Are Sociopaths and Psychopaths Interchangeable? Tony Soprano Meets Donald Trump

The unrecognized controversy between these dueling diagnostic constructs contributed to a widely experienced confusion on the part of lay people and psychological professionals alike. And had led lay people to use “psychopath” and “sociopath” interchangeably—only to have a psychological priesthood rap their knuckles with a ruler for not using the “correct” term (antisocial personality disorder)—a term that Big Tony at the shipyard has never gotten his head around. Though Big Tony knows damn well what a sociopath is. (“The dudes are ganged-up, and do bad shit to people, and don’t even feel bad about it”).

Yet even many psychologists continue to be confused in sorting out the following terms: sociopath, psychopath, antisocial personality disorder. Most just know that “sociopath” is no longer used. The clearest discernment may have been offered by Canadian-born psychologist Robert D. Hare—who for the past several decades has been recognized as the world’s leading authority on psychopaths. Hare didn’t dismiss the term sociopath as if it were merely an outdated label. He considered them as different, though, than psychopaths, in that the former were caused by growing up in an antisocial or criminal sub-culture, rather than from a fundamental lack of social emotion or moral reasoning (as is the case with psychopaths ).

In other words, Tony Soprano is a sociopath, not a psychopath. So is Ray Donovan. For neither would exploit their own children, the way Ray Donovan’s father did. Ray’s dad I see both as a malignant narcissist, and as well as a psychopath. He’s more chaotic. And it’s all about his needs, chaotic needs that lead him to commit self-destructive acts, that also become destructive for his kids. And Ray is constantly trying to protect both his brothers and his kids from the destructivity he knows his father leaves in his wake.

Tony and Ray aren’t great role models for their kids, and in that way “irresponsible.” But Tony and Ray aren’t totally absent of traits with a redeeming humanity, though sometimes they’re obscured. Whenever his brothers face difficulties, for example, Ray stops whatever he’s doing, and speeds in his black sedan to fix things. Being a “fixer” is what he does, and he’s good at it. It’s a craft and a craftiness that goes back to having to fix things in a broken family with a psychopath for a father.

Tony and Ray grew up in families with criminal fathers, and as Hare told us, being shaped in such gangland environments is what creates sociopaths. But they’re not totally lacking in any accountability toward others. They feel family obligation, and are capable of feeling guilt—unlike psychopaths—as well as failed responsibility, and remorse. They’re capable of speaking the truth, even crying, Tony’s actually in therapy. (Could anything in the last 3 sentences apply to Donald Trump?).

Squat Peter Clemenzo in the Godfather is at once a good family man, yet he’s also a killer. That’s just what you do, if you’re in this “family.” When Clemenzo oversees Paulie’s murder in his black sedan by the side of the road, he’s not only thinking of the responsibility he’d just carried out for his crime family, but his responsibility to his personal family, as he—now famously—says: Leave the gun, take the cannoli.

Back to Hare...While he didn’t disregard sociopathy, neither did he disregard the DSM term antisocial personality disorder either. Though he did view it as separate from his construct of psychopathy, as the two constructs didn’t list the same personality traits (though that to me, seems not entirely true, for the DSM did import some of Hare’s and Cleckley’s traits, while sensing the need for more of them throughout the years).

Actually, Hare thought the DSM construct of ASPD would validly apply to many more people than the disorder he and Cleckley had been profiling. And though there are no statistics for sociopaths—the DSM had thrown them all overboard in 1980—Hare’s belief has been that many more people would be covered by that term than ASPD.

Another takeaway I’d offer is, that since sociopathy actually refers to the largest population of these similar but separate disorders, future editions of the DSM might return to its earliest roots in supporting and publishing research about sociopaths in forthcoming editions. This, rather than leaving its cupboard so bare, or turning a snobby nose at those who continue to use the term.

And though the term psychopath would truly only apply to the smallest population of the various diagnostic constructs being explored here, that population has had a impact upon the world far beyond its numbers. And so, it too should command its own full and rightful presence in a manual that purports to be American psychiatry’s official manual of mental disorders.

For when pathologies—whether personality disorders or viruses—fail to be adequately recognized, their destructivity can increase, until their full force catches us by surprise, and with consequences truly disastrous.

In fact, our lack of recognition of psychopaths has already had a disastrous consequence. Which brings us back to Cleckley, psychopathy’s seminal authority…