Therapists of Reddit, what made you realize you were treating a sociopath?

1. Psych nurse here. Patient I gained a lot of trust with told me about this person he and two others tortured almost to death. I knew the case because it made the news. He went to jail for it. Went in to details about the torture. It included making hundreds of cuts to the persons body and giving them an acidic bath. Anyways, his story is that this person raped the neighbourhood girl with Down syndrome and it was a payback. This guy was in our ward for about a month (continually threatening suicide if he was discharged). After weeks of knowing him and gaining some form of trust with me, he ended up admitting to me that he had made up the lie about the rape because he simply didn't like this guy because of an argument (probably drug related) years back. Tl;dr patient lied about a rape so he could convince his friends to abduct and torture a man that he had some petty disagreement. Thing is he stood trial as a minor and threw his mates under the his, claiming they were the instigators and he simply went along with it. They are still in jail
   — philjorrow


2. Great kid during the day, tortured his foster siblings and videotaped it at night. Loved being the “good kid” in the house during the day and “didn’t understand why Jimmy would scream and hit so much.” Meanwhile “Jimmy” was his target at night but wasn’t verbal and couldn’t tell anyone. Sociopath was always kind to the verbal child so only Jimmy was prey. In front of the foster parents, Sociopath seemed like a model teen. Finally a video surfaced through sheer dumb luck and now Sociopath is in jail. No one believed it until they saw the video. He’s handsome, charming, and will ruin lives because his youthful offender status means he won’t have a criminal record. Tip: if someone puts themselves in a victim role, run. They want you to save them. When someone is genuinely overcoming trauma, it doesn’t look like that. I am positive that Sociopath will use his foster care history to seem vulnerable and pull in a woman to torment and manipulate.
   — yayyyboobies


3. I've worked with a few, the most disturbing one was an ex military guy. He had served time in Iraq in the early 2000s, and he had killed in the line of duty. He always seemed a bit off, but the story he told me that was like, "holy fuck he's a sociopath" was when he told me about how he would do things like kill goats, because he could get away with that and some families there depend on livestock to survive. He also told me about making starving children fight over candy. He talked about watching kids fight to the death with rocks over candy he would throw on the ground. Awful, scary stuff. This person is currently a free man. The second was more of a "sterotypical" sociopath. He had been arrested for drug possession, and during the arrest attempt had stabbed himself a few times while trying to stab the arresting officers. He was very sharp, but intentionally choose the life of a drug dealer because it was violent. I don't think he ever actually killed anyone, but he definitely abused people pretty horrifically. He dealt meth and enjoyed power tripping off messing with desperate addicts. He would make them do gross/painful/awful things to "earn" their fix. He was also the only antisocial person I've ever met who had a weakened pain response. He once stabbed himself with a pen to prove to me he "didn't feel pain". And I mean like a legit, buried the pen in his flesh, blood everywhere kinda stab. Yeah....
   — PinkSkirtsPetticoats






4. My dad's a (now semi-retired) psychologist. Back in the 90's, he was working as the director of psychology for a large housing and treatment facility for the severely mentally disabled. He wanted to get into doing some therapy sessions for non-disabled folks on the side, just to mix things up and stretch his professional wings a little. Our house had a home office "wing" with a separate entrance, so he decided to start seeing a few patients on the weekends. This plan lasted about three weeks before he realized that he'd made a terrible mistake. One of his patients, a very large gentleman, began visibly melting down during a session, pacing around the office and acting increasingly erratic. My dad's thoughts turned to the fact that his wife and three kids were now in the same house with a big dude who was clearly unstable. He slowly positioned himself by the door in case the guy tried to bolt for it. The guy noticed this, *pulled out a gun*, and said, "Don't worry, if I wanted to hurt you or myself, I would have already used this by now." My dad utilized the same skills that he knew from working with violent patients at his main job to talk the guy into putting the gun away. He escorted him from the premises, and never saw another patient at home again. My mom was *pissed*.
   — wafflesareforever


