M. E. Lewis (not her real name) is a self-proclaimed sociopath who posits that “sociopathy exists on a spectrum of severity, from the death row inmate to the ruthless venture capitalist to the calculating cheerleading mom.” Her book opens with excerpts from a psychological evaluation she had performed to identify her personality, which the evaluator concluded approximates a “socialized” or “successful” psychopath. Lewis abandoned the label psychopath in favor of sociopath “because of the negative connotations of psycho” among the community at large. “I may have the disorder,” she writes, “but I am not crazy.”

An attorney by trade, Lewis devotes early sections of the book describing how she functions and succeeds within business and corporate cultures: relentless in achieving her personal goals, out-thinking her peers, taking a risk-benefit perspective with virtually everything she does, and hiding among the many people she “mimics” but cannot relate to. With a nod to her entrepreneurial instincts, she currently writes for and manages a blog for an online community of self-identified sociopaths–many of the communications among these individuals are reproduced in the book. Confessions of a Sociopath also gives us a full account of clinical and research inquiry about the topic, from Hervey Cleckley’s profiles of the “psychopath personality” published in the 1940s to Robert Hare’s influential diagnostic instrument, the Psychopathy Checklist-Revised (PCL-R). There is further commentary on brain imaging, genetic studies, neurobiology, and the Diagnostic and Statistical Manual of Mental Disorders, all intended to explore the origins of sociopathy in its many manifestations.

As memoir, the book details the author’s childhood, familial experiences, and many events that shaped the person she became. She spends considerable time discussing her father, who’s “narcissism made him love me for my accomplishments because they reflected well on him, but it also made him hate me because I never bought into his self-image, which was all he really cared about.” Her mother and siblings get similar exposure. Lewis, it seems, was troubled since birth, overactive, impulsive, immoderate, and emotionally unstable. This quote about her family perhaps best explains the worldview she ultimately acquired: “Not everyone in the family is a sociopath; I am the only one who has been diagnosed as one. But we grew up sharing a perspective of blunt practicality and disdain for moral sentiment, having tacitly agreed to a collective rejection of the outside world.”

Thomas manipulates, lies, strategizes, seeks control, and generally is duplicitous in her workplace interactions. And yet, she is generous with her money, assists friends in need, gets rave professional reviews, and is devoutly religious. It takes time to reconcile these admirable qualities with her very unpleasant behavior and capacity to do harm. My take from the book is that she behaves purely on empirical and not moral grounds. “It is rational for me to obey the law,” she says, “because I do not want to go to jail; it is rational for me not to harm or injury other people, because a society in which everyone acted harmfully would inevitably cause me harm too.” Ultimately, she concedes that the defining characteristic of a sociopath is a distorted sense of self, in effect, lack of conscience and inability to feel remorse which occurs because emotion is disconnected from actions and consequences.

Like recent books such as The Psychopath Test by Jon Ronson and The Sociopath Next Door by Martha Stout, Confessions of a Sociopath is a good choice for the lay public to learn more about a complicated psychiatric condition that is not easily defined. To her credit, Thomas bares her soul through exhaustive self-analysis and personal exploration, sometimes tedious, but insightful nonetheless. She also argues convincingly that sociopathy comes in many forms that only a keen eye can detect. This book, in a small way, tells us what to look for.

© 2013 James K. Luiselli

James K. Luiselli, Ed.D., ABPP, BCBA-D is a psychologist affiliated with May Institute and a private-practice clinician. Among his publications are 9 books and more than 275 book chapters and journal articles. He reviews books for The New England Psychologist.