She’s a sociopath – and a therapist. This is what she wants you to know about her

This story is part of the March 16 edition of Good Weekend.See all 14 stories.

Sociopaths are modern-day boogeymen, and the word “sociopath” is casually tossed around to describe the worst, most amoral among us. But they are not boogeymen; they are real people and, according to US psychologist and author Patric Gagne, widely misunderstood.

Gagne wrote Sociopath, her buzzy forthcoming ­memoir (out April), to try to correct some of those misunderstandings and provide a fuller picture of sociopathy, which is now more frequently referred to as antisocial personality disorder. As a child, Gagne found herself compelled towards violent outbursts in an effort to try to compensate for the emotional apathy that was her default. As she got older, those compulsive behaviours turned into criminal ones, such as trespassing and theft. Eventually, she discovered there was a name – that dreaded word – that could be used to describe and explain her experiences of remorselessness, criminality and lack of empathy. The desire to destigmatise her experience and to help others who may share it (Gagne previously worked as a therapist to those with the ­disorder and has also written about sociopathy) put Gagne on a path that led to Sociopath.

“I’m not trying to say, ‘Sometimes we do bad things, but we’re really sweet on the inside,’ ” says Gagne, who is 48 and lives in Los Angeles. “I’m saying there is more to this personality type.”

When I hear the word “sociopath”, I think of an antisocial, uncaring person who is interested only in satisfying his or her own desires. What’s a clearer picture? Sociopathy is a perilous mental disorder; the traits associated with sociopathy aren’t great. But that only tells part of the story. The part that’s missing is you can be a sociopath and have a healthy relationship. You can be a sociopath and be educated. That’s a very uncomfortable reality for some people. People want to believe that all sociopaths are monsters and that all monsters are easy to spot.

In the book, you write about stabbing a classmate with a pencil when you were a kid, and then, as you got older, trespassing and stealing cars. You don’t ­succumb to those sociopathic compulsions any more. How did you learn to control these urges? As a kid, I didn’t understand why I was acting out the way that I was. All I knew was I felt this pressure, and something in my brain was telling me, “Punch that kid, and you’ll feel better.” As I got older I understood, OK, there’s a name for this, there is a whole group of people who share this diagnosis. Once I ­understood that I wasn’t out in space untethered and going crazy, I was on the path to understanding that when I had those feelings of “go steal a car”, I could go, “Yes, I could do that, but now I understand what’s going on.” That ­understanding helped break the cycle, or at least ­redirect the compulsion towards something less destructive.

‘When I go to the grocery store and I come home, if anything that I’ve purchased has gone bad, I’ll make a mental note: I’m stealing this next time.’

Patric Gagne

What does that redirecting look like in practice? Every once in a while I will have an urge to do something destructive just because I can, and my redirect is, “Do you want this destructive behaviour? Or do you want to continue to maintain this life that you have, which requires that you not do those things?” I have to have that conversation with myself.

What’s a recent sociopathic impulse you’ve had? This is a very vanilla example. When I go to the grocery store and I come home, if anything that I’ve purchased has gone bad, I’ll make a mental note: I’m stealing this next time.

You write about your difficulty with under­standing other people’s emotions, feeling apathy and ­lacking empathy. But you also write about experiencing love. Why are you innately able to feel love but not, say, empathy? The way I experience love seems to be very ­different from the so-called neurotypical experience. My experience of love seems less emotional. If I had to explain what love feels like to me, I would say sym­biotic. So, a relationship that’s beneficial to both people involved. Not transactional, not possessive, not ego-driven. Mutual homeostasis. It’s not that I’m unable to access emotions or empathy. It’s that my experience of those emotions is different.

When you write about becoming a mum, you say that profound feelings of love toward your child were non-intrinsic, and you had to work to experience them. Can you tell me about that work? As a woman – forget my personality type – you’re inundated with all these images. Your child is born; it’s incredible. I did not experience that. I didn’t have that immediate “baby is born, I’m overwhelmed with love”. It was, “I don’t know this person. This person is very loud”! That connection just isn’t there. It’s not innate. But over time, you can build it. Much like when I first met [my husband] David: I knew right away that this person was going to be important in my life, but I didn’t have those sweeping romantic, flowery emotions affiliated with that experience. That was the same when I first met my son. Now I just think he’s a great kid!

