Antisocial Personality | Personality Couch

Ep 55: The Dark Schizoid

Tue, 02 Jun 2026 04:00:01 -0500

Additional Podcast References

Ekleberry, S. C. (2009). Cluster A: Schizoid personality disorder and substance use disorders. In Integrated treatment for co-occurring disorders: Personality disorders and addiction. Routledge. https://doi.org/10.4324/9780203843710
Millon, T., Simonsen, E., Birket-Smith, M., & Davis, R. D. (Eds.). (2003). Psychopathy: Antisocial, criminal, and violent behavior. Guilford Press.
Nilsen, D. (2021). History of a drowning boy: The autobiography. RedDoor.
Wagner, J. (2023, Fall). Wings and arrows: Inner movements. [Training]. Enneagram Spectrum Training and Certification Program - Part 1, Virtual.
https://en.wikipedia.org/wiki/Dennis_Nilsen

The Dark Schizoid

Tue, 02 Jun 2026 04:00:00 -0500

I believe schizoid personality disorder is the most misunderstood personality disorder. While theories like psychodynamic have a deeper understanding of the internal turtle-y workings involved in schizoid dynamics, Millon and the DSM-5-TR take a deficit-based approach, highlighting criteria such as a lack of or decreased capacity for emotions, pleasure, intimacy, community, and desire for interpersonal connection¹ ². Most schizoid personalities are quite harmless, passively flying under the radar and busying themselves in their minds rather than the world. In contrast, those with antisocial personality disorder are actively going against rules, norms, and the law. Are these two personalities too different to overlap or combine? Let’s explore!

Similarities & Differences Between Schizoid & Antisocial

There are no overlaps or cross-mentions of schizoid and antisocial personality disorder in the DSM-5-TR¹. Millon’s theory notes they are opposite in terms of adaptation and energy, with schizoids being passive and antisocials being active². They are both detached from pain, but the schizoid is also detached from pleasure while antisocials can be pleasure seeking². Antisocials are strongly self-oriented, while schizoids are average in this area; however, both are detached from others². So the main overlaps here are detachment from others and pain, yet we’re still comparing antisocial tigers to schizoid turtles.

Other similarities include childhood neglect from parents, non-responsiveness, non-conformity, and aloofness…but again, there are different dynamics underlying these. Childhood neglect leads to detachment in both the schizoid and antisocial³, but the schizoid detaches from the world and their own needs, while antisocials detach from anything viewed as “weak” such as emotions, dependent needs, and even empathy. Non-responsiveness to the environment stems from the central nervous system⁴ with schizoids able to detach from the world and their own bodies, while antisocials have higher thresholds for activity due to childhood trauma. Non-conformity is different as well. For the schizoid, the underlying intent is detachment from the need to conform or please others, not defiance. For the antisocial, there’s an active movement to prove their control and autonomy². In regard to aloofness⁵ ⁶, schizoids engage in a solitary lifestyle, showing indifference to relationships, finding intimacy and people-ing too much. Antisocials are aloof in their rejection of others and society. They don’t fit in, they don’t want to fit in, and they do their own thing, making up their own rules to life. So we’re back to the question - can these dynamics overlap within the same person?

Nomadic Antisocial Subtype ²

Millon describes a Nomadic Antisocial subtype, which is an antisocial personality that has schizoid features. Because of rejections and injustices experienced in their past, they still harbor deep resentment, anger, and pleasure-seeking tendencies. However, they aren’t as active in their pursuit of revenge, instead detaching from social and societal responsibilities in order to defend against feeling ostracized, abandoned, and doomed. Their main focus is basic survival, as they roam, drift, and wander along the outskirts of society. It’s been suggested that they are unconsciously forever looking for a home. At a severe level, if they are provoked and/or using substances, they may act out impulsively, abuse alcohol, or become a predator.

When Detachment Turns Psychopathic…and Sadistic… ⁵ ⁶

The overlap between schizoid and antisocial includes detachment, non-conformity, and aloofness, and if you travel to the very extreme end of severity, this is where there is danger in psychopathy. Think about it like this: psychopaths detach from people so hard that they view individuals as inanimate objects to manipulate and mutilate. The interesting thing here is that the three personality disorders that are most associated with violent crime include antisocial, psychopathic, and sadistic, BUT add in a flavor of schizoid aloofness and detachment, and we find a group containing about 50% of males who commit serial sexual murder. So not a schizoid personality at the core, but adding in the schizoid flavor to darker personalities increases risk of danger and “evil.” Check out the serial killer Dennis Nilsen as an example.

Enneagram

Looking at extremes, darkness, and danger is always fascinating, but it’s very rare. Much more common are healthier overlaps containing schizoid and antisocial dynamics. Because the DSM-5-TR focuses on pathology, there’s not much information on healthy/normative personality dynamics, so I like to use the Enneagram to describe it. Simplistically, there is a shared line of growth and stress between Type 8s (antisocial dynamics) and Type 5s (schizoid dynamics). I’ll have to save an in depth analysis of this for its own blog, but in sum: Schizoid and Antisocial can overlap!

If you want to better understand an antisocial individual in your life, or if you are an antisocial or schizoid personality and want to explore it more, feel free to reach out! If you’re in Virginia (or a PsyPact state), work with us here. If you’re a provider stuck on a case, we also offer consultations for mental health professionals!

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision.). https://doi.org/10.1176/appi.books.9780890425787 ↩︎ ↩︎
Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Putri, A. A. T., Parwatha, N. W., Sutrisna, I. P. B., & Wiguna, I. G. R. P. (2024). Parenting models, spirituality and personality disorders in adolescence: A literature review. International Journal of Health & Medical Sciences, 7(2), 40-52. https://doi.org/10.21744/ijhms.v7n2.2279 ↩︎
Raine, A., & Venable, P. H. (1984). Electrodermal nonresponding, antisocial behavior, and schizoid tendencies in adolescents. Psychophysiology, 21(4), 424-433. https://doi.org/10.1111/j.1469-8986.1984.tb00221.x ↩︎
Stone, M. H. (2007). Violent crimes and their relationship to personality disorders. Personality and Mental Health, 1(2), 138–153. https://doi.org/10.1002/pmh.18 ↩︎ ↩︎
Stone, M. H. (2017). The Anatomy of Evil. Prometheus Books. ↩︎ ↩︎

Ep 54: Antisocial vs Narcissistic Personality | What's the Difference?

Tue, 19 May 2026 02:00:01 +0000

🎬In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) explore the distinctions between antisocial personality and narcissistic personality by analyzing DSM diagnoses, Stones’ Spectrum of Dark Personalities, and subtypes from Dr. Theodore Millon like: Reputation-Defending Devious, Exploitative Egotist, and the Unprincipled Narcissist.

⚠️Note: this podcast does not constitute a professional relationship. If you’re in need of professional help, please seek out appropriate resources in your area. ⚠️

Antisocial Personality vs. Narcissistic Personality

Tue, 19 May 2026 02:00:00 +0000

Antisocial personality disorder and narcissistic personality disorder are tough to differentiate because they often overlap, yet have separate and distinct characteristics¹ ² ³ ⁴. Additionally, narcissism does not have to be at a level of personality disorder. Narcissism is also a trait⁵ ² ³. Further, antisocial does not have to be at a level of disordered personality. Antisocial can simply be behaviors⁶ ² ⁴. It can get quite confusing, so let’s dive into the similarities and differences of antisocial and narcissistic dynamics.

Antisocial and Narcisstic in the DSM¹

In the DSM-5-TR, antisocial personality disorder and narcissistic personality disorder do not have any criteria that overtly overlap. However, antisocial personality disorder’s associated features include arrogance, charm, and lack of empathy - all of which are part of narcissistic personality disorder. Also, the DSM-5-TR specifically notes both share traits such as being “tough-minded, glib, superficial, exploitative, and unempathic.” However, antisocials are more impulsive, aggressive, deceitful, and indifferent, with a history of conduct disorder and possible adult criminality. Whereas, narcissists are more envious, needing more admiration from others and being more sensitive to others’ criticism and reactions. They usually don’t have conduct disorder or adult criminality. Overall, it seems that antisocial personality disorder exudes the more severe behavior of narcissistic personality disorder…which aligns with Michael Stone’s work below.

Stone’s Spectrum⁴ & Hare’s Checklist⁶

Michael Stone’s spectrum of negative personality includes both narcissistic and antisocial personality disorders, sandwiching malignant narcissism⁴. (See Episode 27: What’s Worse Than a Narcissist? The Baddest of Them All and its corresponding blog for more in depth information). Understanding malignant narcissism is helpful to see the overlap between narcissistic and antisocial. Malignant narcissism was coined by Otto Kernberg² (super cool and smart psychiatrist) who defined it as a narcissistic core, antisocial behavior, paranoid orientation, and aggression/sadism² ⁴. You can find more about Kernberg’s malignant narcissism here. Pulling in another theory, Robert Hare, a forensic psychologist who studies psychopathy, created a Psychopathy Checklist - Revised (PCL-R) that originally had two factors⁶. Guess what?! One factor correlates with narcissistic personality disorder and the other correlates with antisocial personality disorder⁶ ³ 🤜🫳🎤! …But that’s not even the best way to understand the differences between the two. For that, I like Millon’s theory.

Millon’s Passive Narcissist vs. Active Antisocial³

There’s no question that narcissistic and antisocial personality disorders can be hard to differentiate. Antisocial overlaps most frequently with narcissistic and sadistic personalities; and narcissistic overlaps most with antisocial and histrionic personalities. They are both exploitative, unempathetic, and self-focused, turning to the self to fulfill their needs and find gratification. But how are they different? It’s mostly their difference in adapting to life. Antisocials are active, focusing on modifying their environment, whereas narcissists are passive, focusing on finding accommodations. Narcissists have a passive, core belief of superiority and entitlement. They think, “Things should just come to me, because I’m great and deserve great things.” Antisocials are active in that they work for their superiority. They think, “I got ripped off in life so I have to take what I’m owed. I deserve more because life dealt me a bad hand.”

