1st Feb 2023
Narcissistic sociopaths seek to ingratiate themselves with power, money, pleasure, and other niceties and do so at the expense of others. They might lie, cheat, steal, and manipulate to get their way, and disregard other people’s feelings, needs, wants, and even safety to achieve their goals.
There is no clinical diagnosis for narcissistic sociopathy, at least not in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). 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:
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.
The DSM-5 outlines specific criteria for diagnosing ASPD, which include:
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.
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.
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. 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.
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. 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.
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.
Ask yourself the following questions if you’re concerned about whether someone you know is a narcissistic sociopath:
In addition to the narcissistic-centered warning signs outlined above, narcissistic sociopaths also exhibit the following sociopathic warning signs:
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.
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: