Signs of a Narcissistic Sociopath

What is a narcissistic sociopath?

There is no clinical diagnosis for narcissistic sociopathy, at least not in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V).^[1] However, the DSM-5 identifies two distinct personality disorders, both of which have symptoms indicative of narcissistic sociopathy: narcissistic personality disorder (NPD) and antisocial personality disorder (ASPD).

This unique combination of traits makes a narcissistic sociopath especially difficult to deal with. For example, a narcissistic sociopath displays a pervasive pattern of grandiosity, often presenting as an exaggerated sense of self-importance. Typically, narcissistic sociopaths have an extreme need to be admired for their beauty, intelligence, success, or other positive traits.

Likewise, narcissistic sociopaths believe they are unique in many ways and that others should admire them for their specialness. Because they think they are special, they also believe that only other special people can truly understand them.

Of course, these are all hallmark features of narcissistic personality disorder. Additional features of NPD that are often present in a narcissistic sociopath include:^[2]

• Arrogant or haughty attitudes and behaviors
• A lack of empathy and/or an unwillingness to recognize the needs of others
• A propensity for envy (or a belief that other people are envious of them)
• A sense of entitlement
• Exploitative behavior 

However, narcissistic sociopath traits also align with antisocial personality disorder. ASPD is characterized by reckless, manipulative, and sometimes criminal behavior. People with ASPD tend to be impulsive, deceitful, and disregard the needs and feelings of others.^[3] 

The DSM-5 outlines specific criteria for diagnosing ASPD, which include:^[4]

• A pervasive pattern of violating or disregarding the rights of others in three or more of the following ways:
  • Failure to conform to social norms for lawful behavior
  • Using deceit, lies, aliases, and other means of conning others either for personal profit or pleasure
  • Impulsivity and failure to plan
  • Aggressiveness and irritability, typically resulting in physical altercations or assault
  • Reckless disregard for one’s safety and the safety of others
  • Prolonged irresponsibility, including the inability to maintain a steady job or honor monetary obligations
  • Lack of remorse for violating the rights of others or hurting others
• Must be at least 18 years of age
• Evidence of the associated behaviors must onset before the age of 15
• Antisocial behaviors must not occur exclusively as a result of bipolar disorder or schizophrenia

While it might seem like it should be easy to identify a narcissistic sociopath, this isn’t always the case. Narcissistic sociopaths can be charming, charismatic, well-educated, and wealthy. They might also have a wholesome outward appearance - being charitable, for example - but not because they want to help others. Instead, doing so feeds their image.

Moreover, many narcissistic sociopaths might be violent, demeaning, or abusive in private but are less likely to do so in public if for no other reason than it would diminish people’s admiration of them.

Narcissistic sociopaths might also be outwardly confident and appear to have high self-esteem and be secure in themselves. This, however, is a ruse. Most narcissistic sociopaths are extremely fragile. As such, there is a high incidence of depression, anxiety, and self-harm among narcissistic sociopaths.^[2][5]

A central set of behaviors often defines a narcissistic sociopath. They tend to be highly manipulative, abusive, and power-hungry. They also lack empathy and constantly seek love, adoration, and attention from others.

The symptoms associated with NPD and ASPD are difficult enough on their own. But when presented together, the resulting behaviors can be extremely challenging. This includes criminality, amoral behavior, and even sadistic behavior.

What is the difference between a narcissist and a sociopath?

As detailed above, there are some distinct differences between narcissism and sociopathy. For example, narcissists have an exaggerated sense of self-importance. Sociopaths, on the other hand, are characterized more by their lack of empathy for others and lack of remorse for their actions. 

If we extract narcissism and sociopathy from the prior discussion of narcissistic sociopaths, we can see other differences between these two types of conditions.

Narcissists usually fall into two categories: grandiose and vulnerable. Grandiose narcissists present symptoms of grandiosity, boldness, and in some cases, aggression. Vulnerable narcissists tend to be defensive and hypersensitive to criticism.^[2] In contrast, there are no subtypes of antisocial personality disorder.

Narcissists also differ from sociopaths in that narcissists sometimes feel shame and helplessness, leading to depression and anxiety. Occasionally, a narcissist might even feel remorse for their behavior.

Sociopaths do not fit this mold. While narcissists are selfish and care about their image, sociopaths don’t care about other people or what others think of them. A narcissist will work tirelessly to maintain a well-crafted image. However, a sociopath has little use for such things and might engage in abhorrent and illegal behavior if it suits them.

The reasons for manipulation also differ. Someone with NPD manipulates other people for their own gain. A sociopath does so for pleasure, even if it means hurting others. 