5. Honestly, he made me feel scared and panicky to be in the same room. Part of being a therapist is you build a very strong client-therapist bond, and there's a lot of empathy/openness in the room, so things can get quite intense and emotional (in a good way). With this guy I felt like a tiny trapped little animal in the room with a dangerous predator. He had no remorse for his actions. He'd slip in remarks meant to impress/threaten, then look somewhat annoyed when I did not react (I was reacting inside). I do not fully recall his name/looks and wouldn't on here anyway, but on the outside he looked totally normal and actually seemed kind of ok. But after talking to him for a while, there was this emptiness that I found quite disturbing. He casually admitted to domestic abuse in the same way someone would admit they left the hall light on by accident... to me, in front of his partner!! He'd never brought it up before and, as a trainee I should NOT have been working with DV cases. They would be triaged and referred to someone with specialist experience. I can't go into details, obviously, for confidentiality reasons... but it was a huge overreaction to an honest accident (could have happened to anyone) and he literally mentioned it in passing, and seemed to be more like 'Oh for gods sake, this isn't even worth mentioning, why did I bring this up, I'd rather be talking about myself' rather than 'I tried to strangle my partner'. He just didn't care. I remember just nodding and remained calm, whilst drawing a huge fucking exclamation mark on my notes. I made it through the session somehow, then immediately told my supervisor and had him transferred to a different counsellor. I've honestly never been so scared of another individual just from a 'vibe'.
   — d3gu


6. They came in to the hospital after making a suicide pact with someone and didn't follow through with it and the other person completed. Acted really broken up and said they felt guilty about it and seemed genuine. It was all an act. Later on during the inpatient stay they made another suicide pact with another patient who then told us about it and said the sociopath was pushing them to come up with a plan and pick a date to do it. Apparently they had done this with like 3 other people and getting admitted to psych units was their way of finding vulnerable people to target. Edit: A few more details because this got way more attention than I thought it would when I quickly wrote it before bed last night. Legal charges were being pursued but it was questionable at the time they were admitted whether they would be held responsible or not. This was part of the reason for the admission; the person said they were suicidal because they might be charged with manslaughter for the person that completed and the treatment team was in contact with the police several times (especially after we found out they were targeting people on the unit). Ultimately I think we discharged them to the care of a family member after pursuing court ordered treatment and I do not know if they ever ended up getting charged or not (although I sure fucking hope they did, encouraging vulnerable people to complete suicide is just as bad as murder in my mind). The 3 other times it happened the people did not end up completing and we only found out about them after the fact from collateral from family members. The furthest it went was they made plans with a person from new york to drive to meet each other and complete together in like Ohio or something. Then the friend one happened and they got in trouble and got admitted to our unit for SI. They were actually discharged the first admission and we all felt so bad for the person. We just thought they made a pact and backed out and were being targeted by law enforcement. I worked with the individual in group but did not have them on my individual case load and my initial impression was that of a decent person who had been through some really tough times but was engaged with services and fairly intelligent/charming. One of my colleagues is a forensic psychologist and she had them on her individual case load and even she was suckered by them. It blew all of our minds when we heard they were trying to get someone else to make a pact on the unit. Also yes I used the term sociopath but that really isn't used any more. They likely had antisocial personality disorder as others in the thread have mentioned but they refused to comply with personality testing after they were confronted by the treatment team. I don't really do psych testing but they asked me to do an informal assessment and meet with them to see if we could get any other information since I had good rapport with them from past groups. Holy shit, I don't think I've ever been that terrified talking to someone in my life and I've worked with a suspected serial killer, rapists/pedophiles and tons of people experiencing psychotic episodes. The switch I saw in this person really rattled me and I ended up talking a lot about the case with my clinical supervisor. Thanks for all the questions! I have to go to work but I'll try to answer as many as I can when I get a chance. Also of you or anyone you know if experiencing suicidal ideation please get help!
   — denialofdeath