Millon’s Narcissistic & Antisocial Overlapping Subtypes³

Remember how antisocial overlaps most with narcissistic and sadistic, and narcissistic overlaps most with antisocial and histrionic? Millon has a few subtypes that showcase this. The Reputation-Defending Devious is an antisocial personality with narcissistic and sadistic features. They pursue status and reputation, a seemingly narcissistic venture; however, they do so for power, not image. And, they actively take what they feel they are owed, not just passively feeling it should be provided to them. They present as tough, invincible, and unconquerable, often showing up at the “top” of their group, be it Wall Street, business, gangs, politics, etc.

The Exploitative Egotist is a narcissistic personality with antisocial and histrionic features. In their superiority pursuit, they attempt to gain self-worth by seducing others in games of sexual exploits, which only last a day to a few weeks because it’s a very shallow intimacy. They are a phony type of confident and cleverly deceptive, acting without conscience because they are obviously above everything. They can’t put the money where their mouth is, yet fear being exposed because of their underlying inadequacy.

The Unprincipled Narcissist is a narcissistic personality with antisocial features. They present with shallow charm and false toughness, which easily cracks to show the arrogant amorality underneath. They enjoy the dynamics of exploiting others before others do it to them, contemptuously conning others and being vindictive. They expect to be treated as special, still maintaining the core of narcissistic passive entitlement.

There’s a couple more I found helpful to understand. Though not a mixture of narcissistic and antisocial, Millon states that the Compensatory Narcissistic Personality Disorder tries to compensate for deprivations in childhood (like the antisocial), but they try to create an image of superiority instead of actively taking power. Personally, I had trouble understanding how the Covetous Aggrandizing (antisocial) did NOT overlap with narcissistic personality. The Covetous Antisocial takes and takes and takes, sometimes displaying what they take in ostentatious ways. It sounds narcissistic, but because they actively acquire their possessions and power, and because they are never satiated, they are the prototypical antisocial personality.

In sum, antisocials and narcissists are self-focused, unempathetic, and exploitative. If I were to use my own words to describe the main difference between both, I would say: Antisocials don’t give a 💩 and actively take power, but narcissists are sensitive to ego wounds and passively feel they should be provided their needs. In real life, there aren’t textbook-clear divisions of antisocials and narcissists, and malignant narcissism may be the grey area in-between.

It’s hard to parse all this out! If you want to better understand these dynamics in yourself or others, therapy and/or psychological testing can help! If you’re in Virginia (or a PsyPact state), check out our private practice, Quest Psychological and Counseling Services for available services. If you’re a provider stuck on a case, we also offer consultations for mental health professionals!

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision.). https://doi.org/10.1176/appi.books.9780890425787 ↩︎ ↩︎
Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. Yale University Press. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Stone, M. H. (2018). The place of psychopathy along the spectrum of negative personality types. Contemporary Psychoanalysis, 54(1), 161–182. https://doi.org/10.1080/00107530.2017.1420376 ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Akhtar, S. (1992). Broken structures: Severe personality disorders and their treatment. Jason Aronson, Inc. ↩︎
Hare, R. D., Harpur, T. J., Hakstian, A. R., Forth, A. E., Hart, S. D., & Newman, J. P. (1990). The revised Psychopathy Checklist: Reliability and factor structure. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(3), 338-341. https://doi.org/10.1037/1040-3590.2.3.338 ↩︎ ↩︎ ↩︎ ↩︎

Ep 53: Antisocial Personality vs Psychopathy | What's the Difference?

Tue, 05 May 2026 02:00:01 +0000

🎬In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) explore the complex distinctions between antisocial personality and psychopathy, delving into historical terminology, key theories, and nuanced subtypes. This episode offers a deep dive into dark personality traits and how they differ.

⚠️Note: this podcast does not constitute a professional relationship. If you’re in need of professional help, please seek out appropriate resources in your area. ⚠️

Antisocial Personality vs. Psychopathy

Tue, 05 May 2026 02:00:00 +0000

Today, the word “psychopath” elicits a picture of a cruel, law-breaking, destructive individual who is probably a murderer. This is actually nowhere near what the original understanding of the term meant. In the 1800s, it was a question of etiology: Does the pathology originate in the psyche (psychopath), or does society create the pathology (sociopath)¹. Psychopathy captured a vast array of disorders, until Cleckley’s 1941 book, “The Mask of Sanity,” attempted to clear up some of the terminology confusion¹ ² …but the confusion has continued.

A Broad Timeline of Psychopathy in Different Theories

The first DSM in 1952³ did not use the term psychopathic, instead listing sociopathic personality disturbance until the 1980 publication of the DSM-III used the term antisocial personality disorder⁴. Meanwhile, psychodynamic literature and the PDM-2⁵ stated,
“We prefer the earlier term ‘psychopathic’ (Cleckley, 1941; Hare, 1991; Meloy, 1988, 1997) to the current ‘antisocial.’ Many people with psychopathic personalities are not obviously antisocial; that is, they are not observably at odds with social norms. In fact, many people with psychopathic personalities are able to pursue their agendas in contexts of social approval and even admiration” (p. 50)⁵. Robert Hare⁶ used Cleckley’s² work to create a Psychopathy Checklist in the 1970s, narrowing the definition of a psychopath¹. The DSM seemingly attempted to capture a more severe personality pathology, listing sadistic personality in the appendix of the DSM-III-R (1987), but it was dropped in the DSM-IV (1994), with the current DSM only listing antisocial personality disorder⁷ ⁴ ⁸. However, the PDM-28 and Millon⁴ ⁸ both describe a separate sadistic personality⁵ ⁴ ⁸… and finally Stone proposed a negative personality continuum including antisocial, psychopathy, and sadism⁹ ¹⁰. Let’s unpack this more!

Stone’s Negative Spectrum of Personality ⁹ ¹⁰

Michael Stone, a forensic psychiatrist, wrote about a negative spectrum of personality with six main components where he argued psychopathy is more severe than antisocial. Each level is progressively worse and subsumes all that comes before it. See Episode 27: What’s Worse Than a Narcissist? The Baddest of Them All and its corresponding blog for more in depth information.

Negative personalities with negative traits like being abrasive or severely negative traits like aggression.
Severe personality disorders including narcissistic and/or paranoid personality disorders.
Malignant narcissism¹¹ is narcissism with antisocial behavior, sadism/aggression, and paranoid flavors.
Antisocial personality disorder (without psychopathy).
Psychopathy, including non-violent psychopathy or psychopathy with violence.
Sadism, including sadistic personality traits, as well as sadism with terrorism.

Hare’s Psychopathy Checklist ⁶

Robert Hare, a forensic psychologist, expanded Cleckley’s² work and created the Hare Psychopathy Checklist in the 1970s, and it has since been revised: Hare Psychopathy Checklist Revised (PCL-R)⁶. The PCL-R is a 20-item semi-structured interview where one can obtain a score ranging from 0 to 405. Stone highlighted those with only antisocial personality disorder would have a PCL-R score of “low to about 20”⁹. Scores from 15 to 29 indicate “some psychopathic traits,” and scores of 30+ reflect clear-cut psychopathy⁹.

This is super important to understand because it contributes to the differentiation of antisocial personality disorder and psychopathy, as psychopathy has a much narrower definition. This is demonstrated by 70-80% of prisoners meeting criteria for antisocial personality disorder, but only 15-25% meet the criteria for psychopathy according to the PCL-R⁹ ¹⁰. Another big difference is that antisocial children don’t usually become antisocial adults, and young adults with antisocial personality disorder will “burn out” around their 40s, whereas psychopathy is pervasive. The aging out dynamic does not happen in psychopathy⁹ ¹² ¹⁰.

Millon’s 10 Psychopathic Subtypes ¹³

While Hare created a measure to detect the severity of psychopathic dynamics, Millon focused on understanding the different personalities, features, and flavors that can make up a psychopath. He wrote a chapter outlining 10 Subtypes of Psychopathy with many of them overlapping with Stone’s continuum. A very brief overview is listed below:

Spineless Psychopath (Avoidant, Dependent): Insecure and feel weak, harming others as a countermove.
Unprincipled Psychopath (Narcissistic): Arrogant, fraudulent, and exploitative.
Disingenuous Psychopath (Histrionic): Impulsive, resentful, and deceitful, wrapped up in a friendly, sociable exterior.
Risk-Taking Psychopath (Histrionic, Antisocial): Flagrantly disregard danger and pursue thrill at the expense of others, being irresponsible and neglectful.
Covetous Psychopath (Antisocial): Feels like life ripped them off, so they revengefully take from others to make up for it.
Malignant Psychopath (Paranoid): Resentful, mistrustful, envious, and vindictive, thinking others are out to get them and having vengeful fantasies that can be acted out.
Abrasive Psychopath (Paranoid, Negativistic): Obnoxious and antagonistic, spewing venom without remorse.
Explosive Psychopath (Sadistic at borderline level): Has unpredictable, vindictive, and rageful outbursts with or without provocation, though they are super sensitive to feelings of betrayal.
Malevolent Psychopath (Paranoid, Sadistic): Suspicious, hostile, vindictive, and destructive, as well as having a cold-blooded ruthlessness to find revenge for their childhood mistreatments. “Many murderers and serial killers fit this” (p. 168)¹³.
Tyrannical Psychopath (Negativistic, Sadistic): Abusive, calculating, and actively attacking when met with resistance/weakness, going out of their way to be inhumane and unmerciful. They are one of the most pure forms of the classical psychopath.