These disorders are treated in different ways as well. Someone with NPD might respond to therapy (e.g., transference-based therapy, schema-focused therapy), medication, or a combination thereof.^[2] 

Medicinal treatments address symptoms associated with NPD, but there are no FDA-approved drugs that directly treat NPD. For example, antidepressants might be prescribed to help patients manage mood-related symptoms like depression. In some instances, antipsychotics like risperidone might have beneficial effects for helping reduce associated symptoms.

Despite years of testing different therapeutic interventions, no therapies currently demonstrate efficacy in treating ASPD.^[4] Likewise, no pharmacological treatment is presently available for ASPD, though patients are often prescribed medications to help mitigate associated symptoms.

For example, antipsychotics are often prescribed to help manage aggression. Impulsivity is often managed with anticonvulsants, such as carbamazepine and oxcarbazepine. Furthermore, atomoxetine or bupropion are typically prescribed to treat ADHD symptoms that commonly present with ASPD.^[4]

Warning signs of a narcissistic sociopath

The primary red flag of a narcissistic sociopath is the presence of both narcissistic and sociopathic traits. As discussed earlier, there are no diagnostic criteria for narcissistic sociopathy. However, we can derive a set of warning signs from the DSM criteria for NPD and ASPD.

Narcissistic Warning Signs

Ask yourself the following questions if you’re concerned about whether someone you know is a narcissistic sociopath:^[2][6] 

• Do they have delusions of grandeur? Narcissistic sociopaths see themselves as better, more important, and more special than others.
• Are they selfish to an extreme degree? Anyone can behave selfishly from time to time, but selfishness is a hallmark characteristic of narcissistic sociopaths.
• Are they manipulative?  Again, anyone can be manipulative, but narcissistic sociopaths typically elevate the manipulation to a different level.
• Are they overly concerned about how they appear to others? We all want to be liked and appreciated, but narcissistic sociopaths are obsessed with the appearance of being successful, loved, and admired.
• Do they not handle criticism well? Narcissistic sociopaths react negatively to perceived slights and might respond with explosive anger or contempt when they don’t receive special treatment. Furthermore, narcissists are incredibly self-conscious and often have very low self-esteem.

Sociopathic Warning Signs

In addition to the narcissistic-centered warning signs outlined above, narcissistic sociopaths also exhibit the following sociopathic warning signs:^[4]  

• Do they lie a lot? Sociopaths use lying and deception to get their way.
• Is there a lack of understanding of right and wrong? Criminality is common among sociopaths because of an inability to distinguish right from wrong.
• Do they act impulsively? Sociopaths often act without consideration of the consequences. Risk-taking behaviors are common, including those that might cause physical, mental, or emotional harm to others.
• Are they insensitive and arrogant? These personality traits are common among sociopaths, in addition to being extremely manipulative.

Other Warning Signs of Narcissistic Sociopathy

Yet other warning signs might be evident in the behavior of someone you suspect to have narcissistic sociopathy. For example, an obsession with power and control over others is common among narcissistic sociopaths. Likewise, they tend to cast people aside when they are no longer of use.

Furthermore, narcissistic sociopaths seek out cheap thrills to stave off the boredom they often feel. For example, they might inflict intentional harm on another person to amuse themselves for a short period of time. This relates to another warning sign - feeding off of negative energy.

Seeing other people in fear, pain, or experiencing chaos can be exhilarating for a narcissistic sociopath. For easily bored people, witnessing pain and suffering unfold can hold their attention like nothing else. These sadistic tendencies are telltale signs of narcissistic sociopathy. They also speak to the danger narcissistic sociopaths pose to themselves and others.

How to deal with a narcissistic sociopath

Often, the best way to deal with a narcissistic sociopath is to avoid them at all costs. However, this is easier said than done. In many instances, people don’t realize they’re dealing with a narcissistic sociopath until they’re already involved in a relationship - romantic or otherwise.

If avoiding a person isn’t possible, there are some things you can do to protect yourself until you can safely extract yourself from a relationship with a narcissistic sociopath:

• Minimize the likelihood of becoming a target - Avoid confrontations with narcissistic sociopaths, lest you risk becoming the subject of their rage. Instead, practice self-restraint, be calm and rational, and set boundaries to minimize conflict.
• Educate yourself about narcissism and sociopathy - Learning about these disorders can shed light on why narcissistic sociopaths behave the way they do.
• Practice self-care - Most narcissistic sociopaths will not seek treatment to better their circumstances. Instead, it’s often their loved ones that seek treatment for themselves. If you’re struggling with the effects of someone else’s narcissistic sociopathy, therapy can help you cope.
• Remember that narcissistic sociopathy is not a choice - Having a narcissistic sociopath in your life can be taxing. But remember that their behavior is not their choice. It’s thought to be caused, in part, by inherited traits.^[7][8]Practice empathy and understanding to the best of your ability.
• Leave the relationship if necessary - Narcissistic sociopathy is not easily treatable, nor are people with this condition easy to change. If the situation is untenable or dangerous, choose to protect yourself and leave the relationship.