7. I've been a licensed therapist for going on three years now, but I've been seeing clients (with an Intern license) for about five years. The vast majority of my clients have been on probation or parole and have had a wide range of mental illnesses, including anti-social personality disorder (ASPD). My mentor described folks with ASPD like this: "It's in the eyes. They've got shark eyes: cold and predatory, like they're staring right through you, looking for your weaknesses to exploit." And, having worked with several people with that diagnosis (and adolescent precursor Conduct Disorder), it's pretty damn accurate. People with ASPD are some of the most manipulative people around, and many of them *enjoy* it. Manipulating people is almost a game to them--well, a mini-game to indulge in while they work on whatever else they're planning, even if it's as simple as "present as normal." And, let me tell you: they're *good* at it. It's incredibly difficult to out-play someone with the diagnosis at their own game because they've been playing it their entire lives. Since my clientele are court-ordered, most of the manipulation revolves around trying to cover up whatever else they're doing (abusing their domestic partner, abusing substances, etc.). Some are more impulsive than others with the diagnosis, but they all have the shark eyes. EDIT: I've gotten a couple of comments about this post being irresponsible and/or stigmatizing to folks with mental illness. First, let me be very clear: this is, in no way, a diagnostic indicator of anti-social personality disorder. I do not just look someone in the eyes and magically know that they've got the disorder. I utilize a diagnostic questionnaire based on the DSM V's criteria for said disorder and compare it to the case history I've been provided by previous treatment providers as well as from probation or parole. If you think you can tell if someone is clinically anti-social (note, not the same as asocial) by looking them in the eyes, you're doing it wrong and missing the point of my post. In my experience, the "shark eyes" look is a physical tell to other traits, such as notable lack of empathy, tendency towards manipulation (sometimes for the fun of it), and the like--it's a constellation of symptoms of which the "shark eyes" only plays a very small part in, but it's pretty noticeable once you already know what you're looking for. Basically, don't go around claiming someone you know is a sociopath because the way they look at you makes you uncomfortable--basically, don't try and armchair pathologize.
   — FraterEAO


8. Psychologist who works in a correctional setting here. Yes I agree with the people who commented regarding dsm 5 criteria for aspd I've seen a lot of those. In regard to personal experience the people that make my stomach turn are the unrepentant sex offenders. I think many sex offenders suffer from a treatable (albeit gross) disease. But I've met many who try to justify what they did ("it happened to me"), rationalize it ("it's legal in other countries"), and flat out blame the victim ("___'s parents should have taught him/her better"). I won't debate these people and I typically redirect since there's not getting through to people like that. I also learn I've worked with a sociopath when I figure out I got hoodwinked after the fact. Like an inmate has left my office and I think "oh what a nice guy" and find out what he's really like from other inmates or staff.
   — Valenscooter


9. I work in a residential substance abuse program. I don't take offense to most clients behaviors; they were in the midst of their addiction and they're trying to get better for any number of motivators (self-referral, family, probation/parole mandated, etc.). I've worked with convicted murderers whom were remorseful and great to work with, so whatever, let's do some work together. But I'll speak of one person whom I believe to have Antisocial Personality Disorder: After approximately 30 minutes talking to him during intake, I could tell how well he might be able to manipulate those he believes are "dumber" than him, and he stated as much. He mimicked my language, posture, he spoke eloquently, and was charismatic as all hell. But something was just *off*. I take note, and move on; needed more data. And as he continued in the program it became apparent. Everything was someone or something else's fault. Failed relationships, his addiction and particular drugs of choice, his inability to hold jobs; no accountability or responsibility. He even blamed his brother for getting upset that he (my client) *stabbed his brother*. After my client had stolen his brother's car in the dead of night and drove it in a ditch and abandoned it; then he lied about it and stabbed his brother for being "annoying". He manipulated other clients and staff, and was damn good at it, except for a few of us who would call him out in group sessions or through behavioral contracts. He was my individual client and during a session, I was challenging him because there were inconsistencies in something he shared. Then he finally came clean. He is HIV+ (I was aware of this). He contracted HIV by cheating on his partner or sharing a needle (he and the person he cheated with shared needles). He had discovered he was HIV+ prior to his partners return, as they were gone for an extended period of months. He got on treatment, and then... didn't tell them at all. Still hadn't at the time I stopped working with him, and I believe they are still together. Additionally, he shared that he drugged this partner, whom had a family history of meth abuse and had never used as much as a joint, for his own sexual pleasure, multiple times, sober and high. The partner would have severe "anxiety attacks" after sex acts (which he convinced them they were) and they believed him. You could see his whole fucking body light up in relaying these acts. He laughed and stated that he couldn't believe that they believed and trusted him. A complete disregard for others (this wasn't the only thing he shared that made me want to hang a warning sign around the guy). He completed treatment by going through the motions and is now out in the community. He is young. I have a strong feeling that at some point he will move to even more malicious acts, and I wouldn't be surprised if he kills someone in the future. Edit*: So it has been nice being able to discuss this with those interested. I've done case presentations of this guy at conferences, and he's one of those clients that I think will always stick in my mind. But it's late late for me, and I have a groups to run and clients to see later today. Will try to respond some tomorrow, if/when I have time. I understand that this is some heavy and possibly triggering stuff, but I hope that anyone involved with somebody like the person I described gets or has the support that they need. Take care, all.
   — throwingitaway987654