Photo by Sebastiaan Stam

Overall, it seems that Millon⁴ ⁸ ¹³ understands the types and flavors of psychopathic personalities, Hare⁶ understands the dynamics that highlight severity to indicate a psychopath, and Stone¹⁰ understands there’s a continuum of building blocks that creates a pathway from non-pathological personalities to psychopathy. All are important in comprehending the big picture of how antisocial personality overlaps with, and is different from, psychopathy.

Let us know your thoughts on the differences between antisocial personality and psychopathy! If you want to better understand these dynamics in yourself or others, therapy and/or psychological testing can help. If you’re in Virginia (or a PsyPact state), check out our private practice, Quest Psychological and Counseling Services for available services. If you’re a provider stuck on a case, we also offer consultations for mental health professionals!

References

Akhtar, S. (1992). Broken structures: Severe personality disorders and their treatment. Jason Aronson, Inc. ↩︎ ↩︎ ↩︎
Cleckley, H. (1988). The mask of sanity: An attempt to clarify some issues about the so-called psychopathic personality (5th ed.). Emily S. Cleckley. ↩︎ ↩︎ ↩︎
American Psychiatric Association. (1952). Diagnostic and statistical manual: Mental disorders (1st ed.). https://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf ↩︎
Millon, T. (1981). Disorders of personality: DSM-III, Axis II (1st ed.). Wiley. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). The Guilford Press. ↩︎ ↩︎ ↩︎
Hare, R. D., Harpur, T. J., Hakstian, A. R., Forth, A. E., Hart, S. D., & Newman, J. P. (1990). The revised Psychopathy Checklist: Reliability and factor structure. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2(3), 338-341. https://doi.org/10.1037/1040-3590.2.3.338 ↩︎ ↩︎ ↩︎ ↩︎
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision.). https://doi.org/10.1176/appi.books.9780890425787 ↩︎
Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc. ↩︎ ↩︎ ↩︎ ↩︎
Itzkowitz, S., & Howell, E. F. (Eds.). (2019). Psychoanalysts, psychologists and psychiatrists discuss psychopathy and human evil. Routledge. https://doi.org/10.4324/9780429262425 ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Stone, M. H. (2018). The place of psychopathy along the spectrum of negative personality types. Contemporary Psychoanalysis, 54(1), 161–182. https://doi.org/10.1080/00107530.2017.1420376 ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. Yale University Press. ↩︎
Stone, M. H. (2007). Violent crimes and their relationship to personality disorders. Personality and Mental Health, 1(2), 138–153. https://doi.org/10.1002/pmh.18 ↩︎
Millon, T., Simonsen, E., Birket-Smith, M., & Davis, R. D. (Eds.). (2003). Psychopathy: Antisocial, criminal, and violent behavior. Guilford Press. ↩︎ ↩︎ ↩︎

Ep 52: The Six Antisocial Subtypes

Tue, 21 Apr 2026 02:00:01 +0000

🎬In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack the passive-parasitic and aggressive subtypes from history before jumping into Dr. Theodore Millon’s 6 subtypes. At the mild level, we look at: the Covetously Aggrandizing & Disaffected Aggrandizing Antisocials. At the moderate level, we explore the Risk-Taking Devious and Reputation-Defending Devious Antisocials. At the severe/disordered level, we discuss the Nomadic & Malevolent Antisocial Subtypes. We end with our thoughts and opinions about the line for disorder and explain why the antisocial personality is so challenging to understand.

⚠️Note: this podcast does not constitute a professional relationship. If you’re in need of professional help, please seek out appropriate resources in your area. ⚠️

Antisocial Personality Subtypes (Millon)

Tue, 21 Apr 2026 02:00:00 +0000

Antisocial personality disorder has an interesting history filled with confusion and arguments, one of the first being the difference between psychopathic and sociopathic¹ ². Are antisocials born (psychopathic) or made (sociopathic)? While psychodynamic researchers did note there is an aggressive antisocial personality (impulsive, acting out) and a passive-parasitic personality (con-artist, chameleon)², there aren’t many subtypes outside of Millon’s work¹ ². So let’s take a look!

Aggrandizing Personality: Mild - Normal Level¹ ²

At the mild level, we have the Aggrandizing (“to make bigger”) Personality. Even though this is the mild level, society often rejects these antisocials who go against the current, viewing them as pathological. However, the “bad things” about antisocials can be sublimated into society in a way that is adaptive. Things like: ambition, independence, competition, risk-taking, decisiveness, etc can work for society and for themselves. Their willpower is amazing, and they’re great at overcoming things, but do so independently. They take charge, they’re assertive, and they’re dominant… and they can also be overly focused on self-interest. Let’s look at the covetously aggrandizing and disaffected aggrandizing subtypes.

Covetously Aggrandizing ¹ ²

The core of the covetously aggrandizing subtype involves greedy self-enhancement and a desire to possess/dominate by being pushy, envious, and taking over things. They are angry, resentful, and revenge driven, “manipulating others like pawns in a power game.” Why? Because they feel like life has deprived them of what they are rightfully owed (love, support, materials), while others have more than enough. So, they take, even if it means lying or destroying, but they are insatiable, like a self-centered lion who is forever hungry - a predator pursuing prey. They can even be ostentatious and display what they’ve taken as a form of power. It’s important to note that this is different from narcissists who have a passive attitude of entitlement and can feel satisfied with possessions when it meets their image needs. Covetous aggrandizing personalities are actively exploitative to take things because of their deep sense of emptiness and powerful hunger for love and stuff they didn’t get in childhood.

Photo by Luke Miller

Disaffected Aggrandizing ¹ ²

The disaffected aggrandizing subtype is oppositional, not caring to please others, rely on others, or consider others’ input when making decisions. They focus on their autonomy because they don’t want to conform to society or play by the rules. They have so much energy and try to direct it, but they can take on too much too fast or start something very intensely, failing to follow through. They struggle with abstract goals, preferring to work physically for visual, tangible outcomes… and those outcomes need to happen ASAP because they are quite impatient. They switch between a troubled discontentment and unstable, random action, especially because they like the unconventional ideas that are hard to achieve. They are motivated by newness and risk, so sometimes others view them as making impulsive moves, but they actually have thought it out. Their disillusionment with self and others, paired with their dissatisfaction, results in withdrawal, irritability, and hostility alongside their courageous self-determination.

Devious Personality: Moderate - Problematic Level ¹ ²

Mild subtypes can disintegrate into moderate severity if their high needs for gratification and independence are not successfully met, becoming more impulsive, irresponsible, and non-conforming. They become more overtly antisocial and devious. Millon describes the risk-taking devious and the reputation-defending devious.

Risk-Taking Devious (Histrionic, Turbulent (Exuberant) Features) ¹ ²

The Risk-Taking Devious subtype overlaps with histrionic and turbulent features, being impulsive, unreflective, fearless, audacious, and reckless. They seek thrills, needing excitement and stimulation, totally unfazed by danger, pursuing legit perilous adventures and gambling with life in search of trying to feel alive. Their sympathetic nervous system needs a much higher input to achieve an excitement level. They do things like skydiving, drag racing, and jumping into a pool from a hotel balcony, but to others, it seems silly, not courageous. They don’t control their behaviors, act before thinking, and don’t think or care about consequences. There’s a case in Millon’s book² where a man “has a death wish he tries to sell as a quest for the ultimate life” (Millon 2011, p. 451). So even at events with others doing similar things, he’d get kicked out for being too extreme. He reportedly stated, “You have to have a hint of death in your life for existence to be truly savory” (Millon 2011, p. 451).

Photo by Tom Fisk

Reputation-Defending Devious (Narcissistic, Sadistic Features) ¹ ²

The Reputation-Defending Devious subtype overlaps with narcissistic and sadistic features, wanting status and reputation. They become someone “not to be trifled with,” wanting others to see them as infallible, powerful, brave, invincible, not to be conquered, always to be respected, etc. They are overreactive to slights, sometimes brooding then having an outburst, or sometimes erupting intensely, being intimidating, threatening, and posturing. Their focus is on defending their reputation, but not necessarily in hostility. Some are loners, others in gangs. Some are aggressive leaders, alphas, and dominants at the ‘top of the pack.’ Sometimes they can be violent which is the sadistic part. They can engage in violence/terrorism, feeling like they are the victim and are justified in their counteractions.

Antisocial Personality: Severe - Disorder Level ¹ ²

The moderate subtypes can disintegrate easily into the severe level due to social rejection, which means we’re possibly in Antisocial Personality Disorder territory where they withdraw or turn aggressive toward society, focused only on their own self-interest. Their previously antisocial and socially unacceptable acting out turns into a pervasive lifestyle. Here, we have the nomadic antisocial and the malevolent antisocial.

Nomadic Antisocial (Schizoid, Avoidant Features) ¹ ²

The Nomadic Antisocial subtype showcases schizoid and avoidant features. They still have deep anger, resentment, and desire for pleasure that stem from previous rejection and injustices, but they are less active in their revenge-seeking, preferring to detach themselves from the social world and societal responsibilities. Why? Because they are defending against feeling abandoned, ostracized, and ill-fated, having a core mood involving doom and invincibility. They prefer to focus only on basic survival, roaming, wandering, drifting, sometimes being homeless, and functioning on the outskirts of society. I like this quote from Millon: “This sense of ‘being no place’ is both similar to and different from the experience of depersonalization; nomadics appear vaguely disconnected from reality, possess no clear sense of self, and seem to be transients both within themselves and their environments” (Millon 2011, p. 458). Additionally, if provoked or using substances, they can impulsively act out, and they can be prone to predation, prostitution, and alcoholism.

