What's The Difference Between A Narcissist & A Sociopath?

Clinical Psychologist By Martha Stout, Ph.D.
Clinical Psychologist
Martha Stout, Ph.D., is a clinical psychologist specializing in recovery from psychological trauma and PTSD. She served on the faculty in psychology in the department of psychiatry at Harvard Medical School for more than 25 years.
Young Woman Looking at Her Reflection in the Mirror
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The fundamental difference between sociopathy and narcissism is an important one but can be surprisingly irrelevant in the real world: Where the sociopath is devoid of both conscience and empathy, the narcissist lacks "only" empathy.

In other words, the sociopath can neither form feelings of connection with others nor directly perceive their emotions, whereas the narcissist cannot perceive the emotions of others but can, in their way, form interpersonal bonds. Because they have the capacity to bond, the narcissist does experience the emotion of conscience. But the narcissist's ability to act on that conscience is severely flawed by their impenetrable ignorance of other people's feelings and needs.

How to tell if it's sociopathy or narcissism.

The icy coldness of sociopathy results in large part from congenital deficits in the brain's ability to process emotional and interpersonal input. The lack of empathy in narcissism is thought to result primarily from a shortfall in the emotional connection between a small child and their primary caregiver, who also may be abusive and/or narcissistic. In this case, the normal development of the limbic-brain areas involved in empathy and compassion is disrupted by a dysfunctional caregiver's failure to reflect to a young child the emotions they are experiencing (as in, "Seems like you're feeling mad").

In the real world, as opposed to the clinical one, the major discernible difference between narcissism and sociopathy is the distinction between hot and cold behaviors. The sociopath exploits others using behaviors that are cold, emotionless, and calculating, including (in most circumstances) a studied charm. The narcissist exploits people, too, but through emotional behaviors that arise from an ironclad belief in their own superiority and a certainty that they deserve unlimited success, power, brilliance, beauty, or ideal love.

With both sociopaths and narcissists, there is usually a honeymoon phase at the beginning of a relationship, in which the disordered person can seem "too good to be true." Typically, a relationship with a sociopath ends with the discovery of some act of deceit that is too great to be ignored or reinterpreted. It is at this point that a victim may look into the sociopath's eyes and realize with a shock, as many patients tell me, that their eyes are "predatory" or "scary"—the eyes of a stranger, which makes them easier to leave.

A relationship with a narcissist can be stickier; the victim may continue, sometimes for years or decades, to try to talk the narcissist out of their narcissistic behaviors, to shout and cry, to explain what the narcissist "must" do to correct the damage they are causing. The victim typically loses all respect for the narcissist and comes to see them as ridiculous, weak—a permanent "child."

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The difference in a real-world scenario.

In interpersonal situations, a sociopath might be more difficult than a narcissist to distinguish from a normal person because both the normal person and the sociopath seem to respond compassionately to the distress of a family member or a friend. In other words, in many situations where the narcissist would be clueless, unresponsive, and perhaps annoyed, the sociopath will be responsive, often charmingly so, creating a better disguise than the narcissist has.

Imagine two lovers walking down a steep and icy street on a wintry day. He watches her to make sure she does not slip, and in doing so, he himself falls and breaks his arm. Tears of pain fill his eyes, and he asks her to get him to a hospital. She is a narcissist. Her arm is not broken, and so, in her cosmos, there is no pain—just inconvenience.

She says, "It doesn't really look that bad to me. Let's keep going. You'll probably start to feel better in a minute."

Only after 10 minutes of arguing does she finally hail a cab and take him to an emergency room, complaining the whole way about the bother.

Now imagine a second couple on a similar icy street. He falls and breaks his arm and asks to be taken to a hospital. But this fellow's companion, beyond narcissistic, is a sociopath.

She says, "Oh my God, you poor thing! We need to get you to an emergency room now!"

Seemingly all compassion, she hails a cab and gently helps him into it. When they get to the hospital, she assists him through the check-in process and remains solicitous until he is finally called in to get an X-ray. A doctor gives him a painkiller in the examining room and sets his arm and he starts to feel a little better, but when he returns to the waiting room to rejoin her, she is gone. He manages to get himself home and does not see her again for four days. When she finally shows up, she is full of concern and apologies. She says that while she was in the waiting room she got a call from her sister, who was very ill. She rushed to another city to be with her and was so distraught that she forgot to call him.

In actuality, she spent those four days with another man, one who was not incapacitated by a broken arm. She had thought this new lover might be rich and then discovered he was not.

The difference is, once again, warmth versus coldness. This difference—a rudimentary ability to connect and love, versus the cold absence of this ability—is why the sociopath cannot be helped and the narcissist occasionally can be, and this is obviously an important consideration.

The sociopath will enter therapy only if they are court-ordered, or perhaps if there is some other motivating contingency—one that has, of course, nothing to do with the pursuit of psychological change—and will depart as soon as possible. The narcissist, in contrast, sometimes attends therapy voluntarily and may stay for a while—because they are in real pain, usually over the inexplicable (to them) loss of a relationship or of several relationships.

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