Patric Gagne: “I think my sociopathy is entirely beneficial to me. I see my friends struggling with guilt. On an almost daily basis I think, I’m glad I don’t have that.”

Are you able to describe how you’ve built a sense of morality?
Just because I don’t care about someone else’s pain, so to speak, doesn’t mean I want to cause more of it. I enjoy living in this society. I understand that there are rules. I choose to follow those rules because I ­understand the benefits of this world, this house where I get to live, this relationship I get to have. That is ­different from people who follow the rules because they have to, they should, they want to be a good person. None of those apply to me. I want to live in a world where things function properly. If I create messes, my life will become messy. I think people are uncomfortable with the idea of, You don’t really care? What does it matter? What does it matter why I choose to help the woman cross the street? Why does it ­matter why I choose to pick up a wallet and hand it to the person as opposed to keeping it? It’s not because I’m a good person. It’s not ­because I would feel shame or guilt. But why does that matter?

What advice do you have for ­neurotypical people about how best to interact with someone who identifies as sociopathic? I’m not sure neurotypicals need any, because I have been identifying as a sociopath for years now, and my experience with people who don’t know that has been positive. I have yet to encounter anybody who, when I disclose my diagnosis, acts afraid or upset. I think, inherently, neurotypicals are fascinated by sociopathy because it’s a relatable ­disorder. Everybody has that darkness in them. Everybody has those thoughts that they shoo away ­because of guilt. If more conversations between neurotypical and so-called neurodivergents were to occur, it would benefit both. It would benefit the sociopathic person because that acceptance lets 80 per cent of the air out of the balloon, but it would help the neuro­typicals, like, “Oh, I can share things with this person that maybe I couldn’t share with other people.” I get more secrets from strangers after telling them my ­diagnosis; you wouldn’t believe the things that people have told me because they feel safe.

What secrets do they tell you? Oh, man. I was sitting across from a man at a ­dinner party – this was two years ago – and my diag­nosis came up, and 30 seconds afterward he said, “You know, I have thoughts of killing my wife a lot”. Not to normalise that, but I was like, “Tell me about that.” And he goes: “I’ve really thought about it. I’ve reached out to people about hiring somebody to kill her.”

“I get more secrets from strangers after telling them my ­diagnosis; you wouldn’t believe the things that people have told me because they feel safe.”

So people just assume that you’re a sympathetic audience? Yeah, because these are things you’re not supposed to think about. So to be able to talk to somebody – you don’t have to worry that I’m going to start clutching my pearls.

You were a practising therapist, and we think of therapists as highly empathic, invested in the emotions and stories of their ­clients. So how did you relate to your clients? I didn’t relate to them. Now, that is not to say I didn’t care about my patients. The easy answer is, of course I care about you. I wouldn’t continue to see you if I didn’t, but why do you need that reassurance from me? My job is to help you understand what’s going on with you. My job is to help you take your emotions, separate them out, explore your motivation. That’s my job. I think that I was a good therapist because I was able to parse those things out unemotionally. My gift to my therapy patients was that I was able to lend them sociopathy: Why do you care? What does it matter? What do you need from that? That, I felt, helped them achieve things that maybe a non-sociopathic therapist couldn’t have offered.

In the book, you describe things like mirroring people back to themselves or your conscious and ­intentional manipulation in the moment. Is that happening now? Listen, everyone has a front-facing persona. Most people use that persona as a preference: a desire to be liked, a fear of judgment, wanting somebody to be friends with them. But sociopaths use it out of ­necessity, and that’s a really important distinction. My decision to mask is not because I have some dark ulterior motive. It’s because you guys are interesting to me. Neurotypical emotions are so colourful and complex. In order for me to engage with you, you have to feel comfortable with me. In order for you to feel comfortable with me, I have to mask. I find that people are unnerved by me when I’m not masking. Because ­otherwise I’m quiet. I ask invasive questions. I stare. My affect is low. The bottom line is that I want you to feel comfortable, so I engage. I smile. I mirror. It’s not nefarious; it’s necessary. The issue here is motivation. I don’t mask because I’m ­secretly trying to kill you. I mask because I want you to feel comfortable because I find you interesting.

What’s an invasive question you want to ask me? Why are you interested in me? Why are you ­interested in sociopathy? Talk to me about your darkness. I’m not expecting answers.

You want to get into it? Oh, yes. I find neurotypical people absolutely delightful!

