Antisocial Personality Disorder, Borderline Personality Disorder, Narcissistic Personality Disorder, Personality Disorders

Are psychopaths aware of their condition? Do they care?

antisocial personality disorder

Why are we so interested in psychpaths?

Cold-blooded psychopaths and criminals are fascinating (and terrifying!) creatures. They fascinate us so much because they seem to express normal animalistic feelings, like rage, without much fear of social consequences, shame, or rejection.
So what is the subjective world of the psychopath really like? Admittedly, it seems quite foreign to me, but let me take a stab (figuratively speaking–no one was harmed in the writing of this post) at an explanation.

Psychopathy and antisocial Personality disorders are personality pathology

Psychopathy and antisocial traits are fundamentally deficiencies in personality (i.e., they are personality disorders). A defining feature of personality disorders are that the “symptoms” are baked into someone’s day-to-day experience, and are therefore invisible–like water to a fish. The psychology jargon for this is that the traits are “egosyntonic”.


In treating personality disorders, the first step is to build a discrepancy between the patient’s sense of social reality and a more widely-held feeling of social experience. Personality disorders bloom in families that are both extreme, harsh, and/or abnormal in their cultural practices compared to the society at large.


The family may also, without awareness, isolate the family from people or experiences that might call attention to the abnormality. Thus, children grow up to be adults with harsh, odd, and provincial ideas about how things should be–that is, people are stupid or annoying if they don’t follow the cultural customs of my family of origin.

What is different in “healthy” development?

health childhood

In healthy development, individuals learn both a “normal” way of being in the world, which we define as a common cultural denominator. Healthy people also learn which family adaptations and traits peers like and which idiosyncrasies draw negative attention. In short, healthy people develop “observing egos.”


Observing egos are functional aspects of cognition wherein a person can look at a situation from a third, neutral position. Whenever you are thinking about (or checking in with someone else) to ask “is that normal?”, or “is it weird that I said that?”, you are giving your observing ego data to check future social situations.
Individuals with personality disorders, like psychopaths (or people with antisocial personality disorder), narcissists, and sufferers of BPD have impaired observing ego functions.

What’s different about psychopaths?

charming psychopath

The added complexity here is that people with antisocial personality disorder, or psychopaths, don’t really worry about whether or not others perceive them negatively. Acting strange is only a problem if it interferes with the attainment of a goal.


Ironically, psychopaths often develop amazing charm because they can practice being disarming with little to no anxiety; they either get what they want or don’t. In this way, psychopaths may feel “bad” (i.e., disappointed), but seldom, guilt, shame, embarrassment, or other emotions associated with social rejection.


Narcissists, even malignant narcissists, feel tremendous pain around social rejection–this is why we use the term “narcissistic injury”. People with BPD are highly affiliative and have deep desires for intimacy and connection, and so abandonment and rejection are fraught with profound pain and anxiety. Psychopaths don’t worry much about the acceptance of others. In fact, antisocial individuals tend to see people who make personal sacrifices for acceptance or the greater good as chumps and fools.

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