Photo by Fariborz MP

Malevolent Antisocial (Sadistic, Paranoid Features) ¹ ²

The Malevolent Antisocial subtype showcases sadistic and paranoid features being vicious, brutal, callous, fearless, and hostile with a chip-on-the-shoulder attitude and a readiness to lash out at all times. Motivated by the unjustness of their childhood mistreatments (real or perceived), they are guarded against constant potential imminent attacks and betrayals, distrusting any positivity from others. They have adopted a “cold-blooded ruthlessness" in their pursuit for revenge and retribution, rejecting their own weakness and proving their own strength in a way that can be dangerous or elicit punishment…which makes them feel they are treated unjustly…which turns into a cycle. With more power, they actually become more brutal to keep supporting their strong, powerful self-image.

Photo by Sebastiaan Stam

Do you resonate with any of these? Antisocial personality dynamics and disorder can be extremely difficult to separate from other dysfunction. If you want to dive into your own antisocial side or the antisocial dynamics of someone in your life, therapy and/or psychological testing can help! If you’re in Virginia (or a PsyPact state), check out our private practice, Quest Psychological and Counseling Services for available services. If you’re a provider stuck on a case, we also offer consultations for mental health professionals!

References

Millon, T., Grossman, S., Millon, C., Meagher, S., & Ramnath, R. (Eds.). (2004). The schizoid personality. In Personality disorders in modern life (2nd ed., pp. 371–402). Wiley. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Millon, T. (2011). Apathetic styles, asocial types, schizoid disorders: The AAS spectrum. In Disorders of personality: Introducing a DSM/ICD spectrum from normal to abnormal (3rd ed., pp. 663–707). Wiley. https://doi.org/10.1002/9781118099254 ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎

Ep 51: A New Psychoanalysis of Antisocial Personality Disorder

Tue, 07 Apr 2026 02:00:01 +0000

🎬In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) dive deep into the complex inner world of antisocial personality disorder, challenging the traditional DSM view and exploring psychoanalytic theory to uncover the internal processes behind antisocial behaviors. This episode is essential for clinicians, students, and anyone interested in understanding the motivations and defenses of antisocial individuals. ⚠️Note: this podcast does not constitute a professional relationship. If you’re in need of professional help, please seek out appropriate resources in your area. ⚠️

Antisocial Personality - Outside the DSM

Tue, 07 Apr 2026 02:00:00 +0000

The first personality disorder in psychiatry was psychopathy¹, which means it has an extremely long, convoluted history that I can’t fully go into for this blog. I do think it’s necessary to clear up some terminology because it’s super confusing. First, the DSM-5-TR (psychiatry diagnostic model mainly used in the United States) uses antisocial personality disorder², while the ICD-11 (global diagnostic model) captures antisocial personality using the construct of dissociality. Then there are former names for antisocial personality including, psychopath(y), psychopathic personality³, sociopath(y), sociopathic personality [DSM 1], and dyssocial personality³. However, we currently and complacently use the term psychopath(y) to describe the “worst” of people who violate laws, like serial killers, majorly influenced by Hare’s Psychopathy Checklist.

Further, we have the confusing concept of describing behaviors versus actual personalities¹. This is akin to describing symptoms versus the disease. For example, a headache could be a symptom of hypertension, diabetes, or a brain tumor, all of which are very different. In the same way, vandalism is an antisocial behavior that could be acted out by multiple personalities such as narcissistic, paranoid, or antisocial (PS: Antisocial behavior used to be called dyssocial behavior or sociopathic behavior). This is a major criticism of the DSM-5-TR’s portrayal of antisocial personality disorder² - that the criteria are mostly behaviors, not necessarily capturing the underlying personality dynamics⁴ ⁵ ⁶ ⁷. So what is underneath the exterior behaviors of the antisocial personality? 🤔

*Please also note that antisocial (against social) does NOT mean asocial (not social).

Photo by Henlynn

The Makings of Antisocial Personalities

The genetic research on antisocial personalities is tricky because it’s hard to separate antisocial behaviors from the actual antisocial personality, and genetics from environment. Robins (1966)⁴ found that having a sociopathic or alcoholic father contributed to antisocial personality, even if the father wasn’t present…but what if the impactful variable was actually the absence of the father (physically or neglect from substance abuse)? It’s a chicken or egg conundrum.

In childhood, they did not have adequate attachments, were “unloved⁴,” and suffered traumatic injustices. They likely felt helpless and powerless, not having confidence in their own power or in the power of others to help/protect them. So power becomes very important to them, and they seek confirmation of their own omnipotence or power. Let’s paint a picture. Envision a child that is neglected, traumatized, abused, etc, and inherently helpless due to age. Teachers, cops, Child Protective Services were in their life, but didn’t save them. The systems and law failed them. They are left to save the self, to not rely or trust others, to reject their helplessness and weakness, and embody the power that they need. They learn that emotions and vulnerability are weak. Action is learned, not emotions and not caring for others. They need to act. To have personal power. To save the self. Invest in the self. Be self-focused. Survive.

Photo by Pixabay

The Workings of Antisocial Personalities

Because survival is a big part of childhood for antisocials, their automatic nervous system operates at high levels and eventually stays there as a baseline. This is also paired with low serotonin levels, depression, and emptiness. Then, they need more sensory and emotional input to get above that baseline for pleasurable excitement and to just feel alive. So not only do they struggle to regulate their emotions, vacillating between anger/rage and “manic exhilaration,⁷” they need intensity, like sky diving, drag racing, etc. I also suspect this is influenced by primitive envy⁵, as antisocials likely feel there’s something others have that they lack (e.g., love, connection). They “wish to destroy that which they most desire⁵.” They reject and devalue the vulnerable, squishy things in life, but they unconsciously want it. It’s hard to communicate this, but it comes out in their behaviors, like a baby can both smile and then bite mom. A pathological example of this is how Ted Bundy destroyed young women that looked like his mother, noting he needed to “own” them⁵. I think it’s really important to look on the inside of antisocials because we get so distracted by their fierce behaviors.

The Defenses of Antisocial Personalities⁸ ⁵

All personalities defend against anxieties and difficulties to adapt to the world. The main defenses that antisocial personalities use are primitive, including omnipotent control, projective identification, acting out, and dissociation.

Photo by Fernando Cortés

Omnipotent Control involves the need to exert and confirm one’s power to defend against weakness/shame. It is a defense learned in the first 6 months of life when there isn’t any understanding of separateness between infant and mother. If an infant is hungry, the infant gets milk, and the infant believes it is all-powerful. This is also an extension of primary narcissism. In an adult relationship, this could look like inconsideration: “I am not cold, so you must not be cold.” Pathologically, this could be consciously manipulating to have someone under their thumb. Omnipotent control is found in many areas where there are power dynamics (e.g., politics, business, law, religious hierarchies, military).

Projective Identification involves putting an unacceptable quality characteristic on another person, then the other person identifies with it. For example, if the antisocial person feels weak in any way (which is definitely not acceptable to them), they might act dominant/powerful with you, making you feel and identify as weak. Or if they don’t trust you, they elicit mistrust of them…or if they’re angry, they lash out and now you are angry…or if they can’t feel empathy for you, you now find yourself not able to be empathetic toward them…etc. The antisocial’s struggle to verbally express emotion can easily result in evoking their feelings in others so that others can understand. This is paired with the next defense.

Photo by Piet Bakker

Acting Out is essentially behaving on emotions to relieve them, but usually in an oblique manner (e.g., fighting, threatening, stealing). Antisocials act, but they also need more to get to their threshold of feeling. For example, their startle response is lower and their tolerance for darkness is high. They may be stuck in their fight response, always being on guard for threats. But do they actually feel anxiety? Do they lack anxiety or just hide it? We would never see their anxiety because they act so fast due to hypervigilance and past trauma. Healthier antisocials can experience anxiety, and they either hide it or it comes out as anger or irritability.

Dissociation is separating impulses, thoughts, or emotions that are too “threatening” to the ego. This can be anything from minimizing personal experience to complete amnesia. To assess this in an antisocial is tough because they can lie and manipulate, so they may not actually be utilizing this defense. However, dissociation and abuse are linked, and antisocials have experienced abuse. Additionally, when raging, the memory part of the brain can shut down, leading to decreased ability to recall what actually happened.

Photo by Tima Miroshnichenko

Can Antisocial Personalities “Get Better”?

Theorists, researchers, and clinicians have been in conflict about this for over 200 years, yet there is a strong stereotype that antisocial personalities are untreatable⁴ ⁶ ⁷ ¹. This is where moral judgment infringes on professional assessment. Antisocials reject society, so society rejects them⁵. However, there is evidence that some antisocial individuals can make progress⁵ ¹.

Summing all of this up, the DSM doesn’t capture the personality underlying the external behaviors. Most antisocial personalities aren’t even engaging in criminal behaviors⁶ ⁷, which goes against a lot of what we think when we hear the term “antisocial.” To look inside the antisocial personality is to see the expanse of darkness inside all humanity, and if you dig deep enough, you’ll find the seed of pain every individual has buried within. I’ll leave you with this quote from Danish psychiatrist Georg Sturup 19518:
“Don’t forget these people. They have no one, yet they are people. They are desperately lacking and in terrible pain. Those who understand this are so rare; you must not turn your back on them.”

Photo by Elti Meshau

Antisocial personality dynamics are complex!!! If you want to better understand an antisocial individual in your life, or if you are an antisocial personality and want to explore it, feel free to reach out! If you’re in Virginia (or a PsyPact state), check out our private practice, Quest Psychological and Counseling Services for available services. If you’re a provider stuck on a case, we also offer consultations for mental health professionals!