I’ll give you two reasons I’m interested: I was sent the book, and I started reading, and the opening ­involved you as a second-grader stabbing a kid in the head with a pencil. I thought, Holy moly, readers will be interested in this! So there was a mercenary quality to my own interest. Then also, there are times when I’ve ­wondered if the skills that I’ve learnt from doing my job over the years are basically just forms of interpersonal manipulation, and I was curious to talk to you as a roundabout way of exploring that question for myself. Do you manipulate people in order to execute your job?

I think there is a degree of manipulation, but what do we really mean by manipulation? Is manipulation by definition negative, or does manipulation just mean intentionally creating a certain inter­personal context? That sounds like a justification to me, which means you’re sidestepping shame or guilt.

I disagree. That would be like saying therapists are always guilty of “manipulation”. Just so we’re clear, when I said justification, I wasn’t trying to say that what you were doing was bad. You’re talking to a sociopath! I don’t think ­anything that you’re doing is bad. Yes, you are ­manipulating people to a certain extent – to your point – in the way that I might manipulate somebody in therapy, but I would never feel the need to justify it, and your justification came so quickly. That’s why I was like, Hey, what’s happening that you felt the need to defend your answer?

‘A lot of people who exhibit sociopathic symptoms have strong feelings for pets … now let’s extend that feeling to someone close to you.’

Patric Gagne

We don’t usually say we have to ­justify a positive thing. That’s probably why I reacted that way. What else? How much of that dark side of sociopathy can you relate to? And if you don’t have an easy answer for that, was it comforting to read about somebody who was open with their experience of being fully immersed in their darkest impulses and a lot of times carrying them out?

Well, I would say that one question that the book raised for me was the extent to which a lot of behaviours that people do could be considered sociopathic, and we just don’t understand them that way. Plenty of us do things that we know are bad because the transgressions feel good. It feels good. Why? I think it feels good because it feels free. To do something bad, it’s like, I don’t give a [expletive]. The consequences – be it internal guilt or getting thrown in jail – happen after. In this moment, I’m going to do this because it feels [expletive] great to just not care. That is what the sociopath experience is almost all the time. One piece of advice I would give to anyone who sees themselves in my description is to find an external philosophy that works for you. I liked karma. It seemed clean. It seemed organised. Find that philosophy for yourself, because you’re not going to get to rely on internal checks and balances.

I realise I didn’t quite understand what you meant when you said that you can experience empathy, just differently. What is empathy to you?
Eventually as I got older, what I started to realise is that if I can connect to something that I can inter­nalise naturally, I use that as a bridge to broaden my ­empathic response. For example, I’ve found frequently that a lot of people who exhibit sociopathic symptoms have strong feelings for pets. That’s a great bridge: you would feel upset if something happened to this animal that you care about. Now let’s extend that feeling to someone close to you that you have a strong relationship with.

But when you say “extend that feeling”, is it ­cognitive understanding that you’re describing or an emotional response? At first it is cognitive. Then, over time, that does grow into the emotion. It’s the understanding of it that leads to the feeling. I’m sure you’ve had a situation where someone is explaining something to you, and at first you’re like, I don’t care.

Multiple times a day! [Laughs.] Great. Now, imagine if that’s your first instinct, but you understand that you have to be like, Oh, yeah, I understand that I have to care. That is cognitive empathy. You’re not faking it, but you’re internalising it. That’s your first take on something, and then maybe you get to know the situation better, or you find something about that situation that you can anchor to, and then the feeling kicks in.

Do you see your sociopathy as beneficial to you? I think my sociopathy is entirely beneficial to me. I see my friends struggling with guilt. On an almost daily basis I think, I’m glad I don’t have that. The ­psychological characteristics of sociopathy are not inherently bad. Lack of remorse and shame and guilt has been misappropriated to mean this horrible thing, but again, just because I don’t care about you doesn’t mean I want to cause you more pain. I like that I don’t have guilt because I’m making my decisions based on logic, based on truth, as opposed to ought or should. Now, there is a flip side. I don’t have those natural emotional connections to other people, but I’ve never had those. I don’t feel like I’m missing anything. Just because I love differently doesn’t mean my love doesn’t count.

This is an edited version of an interview originally published in The New York Times Magazine. It was edited and condensed for clarity from two conversations. © 2024 The New York Times company

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