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Not so long ago, a woman was sitting on a plane, minding her own business, when the man next to her made several attempts at conversation. Jane, let’s call her, assumed the man was drunk, so she didn’t bother being friendly or making any effort with him. But her unfiltered behavior didn’t go unnoticed, and at the end of the flight, the man politely suggested she might be a psychopath.

That comment resonated enough with Jane that she looked up the term “psychopathy” when she got home. She recognized herself in the descriptions and tried to talk to her sister about it, but her sister seemed hurt and offended. So Jane took it back and said she wasn’t a psychopath and that she didn’t mean it.

That reaction isn’t surprising, says M.E. Thomas, author of Confessions of a Sociopath. “What are the implications of someone you know being a sociopath? Maybe that they don’t love you after all, at least not in the way that you thought they did,” Thomas says. “Maybe that they’ve had bad thoughts about you. Maybe that they’ve manipulated you or hurt you in ways that you weren’t even aware of at the time. Maybe you go back through your interactions with them and doubt their intentions or their feelings for you.”

In recent years, the violent, manipulative psychopath has become so pervasive in popular culture that it’s hard to find a Netflix series about anything else. After watching 400 movies made between 1915 and 2010 to identify “realistically” portrayed psychopaths, Belgian psychiatry professor Samuel Leistedt concluded, “It appears that psychopathy in the cinema, despite a real clinical evolution, remains fictional…Most of the psychopathic villains in popular fiction resemble international and universal bogeyman, almost as ‘villain archetypes.’”

Away from our screens, however, psychopathy is not a monolithic disorder with clearly defined behaviors. It’s nuanced and widely misunderstood, according to James Fallon, a neuroscientist who incidentally discovered his own psychopathic traits when examining his PET scan as part of an unrelated research project.

“The only thing really accepted is antisocial personality disorder (ASPD), which is a subpart of psychopathy,” Fallon says. The latest edition of the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders defines ASPD as a “pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.” Psychopaths are considered to have a severe form of ASPD.

“I don’t like the assumption that because these four letters exist next to my name in my medical notes — ASPD — I should be treated with a great deal of suspicion.”

Scientists estimate that the prevalence of psychopathy in society varies between around 0.2 and 2 percent, and research suggests that those with psychopathic traits are more violent than those without. But experts, also acknowledge that not everyone with a diagnosis is violent, including Fallon.

“I’d never hurt the people I know. I’ve put people in dangerous situations, but I’ll do it with them. I like the thrill, so for me it’s just fun, but most people can’t go there. They still hang around with me but just won’t fall for any traps,” Fallon says. “They’re looking for me to pull a prank on them, but I’ve never manipulated a stranger. They’re very safe around me. I have a rich life with lots of friends, so why lie and put people in true danger?”

Thomas, an attorney and law professor whose book details her life as a self-described nonviolent sociopath, says there is truth to the questions people might ask themselves in Jane’s family’s position, but it doesn’t have to be that way. In the process of being open with people about her own diagnosis, Thomas lost one friend and many professional opportunities, but most of her friends eventually came around.

It would be much easier if people didn’t have misconceptions around psychopathy, she says. In her book, Thomas writes that he calls herself a “sociopath” instead of “psychopath” because of the negative connotations of “psycho” in popular culture — even though psychosis is not a characteristic of psychopathy. For those with an ASPD diagnosis, these popular misconceptions can have serious consequences.

Scout Bolton calls herself a nonviolent, high-functioning sociopath. She was diagnosed with ASPD nine years ago at the age of 20, while under the care of a mental health team for bipolar disorder. Bolton had been getting into fights, dealing amphetamines, and had even been arrested. But today she has a stable life with good friends, a supportive fiancée, and her first child on the way. She blogs about how to turn antisocial traits into positives.

“They’re very safe around me. I have a rich life with lots of friends, so why lie and put people in true danger?”

Because of her diagnosis, Bolton explains, people interpret her positive traits negatively, assuming her confidence is narcissism and her social skills are manipulation — medical professionals included. “Doctors will write you off and believe everything you say is a manipulation,” she says. “I don’t like the assumption that because these four letters exist next to my name in my medical notes — ASPD — I should be treated with a great deal of suspicion.”

Bolton is so affected by the public perception of psychopaths that she often stays indoors to avoid interacting with people. “My life is colored by how hidden I feel, and sometimes it makes me quite contemptuous, to a point where I don’t want to leave the house,” she says. “It’s not aggression or depression. I’m not worried anything bad is going to happen, but I just don’t want to interact with anyone, because I know I’ll go into an overdrive of resentment and a feeling of injustice, so I stay home, lay low, and stay isolated.”

This judgement toward people with ASPD is particularly unfair, Fallon argues, because they’re not responsible for thinking the way they do. “People with obsessive-compulsive disorder (OCD) get obsessions and rituals, but they know they’re irrational,” he says. “Someone with a personality disorder has similar thoughts as someone with OCD, but they think their behaviors are good and true.”

Another unfortunate consequence of pop-culture psychopathy is the fetishization of its dangerous side, which, Bolton says, is a particular problem for women. “We’re here to bring exquisite fire and fury into the lives of the terminally bored, whether we made that decision or not,” she says. “But when people get in relationships with us, they quickly find that all the things they found irresistible about us were a fantasy, and when we fail to live up to that masturbatory illusion, we’re demonized.”

Sexual fantasies aside, the growing public fascination with psychopaths interferes with the lives of nonviolent psychopaths in strange ways. This is something 38-year-old Becky, who also has ASPD, found when she signed up for Facebook to talk to others about her diagnosis. The popularization of psychopathy, she says, has roused people — usually young men who haven’t been diagnosed with a personality disorder — to request membership to the Facebook group she runs for psychopaths. She says people often open with the question, “Have you killed anyone?”

Some psychopathic traits can be attributed to being abused as a child, research has found. Bolton was diagnosed with conduct disorder as a child, which is defined as the display of aggressive and antisocial behavior in children to the extent that it interferes with them leading a normal life, according to the UK’s Royal College of Psychiatrists. Conduct disorder often leads to a diagnosis of ASPD later in life.

Bolton argues that the link between ASPD and childhood trauma makes it even harder to justify the judgements against people with the diagnosis. “If you’re a child going through a hard time at home and you’re reacting with impulsive, tearaway behaviors, you’re written off,” she says. “You’ve become the problem. But what child decides to become a sociopath, just for a laugh?”

Fallon, who attributes his nonviolent nature to his happy upbringing, says he has a series of genes called “warrior genes,” which are thought to be a risk for aggression, violence, and low empathy, but only in those raised in an abusive environment. Being raised in a positive environment can offset some of the genes’ negative effects. “I grew up really good-looking, really athletic, and I got everything I wanted all the time. I don’t know what I’d do if life was bad, because it’s never been bad,” Fallon says.

While the damaging stereotype of the psychopath has far-reaching consequences, Fallon, who helps writers in Hollywood gain a realistic idea of psychopathy, says things are improving. “We’re no longer seeing much of this idea of the psycho, somebody out of their minds, growling and sneering like a mad dog,” he says. “This doesn’t describe a lot of people with psychopathy.”

While Bolton feels unfairly judged because of how psychopaths have been portrayed, she doesn’t want to see the disorder completely censored. “I don’t think it’s necessarily a bad thing to portray real psychopathy,” she says, citing Netflix’s Mindhunter as “a really good portrayal of psychopathy.”

“I like how what seems like benign, and even positive ASPD, seems reflected back in the show’s protagonist,” she says. “I’d like to see more of that.”