References

Millon, T., Simonsen, E., Birket-Smith, M., & Davis, R. D. (Eds.). (2003). Psychopathy: Antisocial, criminal, and violent behavior. Guilford Press. ↩︎ ↩︎ ↩︎ ↩︎
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision.). https://doi.org/10.1176/appi.books.9780890425787 ↩︎ ↩︎
American Psychiatric Association. (152). Diagnostic and statistical manual: Mental disorders (1st ed.). https://www.turkpsikiyatri.org/arsiv/dsm-1952.pdf ↩︎ ↩︎
Akhtar, S. (1992). Broken structures: Severe personality disorders and their treatment. Jason Aronson, Inc. ↩︎ ↩︎ ↩︎ ↩︎
McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Millon, T. (1981). Disorders of personality: DSM-III, Axis II (1st ed.). Wiley. ↩︎ ↩︎ ↩︎
Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc. ↩︎ ↩︎ ↩︎ ↩︎
Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). The Guilford Press. ↩︎

Ep 50: Antisocial Personality: Everything I Learned is Wrong

Tue, 24 Mar 2026 02:00:01 +0000

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unpack some of our difficulties understanding antisocial personality disorder in how it combines psychology, morality, philosophy, and societal judgment. We focus on: where’s the line for disorder; how can we diagnose without judgment; and what does this personality look like when it’s not disordered? We pull from historical examples of antisocial types in specialized roles and also hypothesize that America might have transitioned from a narcissistic nation to an antisocial one.

In need of psychodynamic therapy or a psychological evaluation? OR are you a provider stuck on a tricky case? To schedule with us, please visit the practice website and fill out the inquiry form! https://www.questpsych.org. Clinicians use the email listed on the website.

Rethinking Antisocial Personality Disorder

Tue, 24 Mar 2026 02:00:00 +0000

Confession: I cracked open a whole bunch of stuff on antisocial personality for this new series, and it feels like my brain imploded. There is SO much information, and a lot of it is conflicting. I boiled down my processing to three main focuses:

What is involved in the inner workings of the antisocial personality?
Where is the line where the antisocial personality becomes disordered?
How do we handle morality within a psychologically based personality disorder?

Photo by www.kaboompics.com

Inside the Antisocial Personality¹ ²

Writing a comprehensive understanding of the inner workings of the antisocial personality would take a book, so I will attempt to briefly cover the prominent points. I cannot simply take the DSM-5-TR’s conceptualization of antisocial personality disorder by itself because it doesn’t look at the inner workings of the person but rather focuses on overt, observable behaviors and criminality. Yet, antisocial behavior can be a symptom of many different personality types…Not all criminals are antisocials, and not all antisocials are criminals (duhh🙄). While also not comprehensive, I have anchored my understanding of antisocial personality in the PDM-2 (pp. 50-512) explanation because it doesn’t focus on criminal behavior, noting there are many antisocial personalities that are able to fit into the society (e.g., law, military, police, Wall Street). Key features of the antisocial personality include a possible temperament that is more aggressive with a higher threshold for emotional stimulation (i.e., lower anxiety, higher need for stimulation). They often experience abusive and/or traumatic childhoods³ ⁴, learning to believe “everyone is selfish, manipulative, dishonorable, and/or weak” (p. 512). This results in a fear of being manipulated by others, so they have to manipulate first, which stems from primitive envy and is often expressed through rage. They can become stuck in primary narcissism where they are focused on the self and their own satisfaction, not understanding that others are separate from them. They might think, “I can do whatever I want” (p. 512) to make sure their self-interest is first, which means they must have all the power and control to protect and defend themselves. 💪…But when are these patterns actually considered disordered?

Photo by Kindel Media

When is an Antisocial Personality Disordered?

The DSM¹ focuses on disorder level being abnormal (hence abnormal psych class), but then what is a normal antisocial personality? 🤯 There has to be distress or negative impacts in life, but for this self-oriented personality³, the distress can fall on others¹. “Antisocial personality” inherently implies that these individuals do not fit in the societal box, playing by a different set of rules, yet that doesn’t mean it’s bad or pathological. So, where is the line the antisocial personality crosses to enter into disordered territory? How bad does it have to be? My first idea was that their persistent personality dynamics are harmful to others. Like, killing isn’t okay…except when society deems it “acceptable” in certain situations ranging from killing to protect (e.g., military), ➡️to killing innocents in fear (e.g., salem witch trials), ➡️to genocide (not going to touch that one😔). Thus, the line for disorder territory cannot be harming others because that line changes based on society’s definition. All of this just makes me conclude that we don’t know where the line is, and that the answer should be determined on a case by case basis. Especially because antisocial personalities can overlap with quite a few other personalities…since we obviously have to make this even more complicated. 😵‍💫 I’ll get into this more in an another blog, but for now, I’ll leave you with this graphic to illustrate the overlap…before jumping into another overlap: psychology and morality.

Morals and Antisocial Personality

When morality and psychology come head to head, there are often intense reactions, emotions, and conflict (e.g., Milgram experiment, Stanford prison experiment, interrogation/torture debates). Morality and psychology cannot fully be separated, and this is relevant to understanding antisocial personalities. All the way back in 1835, a guy named Prichard coined the term moral insanity, which is not the same as our current antisocial personality disorder, but it influenced the construct⁵ ³ ⁴. The part I find super important is that Prichard was apparently a major advocate that these types who were “morally insane” should be socially condemned³ ⁴. There is a problem when we place a moral, value-laden position on a psychologically complex construct. Morally, we condemn antisocials and are quick to ostracize them, yet psychologically, we seek to understand and treat antisocials. It is conflictual.

Photo by KATRIN BOLOVTSOVA

We need all personality types in society, and that includes antisocials. There are laws that were placed long ago, and some in current practice, that need(ed) to be challenged (e.g., woman couldn’t vote, Blacks couldn’t sit on a bus, women can’t buy a hat without their husband’s permission in Kentucky, you can get fined $500 for sending unsolicited pizza in Louisiana). But on a serious note, we need personalities that push the envelope and do what none of us dare to do (e.g., 💣disposal, Navy Seal) and sometimes set an example that we view as against cultural norms. We need some antisocial personalities to call out society’s bull💩 unapologetically and bulldoze broken systems for repair. We need antisocials to handle crises, negotiations, high-stake litigation; and to jump out of planes to save others. As with all personalities, we need antisocials to better society, not to permanently destroy it. Thus, we do not need pathological antisocial behavior in society. However, because antisocial personalities don’t play by society’s rules, the line seems to be “whatever doesn’t benefit society in the current moment,” which ventures into morality. For example, when Timothy McVeigh killed in military combat, it was acceptable, but when he bombed a building full of people, it was not (See When Paranoid Personalities Kill (Ep. 32) for a detailed analysis of this case). Morally, many would agree that murder in war is acceptable. Psychologically, McVeigh’s pathological motivation to kill was likely present in combat too, making it a disorder…but would we have known this if he hadn’t become the Oklahoma City Bomber? Probably not.

In conclusion: There is no clear line where antisocial personalities become disordered. 🤷

Photo by fauxels

Can Antisocial Personalities be Treated?
Assuming we can adequately understand an antisocial personality at the disorder level, are they treatable through therapy? Unfortunately, most people ask if we should treat them, venturing into morals and values. This does reflect the inaccurate stereotype that, as a class, antisocials are not treatable⁵ - a vindictive dynamic in society where “moral judgment impinges on professional assessment” (p. 1673). Why? Because antisocials write off others’ needs, and so we write off antisocials’ needs, but this ignores severity and individual differences⁵ ⁴.

There needs to be a clear understanding that multiple things can exist at the same time. The antisocial personality’s psychological/emotional pain is valid, as is everyone’s pain, AND their harmful/destructive behavior is not acceptable. Treatment with an antisocial personality needs to be incorruptible and extremely boundaried. Empathy is viewed as weakness by the antisocial, so it has no place in the treatment room. Power, however, is the currency that can be used to gain respect⁵. Thus, it is extremely difficult for therapists to treat antisocial personalities. We’re uncomfortable with our own darkness, and so we automatically throw those labeled antisocial into the “untreatable” bucket 🗑️. I personally find this ridiculous and hypocritical. Additionally, research does show that institutions provide a better chance of successful treatment for antisocials because there is inherent, fortified structure, hierarchy, and boundaries⁴. So, can antisocial personalities be treated? Yes. Some antisocial personalities can make progress⁵ ⁴.

Antisocial personality dynamics are convoluted, complex, and sometimes dangerous. If you need support for yourself or an antisocial personality in your life, please reach out. If you’re in Virginia (or a PsyPact state), check out our private practice, Quest Psychological and Counseling Services for available services. If you’re a provider stuck on a case, we also offer consultations for mental health professionals!

References

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision.). https://doi.org/10.1176/appi.books.9780890425787 ↩︎ ↩︎ ↩︎
Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). The Guilford Press. ↩︎
Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc. ↩︎ ↩︎ ↩︎ ↩︎
Millon, T., Simonsen, E., Birket-Smith, M., & Davis, R. D. (Eds.). (2003). Psychopathy: Antisocial, criminal, and violent behavior. Guilford Press. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
McWilliams, N. (2011). Psychoanalytic diagnosis: Understanding personality structure in the clinical process (2nd ed.). Guilford Press. ↩︎ ↩︎ ↩︎ ↩︎ ↩︎

Ep 49: Antisocial Personality: The DSM Trash Can Diagnosis for Criminals?

Tue, 10 Mar 2026 02:00:01 +0000

In this episode of the Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) begin our much-awaited series on antisocial personality disorder! In the DSM, antisocial personality is the only diagnosis that includes law-breaking as a criterion. But surely all criminals can’t have the same personality, right? In this episode, we break down its stigmatized history while sharing our thoughts and opinions about the DSM’s limitations. We take a critical look at each of the DSM’s 7 criteria, while also discussing the overlap with other disorders like narcissism, psychopathy, and the sadistic personality.