10. I used to work in a group home for little kids, under 12, with severe behavior problems and psychiatric issues, as a floor staff while I was in college. Several of those kiddos had diagnoses of ASPD, but I was always skeptical because that's a hell of a label to give to a little kid. And then I met AP (not his real initials). This child was six years old, and beautiful. He was perfectly behaved, but many of our residents had a "honeymoon period" of great and normal behavior for a couple weeks after intake, so we were just waiting for him to show his true colors, behavior-wise. His honeymoon period lasted 8 months!! None of the staff knew why this kid was there. His dad wasn't in the picture and mom was serving time, and foster care wasn't working out, which is why we had him, but we didn't have any issues with him at all during those 8 months. He was a perfect little boy. Then one day, he wasn't. I took the kids outside to ride bikes, and the second he was out the door, he ran to the backyard, grabbed a kitten, and crushed its head. The boys' bedrooms were in the basement of the house, they had windows that were on the ground level outside, and he had seen the nest of kittens from his window. I was horrified, obviously, and brought all the kids inside. He calmly told our facilities manager that he had no idea what I was talking about, and looked so confused that the manager questioned me, and I had to go get the dead cat. I was visibly upset, and AP just looked at me and grinned. That was the first "oh shit" moment of several. AP would instigate aggressive behavior to initiate a restraint. Once in a restraint, our procedure was to hold the child for 30 minutes. If they weren't calm at that point, the on-call nurse would give a "booty dart" (shot of benadryl) to calm the kid down. AP loved needles and offhandedly mentioned once that it was his goal to get one shot a day. In another incident, two staff had to escort AP into a secluded area because he was being very violent. During the transport, something happened (i think the metal door shut on him) and AP cut his foot substantially. We went to get the nurse, and when she came to help him he was laughing, digging at his cut to make it bleed more, and writing on the wall with the blood. Most of our kiddos were wards of the state, but AP's grandparents actually came and visited him. The other kids would be so jealous, but AP would (quite convincingly) act like he didn't know his grandparents, and then later he would taunt the others who never had visitors. When I left that job, he gave me a picture he drew of me. It was a typical little kid picture, but there was an X over the mouth and the eyes were scribbled out. I asked him why he drew me that way, and he said "You don't deserve eyes because I don't like it when you see me. You don't deserve a mouth because you say things I don't like.” (Edit-found the [picture](https://imgur.com/a/Zfzqb).) I still work with kids with severe behavior problems, psychiatric issues, and severe disabilities. I love them. I have worked with hundreds during my career. I STILL think about AP. Soon after I left, they transferred him (at 7 years old now) to a more restrictive environment, and the last I heard he was the facility's success story. Mom got clean and he's back home with her, a perfect angel, and he even comes back to the group home to give motivational talks to the other kids on how to behave! I truly hope that's true and his treatment was successful......but that was one scary, scary little kid, and I doubt it. ETA: I am not trying to vilify this kiddo in any way. He was very young and in long-term inpatient residential care. “Scary” isn’t the right word; he was obviously very sick. He stands out in my mind as an example of how much work needs to be done in the field regarding effective interventions and basic awareness and understanding.
    — Phoenyxoldgoat