a positive emotion.
Okay, wanting to hurt someone
is a very antagonistic emotion.
Wanting to hurt someone at some level might even give them a little pleasure-- power for sure.
It's, it's interesting to me that
someone can not be empathetic
but then want to hurt somebody because to me you would have to have the empathy
in order to even know
what it's like to hurt somebody.
(Dr. Ramani)
No, there's a difference between
empathy and understanding:
(Kyle)
Oh, that makes sense.
(Dr. Ramani)
It's like that's why psychopaths make great salesmen, because they understand the person,
they can read a person and immediately say I got his vulnerability. I'm gonna make him buy a car.
(Kyle)
[whispered]
Got it
Psychopaths are great salesmen. Salesman for cars, timeshares, all that, all of that stuff
where they're upselling and almost
taking advantage of someone sometimes,
making them take on more money and cost of something than they really should.
But no, no, no, it's that he was
able to be superficially charming
Psychopaths and sociopaths and narcissists
make great chameleons.
They're definitely able to change the situation
to get what they want and
psychopaths in particular and sociopaths are, they, they view the world as an instrument to fulfill their desires.
(Kyle)
Mmm
That's really what they're about,
which is what...
it's awful because they're going to often discard a partner when they don't have much use for them
or expect them to have a very specific role, so, they may have married her and she may have had their kids,
now, she's gonna have to put up with their affairs because they want something else and too bad
if you don't like it, this is the new world order and I will destroy you in court. It's that kind of thing.
That is insane.
(Dr. Ramani)
Yeah, it's chilling.
I want to leave it right there.
I have learned more about sociopaths and psychopaths than I ever thought possible.
Make sure you check out as well our discussion
about narcissism with Dr. Ramani
Thanks again for being here.
For more information on all things mental health,
make sure you go to medcircle.com
There you can curate your own list of your preferred mental health topics.
It will be delivered to you exactly when you need it.
I'm Kyle Kittleson. Thanks for watching.
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