Antisocial Personality Disorder - The DSM’s Perspective…and Mine

Tue, 10 Mar 2026 02:00:00 +0000

was in the first edition of the in 1952 under the term “Antisocial Reaction,” which is part of the “Sociopathic Personality Disturbance” category¹. It involved people who were callous, , irresponsible, emotionally immature, and loyal to no one, always getting into trouble and not learning from consequences due to rationalizing their behaviors¹. The most recent (2022) criteria of antisocial personality disorder can be found in the (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision²). It provides a more nuanced and narrow view of this personality, but focuses more on behaviors rather than the internal workings of this personality. In my opinion, I feel this has led to gross misunderstandings related to antisocial personalities. Let’s look at the DSM portrayal and see what you think!

Note: Text in these boxes are the exact words from DSM-5-TR²

Antisocial Personality Disorder Criteria

“A pervasive pattern of disregard for and violation of the rights of others, occurring since age 15 years, as indicated by three (or more) of the following²:” (p. 749)

The DSM-5-TR’s framework for all personality disorders involves a pattern that shows up in many parts of life in multiple settings (e.g. home, school, work). Antisocial personality disorder is special in that it defines an actual age, 15 years old, that symptoms must occur by. So it’s not just something that pops up in middle age - it’s a long-standing pattern that starts in childhood and/or adolescence. The main pattern is not caring about and infringing upon the rights of others, demonstrated by three or more of the following noted in the boxes below.

“Failure to conform to social norms with respect to lawful behaviors, as indicated by repeatedly performing acts that are grounds for arrest².” (p. 749)

Whether or not they’re actually caught or arrested, they repeatedly do things they could be arrested for such as, stealing, harassment, destruction of property, or doing illegal things at work. They may be aware of the desires, rights, or emotions of others, but they don’t care. They can lack empathy and take an “everyone has to be out for themselves” approach to life, being extremely self-focused.

“Deceitfulness, as indicated by repeated lying, use of aliases, or conning others for personal profit or pleasure².” (p. 749)

Antisocials use whatever they need to for their own gain. Lying is something they use often, to cover up their last offense, and the one before that, and the one before that…it spins into their own version of rationalized “reality.” There’s a long history in psychology about the “ ” antisocial personality that is a con artist, setting up ³ ⁴. They are no stranger to manipulation, conniving, and to get out of responsibilities (e.g., work, child support, criminal charges) or gain something they desire (e.g., sex, power, money). Some can be super charming and impressive with their communication and intellect, but it’s superficial. It’s all to get what they want.

“Impulsivity or failure to plan ahead².” (p. 749)

Antisocial persons often make spur-of-the-moment decisions, resulting in spontaneous changes in areas like work, home life, or social relationships. They may never have kept a monogamous relationship, instead having a ton of intimate partners. Not only that, but they can be exploitative and irresponsible with those partners. Or they might think their boss is stupid after a specific interaction, so they just don’t show up and quit. Or it can simply be because a rule is “dumb,” and they don’t believe rules apply to them anyway. It doesn’t have to be a major thing that triggers the impulsivity. Again, it can be for gain or to avoid negative consequences. The DSM notes they might be arrogant and have an inflated ego, perhaps feeling like they are too superior for ordinary work, or perhaps they are just super cocky, opinionated, and self-assured. They also tend to not have realistic concerns about problems that could affect them, either now or in the future.

“Irritability and aggressiveness, as indicated by repeated physical fights or assaults².” (p. 749)

The DSM specifically notes that this does include beating a spouse or child. It could also involve animal cruelty and public brawls. It could be basically anything that’s taking their anger out on others and disregarding other living things. There’s a superiority to it, as others are viewed as beneath them. However, it is important to note that self-defense, or defending others, in an aggressive manner is not something that fits here.

“Reckless disregard for safety of self or others².” (p. 749)

There is a lot of risk taking and recklessness. It could show up in driving, so speeding all the time, driving under the influence, lots of accidents. It could be in sexual risk taking or risky substance use. It may even be putting a child in danger through neglect or failure to care. The DSM actually notes they can be reckless and irresponsible parents. Sometimes evidenced by malnutrition, illness from lack of hygiene, neighbors or community taking care of the food/shelter for the child, leaving the child without a caretaker when too young, or not using money for necessities but spending it irresponsibly. There’s a real disregard for the social world, other people, laws, rules, order, etc.

“Consistent irresponsibility, as indicated by repeated failure to sustain consistent work behavior or honor financial obligations².” (p. 749)

Antisocials can be extremely irresponsible. They might be unemployed for long periods of time even though they could get a job, or just quit jobs without a plan to get another. They might just not show up for periods of time at work without any regard for the consequences affecting others. Financially, they might fail to support dependents or pay child support or default on debts. When it gets bad, they might fail to support themselves, fall into poverty or homelessness, become dishonorably discharged if in the military, or end up in penal institutions for years.

“Lack of remorse, as indicated by being indifferent to or rationalizing having hurt, mistreated, or stolen from another2.” (p. 749)

Lack of in an antisocial person can look like displacing blame, minimizing/ignoring their harm, not compensating for harm they commit, and/or spinning a whole different story to keep blame off of themselves. They might think life is unfair, and that everyone is out to help themselves, so you “gotta do what ya gotta do” to survive and not be pushed around. They tend to blame victims for being weak, helpless, stupid, and deserving of whatever bad thing happened - a “he had it coming anyway” or “losers deserve to lose” mentality. The DSM literally says they “frequently lack empathy and tend to be callous, cynical, and contemptuous of the feelings, rights, and sufferings of others.” They really don’t care about people or about rules. There is an extreme self-focus.

There are some other interesting things the DSM says about antisocial personality disorder. Those with antisocial personality disorder “are more likely than individuals in the general population to die prematurely from natural causes and suicide.” Also, antisocials seem to age out of their behavior, often by 40 years old2,5. Which brings me to the question: Is the DSM describing behavior or an actual personality here? All of these criteria involve external, observable features, but none of the internal processes involved in the personality.

So, next we’ll have to explore other theories and conceptualizations to figure out what is going on beneath the surface of antisocial personalities! If you want to better understand an antisocial individual in your life, or if you are an antisocial personality and want to explore it, feel free to reach out! If you’re in Virginia (or a state), check out our private practice, for available services. If you’re a provider stuck on a case, we also offer for mental health professionals!

References

American Psychiatric Association. (152). Diagnostic and statistical manual: Mental disorders (1st ed.). ↩︎ ↩︎
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th edition, text revision.). ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Lingiardi, V., & McWilliams, N. (Eds.). (2017). Psychodynamic diagnostic manual: PDM-2 (2nd ed.). The Guilford Press. ↩︎
Millon, T. (2011). Disorders of personality: Introducing a DSM / ICD spectrum from normal to abnormal (3rd edition). John Wiley & Sons, Inc. ↩︎

Ep 27: What's Worse Than a Narcissist? | The Baddest of Them All

Tue, 06 May 2025 02:00:01 +0000

In this episode of The Personality Couch Podcast, we (licensed clinical psychologists Doc Bok and Doc Fish) unveil the darkest aspects of personality, focusing on narcissism at its most severe forms. We explore the spectrum of personality types that range from mildly unpleasant to dangerously malignant, discussing examples and case studies that illustrate their risk in relationships. We specifically unpack narcissistic and paranoid personality disorders, malignant narcissism, antisocial personality disorder, psychopathy and sociopathy, and sadistic personalities. While further exploring the characteristics, overlaps, and distinctions among these disorders, we end with a discussion about terrorism and extreme manifestations of sadism.

50 Shades of Personality Darkness

Tue, 06 May 2025 02:00:00 +0000

The Dangerous Personality Types

I found something exciting when doing research on narcissism! Michael Stone - a forensic psychiatrist came up with an entire spectrum that helps us understand how narcissism and its associated traits can devolve into psychopathy and destruction.¹ This spectrum has 6 main components, each one getting progressively worse.

Negative Personalities

Negative Traits

First is just all the negative personality traits that people can have, like being abrasive, argumentative, deceitful, discourteous, tactless, and unsympathetic.¹ These are the annoying people who might be jerks, but aren’t necessarily dangerous or criminal. Think of the meddlesome teacher who is up in everyone’s business or the quarrelsome guy at the store who argues with the manager over an out-of-stock product.

Severely Negative Traits

The negative traits can be more severe though, like people who are aggressive, hostile, cruel, predatory, or malicious.¹ It’s the people we really don’t like, or maybe even hate - they’re worse than just annoying. This might be the slanderous, vengeful ex-partner who threatens a smear campaign to end your career, or the grudge-holding boss who is still punishing the employee after a mistake that happened 2 years ago.

This is just the outer layer of the dark personality onion though. Peeling back another layer is when the negative personality traits worsen into actual personality disorders.

Photo by Andrea Piacquadio

Severe Personality Disorders

Narcissistic Personality Disorder

In our podcast, Doc Bok and I have discussed narcissism and narcissistic personality disorder at length (blog/podcast), so I’ll briefly cover it, then provide murderous examples² of those with narcissistic personality disorder to understand the different layers of darkness. Not everyone with narcissistic personality disorder is going to be violent, but their tendency to be self-important, entitled, exploitative, envious, and arrogant, with a need for admiration, belief they’re special, and fantasies of unlimited success do set them up for risky, yucky behaviors. If you add decreased or a lack of empathy in that mix, they are capable of violence.

One example motivated by narcissistic greed is a guy who put pipe bombs under his mother’s car and killed her after he found out she was going to financially cut him off, AND he was hoping for a $10 million inheritance payout.²

Paranoid Personality Disorder

Not all individuals with paranoid personality disorder are going to be dangerous, but those who ARE paranoid AND commit violent crimes have the more severe criteria like pathological jealousy, grudge-holding, and vindictiveness.² (See our blogs here and here for a better understanding of PPD). Interestingly, violent paranoids are more likely to commit mass murders (3+ kills in one outburst),² likely because they desire to take their pain out on the world (see Personalities That Kill).

One example was the guy who stalked then threatened to kill a coworker who would not date him, leading to him being fired. Two years later, he went back to his old workplace and killed seven people and wounded four (including the girl).² This event was actually made into a movie in 1993 called I Can Make You Love Me.

Photo by Fran

Malignant Narcissism

Malignant narcissism is the next dark layer when personality disorders become “worse.” Malignant narcissism is narcissism with antisocial behavior (lawbreaking and against social norms), sadism/aggression (hurting others), and paranoid (attack first because everyone is out to get them) flavors.³ Check out our podcast or blog for a deeper understanding of malignant narcissism. Stone² states, “If there is, from the standpoint of personality, one red thread running through the majority of violent crimes, this would be narcissism.” Those who choose to exploit or destroy others are obviously putting their own desires first with no consideration of others.

An example of a violent malignant narcissist is the doctor who murdered his wife and children and unsuccessfully attempted suicide when he felt he was going to be caught…because he wasn’t actually a doctor and was faking his social status.⁴

Photo by Sebastiaan Stam

Antisocial Personality Disorder

Even “worse” in the dark personalities is antisocial personality disorder. According to the DSM, antisocial personality disorder is a pattern of disregard for, and violation of, the rights of others; criminality; impulsivity; and a failure to learn from experience. It’s helpful to understand that malignant narcissists can engage in antisocial behavior, but ALL antisocial personalities include narcissism.⁵

An example of someone with an antisocial personality without psychopathy is the guy who had a long childhood history of criminality, then after getting out of juvey at age 19, he became the leader of a prominent gang with a goal to protect locals from other gangs and police brutality…and during this time he was also a youth counselor. The problem was he became addicted to angel dust and killed people when stealing money to buy the drugs. He was imprisoned and sentenced to death, but later in prison, he ended up writing books discouraging black youths to engage in gangs. He was actually nominated for the Nobel Peace Prize, but was executed in 2005.⁶

Note here that there’s a difference between antisocial personality disorder and psychopathy. One of the biggest differences is that antisocial children don’t usually become antisocial adults, and young adults with antisocial personality disorder will “burn out” around their 40s. This aging out dynamic does not happen in psychopathy. Psychopathy is consistent and stays lifelong.⁶

Still curious about APD? Here are links to our blogs where you can learn more about this dangerous condition! Personalities as Ice Cream blog, Psychodynamic Personalities blog, and Personalities That Kill blog.

Photo by Elti Meshau

Psychopathy

Peeling back the next layer brings us out of personality disorders that match up with the DSM and lands us in the dark forensic psychology territory. So, what is psychopathy? Robert Hare (expert forensic psychologist) notes psychopaths are “intra-species predators who use charm, manipulation, intimidation, and violence to control others and to satisfy their own selfish needs.⁶” It’s also notable that psychopathy is marked by a complete absence of empathy - not just impaired empathy or blocked empathy.³ There’s actually brain imaging and studies that support this.³ Psychopaths just don’t experience emotions the same way others do.

Sociopathy/Non-Violent Psychopathy

Non-violent psychopathy is definitely a thing.

An example of a non-violent psychopath or a sociopath is the guy who engaged in the biggest known Ponzi-scheme manipulation and swindled people out of billions of dollars. While he was non-violent with no assaults, he did not have empathy and preyed on clients.⁶

Violent Psychopathy

We usually think of psychopathy as involving violence. There’s a ton of examples out there, but Stone² used this one:

One guy was convicted of 11 murders. He has the sexually violent crime “triad” of childhood bed-wetting, animal torture, and fire-setting. Fast forward, and he ended up raping and strangling 11 prostitutes until his arrest. Stone actually interviewed him in prison and noted lack of remorse, “jollity,” pathological lying, and grandiosity. He even embellished his crimes to impress others.²

Photo by cottonbro studio

Sadism

Sadistic Personality

Peeling back the last layer of darkness in terms of personality, we find sadism. Sadistic personalities are common in those who commit violent crimes,² and it’s notable that I’m not talking about sexual sadism here, but an actual personality style.¹ Sadistic personalities achieve dominance through cruelty, humiliate others, are unusually harsh to those under them, take pleasure in others’ suffering, lie to harm others, intimidate others to get them to obey, are excessively controlling, and are fascinated by violence, weapons, martial arts, injury, or torture.¹

A watered down (It’s very sick - so look at your own risk) example of a sadistic personality is the guy who created a torture chamber and killed at least 40 women. They also found 100 videotapes of torture.²

Sadism with Terrorism

The “worst” it can get is sadism with terrorism. It’s only “worse” because it involves a very high number of hurts and deaths with the terrorism aspect, but it’s the same concept as above. An example of large scale terrorism involving sadism is Sadam Hussain, who “probably reached diagnostic threshold for the sadistic (T score M = 81.0), paranoid (T score M = 79.3), antisocial (T score M = 77.4), and narcissistic (T score M = 74.2) personality disorders⁷.” It’s also notable that Hussein had more sadistic features than Hitler.⁷

Photo by Mitja Juraja

So as we funnel down the spectrum of darkness, we take all the personality stuff that precedes it. Thus, a sadistic personality is going to have it all - negative traits, narcissistic personality disorder/paranoid personality disorder, malignant narcissism, antisocial personality disorder, psychopathy, and of course, sadism. Additionally, as we funnel down the darkness spectrum, there are less and less examples of darkness, which is hopeful. On the other hand, Stone states, “There is no “worst case” of sadism, just as there is no bottom to human depravity¹.” Thus, our work and understanding of humanity will never be complete.

Photo by Ralph W. lambrecht

References

Itzkowitz, S., & Howell, E. F. (Eds.). (2019). Psychoanalysts, psychologists and psychiatrists discuss psychopathy and human evil. Routledge. https://doi.org/10.4324/9780429262425 ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Stone, M. H. (2007). Violent crimes and their relationship to personality disorders. Personality and Mental Health, 1(2), 138–153. https://doi.org/10.1002/pmh.18 ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎ ↩︎
Wood, R. (2022). Literature review of malignant narcissism and related constructs. In R. Wood, A study of malignant narcissism: Personal and professional insights (pp. 7–41). Routledge. https://doi.org/10.4324/9781003246923 ↩︎ ↩︎ ↩︎
Lazaro, Y., Mesian, I., Perez, A., Madrazo, I., & Baena, R. (2016). Malignant narcissism: The notorious case of Jean-Claude Romand. European Psychiatry, 33, S630–S631. ↩︎
Kernberg, O. F. (1984). Severe personality disorders: Psychotherapeutic strategies. Yale University Press. ↩︎
Stone, M. H. (2018). The place of psychopathy along the spectrum of negative personality types. Contemporary Psychoanalysis, 54(1), 161–182. https://doi.org/10.1080/00107530.2017.1420376 ↩︎ ↩︎ ↩︎ ↩︎
Coolidge, F. L., & Segal, D. L. (2007). Was Saddam Hussein like Adolf Hitler? A personality disorder investigation. Military Psychology, 19(4), 289–299. https://doi.org/10.1080/08995600701548221 ↩︎ ↩︎

Ep 07: Personalities That Kill

Tue, 30 Jul 2024 02:00:01 +0000

In this episode of the Personality Couch Podcast, we discuss personality darkness and specifically focus on personalities that are prone to violence and extreme behavior. We also discuss two important research studies, the Milgram study and the Stanford prison experiment, that shed light on the capacity for humans to engage in harmful acts. We then delve into the different personality types within Cluster A (schizoid, schizotypal, and paranoid); Cluster B (borderline, histrionic, and narcissistic); and Cluster C (avoidant, dependent, obsessive-compulsive) and discuss their risk levels for violence and murder. In this conversation, we also explore sadistic personalities, a category not included in the DSM, but included in multiple other personality theories. We highlight the characteristics and behaviors associated with each type and discuss the potential for violence and destructive behavior. The conversation emphasizes the importance of understanding these personalities and their potential risks in order to promote awareness and better understanding of human behavior.

Personalities That Kill

Tue, 30 Jul 2024 02:00:00 +0000

One of my favorite topics to dive into is the darkness of humanity and thus the darkness of personalities. Harm to others surrounds us in a ridiculous amount of ways, which makes many people think about not only what others around them are capable of, but of what they, themselves are capable of. The popularity of true crime, dark genres, horror media, etc., provides evidence that people are interested in this topic. And of course, there’s always some recent event that can remind us of the darkness people have in them. There is SO much I could say about this topic (Listen to podcast episode 07 for much more information), but for now, I’m just going to address the question:

🚩What personalities are at the most risk to kill? 🚩

In my opinion, there are three main personality types that fall into the high risk category. I’m going to start with the “least” risky and end with the “most” risky, though please remember that all still are at high risk.

Narcissistic Personalities

Medium Risk to High Risk

Photo by Lance Reis on Unsplash

The thing to remember about narcissism is that those who kill are quite likely to at least have high narcissistic traits, but not necessarily a narcissistic personality structure/disorder. Narcissistic personalities are all about image, ego, and the self, needing admiration and presenting with superiority, grandiosity, and charm (see Episode 04 podcast/blog for more info on narcissistic personalities). They value image so much that they can harm others in their pursuit and maintenance of it. However, there are some types of narcissistic personalities that are at higher risk for actually killing. While some narcissistic personalities are “more pure,” their focus on image is mostly about climbing the social ladder (e.g. Elitist subtype from Millon, p. 397). Now, they’ll react with anger, hostility, and even emotional/verbal abuse, but they’re not apt to physically kill. In contrast, there are some types who connect power with image, resulting in destruction. Millon’s “Unprincipled” subtype of narcissistic personality (Millon, p. 402) is at high risk for killing due to lack of remorse, lack of social conscience, vengefulness, and maliciousness. This subtype includes antisocial features, seen in their desire to humiliate and dominate others. Millon’s “Unprincipled” narcissist seems to be similar to the PDM-2’s mention of the “Malignant” narcissist (PDM-2, p. 46), whose narcissism is combined with sadistic aggression… 🚩Yikes!!

Photo by Tech Nick on Unsplash

Paranoid Personalities

High Risk

Paranoid personalities are tricky. You never really fully know a paranoid personality since they show different faces to different people, which they do because they are suspicious, distrustful, and fearful of others and the world (see Episode 04 podcast/blog for more info on paranoid personalities). They view the world as threatening and against them, and in their defense against this, they tend to attack before being attacked. They can’t handle their own pain and so they transfer it onto others, often in a dramatic manner. They are at a very high risk for destroying others and then themselves, while projecting their own pain onto the masses - such as in a murder-suicide event. It wouldn’t surprise me if many mass murderers have paranoid personality structures. However, while unhealthy paranoid personalities are dangerous in general, some might be most dangerous to themselves (Millon’s “Insular” subtype, p. 975) or in other ways outside of murder (Millon’s “Fanatic” subtype, p. 983). In contrast, Millon’s “Querulously” subtype (Millon, p. 974) tend to be hostile and have delusions, often erotic ones that can result in behaviors like stalking, killing for their object of infatuation, or even killing their actual object of affection. More concerning is Millon’s “Malignant” subtype (Millon, p. 987) who tend to be previous sadistic types who have “fallen apart.” …🚩🚩No bueno!

Antisocial Personalities

High Risk

Photo by Sander Sammy on Unsplash

Antisocial personalities are boundary-crossing, as they tend to disregard and violate the rights of others, social norms, and the law. They are often deceptive, sneaky, and charming on the outside, but can also be impulsive, aggressive, and/or reckless (see Episode 04 podcast/blog for more info on antisocial personalities). In my opinion, antisocial personalities can be somewhat less dangerous than sadistic personalities, because there are some types who are more at risk for harm to themselves (Millon’s “Risk-Taking” subtype, p. 451) or just withdrawal from society (Millon’s “Nomadic” subtype, p. 455). In contrast, Millon’s “Reputation-Defending” subtype (Millon, p. 453) is high in narcissism as well, with a focus on looking tough and powerful with high status. They might have positions of power and rule with aggressive leadership, likely finding a place in extremist groups/cultures. They are very likely to engage in violent acts to “confirm” their own strength, viewing their victims/enemies as the wrongdoers, which they feel condones their violence.

Millon’s “Malevolent” subtype (Millon, p. 458) is perhaps one of the most dangerous personality types, especially as they are paired with paranoid or sadistic features. They tend to be revenge-driven, vindictive, hateful, and destructive. Millon’s bone-chilling description of them on p. 458 includes the statement, “Distrustful of others and anticipating betrayal and punishment, they have acquired a cold-blooded ruthlessness, an intense desire to gain revenge for the real or imagined mistreatment to which they were subjected in childhood.” …Even more scary, they can usually grasp the concept of remorse/guilt in their minds and even experience it emotionally, but they disregard it🚩🚩🚩. This type seems to be the one that comes to mind when we hear the word “psychopath,” and interestingly, it seems to correlate with the PDM-2’s “Aggressive” subtype of antisocial personality (PDM-2, p. 50).

Sadistic Personalities

High Risk 🚩🚩🚩🚩

Photo by Kurt Cotoaga on Unsplash

This category of personality is a bit confusing. The DSM-5-TR does not include sadistic personality disorder, but Millon and the PDM-2 separate sadistic and antisocial personalities. The overall core of sadistic personalities is their enjoyment of inflicting pain on others (see Episode 05 podcast/blog on Millon’s types or Episode 06 podcast/blog on Psychodynamic types for more info on sadistic personalities). Some sadistic personalities feel like they are entitled to control or punish others, often taking positions of power in militaries, schools, or legal systems, as they also have some compulsive traits. Their power leads to feelings of arrogance and superiority, resulting in a tendency to view their “victims” as inferior and maybe not even human - but all this is wrapped up in their “righteous” exterior that they portray as moral (Millon’s “Enforcing” subtype, p. 637). Some sadists are actually very fearful and use violence to disguise their fear, moving against it through counterphobic action. They can be quite cruel and often find themselves in groups with a shared victim, like a hate group - somewhere to put their anger about their own weakness (Millon’s “Spineless” subtype, p. 637). Some might possibly kill those closest to them in an uncontrollable and unpredictable rage that tends to not be premeditated but impulsive. (Millon’s “Explosive” subtype, p. 641).

The one I find the most severely brutal and horrifying is Millon’s “Tyrannical” subtype (Millon, p. 642), which can have paranoid and/or negativistic features. They enjoy destroying, abusing, assaulting, and terrorizing. They are the devious, composed predators who seek out weak prey, and when they attack, they do so with no remorse, unable to stop until their rage is exhausted. Millon states, “What is also especially distinctive is the desire and willingness of these sadists to go out of their way to be unmerciful and inhumane in their violence” (Millon, p. 645), adequately describing them as being “distressingly ‘evil’” (Millon, p. 642).

Hopefully, this helps you better understand your true crime shows and villains in the media you consume. I wouldn’t wish a relationship with these risky types on anyone! It gives a bit of a new meaning to the concept of red flag 🚩. Beware and be well!

Antisocial Personality | Personality Couch

Ep 55: The Dark Schizoid

Additional Podcast References

The Dark Schizoid

Similarities & Differences Between Schizoid & Antisocial

Nomadic Antisocial Subtype 2

When Detachment Turns Psychopathic…and Sadistic… 5 6

Enneagram

References

Ep 54: Antisocial vs Narcissistic Personality | What's the Difference?

Antisocial Personality vs. Narcissistic Personality

Antisocial and Narcisstic in the DSM1

Stone’s Spectrum4 & Hare’s Checklist6

Millon’s Passive Narcissist vs. Active Antisocial3

Millon’s Narcissistic & Antisocial Overlapping Subtypes3

References

Ep 53: Antisocial Personality vs Psychopathy | What's the Difference?

Antisocial Personality vs. Psychopathy

A Broad Timeline of Psychopathy in Different Theories

Stone’s Negative Spectrum of Personality 9 10

Hare’s Psychopathy Checklist 6

Millon’s 10 Psychopathic Subtypes 13

References

Ep 52: The Six Antisocial Subtypes

Antisocial Personality Subtypes (Millon)

Aggrandizing Personality: Mild - Normal Level1 2

Covetously Aggrandizing 1 2

Disaffected Aggrandizing 1 2

Devious Personality: Moderate - Problematic Level 1 2

Risk-Taking Devious (Histrionic, Turbulent (Exuberant) Features) 1 2

Reputation-Defending Devious (Narcissistic, Sadistic Features) 1 2

Antisocial Personality: Severe - Disorder Level 1 2

Nomadic Antisocial (Schizoid, Avoidant Features) 1 2

Malevolent Antisocial (Sadistic, Paranoid Features) 1 2

References

Ep 51: A New Psychoanalysis of Antisocial Personality Disorder

Antisocial Personality - Outside the DSM

The Makings of Antisocial Personalities

The Workings of Antisocial Personalities

The Defenses of Antisocial Personalities8 5

Can Antisocial Personalities “Get Better”?

References

Ep 50: Antisocial Personality: Everything I Learned is Wrong

Rethinking Antisocial Personality Disorder

Inside the Antisocial Personality1 2

When is an Antisocial Personality Disordered?

Morals and Antisocial Personality

References

Ep 49: Antisocial Personality: The DSM Trash Can Diagnosis for Criminals?

Antisocial Personality Disorder - The DSM’s Perspective…and Mine

Antisocial Personality Disorder Criteria

References

Ep 27: What's Worse Than a Narcissist? | The Baddest of Them All

50 Shades of Personality Darkness

The Dangerous Personality Types

Negative Personalities

Negative Traits

Severely Negative Traits

Severe Personality Disorders

Narcissistic Personality Disorder

Paranoid Personality Disorder

Malignant Narcissism

Antisocial Personality Disorder

Psychopathy

Sociopathy/Non-Violent Psychopathy

Violent Psychopathy

Sadism

Sadistic Personality

Sadism with Terrorism

References

Ep 07: Personalities That Kill

Personalities That Kill

Narcissistic Personalities

Paranoid Personalities

Antisocial Personalities

Sadistic Personalities

References

Nomadic Antisocial Subtype ²

When Detachment Turns Psychopathic…and Sadistic… ⁵ ⁶

Antisocial and Narcisstic in the DSM¹

Stone’s Spectrum⁴ & Hare’s Checklist⁶

Millon’s Passive Narcissist vs. Active Antisocial³

Millon’s Narcissistic & Antisocial Overlapping Subtypes³

Stone’s Negative Spectrum of Personality ⁹ ¹⁰

Hare’s Psychopathy Checklist ⁶

Millon’s 10 Psychopathic Subtypes ¹³

Aggrandizing Personality: Mild - Normal Level¹ ²

Covetously Aggrandizing ¹ ²

Disaffected Aggrandizing ¹ ²

Devious Personality: Moderate - Problematic Level ¹ ²

Risk-Taking Devious (Histrionic, Turbulent (Exuberant) Features) ¹ ²

Reputation-Defending Devious (Narcissistic, Sadistic Features) ¹ ²

Antisocial Personality: Severe - Disorder Level ¹ ²

Nomadic Antisocial (Schizoid, Avoidant Features) ¹ ²

Malevolent Antisocial (Sadistic, Paranoid Features) ¹ ²

The Defenses of Antisocial Personalities⁸ ⁵

Inside the Antisocial Personality¹ ²